Examination of Witnesses (Questions 160-168)
THURSDAY 6 FEBRUARY 2003
MS JOAN
ROGERS, MR
NIK PATTEN,
MS MOIRA
BRITTON, MRS
CHRIS WILLIS,
MR KEN
JARROLD CBE, MR
DAVID JACKSON,
DR IAN
RUTTER OBE AND
MR PETER
DIXON
160. That is happening whether you have applied
to be a foundation trust or not. The timescale is slightly different.
(Mr Jackson) That is the point, the timescale. At
the moment the financial flows will be by 2008, which is really
quite a long time.
161. We are talking about having it fully in
a year earlier in a foundation trust.
(Mr Jackson) I do not know. My hunch is that foundation
trusts will have to accelerate the process a lot more than that
for them to work.
162. That is not what the Department of Health
have said, but fair enough. So you might do it in order to get
more quickly to financial flows. Take that out of the equation
as well. What if we are only talking about the governance arrangements,
would you be interested?
(Mr Jackson) Probably; yes. It is not something which
has been focused on particularly this morning, but this idea of
a new form of social ownership opens up opportunities for hospitals
to play a much bigger part in the local community and play a direct
part in the creation of social well being.
163. Probably yes.
(Mr Jackson) I personally, and a lot of my colleagues,
find that a very exciting and interesting prospect. It is quite
possible that if it were just that, it would still be worth going
down this road.
(Ms Rogers) It is not even that it is just that, is
it? This is the best bit and that is a real surprise. I came out
of this thinking all these people are getting at me and my staff
side and there is going to be a great melange of interests and
Stockton will divide automatically with Hartlepool and the whole
thing will be an awful football match, blah, blah, blah. Actually
the constitutional things are quite safe, they are not just going
to let any old usual suspect turn up, raise their hand and be
on the board of governors. There are criteria for selection and
they have to represent a constituency and somehow feed back. Also
this business of engagement has been absolutely frightful for
a lot of us in the service for a lot of years. We mean everything
sincerely and well, we go out and tell people why we are doing
something, as I have done just recently for the best reasons,
which was moving cancer services out of Hartlepool into Stockton.
It was frightful and the usual attitude that they will lynch you
before you get off the platform after explaining yourself. This
bit, even in the little time I have gone around talking to people,
made me wonder why I do not do this more, why I have not been
an ambassador more, why I have not gone out in the streets more
and talked to people. It has been really good. I do believe we
are still going to have these awful football matches sometimes;
sometimes people will not like the change we are making in order
to bring in the government's agenda. I have more chance if they
think I am a sincere woman. They heard what I said and I am out
there talking about it a lot and you have 25 other local people
who hopefully have got beyond the football match in my case and
are singing for me.
164. So you would.
(Ms Rogers) I would; I would go for it just for that
freedom.
(Mr Dixon) We would not. We are in it for the money,
on the basis that we have a lot of real estate in central London
to sell to pay for our new building and keeping the surpluses
is hugely attractive. Also, if we can get more money we can treat
patients better. Our touchstone in this is being able to treat
patients better. That is all we are interested in.
Dr Naysmith
165. Earlier Mr Dixon touched on the possibility
that the democratic arrangements might be taken over by a bunch
of Trotskyists and one or two other categories. I think it would
be more likely that they would be taken over by dissatisfied patients
or people with an axe to grind rather than the people I am sure
the people designing this have in mind, who are ordinary people
who may not yet be ill but they want to have a good system of
health care in place when they do become ill. These are the people
who are going to be the most difficult to attract, are they not?
(Mrs Willis) We have some practices which set up patient
participation groups. That has not been the experience there.
We have had a very wide variety and not the usual suspects. They
are much wider thinking and prepared to be much firmer with other
patients.
166. But you have to work at it, do you not?
You have to set about engaging people.
(Mrs Willis) You have to encourage them to get involved
and provide the environment. We found that you got a very broad
group of participation.
167. Let us assume that you have them and they
are on the board. How can you make sure that they have the skill
and ability to challenge managerial decisions and professional
interests? Is there going to be some sort of training? Is that
mentioned in these proposals?
(Ms Rogers) In some way it is the same as we did with
non-executives. They were not all to the manner born; some of
them were frightfully clever from day one and others were not.
So we trained them a lot; we all needed training in those days
in the financial regime etcetera. You need a huge amount of that.
It is a privilege taking them around your hospital and explaining
what you are doing, but they would need training and there must
be the resource—I am sure there would be—to do it,
otherwise they may challenge on the basis of ignorance, which
is what usually happens. That would be a pity on your own board
of governors.
(Mr Jarrold) A tiny, tiny comment. If you have lived
with manic depression for 20 years, if you have lived with diabetes
for 20 years, you know something about your own condition and
about the condition itself. People are not ignorant just because
they do not have degrees. They have a huge amount of life experience
to offer and we must use that.
Jim Dowd
168. I bet those are the ones you will have
the greatest difficulty getting on the boards.
(Mr Jarrold) We shall see.
Dr Taylor: One very brief comment. It is an
absolute breath of fresh air to me to see chief executives of
PCTs and trusts sitting next to each other, obviously working
together. If this had happened in my neck of the woods, I would
not be here.
Chairman: May I thank our witnesses for a very
useful session? We do appreciate your co-operation with our inquiry.
Thank you very much.
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