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Baroness Gardner of Parkes: My Lords, is the Minister aware that many people--of whom I am one--no longer believe that there are too many chiefs as opposed to not enough indians in the Health Service? There may not be enough indians, but the service certainly needs strong management at the top. It is wrong to think that such a huge enterprise can be run without that. Does the Minister agree on the importance of top management?
Lord Hunt of Kings Heath: Yes, indeed, my Lords; the quality of leadership in the NHS is crucial. That is why, in the NHS Plan, we have set out proposals for establishing a leadership centre in order to identify and give support to the lay managers and professional managers who will lead the NHS through a process of change. But at the same time we need to ensure that we reduce unnecessary administration to a minimum level. That was the whole purpose of abolishing the internal market, which made the NHS suffer through a countless and endless paperchase. We have very good leadership in the NHS. That will lead to effective change in the way services are provided.
Lord Elton: My Lords, the Minister focuses on committees and leadership. Given that his interest in these subjects is now aroused, will he recall that a committee cannot lead? Leadership comes from individuals. Is it too late to look back to the hospital matron, who has disappeared from the National Health Service--to its eternal loss?
Lord Hunt of Kings Heath: My Lords, I commend to the noble Lord the NHS Plan, which refers to the creation of "modern matrons". It is true that, over a period of 20 years, senior ward sisters have lost autonomy. Functional management in relation to catering and cleaning has taken away their responsibility for the direct management of individual wards. One of the most important ways in which we can improve patients' quality of experience is to give back to senior ward sisters many more powers than they have had in the past few years. That is what the concept of the "modern matron" is all about.
Lord Hunt of Kings Heath: Yes, my Lords. That report also created an extensive hierarchy. In the past few years, particularly with the introduction of the internal market and general management, the hierarchy was removed. This created problems because, having attained a level above that of ward sister, very few nurses entered senior management positions. At board level in particular, a senior nurse became a professional adviser rather than a manager. We need to turn that situation around. We need senior nurse leaders who can have an enormously influential impact on the quality of decisions taken within an individual hospital.
Baroness Carnegy of Lour: My Lords, the Minister said that the Government do not know how many committees there are within the NHS. If they do not know the number of such committees, how will they know when the number is reduced?
Lord Hunt of Kings Heath: My Lords, we are talking about 516 NHS bodies. It would be quite a waste of time and resources for us to undertake a census or audit of each committee in existence within such bodies. We use the concept of management costs as a way of keeping control on the amount of money spent on management. As I explained, we are seeing a reduction in management costs that will net the health service £1 billion for expenditure on patient services over a five-year period.
The Lord Privy Seal (Baroness Jay of Paddington): My Lords, I am most grateful to the noble Baroness for raising this issue. No one is more enthusiastic than I about improving the procedures of this House so that we use our time efficiently while retaining proper scrutiny. The noble Baroness will be aware that any change needs the agreement of the House, and that there is little scope for executive action. However, proposals are being discussed. One is to consider more Bills under the Grand Committee procedures in the Moses Room, which would certainly achieve the noble Baroness's aim. Unfortunately, at the moment, the opposition to that change comes from her side of the House.
Baroness Sharples: My Lords, I thank the noble Baroness the Leader of the House for that reply. Does she accept that 134 hours in the spill-over have been spent discussing legislation in Committee? Many of the Bills under consideration have been badly drafted--indeed, a number of noble Lords have complained about this--which has resulted in an enormous number of government amendments being tabled. I am sure that the noble Baroness will agree that this, in turn, has led to a lot of very tired, and sometimes rather ill-tempered, Peers in the Chamber. This has also affected the staff, especially the Hansard writers, who are extremely tired.
Baroness Jay of Paddington: My Lords, I certainly agree that we have been sitting for longer than another place in the spill-over period. However, if the noble Baroness were to look at the comparative figures of the number of hours that we have been sitting, she would see that during the previous Session the House sat, on average, for seven hours and 36 minutes each day. Moreover, in each of the previous four Sessions, the average sitting day was also over seven hours. I agree with the noble Baroness that we need to be very aware of the stress and strain put on the staff who serve us so well.
Lord Tomlinson: My Lords, does my noble friend recall that we had a debate tabled in the name of my noble friend Lord Peston earlier in the year, not only on the question of hours but much more besides? Perhaps my noble friend could advise the House what has been done since then, and tell us what has been achieved.
Viscount Cranborne: My Lords, can the noble Baroness tell the House how many amendments have been proposed by the Government, both in Committee and on Report, to government legislation in this House during the current Session? If the answer to that question is what I suspect it will be, does the noble Baroness agree that the main culprit is not the procedures of this House but the inability of the Government properly to prepare their legislation? Indeed, when the Government realise that they have failed to do so, they use this House as a means of rewriting legislation wholesale and then ram it through another place without proper consideration. Does the noble Baroness further agree that the proposal that she has just made about taking a greater proportion of Committee stage business off the Floor of the House will actually make it easier for the Government to ram through more legislation, rather than it being considered properly?
Baroness Jay of Paddington: My Lords, I am afraid that I do not agree with any of the points made by the noble Viscount, especially the final one. I did not suggest--indeed, I have never suggested--that the majority of Committee stages should be held in the Moses Room: I simply said that the Government Chief Whip and the usual channels have discussed the possibility of more Bills being considered in the Moses Room. For example, during this Session it has been possible to agree that Committee stages in the Moses Room should be taken only on Bills that will last just one day. As I understand it, that has not been the situation in previous Sessions.
I turn now to the number of amendments passed this year. As I am sure the noble Viscount is aware, information on the number of government amendments, as opposed to other amendments, is not kept in that form. However, I can give the noble Viscount the total number of amendments: during this Session 3,936 amendments were tabled, compared to 2,002 in the previous Session and 2,164 in 1992-93. Although the number of amendments for this year is large, I am sure that both the noble Viscount and noble Lords will see that it is not out of proportion when compared with other years.
Lord Wallace of Saltaire: My Lords, in addition to taking more Committee stages off the Floor of the House--after all, Committee stages are intended to explore the ramifications and details of Bills--would it be of assistance to the House if we were to accept the proposal that votes should not be taken during Committee? Surely the taking of such votes on Report would be more appropriate for a part-time House, as this is.
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