Crumbling showpiece hospitals

Abstract

The Commons Public Accounts Committee dearly loves to take a look at the National Health Service, and its latest report returns to an old sore?the excessive cost of repairs to some of what were alleged to be NHS showpiece hospitals, almost before they had been put to use. The Sick Children's Hospital in Glasgow was a classic instance, but it was only one of 13 examples of crumbling showpiece hospitals. The report (16th report of the Committee of Public Accounts, 1983-4; House of Commons paper 113) notes that to date health authorities have recovered only ?400 000, or about 1%, of the total rectification costs of ?30m from the consultants responsible for the buildings, and serves notice that progress had better be reported at the end of the present financial year, or else. The report is also critical of the slow response by health depart? ments to the need for health authorities to establish cost effective systems for controlling stores and articles in use, including finen, in the NHS. It says that there is public concern, rightly, that NHS property is not being properly safeguarded. On accountability, it welcomes the system of annual reviews but says that urgent action is required in Scotland and Wales to produce overdue operational plans as a basis for effective reviews. It also warns the DHSS that when the committee returns to the subject it will want evidence of practical results achieved through the annual review system in England. The Griffiths report is seen as a useful contribution to improving management in the NHS, and the parliamentary report notes that it could result in an appreciable change of emphasis in the management of the NHS. That would affect NHS manpower. But it is highly critical of the success health departments and authorities have had in bringing NHS manpower under control. Quite inadequate is the verdict. The Public Accounts Committee also concludes that it is unsatisfactory that the DHSS has failed to establish arrangements for monitoring the reduction of management staff achieved by health authorities as a result of the 1982 reorganisation, for com? parison with the estimate of 3000 to 4000 posts.