HEALTH COMMITTEE 1992-97
Report by Mrs Marion
Roe, Chairman of the Committee
1. The Committee has discussed
the recent recommendations by the Public Service Committee and
the Trade and Industry Committee as to how the effectiveness of
select committees might be improved. The comments which follow
are my own, but they build upon the views of colleagues expressed
in the Committee's discussion.
Scrutiny of Agencies and other
non-departmental bodies
2. The Department of Health
has not devolved major functions to agencies in the way that some
other Government departments have done and accordingly the Health
Committee has taken very little evidence from agencies.
3. However, the introduction
of the internal market in the NHS, combined with last year's abolition
of regional health authorities, has created a situation which
replicates some of the difficulties of scrutiny which have arisen
in the case of agencies. While there has been an increasing emphasis
on decision-making by local health purchasers, there appears to
have also developed an unwillingness on the part of the Department
centrally to monitor local developments and this in turn has limited
the Department's ability to respond to requests for information
from the Committee. Rather more often than we would wish, such
requests meet with the response, `this information is not held
centrally'.
4. One example will suffice.
Our inquiry two years ago into the London Ambulance Service focussed
on the reasons why the introduction of computerised ambulance
despatch in London had proved so difficult. We asked the Department
how many ambulance services outside London had installed computerised
despatch systems and for details of the systems used.
5. On receiving the reply
that none of this information was held centrally, we requested
the Department to contact ambulance services and obtain the information.
The Department declined, for reasons that were later explained
in oral evidence by the relevant Minister, Mr Sackville: "my
officials ... were all ready to write round to ambulance services
to seek to collect this information for you. I had to instruct
them that I did not believe that this was a proper use of their
time and that there was no reason why the Committee should not
collect this information yourselves" (HC 20-II, 1994-95,
Q928).
6. Believing the information
in question to be essential to our inquiry, we did as the Minister
suggested and wrote to every ambulance trust in England and Wales,
publishing the results of this survey with our Report. This exercise,
however, consumed a considerable amount of staff time and is not
an expedient that can be frequently repeated. In most cases we
have no option but to accept that information which is not available
centrally cannot be obtained. Last Monday, for instance, having
been told by the Department that they do not know how many school
nurses there are in England, or how many schools have a school
health service, we discussed whether to seek the information by
writing to each health authority, but decided that owing to time
constraints this would not be practicable.
7. In the case of computerised
ambulance despatch systems, the Minister argued that the Department
had no management need to acquire the information the Committee
had requested. This may or may not have been so, but there is
no doubt in our minds that in many other cases, such as that of
the school nursing service referred to above, there does
appear to be a management need for central monitoring and data
collection on important issues which is not currently being met.
Resources - constraints caused
by lack of staff and Members' time
8. There was general agreement
amongst colleagues that more staff resources would increase the
effectiveness of the Committee, particularly by enabling more
routine detailed analysis of expenditure. The numerous other
demands on Members' time do, of course, impose unavoidable constraints
on the amount of business that can be transacted by any select
committee. For most of this Parliament the Health Committee has
met only once a week, but over the past 7 or 8 months we have
been meeting regularly twice a week, on Mondays to consider draft
reports and on Thursdays to take evidence. It would assist us
if the whips, when reaching decisions on the membership of standing
committees, were to take greater account of the burdens imposed
on Members by select committee business.
Relations with the PAC and
NAO
9. Colleagues were agreed
that PAC did valuable work in the health field but that in principle
the resources of the NAO could be made directly available to departmental
committees without compromising the role of PAC. There was support
for the proposals put forward by the Public Service Committee.
Two secondees from the NAO have worked for the Health Committee
in the post of specialist assistant and their expertise and high
level of professional skill has been of great assistance to us.
Parliamentary commissions
10. There was agreement
that the concept of parliamentary commissions was an interesting
one which should be further explored. It was also felt that mechanisms
should be introduced to facilitate select committees' ability
to commission research projects on a scale or of a complexity
beyond that which specialist advisers can be reasonably expected
to tackle.
Difficulties in obtaining
evidence from Government Departments and summoning of named officials
/ ordering the attendance of Members
11. I have outlined above
the difficulties we have from time to time experienced in obtaining
information from the Department of Health. Circumstances have
not arisen in which we needed to summon named officials or insist
on the attendance of Members of the House. However, there was
support for an extension of committees' powers in this regard
as proposed by the Trade and Industry Committee.
Access to intelligence material
12. The Health Committee
has hitherto had no need to consult intelligence material and
no views were expressed on this proposal.
Ban on paid advocacy
13. In my view there is
an urgent need for clarification of the extent to which the post-Nolan
ban on paid advocacy affects the position of members of select
committees; a body of case law should be built up as soon as possible.
General
14. In general, members
of the Committee regarded their select committee work as valuable,
encouraging deep thought about issues and sensible consensus wherever
possible, stimulating improvements to health service provision
and putting much useful information in the public domain. There
was a widespread view that Parliament does not sufficiently exploit
the potential of select committees and that their role is weakened
by too great a turnover of membership and by lack of opportunity
to link committee work with the work of the Chamber.
