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NHS Trusts (Debt)
6. Mr. Skinner: To ask the Secretary of State for Health how many hospital trusts have notified his Department that they will be in debt in the current year; and if he will make a statement. [3471]
Mr. Dobson: I am sure that my hon. Friend will be interested to know that, as part of the unfortunate legacy that we inherited from the outgoing Tory Government, 128 NHS trusts out of a total of 429 entered the current financial year in deficit, as did 59 of the 100 health authorities. I have asked the trusts to submit to me by July their revised financial plans for the current year; then I shall be able to find out what debt they expect to be in at the end of the year.
Mr. Skinner: Does my right hon. Friend, like the rest of us on the Government side of the House, acknowledge that those figures are appalling, as is the fact that when Labour assumed office there were 1,164,000 people on the waiting list? The Tory Government's grand Frankenstein experiment of meddling with the national health service, and trying to privatise it without telling the British people what they were doing, has resulted in misery for millions of people.
I wish my right hon. Friend well in his shuffling of the pack at the national health service, moving money from one area to another, but does he agree--I shall help him here, so I hope that he does--that next Wednesday, when the Budget is announced, it will be essential for his Department to receive more money? Does he agree that we need to raise additional revenue, so that after five years the national health service will be in as grand a condition as it was when we kicked it off in 1945?
Mr. Dobson:
I should explain to my hon. Friend that even the figures that I announced in my main answer were
For the time being, all I can say about the funding of the health service is that far too much money is going into the bureaucracy, and that we have arranged for £100 million of that to be transferred to patient care this year. We also revealed, in the recent report, that between £80 million and £100 million has been wasted by prescription fraud, about which the previous Government did nothing.
We must ensure that every penny available to the national health service is spent as it ought to be, not lost through fraud or the bureaucratic nonsense of the internal market that the previous Government introduced--
Mr. Dobson:
There certainly is a vast amount of waffle in the national health service at the moment, and it is there because of the internal market, which is draining funds out of patient care.
Mr. Simon Hughes:
Although I accept that the Secretary of State is trying to find relatively small beer in the NHS Budget, may I take him back to the central question, which not only the hon. Member for Bolsover (Mr. Skinner) but pretty much everyone in the country is asking? Given that Labour Ministers clearly knew the score before the election as to how much the NHS was in debt, and given that all the advice he receives is that the NHS needs more money, does the Secretary of State sign up to the Cabinet policy that there will be no additional money for the NHS this year and next? Will the Budget remain for two years at the limit inherited from the Tories, or is he arguing around the Cabinet table for something different?
Mr. Dobson:
For a start, it is worth reminding everybody that the NHS spends £36 billion a year--a lot of money--and some of that money could be better deployed in improving services. We are setting about that, and we are keeping all our election promises. We promised that we would have a comprehensive spending review, that we would shift funds from bureaucracy into patient care and that we would target that money initially on breast cancer treatment. We are carrying out those promises, and we will continue to meet our obligations and keep all the promises that we made.
Mrs. Brinton:
Is my right hon. Friend aware that today the Peterborough Hospitals NHS trust has announced that, by March 1998, it will face a £2 million overspend and that, to avert that overspend, it will have to close a theatre and drastically reduce beds? In view of that, will he assure me that, when considering hospitals for flagshipping for the private finance initiative, Peterborough will have top priority?
Mr. Dobson:
My hon. Friend draws attention to yet another Tory failure. The Tories talked and talked about getting private finance for the building of hospitals, and spent £30 million on consultants' fees, but they never got a single brick laid in any hospital. The Minister of State,
Mr. Jack:
So far, all we have heard from the Secretary of State is waffle; we have had no straight answer to questions on the resourcing of the health service. His "savings" amount to the equivalent of one additional day's resources. On my first appearance at the Dispatch Box for Health questions, may I try to be helpful to the Secretary of State by offering him an opportunity to save some £740 million? He may be aware of the excellent work done at the Devonshire Road hospital in Blackpool on the treatment of osteoporosis. If that work were done widely in the NHS, some £740 million could be saved and 40 premature deaths a day could be prevented. On World Osteoporosis Day, may I ask him to include in his fundamental review of the health service a thorough re-examination of the way in which osteoporosis is treated in the NHS?
Mr. Dobson:
It beggars belief that a former Treasury Minister can get up and belabour us for inefficiency, as he sees it, in the NHS for which we have been responsible for eight weeks after 18 years of Tory responsibility.
Mr. Jack:
What about osteoporosis?
Mr. Dobson:
The right hon. Gentleman has mastered the word "osteoporosis" and we all admire his efforts.
There are many areas within the NHS where we can improve the way in which money is spent, and that is one reason why we are having a fundamental comprehensive review. We will include that in the review. But I must ask the right hon. Gentleman--why did his lot not review that years ago?
