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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![1 February, 1951.] [Continued. with his staff. In another group perhaps most of the committee or the chairman have had no previous experience of work- ing with a consultant staff. That is true, I think I can say. of the Paddington Group. Mr. Diamond. 327. When you quote the Paddington Group as an example of what you do not approve, namely the appointment of a sub- committee of the management committee rather than representatives of the medical] committee, and when you say that you want the medical committee to have powers of recommendation but not to tie the execu- tive, surely what you are saying the whole time, and what this document is saying, 18 that you do not want larger representation on the regional boards and management committees but you want much more offi- cially recognised and powerful consulta- tion?—That is our strongest wish. Chairman.] Before you came in, Mr. Diamond, Doctor Hill really did make that point. He said that, although they would like slightly larger representation, that was for the purpose of just seeing that the medical interest was -watched, but consulta- tion was the matter about which they really felt strongly. Mr. J, Enoch Powell.] Would it not be of great value to this Sub-Committee, if there have been cases in the example to which Doctor Hill referred where proposals for economy and more efficient working have been put up and not acted upon, if we could know about them? It would ob- viously strongly reinforce Doctor Hill’s argument, and it would be of assistance to us. Chairman. 328. I do not know whether Doctor Hill can give us that evidence. It would not necessarily find its way to the British Medical Association—unless you have any personal evidence?—I have some personal evidence from the hospital to which I my- self belong. I regard the Paddington group of hospitals as a costly group of hospitals, and I think considerable savings could have been made. Better liaison between the staff of that group and the management com- mittee would have resulted in such economies. One hospital in that group, on the staff of which I am, had a considerable staff of people of all grades, including a lot of junior grades, and when they were taken over on the appointed day, owing to the lack of proper liaison between the con- sultants of that group and the management committee, and the board above them too for that matter, there is no doubt ex- cessively senior gradings were given to a lot of staff. That must have cost public funds in that one hospital alone thousands of pounds a year, which need not have 10894 been spent with more skilled advice on those individuals to the administrative body before the gradings were given. There is no doubt that, when a body not very well instructed have to grade certain people, they will tend, I think it is only human nature, to err on the side of generosity rather than do an injustice. 329. To interrupt you, I think the point you are making is this: better co-operation between the medical and the lay sides of _ hospital must make it more efficient?— es. 330. I think we must accept that, and. say that efficiency leads either to better service or better hospitals or both?—Yes. 331. Your case is that you get that co- operation better on the lines set out in your memorandum, as extended by this evi- dence?—Yes. (Professor Cloake.) I would like to say that it also works back the other way. If the medical staff has representa- tion on the board it does naturally become much more identified with the wishes and aims of the board itself. If the aim of the board is economy they are the very people to know why and how it can be effected, and they will carry that back to their own staff, so that you bring them enthusiastically and willingly into’ co- operation. That is a very important item, this identity of interest, so that the board and the staff do not feel that they are working with different aims, and some- times at loggerheads. 332. Could we perhaps deal with the other two levels in this connection? You have spoken of the hospital and regional levels. Does the same apply at group level? —(Dr. Rowland Hill.) Yes. At group level there can be no doubt that the proper arrangement of our hospitals in the country should be that there is a recognised group medical staff advisory committee. If I had been the Minister with my knowledge of hospitals, I should have put that in the Act. There is one medical committee statutorily recognised in the Act. That is better known as the local medical com- mittee which is the advisory body to the executive council, and that is recognised in the Act. .A similar body advising the group of hospitals is just as vital, and should be in the Act. We asked for that as soon as we saw the present Act, and we asked that it should go into the Amendment Act. 333. Why was it refused?—It was re- fused, I thought, without the adequate attention which we should have liked it to have been given.. The phrase used by the chief secretary of the Ministry in refusing it was that if it came into the Act he thought it would make the Service too rigid, and he thought it better. C4](https://iiif.wellcomecollection.org/image/b32182478_0073.jp2/full/800%2C/0/default.jpg)
