3 Dec 1996 : Column 777
House of Commons
Tuesday 3 December 1996
The House met at half-past Two o'clock
PRAYERS
[Madam Speaker in the Chair]
PRIVATE BUSINESS
King's College London Bill [Lords]
Motion made, and Question proposed,
That the Promoters of the King's College London Bill [Lords] may, notwithstanding anything in the Standing Orders or practice of this House, proceed with the Bill in the present Session; and the Petition for the Bill shall be deemed to have been deposited and all Standing Orders applicable thereto shall be deemed to have been complied with;
Hon. Members:
Object.
That if the Bill is brought from the Lords in the present Session, the Agents for the Bill shall deposit in the Private Bill Office a declaration signed by them stating that the Bill is the same, in every respect, as the Bill which was brought from the Lords in the last Session;
That, as soon as a certificate by one of the Clerks in the Private Bill Office, that such a declaration has been so deposited, has been laid upon the Table of the House, the Bill shall be read the first and second time (and shall be recorded in the Journal of this House as having been so read) and shall be ordered to be read the third time;
That no further Fees shall be charged in respect of any proceedings on the Bill in respect of which Fees have already been incurred during any previous Session.--[The First Deputy Chairman of Ways and Means.]
Debate to be resumed on Tuesday 10 December.
3 Dec 1996 : Column 778
Oral Answers to Questions
HEALTH
Capitation Funding
1. Mr. Whittingdale: To ask the Secretary of State for Health what progress has been made towards full capitation funding of district health authorities; and if he will make a statement. [5611]
The Parliamentary Under-Secretary of State for Health (Mr. John Horam): The health authority revenue allocations announced last Thursday show that in 1997-98, the next financial year, considerable progress will be made towards that goal.
Mr. Whittingdale: Is my hon. Friend aware that North Essex and South Essex health authorities are further away from their capitation target than any other health authority in the country? I thank him for recognising that by announcing an increase of 2.6 per cent. in real terms in this year's settlement, but is he aware that that will still leave North Essex some £14 million short of its capitation target? That is likely to cause real difficulties. Can he therefore give me an assurance that, in future years, he will concentrate on giving extra resources to authorities that remain below their capitation target?
Mr. Horam: I am sure that it is not a great comfort to my hon. Friend to know that there is another health authority worse even than North Essex in terms of its distance from the capitation target. None the less, he will be aware that, in this settlement, we have achieved another £16 million towards a total of £370 million for North Essex, which brings it to 3.77 per cent. below its capitation target. I certainly give him the assurance that we will continue to make progress in that direction. Indeed, given what the Prime Minister and my right hon. Friend the Secretary of State for Health have said about real resources over the next few years, if another Conservative Government are elected, we will certainly make progress towards that end.
Ms Coffey: If the Minister is introducing a more equitable distribution of resources to health authorities, why is he introducing a challenge fund for the care of the elderly? Is it not a fact that all that will happen is that money will go to the best bidder and not necessarily to those with the most need? Is that not just another example of the Government's lottery of care for the elderly?
Mr. Horam: I am glad to be able to tell the hon. Lady that, as a result of the fairly small changes to the capitation formula, which we will incorporate in next year's figures, no less than 86 per cent. of total capitation funding will be related to needs.
Mr. John Greenway: Does my hon. Friend agree that hospital trusts operate within a number of former health districts that still receive below the national average for health funding? In particular, and as my hon. Friend knows, Scarborough district and Scarborough and North East Yorkshire Healthcare NHS trust have a deficit. Can my hon. Friend reassure me and my many constituents,
3 Dec 1996 : Column 779
and those of my hon. Friend the Member for Scarborough (Mr. Sykes)--[Hon. Members: "Where is he?"]--that their needs will be met from the enormous increase in funding of £1.6 billion, which the Government announced last week?
Mr. Horam: Perhaps I can reassure my hon. Friends inside and outside the Chamber that, as a result of my right hon. Friend's decisions, North Yorkshire is now only 0.5 per cent. away from the target funding. I am sure that we will eliminate that shortfall in the next year of a Conservative Government.
Hospital Deficits
2. Mr. Bayley: To ask the Secretary of State for Health if he will make a statement on NHS hospital deficits last year. [5610]
The Minister for Health (Mr. Gerald Malone): Financial information for 1995-96 will be available later this month, following analysis and validation of the trust audited annual accounts by the national health service executive.
Mr. Bayley: Does the Minister recall that the most recently published NHS accounts listed 13 NHS trusts in non-technical deficit and said that the NHS executive would take action to remedy those deficits? Is he further aware that, of those 13 trusts, 11 were still in deficit the following year and that the aggregate deficit had gone up from £10 million to £20 million? Is that not an indication that the internal market is putting trusts into deficit? What action does he intend to take to stop the closure of more trusts such as the Anglia Harbours NHS trust?
Mr. Malone: I recognise from the question an article that appeared in a newspaper close to the hon. Gentleman's constituency setting out his concerns, which I do not regard as justified. His concern is that those trusts that have a deficit cannot manage their way out of it.
In 1994-95, 16 trusts recorded real retained deficits; 10 of them remained in real deficit in 1995-96 and five forecast deficits in 1996-97, so the point that the hon. Gentleman tries to make is wrong. He would do better to remember his own advice, which is that if he wants to do something about all that, he should encourage those on his Front Bench to increase spending in the health service in real terms, as the Government have done. The hon. Member for Islington, South and Finsbury (Mr. Smith) tried this morning, but palpably failed.
Mrs. Roe:
Does my hon. Friend agree that the Secretary of State's announcement of £23 billion for health authorities last year may go some way to deal with a projected deficit slightly in excess of £100 million?
