6 MAY 1972, Page 32


Even so devoted an admirer of the National Health Service as myself must shortly begin to wonder whether its problems are at all soluble, without a complete change of both principle and structure.

The very phraseology employed by Sir Keith Joseph in his recent parliamentary reply to Hugh Delargy on the subject of an inquiry into nursing standards at South Ockenden Hospital has a defeatist ring about it. On April 11 Sir Keith told Barbara Castle that the hospital management committee at Ockenden had set up an inquiry into compaints about nursing standards and that he had left it to them to decide whether a further, outside and independent, investigation would be needed. The management committee decided that is would: "They have," Sir Keith told the House in a written answer, "since asked that these complaints should be referred to an independent inquiry." Yet another scandal, in a word, is about to be dissected and revealed. Where can it all end? The issue must now be decided in Sir Keith's own mind. Does he believe that the management and administrative reforms which his consultative document on NHS reforms visualises will, in time, sort out the abuses and faults in the system, and has he the nerve to wait until the matter is decided? Or should there now be a Royal Commission on the NHS, which would thoroughly ventilate its problems? I myself believe that some such objective overview is now required.

The hospital scandals of which we have seen so much in recent years — and especially since the present government took office — are the high tragedy of the NHS situation, because they involve the lives and happiness of the sick, and those who, because of illness, are unable to look after themselves. But there is pathos too. The DHSS has just issued a circular headed, 'Good Food Guide Study on Hospital Catering: Sir Keith Joseph seeks value for money.' The circular contains summary of a study of catering standards in six NHS hospitals which shows that quality of food and expenditure on it do not always equate with one another. Sir Keith now proposes to start discussions with Regional Hospital Boards on the possibilities of getting management committees to take a special interest in hospital catering, with a view to improving both the quality of food and also the efficiency of its relationship with expenditure. Clearly the Secretary of State is in a dilemma. Properly and naturally, he wants to improve food standards. He is also torn by the fact that the efficient disposition of resources would both achieve that first end and make for a more economical use of money. The sum is not trivial: £51 million is spent each year on food in hospitals, and that is not an insignificant percentage of the whole NHS outlay. Nonetheless, it is surely more desirable to emphasise patients' needs rather than expenditure.