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House of Commons
Tuesday 21 January 1997
The House met at half-past Two o'clock
PRAYERS
[Madam Speaker in the Chair]
PRIVATE BUSINESS
King's College London Bill [Lords]
Order for Third Reading read.
To be read the Third time on Tuesday 28 January.
HEALTH
Capitation Funding (Nottingham Health Authority)
1. Mr. Tipping: To ask the Secretary of State for Health what level of capitation funding the Nottingham health authority will receive in 1997-98. [10356]
The Parliamentary Under-Secretary of State for Health (Mr. John Horam): In 1997-98, Nottingham health authority will receive an integrated allocation of £285.6 million--a cash increase over this year of £12.1 million.
Mr. Tipping: Will the Minister confirm that, under the capitation formula, Nottingham will next year receive a growth in funding of 0.34 per cent. over this year? Given that fact, will it not take another seven years for it to reach 100 per cent. formula funding? The Queen's medical centre has not carried out non-urgent operations since November. Should not Nottingham people and Nottingham health services receive a fair share of the cake?
Mr. Horam: I hear what the hon. Gentleman says, but I note that Sir David White, the chairman of Nottingham health authority, said that Nottingham's funding in the next year is in line with that authority's proposals for development, and that
- "Due to a better than expected national settlement for the NHS and the case put forward by the authority . . . I am happy to say that the prospects for the development of our local services--and the maintenance of excellence--looks more certain for next year."
Sir Jim Lester: Does my hon. Friend understand that those of us who seek the return of a Conservative Government recognise that both parties acknowledge that
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Nottingham needs the additional money? The settlement is a step in the right direction, but it is only one step and we want considerably more money, year on year, to restore us to the correct position of parity with other similar teaching areas.
Mr. Horam: As I said in reply to the hon. Member for Sherwood (Mr. Tipping), he has got a far better deal out of this Government than he will ever get out of a Labour Government. Progress was made last year and this year, and will be made next year--if a Conservative Government are re-elected, funding for health authorities will ensure that progress is made in every year to come. I am sure that my hon. Friend looks forward to the re-election of a Conservative Government.
National Health Service Funding
2. Mr. Loyden: To ask the Secretary of State for Health what representations he has received from the Centre for Policy Studies concerning the future funding of the national health service. [10357]
The Secretary of State for Health (Mr. Stephen Dorrell): I have received no such representations.
Mr. Loyden: Will the Minister confirm that a pamphlet recently issued by the Centre for Policy Studies, the author of which was a special adviser to the former Secretary of State for Health, now the Chancellor of the Exchequer, proposed that future policy on the NHS should involve the introduction of top-up fees and vouchers? Does not that show that it is now undeniable that a Conservative Government serving their fifth term would abolish the national health service as we know it and as its founders intended it to be?
Mr. Dorrell: The hon. Gentleman asks me about the future funding of the national health service. The Government's policy on that is set out not by the director of the Centre for Policy Studies, but by the Prime Minister. He set it out clearly at the Conservative party conference, when he laid down a challenge, which the Labour Front Bench has so far refused to take up. A re-elected Conservative Government will increase real-terms funding for the health service through the life of the next Parliament, year by year by year by year by year. When will we hear from Labour Front Benchers how they will match that pledge?
Mrs. Roe: Is my right hon. Friend aware that the Centre for Policy Studies document "A Conservative Agenda" congratulated the Government on their record of increasing NHS funding since 1979? Does he agree that it is only against a background of guaranteed financial growth throughout the next Parliament that the NHS can continue to thrive?
Mr. Dorrell: My hon. Friend is precisely right. The CPS made another suggestion--that we should abolish the regional health authorities. The Government have already done so and delivered as a result £100 million of administrative savings. That was done over the opposition of Labour's Front Benchers, who would be taken a great
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deal more seriously on the question of administrative savings if they ever voted for one, instead of voting against them.
Mr. Simon Hughes: The Secretary of State and I probably agree that the health service needs more money, although we would disagree about how much. I would argue for more than he would and both he and I would argue for more than the Labour party would.
Mr. Campbell-Savours: Where did the hon. Gentleman get that line from?
Mr. Hughes: From Labour's figures.
Laying that argument to one side for the moment, will the Secretary of State accept that there is one area on which we can agree immediately--that, for one year, we could halt all closures while an independent body such as the King's Fund assessed demand and supply in the health service, so that we could at least agree on the facts before returning to the debate about money?
Mr. Dorrell:
With great respect to the hon. Gentleman, I do not believe that it is in the interests of the health service or, most important, its patients to freeze the development of the health service. We need to have a service that uses a growing budget, year by year, to deliver improving service to patients. That is the commitment that the present Government give. The commitment given by the Opposition is that they invite patients and the health service to rely on the hon. Member for Islington, South and Finsbury (Mr. Smith), who told Pulse,
Mr. Congdon:
Does my right hon. Friend agree that the increase in real-terms funding for the NHS--of more than 70 per cent. since 1979--demonstrates the Government's continuing commitment to the NHS? Does he also agree that the record number of patients being treated, including the increase in the number of people having hip replacements and heart bypasses, also demonstrates that firm commitment to the NHS?
Mr. Dorrell:
My hon. Friend is exactly right. The figures for the past seven years are: an increase of a quarter in the real funding for the NHS and an increase of a third in the number of patients treated. That is the Government's record--extra funding, used efficiently to treat patients. It is a record that the Labour party cannot match in office and would not and cannot match now, ahead of a general election.
Mr. Chris Smith:
Is it not the case that the so-called promise made by the Prime Minister about year-on-year increases in real-terms funding for the health service was disavowed two months later by the Chancellor of the Exchequer, when he published the figures in the Red Book? Will the Secretary of State admit that page 142 of the Red Book shows clearly that, in the second year, the Government expect a fall in real-terms expenditure in the Department of Health and that, in year three, they expect
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Mr. Dorrell:
Page 142 of the Red Book deals with excise duties, tobacco, fuel, air quality package, and alcohol. The hon. Gentleman cannot even get his page references right. He is probably referring to table 5A.1--
Mr. Dorrell:
I am looking at the 1997-98 Red Book, published in November 1996. The hon. Gentleman has the wrong reference.
The substance of the hon. Gentleman's point, as he knows very well--we dealt with it repeatedly around Budget time--concerns the commitment set out in the Red Book to real-terms increases in NHS funding, provided at 3 per cent. growth in current funding for year one, and provided at more modest levels in years two and three. That still represents real growth, which the right hon. Member for Dunfermline, East will not allow the hon. Gentleman to match.
Mr. John Marshall:
Can my right hon. Friend confirm that the right hon. Member for Dunfermline, East (Mr. Brown) will not increase health service spending but will burden the health service with the costs of a national minimum wage, which will mean extra pay for manual workers in the health service and less money for patient care?
Mr. Dorrell:
My hon. Friend is exactly right. The right hon. Member for Dunfermline, East is so unconfident of his ability to deliver a growing economy that he knows he cannot match our commitment to the national health service. What is more, even the paltry budget that the slow-growing British economy under Labour would allow the hon. Member for Islington, South and Finsbury includes a prior commitment to abolishing compulsory competitive tendering. That will cost him £90 million. There is also a prior commitment to introducing a national minimum wage, which the right hon. Member for Livingston (Mr. Cook) was the last Labour spokesman to cost--at £500 million. That makes £590 million that will come out of patient care before the hon. Member for Islington, South and Finsbury can even begin to think about a growing health service.
"I'll fight my corner for NHS funding."
We know what that means--he will lose his corner, as the right hon. Member for Dunfermline, East (Mr. Brown) made clear yesterday.
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