Eleventh report from the Select Committee on Estimates : together with the minutes of evidence taken before sub-committee E and appendices, session 1950-1951: regional hospital boards and hospital management committees.
- Great Britain. Parliament. House of Commons. Select Committee on Estimates
- Date:
- [1951]
Licence: Public Domain Mark
Credit: Eleventh report from the Select Committee on Estimates : together with the minutes of evidence taken before sub-committee E and appendices, session 1950-1951: regional hospital boards and hospital management committees. Source: Wellcome Collection.
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![were, they would be integrated into the National Service, and would come under the management of the National Service. Do 1 understand now from you that your scheme is that, if people put up money to support this school, you manage the finance and you manage the school?—Yes, Sir, the school will be a part of the nurses’ training. 192. Who will be responsible for the management and upkeep of the school, the State or you?—I take it that what we en- visaged was merely the setting up of a build- ing where the training could go on and where the personnel can be all together. At the moment they are scattered between various hospitals where the training of nurses has to be carried on. What we want to aim at is getting a more efficient system within a given building. 193. Who would manage the system after you had started it?—-The hospital board. Mr. Thomas Reid.] That is the State. Chairman. 194. The regional hospital board?—It is the teaching hospital board of which I am speaking. (Dr. Rowland Hill.) The Board of Governors. There is, i think, just one point, a correction. The figure I suggested is a very tentative one, although it has been discussed. The figure is in the neigh- bourhood of £1,000,000 for a regional board which might have a budget of £10,000,000. There are only fourteen regional boards in the country, and so that would give a figure of £14,000,000 not £40,000,000. I think a figure of something of that order before the war was the annual income of a voluntary hospital movement in the country. 195. That included, I think, the weekly subscriptions?—All sorts of things. 196. It of course could not be revived, for obvious reasons?—No. It is of interest to note that some of these contributory schemes are still in operation, like the H.S.A. I notice that, since we submitted this document to you, an old-established contributory fund of this character has re- ported that in the last twelve months it gave £25,000 voluntarily to hospital manage- ment committees and regional hospital boards. I must also comment that, since we submitted our memorandum, although there is no connection between them, you will have observed the decision of the Minister to send out a reminder to people who have voluntarily covenanted to give subscriptions to hospitals. Chairman.] I am not certain that we are not wandering rather far from the matters we have got to discuss here. Can we come now to this application of block grants? Mr. Diamond. 197. May I ask about one aspect of over- centralisation with which we have not dealt so far? Doctor Hill explained that he regarded the present administration as being over-centralised, and he drew a comparison between the hospital routine in which he had been, I think he said, brought up and the present situation. Do I gather that the hospitals to which Doctor Hill is referring in this document are those which were voluntary hospitals before the war, and is it from those hospitals that Doctor Hill is drawing on his experience?—I have been connected with municipal hospitals and before that with guardians’ institutions for as long a period of time as I have with voluntary hospitals, and I should think my experience is about equal between the ‘two. But you must remember that local health authorities with great regret lost their hospitals, and even a local hospital is ex- posed to the same tendency towards over- 198. Is that saying the difference is marked throughout, the difference between the smooth and expeditious running of a hospital which is referred to in this memo- randum and now or is it the difference between that which is stated to be his experience before the war and the present time where the defect results from over- centralisation? Is that difference alleged to be equally great in the ex-voluntary hospital and the ex-municipal hospital?—I think it is equally great, except of course perhaps with one exception, the London County Council which has the largest iocal authority hospital service in the world. There was perhaps a certain amount of over-centralisa- tion in that. With the possible exception of the London County Council one would have said that a major health authority like a county borough had no over-centralisation where they had perhaps one, two or three hospitals, for example the City of Birming- ham with Selly Oak, Dudley Road and per- haps one or two others. They were not over-centralised in the same sense as a great region like the South-West Metropolitan Region, stretching right down tc Bourne- mouth. As we mention in this memorandum peopie working on the periphery of that region are very conscious of this rule from a distance. Chairman. 199. Doctor Hill, to deal with exces- sive centralisation you propose that the finances of the hospital should be carried out completely by a system of block grant. Y think that is the short effect of your memorandum. You propose that a sum should be set aside by the Government for the Hospital Service, that it should be divided between regional boards and boards of governors, and I think you suggest that](https://iiif.wellcomecollection.org/image/b32182478_0057.jp2/full/800%2C/0/default.jpg)
