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Parliament: Royal Commission On The NHSSource: The British Medical Journal, Vol. 280, No. 6210 (Feb. 2, 1980), p. 338Published by: BMJStable URL: http://www.jstor.org/stable/25438747 .

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338 BRITISH MEDICAL JOURNAL 2 FEBRUARY 1980

PARLIAMENT

Royal Commission on the NHS

The Secretary of State for Social Services told

the House of Commons in a debate on the

Royal Commission on the NHS on 23 January that doctors and nurses must be protected from the ever-mounting pressure of demand

made on them. If people demanded "a pill for

every ill" they could not complain if the resources were not there when serious trouble arose. Successive generations of politicians had

encouraged people to believe that they were

always entitled to have every health expectation

promptly satisfied. The Royal Commission, Mr Patrick Jenkin said, had suggested elimina

ting health charges. That would mean cutting

spending on the Service by ?250m?the

equivalent of building five new hospitals

costing ?50m each and every year. No other

advanced country financed so high a proportion of its health care from taxation, and the

Government, he said, had set in train an

investigation of the possibilities of increasing the insurance element as a means of financing the NHS.

The proposals in the Government's con

sultation paper, Patients First, would mean

more effective management and allow a better

understanding among health authority mem

bers, staff, and public. The Government had

disagreed with the commission's view that the

family practitioner committee system should

be abolished. The consultation paper had

raised the question of the need for community health councils with the creation of more

locally based district health authorities. The

Government also rejected the commission's

suggestion that RHAs should be accountable to the House of Commons. Mr Jenkin said

that the professional advisory machinery would be simplified so that views of clinical

doctors and other professionals would have

more impact on health authorities but at lower

cost to the Service and with less time wasted

by highly trained clinicians sitting on com

mittees. The Secretary of State has asked the

Health Education Council to conduct a

thorough review of its work to see how it could

become more effective.

At present only 9% of the population was

receiving fluoridated water but the Govern ment had no proposals at present to introduce

legislation; it preferred to use powers of

persuasion. On the question of smoking, Mr

Jenkin reported that the Government was

discussing with the tobacco industry new

arrangements to replace the current agreement which ran out at the end of March. The nego tiations covered advertising, promotions, the

health warning, and reductions of yield of

harmful substances in cigarettes. He told the

House that the Government had been

reviewing hospital policy and intended to issue a discussion document explaining the problems and setting out the options.

Call for abolition of charges

The Opposition spokesman on health and

social security, Mr Stanley Orme, moved an

amendment to the Government's motion to

take note of the report, to welcome the report and particularly its unanimous endorsement

of the principle that the NHS should be free at

the time of need and nationally financed. All

charges should be abolished he said. Private

practice was immoral and no one should have

the right to buy health care. Mr Orme welcom

ed the commission's attention to the quality of primary care services in the declining inner

city areas and its emphasis on an antismoking

policy, statutory fluoridation, and the proposal to bring abortion more firmly within the NHS.

Mr Orme thought that some control over the

drug industry and prescribing would become

inevitable. The Health Service needed more

money, he said, but the only sensible demo

cratic way of funding it was through taxation.

Commenting on the low morale in the NHS, Mr David Ennals said that people resented the new levels of prescription charges. He

criticised the suggestions for an insurance

system. The people who needed the Health

Service most were the bad risks?the elderly,

disabled, chronically sick, and the young. They were too poor to pay the high premiums health

insurance would entail. Another Opposition

spokesman, Mr Richard Moyle, thought that

the new agreement on smoking with the

Questions in the Commons

Consultants. The following table shows the

number of consultants* in post and vacant

consultant posts in each region in England and

Wales on 30 September 1979.

Region All authorities England . . Northern. . Yorkshire Trent East Anglia North-west Thames North-east Thames South-east Thames South-west Thames

Wessex . . Oxford . . South-western

West Midlands Mersey . . North-western London postgraduate

teaching hospitals Wales

Total

14 310 13 596

866 862

1014 476

1333 1391 1165 926 676 572 748

1189 660

1103

615 714

Number in postf 13 403 12 734

802 809 945 458

1259 1232 1095 845 665 530 712

1133 620

1034

595 669

Vacant postsj

907 862

64 53 69 18 74

159 70 81 11

42 36 56 40 69

20 45

*This includes SHMOs with allowance. tWhere consultants hold appointments in more than one region they are shown in each of the regions where they work. The total numbers of consultants in post at 30 September 1979 in England and Wales without double counting were 12 531. +These columns do not include posts for which regions have been given central manpower approval but which have never been filled or advertised.

Social Services, 17 January.

NHS manpower. The total number of people employed in the NHS in 1971 and 1977 and

the percentage employed as doctors and nurses and in administration were as follows:

1971

All directly-employed staff and independent contractors . .

of which: administrative and clerical. .

medical and nursing and midwifery

*Whole-time equivalent.

wte*

675 269

70 396 328 787

10-4 48-7

wte

793 600

99 037 395 067

12-5 49-8

Social Services, 17 January.

Special hospitals. The nursing staff complement in the special hospitals and the

nursing staff who have resigned are set out below:

Year 1976 .. 1977 . . 1978 . .

Year 1976 . . 1977 . . 1978 . .

Nursing staff in post at 31 December Broadmoor Rampton Moss Side

434 558 271 464 570 261 441 583 268

Narsing staff resignations during year ending 31 December Broadmoor Rampton Moss Side

45 47 31 .... 40 46 45

.... 50 46 31

Park Lane 104 133 133

Park Lane 15 11 34

Social Services, 18 January.

tobacco industry should be tougher than the

last. The health warning on packets should be

tightened up and there should be no new

brand of cigarettes with a tar content of above 15 milligrams.

Winding up for the Government, Dr

Gerard Vaughan complained that the Labour

Government had regularly criticised the 1974

reorganisation but had done nothing about it.

The last five years had seen capital investment

reduced by ?193m?almost 35%. The total

number of beds had been reduced. Waiting lists had increased by 170% to nearly 750 000.

During the last five years staff working in the

NHS had increased by about 13% but the

administrative staff had increased by 30%. The

Minister of State said that there was a need not only for a viable NHS but a need to draw extra resources into health. That was why the

Government wanted to develop the private sector in partnership, not in conflict, with the

NHS.

The amendment was lost by 191 votes to

159?a Government majority of 32?and the

motion agreed to.

MEDICAL NEWS New professor of anaesthetics,

University of Oxford

Professor Malcolm K Sykes has been

appointed Nuffield Professor of Anaesthetics

in the University of Oxford from 1 June. Professor Sykes was educated at Magdalene

College, Cambridge, and University College

Hospital, London. After Army service he

worked at University College Hospital from

1952, first as assistant and then senior registrar and subsequently as lecturer and senior

lecturer in anaesthetics. In 1967 he was

appointed reader in anaesthetics at the Royal

Postgraduate Medical School, London, taking

up his present post of professor of clinical

anaesthesia there in 1970. He was assistant

editor of Anaesthesia from 1966 to 1970.

Stoke Mandeville appeal

An appeal for at least ?6 million for the

spinal injuries centre at Stoke Mandeville,

Aylesbury, was launched last week by Jimmy

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