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The Nhs: Number Of Employees

Volume 416: debated on Thursday 29 January 1981

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3.16 p.m.

My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government how many people are employed in the National Health Service as at the latest convenient date; and what were the comparable figures in 1970 and 1960.

My Lords, the number of people employed in the National Health Service in Great Britain as at 30th June 1980 is provisionally estimated at 1,162,000. The equivalent figures for 1970 and 1960 were 719,000 and 550,000 respectively. These figures, which include both full-time and part-time employees, are based on a return made to the Department of Employment by all National Health Service employing authorities.

My Lords, do not those figures confirm the impression that the National Health Service is the biggest growth industry in the country? Do they not also indicate to my noble friend that there is room for some retrenchment there without any diminution in the effective service given to the patient?

My Lords, there is no doubt that this is a growth industry, and successive Governments have given increased resources in real terms to the National Health Service as a matter of policy. However, I make no apology for the continued increase in National Health Service manpower. If the country wants the benefit of medical advances, more intensive use of hospital facilities to reduce waiting lists and a better community health service for an increasingly elderly population, National Health Service staff numbers will continue to grow.

My Lords, is it not a good thing that it should be a growth service? Is it not true that over the last few years our hospitals have dealt with more out-patients and in-patients than ever before, and that it is highly desirable that they should continue to do so?

My Lords, I entirely agree with the noble Lord. There have been great medical advances and much more complicated treatments are given; and it is impossible to do this very labour-intensive work without increasing staff.

My Lords, as one who has recently been attending a much loved and close relative in hospital under the Health Service, does the noble Lord know that if he visited that hospital—the name of which I can give him—he would find young nurses working brilliantly, devotedly and with infinite good temper on older patients, and following in the finest steps of the nursing profession, and that they are over-worked rather than under-worked?—as most of the staff appear to be.

My Lords, I am grateful to the noble Lord for that observation.

My Lords, do my noble friend's comments also seek to justify the very substantial increase in the administrative services and administrative staff which—partly, no doubt, as a result of successive re-organisations—have greatly grown?

My Lords, I am afraid that all groups of staff in the National Health Service have grown, but in 1976 the previous Government started an exercise to reduce the proportion of management costs and they have now been reduced from 5·6 per cent. The target was 5·25 per cent. and it is actually down to 5·05 per cent., which is, I think, satisfactory. There has also been a small decrease in ancillary staff.

My Lords, could not the Government take heed of these figures and take heart from these figures, and, instead of boasting about not taking a U-turn, not only take a U-turn but do a somersault when thinking about unemployment?

My Lords, I am not sure that I am sufficiently active to do a somersault.

My Lords, can the noble Lord give us a figure of increase following the reorganisation which took place on the basis of the report made by the American efficiency expert brought in by the Conservative Government?

My Lords, I wonder whether the noble Lord would say that again? I could not quite hear him.

My Lords, can the noble Lord give us a figure of increase due to the reorganisation which took place based on the report made by the American efficiency expert brought in by the previous Conservative Government?

My Lords, I imagine that the noble Lord is going back to 1974. There was certainly a considerable increase there and I think many members of the Government have said that, although many of the things in the 1974 reorganisation were very well received, the introduction of area health authorities was not a good idea. As the noble Lord will know, we are now doing away with those.

My Lords, will the noble Lord confirm that, despite appearances, this country has one of the cheapest health services in the world, and that the national expenditure on health as a proportion of the national income is lower here than in most other developed industrial countries?

My Lords, the noble Lord is quite right, and I believe the figure is now 5·5 per cent. of the gross domestic product.

My Lords, would the noble Lord agree that increasing numbers of our people are now living to a ripe and happy old age? Is this not in fact largely due to the National Health Service? Therefore, should we not stop nagging about it?

My Lords, can the noble Lord give the House an assurance that the overriding consideration will always be the interests of the patients, and that any intended cuts in personnel will never be made at the patients' expense?

My Lords, that is the whole point of Patients First and the reorganisation by the last Health Services Bill.

My Lords, will the Government take this into account in the reorganisation with which we are now faced, and give an undertaking that this sort of problem will be constantly under review, because there is no doubt that there are other ways of delivering medical care than the one we have used in the last 20 years? We must prepare for the 21st century and a streamlined Health Service.

Yes, my Lords, it is permanently kept under review. So far as the worries which I know many noble Lords have about the number of unnecessary people, in their view, working in the National Health Service, cash limits do exercise a considerable discipline on area health authorities.