Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 20-39)



  20. You decided that you wanted them.
  (Sir William Wells) No, it is not up to me. I do not decide; it is the Secretary of State who decides.

  21. But you gave the impression that you had some sort of input.
  (Sir William Wells) Certainly, I had input.

  22. To me, this looks like an old pals' act. Surely, if this is supposed to be transparent—and Members of Parliament are either seriously going to be involved in this process, whether we come to this later or not—I know that from other colleagues in our area there is a track record in all of this. It seems extraordinary that you did not at least go for one fresh face.
  (Sir William Wells) Well, we went for six fresh faces.

  23. But not in our area.
  (Sir William Wells) Yes, but that—

  24. Absolutely hopeless.
  (Sir William Wells) The six out of the eight were new. Two were totally new to the National Health Service.

  25. It is absolutely hopeless then, that it was a short straw in our area and it is the same old regime.

John Austin

  26. In the memorandum you submitted you indicated that the local appointments include the chair of the NHS body. What weight is given to his or her opinion, given their relationship with and accountability to the board?
  (Sir William Wells) This is quite a difficult one, and in a sense a very good question. There is a danger both ways. There is a danger that the chairmen will tend to over-influence the interview panel to get on people that they want regardless, and you get back to the old pals' act. If you do not involve them there is a danger that they are not able to put together a board that will work as a team. Anyhow, we discussed this at some considerable length with OCPA because we knew it was a sensitive issue. Dame Rennie and I agreed that the balance that we should achieve was to put the chairman on the interview panel but to ensure that the chairman was not chairman of the interview panel; so that the chair was another chair from outside that particular part of the health economy, and therefore they had a completely independent view. That, together with the independent assessor, will give an ability to make sure that things were not being over-biased to the local chair's views; and, on the other hand, he or she would be there in order to be able to make them, in terms of a choice between two even candidates, decide as to one that would fit in better than another.

  27. Turning to the role of the chief executive, you specifically said he has a role in re-appointments. What role does the chief executive have in relation to new appointments, if any?
  (Sir William Wells) Not much.

  28. Why not?
  (Sir William Wells) Largely because the chair becomes his boss, of course. The Chief Executive is accountable to the chair of the trust or strategic health authority. As far as non-executives are concerned, I have absolutely no doubt that there are informal discussions between the chair and the chief executive about non-executives, but it does not form a formal part of the process.

Julia Drown

  29. Can you tell us a bit more about the appeals procedure, if there is any, for unsuccessful candidates? You said candidates have recourse to OCPA if they have any concerns about the quality of the process, but can you say what that means? How do you define "quality" amongst other things? What about those who have not been re-appointed; does the same apply?
  (Sir William Wells) The situation is that the board of the Commission makes a decision as to whether somebody is going to be appointed or not re-appointed. Aggrieved people can then complain to me, as Chairman of the Commission, and I deal with all of those complaints myself. There are a whole variety of complaints and we try and answer them to the best of our ability. If they are not satisfied with what I have got to say, or alternatively they feel they want an independent view, then they can go to OCPA, but OCPA will only express views on the process, whether it was done in accordance with the process in a timely and efficient or otherwise manner; they do not make any judgment on the quality of the decision.

  30. Have there been any cases so far where you felt the wrong decision was taken, and somebody did have a genuine grievance that should have been addressed in some way?
  (Sir William Wells) No, not in respect of decisions that we have made. A number of people have complained quite legitimately about things which have not been done as well as we might have liked, and we are very conscious of that. We are determined to reduce this down to the very minimum.

  31. You said earlier that you were taking steps to try and widen the pool of people coming forward, and you have referred to some of the diversity of issues that you put in your evidence to us. Can you say more about what those steps are?
  (Sir William Wells) We have done two things within the Commission itself. We have set up an ethnic minority advisory group and set up a disability advisory group. Statistically, we have not done at all badly on ethnic minorities, but nevertheless we still want to make sure we are tapping much more into those populations. In many cases, they do not necessarily readily come forward to put applications in, and therefore we are using this group to advise us how we can best get into these various communities. As far as disabled people are concerned, we are conscious, although we have no statistical evidence, that we have not done as well as we should have done. Certainly, in the past we do not think that has been the case. Therefore, we are waiting for them to advise us as to how we can make it easier for disabled people—and I am not just talking about physically disabled people—to play a part in these boards. Generally, we are very keen to try and not move away from using advertisements, because we use advertisements for everything because we think that is the only way you can properly get it out; but we also want to get into communities much more. Therefore, we are arranging for commissioners and chairs of trusts to talk to local groups and the like, to explain the work of non-executives and what they can contribute. Local community groups can therefore hopefully get a greater understanding of what is entailed in this, and therefore broaden the group from which we are drawing.

  32. As you say, you have been more successful in terms of ethnic minority candidates and nearly achieving targets and exceeding them for non-executives. Is that because you had the groups specifically set up first?
  (Sir William Wells) No, it is because we have tried very hard at it, or our predecessors tried very hard at it. We still believe that there is more to be done in that direction.

  33. In relation to women, is the target to have 50 per cent of appointments so that you virtually have 50 per cent of people on boards who are women, or just 50 per cent of appointments so that we get there slowly? Is the target to get to 50 as soon as possible?
  (Sir William Wells) We do not positively discriminate. We only appoint on merit. We are at over 50 per cent of non-executives, or nearly 50 per cent. Where we have some way to go is on the percentage of chairs that are female. That is because we came from an incredibly low base.

  34. Given the high proportion of women working in the health service, and given that it is women generally who use the health service more, would you expect there to be higher interest and numbers?
  (Sir William Wells) We get a significant interest from women. We have increased the levels very significantly. It was not many years ago that there were less than 10 per cent. You do reach a point with these kinds of percentages when you can only make progress very slowly if you are going to not positively discriminate.

  35. It depends whether you think the talent is out there. I have current chairs at 40 per cent of women, so that would still suggest there is some way to go.
  (Sir William Wells) Absolutely.

  36. What are you doing to try and increase that?
  (Dr Roger Moore) Some of that might arise naturally because quite often chairs are drawn from people who have served as non-executives and had experience on NHS boards. Now that we have increasing numbers of women non-executives, we should see women coming through to be chairs significantly over future years.

  37. You have to wait for that process to happen.
  (Sir William Wells) It is happening.

  38. You never bring the chairs in without them having been non-executives.
  (Sir William Wells) No, we do, but I think that Dr Moore is saying, quite rightly, that people who have had a period of time as a non-executive director are pretty well equipped to come on and be a chair.

  39. What is the policy on age of non-executives?
  (Sir William Wells) We do not have one.


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