Select Committee on Liaison First Report


APPENDIX 13

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.


 
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Prepared 13 March 1997