NHS lacks leadership consistency, peers told

Speaking during the committee stage debate of the Health and Social Care Bill in the House of Lords, Baroness Cumberlege drew a parallel with the 25-year tenure at Manchester United of manager Sir Alex Ferguson and the football club’s success.

She said: “I just wonder if we had that inspiring leadership for a real length of time, what difference it might make to the NHS.”

“One of the real problems that we have, and it exists even if it is the same party in power for a length of time, we lack a consistency of leadership, because the Secretaries of State are here one minute and gone the next,” she added.

Since 1997 there had been seven health secretaries she said, adding: “I think that contributes to an NHS that gets confused, that gets fed up and is mistrustful of its masters.”

Baroness Cumberlege said that Peers “should not be timid in allowing liberation”.

The Bill, specifically clause four, she added, gave the Secretary of State an “opportunity to exercise his duty to promote autonomy and resist the temptation to meddle and micro manage the NHS when he feels that is appropriate so far as it is consistent with the interests of the health service”.

Tory Lord Mawhinney, a former health minister, disagreed with Lady Cumberlege and said the accountability of the NHS needed to be paramount.

“You can’t have a publicly accountable health service without politicians and without politicians being in charge,” he said.

“We part company in a quite fundamental way about the accountability of something that spends £128 billion a year.”

And he told peers: “If you are spending £128bn of public money, the public whose money you are spending are simply not going to say when big problems arise ‘well that’s OK, we’ll listen to him or her because they are chairman of a quango’.”

Independent crossbencher Baroness Murphy, a psychiatrist and former chairman of various health authorities, said more autonomy was “absolutely vital” to prevent political interference.

“We must have organisations in the health service that set their own objectives, that manage them properly and start concentrating on the frontline of patient care,” she said.

Health minister Earl Howe said clause four of the Bill, which deals with autonomy, would feature in the negotiations taking place outside of the chamber on the role and responsibility of the Health Secretary in the reformed NHS.

Debate on the committee stage of the Bill was later adjourned until next Monday.