Mr. Malone:
My hon. Friend is right. I repeat what my right hon. Friend the Secretary of State said when he was questioned in the health debate last week about first quarter returns for trusts: there is an estimated surplus this year of about £60 million. That proves, as my hon. Friend suggests, that this is a well-managed service with an increasing resource that has been given by the Government.
Rev. Martin Smyth:
There has always been pressure on finance in the health service. In the past, a balance was
3 Dec 1996 : Column 780
Mr. Malone:
The hon. Gentleman is right to point to the fact that, over time, trust accounts must be balanced. That is happening. Trusts are obliged to balance their accounts on a following year basis. Trusts that have difficulty have made enormous progress towards eliminating deficits over time. That is precisely what we expect health authorities, which are purchasers, and trusts, which are providers, to do--and it is made all the easier because, this year, every health authority has been given increased spending in real terms.
3. Mr. Pawsey:
To ask the Secretary of State for Health what is the current level of spending on the national health service; and what it was in (a) 1979 and (b) 1989 in real terms. [5612]
The Secretary of State for Health (Mr. Stephen Dorrell):
National health service total net expenditure in England is planned to be £34.4 billion in 1997-98. At constant prices, the equivalent expenditure in 1978-79 was £19.6 billion, and in 1988-89 was £26.5 billion.
Mr. Pawsey:
I thank my right hon. Friend for that very revealing reply, which emphasises, as nothing else would, the Government's continuing commitment to the nation's health. Does my right hon. Friend agree that the evidence for that increase in spending can be found in every trust hospital and every fundholder's surgery and is experienced by every member of the public who goes for treatment?
Mr. Dorrell:
My hon. Friend is absolutely right. Those figures represent a 30 per cent. real terms increase since 1990--an increase of three quarters since 1979. Most important for the future is the Prime Minister's commitment to year on year on year on year on year real terms increases in NHS spending. In this morning's Daily Mirror, the hon. Member for Islington, South and Finsbury (Mr. Smith) wrote an article. He said:
Mr. Simon Hughes:
I believe that everyone will welcome what is a relatively generous settlement for the coming year, which has been secured by the Secretary of State and by the Government. The Secretary of State is correct to say that, even after this morning's speech by the hon. Member for Islington, South and Finsbury (Mr. Smith), the Government's financial commitment is considerably greater than the Labour party's.
If the Government are so committed, why is there not a similar commitment for the following years, which, according to the Chancellor's announcement, do not show any continuing real growth? Is not the truth that the
3 Dec 1996 : Column 781
Mr. Dorrell:
I am grateful to the hon. Gentleman for his recognition of a "relatively generous settlement", as he called it, for next year but, with respect, he is wrong about future years. The Red Book shows a real-terms increase, to which we are pledged, for national health service expenditure in year 2 and year 3. The Labour party refuses to give such a pledge. The hon. Gentleman was too generous to the shadow health spokesman, whose pledge for next year is not to volunteer back to the Treasury health money that this Government have committed to the NHS.
Mr. Dunn:
Can my right hon. Friend confirm that the Government's commitment to the national health service allows the people of Dartford--
Mr. Jacques Arnold:
And Gravesham.
Mr. Dunn:
--to look forward to the construction of a new district general hospital early in the new year? Will he accept my thanks and pass them on to his Ministers and other colleagues who have worked so hard to bring about that result?
Mr. Dorrell:
I am grateful to my hon. Friend. I was as pleased as he was by the health authority's decision last Thursday. If and when the hospital is built, as we intend that it should be, I am sure that it will benefit the citizens of both Dartford and Gravesham. I look forward to the day.
Mr. Chris Smith:
Will the Secretary of State confirm, first, that he has cut capital spending on the health service by one third in the current year and next year and, secondly, that page 124 of the Red Book, which presents the control totals in real-terms figures, shows that, between 1998 and 1999, there is to be no real-terms increase in planned spending on the health service? Does not that show that the Chancellor has already torn up the promise given by the Prime Minister at the Tory party conference?
Mr. Dorrell:
The hon. Gentleman is wrong on both counts. The Red Book makes it clear that the cash plans for the health service in year three are increasing faster than the GDP deflator. [Hon. Members: "Real terms."] We plan for the health service in cash spending, as the hon. Member for Islington, South and Finsbury (Mr. Smith) is also committed to do. The cash spending for the health service in year three increases faster than inflation. Hon. Gentlemen might misunderstand me. Faster than inflation means real-terms growth. That is what the Government are committed to, what they have delivered for 18 years and what this Conservative Government will deliver in the next Parliament. The hon. Gentleman has only to wait and see.
Mr. Duncan Smith:
Does my right hon. Friend agree that, notwithstanding the increase in the figures, one of the key points is the way that the service is delivered? It is more efficiently delivered now, so the pounds spent are spent on more people. I am particularly concerned about fundholding practices. The Opposition's position on
3 Dec 1996 : Column 782
Mr. Dorrell:
My hon. Friend is right to say that fundholding has worked. It is the option that has been chosen by almost 60 per cent. of GPs in England--because they believe that it is in the interests of their NHS patients that they should be come fundholders. My hon. Friend was wrong about the hon. Member for Islington, South and Finsbury. The hon. Gentleman made it crystal clear this morning that he intends to abolish fundholding--[Hon. Members: "Hear, hear."] Hear, hear, Opposition Members say. If they really cared about health service patients, they would take the hon. Gentleman to one side and ask him why he intends, if he is ever given the chance, to deny to GPs working in the health service the option that they think is in the best interests of their patients. That is what the hon. Gentleman announced this morning: he does not care about NHS patients.
"Labour will match the Tories' plan for funding the NHS--we are very serious about that"--
so serious that they will match it for year one. What about year two, year three, year four and year five of the next Parliament?
| Next Section
| Index | Home Page |