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National Performance Targets

Volume 447: debated on Tuesday 20 June 2006

1. How many whole-time equivalent NHS staff are employed in monitoring and reporting on national performance targets; and how many there were in 1996. (78460)

The data are not held centrally. However, we are committed to reducing the number of national targets. That number has reduced from 28 in 1996 to 20 for the current three-year planning round.

If the Secretary of State cannot answer the question directly, does she accept that the need for constantly collecting information and reporting on targets is a significant contribution to the doubling of management staff since she took office, as opposed to a 30 per cent. increase in medical staff? Is she aware that if management staff had increased at the same pace as medical staff, there would be 12,000 fewer and the NHS would have saved about £500 million a year—a large part of its deficit?

No, I do not agree, and the hon. Gentleman is absolutely wrong. The proportion of the NHS budget that is spent on management and senior management has gone down. It was 5 per cent. and it has gone down to below 4 per cent. in the latest figures. There are 10 nurses now for every manager, as there should be. The hon. Gentleman’s implication that good health care does not require good management is nonsense. I have great respect for him and he ought to know better than to suggest that.

In respect of reducing national performance targets still further, will my right hon. Friend be cautious about reducing performance targets in relation to mental health, since there is evidence already that mental health is regarded as a rather low priority by many primary care trusts? For example, the Milton Keynes PCT is targeting mental health services in trying to get within budget.

I understand my hon. Friend’s concern about the impact of the overspending in a minority of organisations on the rest of the service, including on mental health services. The Minister of State, my hon. Friend the Member for Doncaster, Central (Ms Winterton) this morning launched a further document on the improvements that we need to continue seeing in mental health services specifically. I think she would agree that simply adding constantly to the number of national targets is not always the best way to ensure that local staff and local hospitals can respond in the best way possible to the needs of their local community, and ensure that they are delivering the best health care within the substantially increased budgets that we have given them.

How does the Secretary of State justify the Oxford Radcliffe Hospitals NHS Trust losing 600 NHS posts, including managers? She might like to reflect on the fact that on Sunday some 5,000 of my constituents, along with Labour councillors and representatives of Unison, the Transport and General Workers Union and the GMB, all gathered together to express concern about what is happening to the health service in Oxfordshire, and to the Oxford Radcliffe Hospitals NHS Trust in particular.

Of course I understand the concerns that the hon. Gentleman raises, which are reflected among his constituents and among the staff and their unions. Let me reassure him, and particularly the staff, who face a very anxious time, that the Oxford Radcliffe and any other hospital in a similar situation will do everything it can to avoid compulsory redundancies and to support staff to be redeployed, where necessary, to new jobs. Does the hon. Gentleman accept, however, that with medical technology changing, and with huge and unacceptable variations in the quality of care and the value that is given to patients by different hospitals, it must be right to expect hospitals to use new medical technology and best practice to become as effective as possible in their use of resources? That means difficult decisions in some places, but we should have the courage to take them, and he should have the honesty to support them.

At the previous Health questions, I raised a problem involving staff at NHS Direct. I was promised a meeting with a Minister, but it has not taken place and I cannot understand why. In addition, the chief executive of NHS Direct has still not responded to my correspondence. I wonder whether the Secretary of State will ensure that a meeting takes place quickly. Jobs are going down the road, which is not good enough, and it is time for the Department to be put into order.

I am extremely sorry that my hon. Friend has received neither a reply nor a meeting, although I understand that my noble Friend Lord Warner, the Minister with responsibility for health service reform, had to attend a debate in the other place when that meeting should have taken place. Another date and time that suits my hon. Friend will be organised as quickly as possible, and I will ensure that that meeting happens and that he gets a reply to his letter.

The Secretary of State will be aware that the monitoring of performance targets is undertaken not only by NHS staff, but by patients’ groups. Will she therefore urgently investigate the case of Queen Mary’s hospital in Sidcup, which has had problems with hygiene in the past and which has reportedly cancelled two inspections by its own patients’ forum—it has told the patients’ forum that it cannot investigate hygiene by using torches to look under beds? Will she investigate that refusal to participate?

Of course I will examine that specific case, of which I was not aware. The Healthcare Commission routinely inspects all health care providers to make sure that they are raising standards to the highest possible level. The hon. Gentleman has made the extremely important point that inspecting and reporting on the quality of care, which requires a certain amount of management time, is essential if we are to give patients the best possible care, which is what we all want.

I support good management in every establishment. Good management has contributed wonderfully to the stupendous improvements that we have enjoyed in our health service in recent years. [Interruption.] I am pleased that those who have not enjoyed the great care that we get in our hospitals have avoided the experience, but if they had had the great misfortune to be ill, they would have been cared for magnificently in our NHS. My local hospital trust meets its performance targets, which still need to be refined. I say that where there is bad management, it should be cured hospital by hospital. The blanket approach has resulted in my local authority paying £500,000 for a benchmarking exercise, which cannot be explained simply by the current cuts.

My hon. Friend rightly refers to the exceptional improvements in many aspects of NHS care. Indeed, he might have been thinking of the improvements in accident and emergency that have got rid of those appalling trolley waits, which was a direct result of our target. The benchmarking exercise to which my hon. Friend refers is one of many ways in which every hospital can examine its own performance to see where it can do even better and improve its care to patients. My hon. Friend supports such improvements, and we will ensure that they continue.