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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![in turn the regional boards should sub- divide their allocation and make block grants to individual hospitals or hospital groups. That is the suggestion?—That is the suggestion. 200. There should be a double-tier block grant in effect?—Yes, that things at any rate should move in that direction rather than in the other direction where more and more scrutiny of small payments occurs from the centre. 201. That involves very wide considera- tions, many of which are outside the direct knowledge of your Association?—Yes, cer- tainly. 202. There is one aspect which I think directly affects you, and that is the position of consultants and specialists in such a scheme. Do you suggest that, if a scheme of that sort were brought in, the con- sultants and specialists should be employed by and paid by the regional boards or by the hospital management committees?—As far as consultants working in non-teaching hospitals are concerned, that is to say those who are at present under contract to regional boards as distinct from boards of governors, there has been no _ suggestion in our profession at all that that should be altered, and that they should become employees of the local hospital manage- ment committee. There has been no such suggestion to alter in that way. 203. You would wish to see them cou.- tinue to be employed by and paid by the regional boards?—By the boards, yes. I am sure that is the case. That is one feature of the present set-up which con- sultants have never questioned. 204. You are perfectly content with that? —Yes. Mr. Thomas Reid. 205. How would it be decided what amount of block grant should be given to any area?—I presume that an estimate would be made of their needs and a block grant made accordingly. I suppose an esti- mate would be made, although this per- haps is really outside our qtestion. Chairman.] Mr. Reid, I was going to say that perhaps we are putting to these witnesses questions which no doubt they are able to answer, but which they cannot very well answer as representing the British Medical Association. Is that not so? Mr. Thomas Reid. 206. I do not know. I was trying to analyse their proposition about the block grant, and to ask Doctor Hill this. Would it not amount to the same thing if the State decided the amount of the block grant? —Yes, the block grant would have to be sanctioned by the State. I think this is what our profession is really meaning behind this statement. It would mean that some of the growing list of detailed enquiries, a two-way enquiry into quite small expenditure to-day, would be stopped. I think my colleagues will tell you we are all conscious of the extra- ordinary increase in the amount of work occasioned by these to and fro enquiries over quite small items. That means taking up the time of clerks, more use of paper, taking up valuable time, and its cost must be considerable. If a lot of that could be cut out so that within certain budgetary limits the centre does not have to make day to day supervision of hospital expendi- ture a great saving should be effected. As far as we can observe from our day te day life in hospitals things appear to he moving in the other direction now. For example, in one hospital of mine certain persons are employed to take imventories, and there came a Ministry instruction: recently that two persons must be employed as inventory checkers to check the work of the people who take the inventories. The secretary of our hospital management committee estimates that the cost of those two inventory checkers will be another £700 in salaries. That is one little ex- ample. This sort of growth, this rather throttling weed of central inspection and control, is certainly growing, and I think my colleagues may have something to say on that. (Professor Cloake.) I think this is the matter we should perhaps emphasise. Chairman. 207. I do want to be very careful here. I am very well aware that you have a great knowledge of these matters because you are individually members of boards and committees, but I think it would be wrong to ask you questions which you may be able to answer unless they are questions which you can answer in your capacity as members and as representing the British Medical Association. I think you appreciate that and I do ask you to limit your replies in that way?—-(Dr. Rowland Hill.) Certainly. From that point of view, as doctors, we have been im- pressed by the delay and the amount of detailed work which occurs when medical equipment has to be ordered. For ex- ample, in the old days when all we had to do was to satisfy a local hospital board, the matter could be very thoroughly dis- cussed and settled in perhaps one meeting. Now we are all conscious of the fact that the ordering of very vital medical equip- ment is sometimes held up for prolonged periods because of the necessity to refer to the centre. Miss Ward. 208. There is a very interesting letter in The Times this morning. Did you see](https://iiif.wellcomecollection.org/image/b32182478_0058.jp2/full/800%2C/0/default.jpg)