7. Dr. Godman:
To ask the Secretary of State for Health if he will make a statement about the outcome of the recent meeting of the European Union Health Council in respect of matters relating to mental health. [3472]
Mr. Boateng:
Mental health was not discussed at the European Union Health Council. Of course, the issue is a concern to member states and to this Government. We want to ensure that mental health problems are addressed through good-quality, effective services, which are sensitive to individual service users' needs, allowing them to achieve their full potential.
Dr. Godman:
Is any attempt being made by the Council of Ministers to establish good standards of practice in the treatment of those individuals with psychiatric illnesses? In particular, are the guidelines published by the Royal College of Psychiatrists for the use of electro-convulsive therapy for certain psychiatric illnesses followed by other medical authorities elsewhere in the European Union?
Mr. Boateng:
We will certainly commend the guidelines produced by the royal college to the European Union Health Council. They are very helpful. When
8. Mr. Whittingdale:
To ask the Secretary of State for Health what assessment has been made of the likely savings to be made for patient care as a result of the Health Authorities Act 1995. [3473]
20. Mr. Forth:
To ask the Secretary of State for Health what estimate he has made of the projected savings to the national health service from the implementation of the Health Authorities Act 1995. [3486]
Mr. Milburn:
It is estimated that annual savings of around £150 million were made as a result of the 1995 Act, but it took three years to get there. We have already announced a £100 million reduction in management costs to be achieved in the current year alone and we are looking carefully at the scope for further savings in 1998-99 and beyond.
Mr. Whittingdale:
Given that answer, can the hon. Gentleman say whether he still supports the establishment of a regional tier of administration for the national health service, as was called for in his party's policy document "Renewing the NHS"?
Mr. Milburn:
We have no plans to reinstate regional health authorities.
Mr. Forth:
That sounds a bit bizarre to me. Was the Minister's party not the party which opposed the 1995 Act and all the savings that he has just told the House flowed from it? Has he not now admitted that he has done a U-turn on one of the undertakings in his party's policy document? How can we place any credibility on the Government's undertakings about savings in the NHS if, on the one hand, they opposed the measures that gave real savings--our measures--and, on the other, the hon. Gentleman is going back on his policy?
Mr. Milburn:
I know that the right hon. Gentleman wants to dwell on the past. That is because he and the Conservative party represent the past--they are living in the past. As he well knows, the Conservative party is not the enemy but the friend of red tape. It increased bureaucracy in the NHS and gave us more invoices, more paper, more red tape, more managers, more administrators and more accountants--but it gave us fewer nurses.
Mr. Rhodri Morgan:
As well as the savings from cutting red tape, which can be diverted into patient care, does my hon. Friend agree that another potentially fruitful source of resources could be made available to the health service by removing the problem of bed blocking, whereby patients cannot be moved from health authority hospitals, where they cost more than £1,000 a week, to old people's homes or nursing homes, where they would
Mr. Milburn:
My hon. Friend raises an important issue. As he will be aware, the interface between personal social services and the health service is crucial in ensuring that very vulnerable people in the community are cared for--particularly the elderly, but also people with disabilities and mental health problems. Sometimes, the gaps in provision mean that such people are not looked after in the most appropriate way.
My hon. Friend should consider two points: first, in planning for this winter, we will expect health authorities and local authorities to work closely together, precisely to achieve the co-operation that he advocates. Secondly, in the longer term, we will consider how best to pool resources to ensure that the gaps between social care and health care are closed.
Mr. Hogg:
Does the Minister accept that any savings that he might make through the Health Authorities Act 1995 would be dwarfed by the additional costs attributable to the minimum wage and to any restrictions that might be placed on competitive tendering?
Mr. Milburn:
The right hon. and learned Gentleman is the master of the red herring--although, in view of his former responsibilities, I apologise for the unintended pun. The Government are committed to ensuring that, in the future, health service resources go where they are most needed: not into back-line bureaucracy but into front-line patient services, where they should have gone in the first place.
Mr. Campbell-Savours:
On the question of savings, my hon. Friend the Minister will have heard my right hon. Friend the Secretary of State say that he expected to receive financial plans from health authorities, and trusts in particular, by a date in July. May we therefore assume that the documents submitted by trusts will include their proposals for reducing deficits by 1 April 1998?
Mr. Milburn:
It is important that all trusts and health authorities should set out clearly how they intend to cope with the financial deficits that many of them have, often through no fault of their own. We will scrutinise extremely carefully the plans from both health authorities and trusts, to ensure that they maximise value for money, and also lead to improvements in patient care.
Dr. Harris:
Given the Minister's surprising answer to the original question on health authorities, how will the Government bring back the necessary strategic planning, democratic accountability and openness in local services without a regional tier of health authorities?
Mr. Milburn:
As the hon. Gentleman knows fine well from his experience in the national health service, there is a regional tier. We intend to work through the regional offices to ensure, for example, that capital developments
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