Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 60-79)



  60. Have you any idea what sort of people these are? One would think that really good personnel managers, human resource managers in today's jargon, would be visibly employed running companies or other organisations. Why are there some floating around?
  (Dr Roger Moore) Many of these people from industry see it as part of their personal development to give something back to the public service, which is why they have come forward in response to OCPA advertisements. The background to this is that OCPA needed twenty individuals to head their independents. They have got something like 120 applicants. They found that about eighty of these were clearly good candidates, so they passed them on to us and in the next month or two we will be having this training and assessment process to hopefully recruit from that number a core of people who we can draw upon.

  61. Have you any idea what proportion come from industry and what proportion come from elsewhere?
  (Dr Roger Moore) A very large proportion of them are from industry. They are the sort of people you are talking about—HR managers, personnel directors and that sort of person. The good thing about them is that they come from all parts of the country, so that makes it easier for them to travel to the interview panels, as far as we are concerned.
  (Sir William Wells) Clearly, we do not want to use any single independent assessor too much, otherwise there is a danger that they become institutionalised. That is why we need quite a big bank, so that—on a point of time—they do not have to give up a huge amount of time because we to not use them too often.

Julia Drown

  62. You said earlier that you might be looking for the non-executive legal skills because that might be lacking on that board. Do you have in your mind the number of gaps you are trying to fill to make up the whole team in terms of non-executives?
  (Sir William Wells) Yes, any board has to be a team, as I said at the beginning. It would be just as wrong to have—

  63. It would be a team with different skills.
  (Sir William Wells) Yes, different skills, different gender, different backgrounds and everything. It is a question of getting the balance of those. What we do not want to do is end up—

  64. I presume there is more than five or six, so how do you get to the point of thinking that what you want is someone with legal skills so that the advertisement for a non-executive specifically specifies that it should be legal skills?
  (Dr Roger Moore) This is largely a matter for the chair of the organisation to identify. They will also look at the strengths of their executive team because there may be gaps in that; or there may be a particular challenge facing that trust.

  65. It is not a requirement from you.
  (Sir William Wells) No. Just to give you an example, if you have a hospital trust that has a PFI project, then they might decide that they needed a non-executive with experience of that sort of general thing. Every single trust has to have an audit committee, and it has to be chaired by a non-executive. You have to have somebody who understands what they are doing in terms of audit. There are certain skills which a chair would be looking for in any event.

  66. Do you not think you would be able to train somebody quite quickly to be able to ask relevant questions on the audit committee?
  (Sir William Wells) I would like to think that. Certainly most trusts now are of 100 million plus turnover, and they are big organisations. I would like to think that they have some form of knowledge of balance sheets and P&L accounts.

  67. If you fill a gap with a person with legal knowledge, are they held responsible for that legal knowledge?
  (Sir William Wells) No non-executive will give executive advice; otherwise we are completely destroying the object of having non-executives. They are there to be able to hopefully make wise comments and help the executives in particular areas, but they are no more responsible for their advice than the non-executive normally talking round a board.

  68. They are getting a benefit of a payment and having an influence without having responsibility.
  (Sir William Wells) They do not get paid anyhow. They are only non-executive people.

  69. Only?
  (Sir William Wells) We would not appoint anybody that just was going to give legal advice. It would be part of their role as a non-executive director, amongst all of the things that they might have a particular skill in accounting, or whatever it happens to be.

  70. Actually, the amount they get paid to be a non-executive in most of the Health Service is more than most of my constituents get paid.
  (Sir William Wells) I withdraw that. A lot of them may think it is very little. It is one of the battles we have, I have to say.

Dr Taylor

  71. Can I go on exploring your independence, and please do not think anything I am going to say is meant as a personal attack, because it is the system. As with Mr Amess, I was a little disappointed to learn that your background, Sir William, is entirely within the NHS and also that Dr Moore was responsible for the system beforehand. Another thing that really worried me was your appointments to the chairs of the 28 strategic health authorities, and 24 of those were previous holders of chairs of trusts or boards appointed by the Secretary of State. Two of them were non-executives, so only two were new blood. The question is, do you really have freedom, and of the 1600 appointments that you have made, how many of those are genuine new blood, and how many were non-execs beforehand? I do not expect you to be able to answer that in detail now.
  (Sir William Wells) We will let you have that information, in relation to the last point you made. We make the appointments, and we made the appointments to the strategic health authorities entirely on the basis of those who applied, and we went out and searched high and low in order to get the highest quality that we could. It was not just a question of appointing one or two existing people. They went through the full process, which was totally objective. I can assure you that on no appointments whatsoever have I or the board had any pressure to appoint anybody by anybody.

  72. Were you fairly short of applicants for those crucial jobs?
  (Sir William Wells) I will answer the question in another way, if I might. Taking on the role of chairman of a strategic health authority, and having to do it at a run, with very short run-in period, is a daunting task, if you come in, so to speak, off the street. We did appoint a couple of people from outside, as indeed two of the regional commissioners were appointed and had never been involved in the National Health Service. It was a monumental learning curve. Given the agenda that the National Health Service is faced with in the very short term, this clearly weighed on those who were doing the interviewing and ultimately came up with a recommendation. I have to say—and this is a personal comment—I have met and know all the strategic health authority chairs and I think they are an extremely high-calibre group of people.

  73. I accept the difficulties with strategy in health authority chairs, which is why I am more than interested to know about the 1600 others. You have already said that you are accountable to the department and to ministers. Does that clash with your obligations to the Commissioner for Public Appointments?
  (Sir William Wells) No. I think we have to be clear as to our accountability to ministers. We are accountable to ministers for our budget. It is pure financial accountability. As we are a special health authority, like all special health authorities we are accountable to the Secretary of State and Parliament for not spending more money than we are given. The only other involvement that we have with ministers is that ministers from time to time set the criteria of the type of person that they believe ought to be appointed generically as non-executive directors. We are currently working on the criteria which was set by two or three secretaries of states ago. We made it pretty public knowledge that we are not altogether very happy with those, and we are working on revising them, but we will have to get approval from whoever is secretary of state at the time. We have no other accountability to the Secretary of State or ministers. We have no accountability for the appointments. We never discuss appointments with the Secretary of State or the Minister.


  74. Do they discuss them with you?
  (Sir William Wells) I can categorically say I have not had one single call or intervention from any ministerial member of the team.

  75. Does that apply to you as well, Dr Moore?
  (Dr Roger Moore) Absolutely.

Dr Taylor

  76. What guidance do you give to new non-executives about declaration of interests?
  (Dr Roger Moore) It is very full. They are given the opportunity to fill in a declaration of interest on the application form, and then the guidance requires each NHS body to keep a register of interests, and the non-executives are expected to declare on that form.

  77. Does it apply to spouses and partners?
  (Dr Roger Moore) I have to collect my thoughts on this because there is some confusion around that. Our guidance at the moment says that it should include indirect interests, which is spouses and partners as well as the direct interests of the individual.

  78. This is the reason for asking because a constituent was told at one primary care trust board meeting that they did have to declare a spouse's interests, and at another they were told they did not, so there is very real confusion.
  (Dr Roger Moore) The latest guidance is to include it.
  (Sir William Wells) You are right to raise the point because there was a lot of confusion.

Mr Burns

  79. Going back to accountability to ministers—and I fully understand the answer you have given and your assurances that ministers have never in any way discussed with you who you should or should not appoint -what guidance is there, either via ministers or within the system, for advising Members of Parliament? I know, in terms of the Fritchie inquiry, that the direct involvement of Members of Parliament in the appointments has changed so that we do not any more, but have ministers given you advice as to how you should notify Members of Parliament of appointments, or notify them of vacancies?
  (Sir William Wells) We have not received any advice from ministers, but we have given ourselves a lot of advice, if that is of any help to you, as I explained to you—


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