Table 7.2
HEALTH CAPITAL INVESTMENT
£million
| 1998-99 | 1999-00
| 2000-01 | 2001-02
|
| Net Public capital1 | 1,195
| 1,3902
| 1,710
| 1,948 |
| Net receipts from Trust and Retained Estate sales (estimated)
| 349 | 272 | 272
| 272 |
| PFI investment (estimated) | 310
| 610 | 740 | 690
|
| Total | 1,854 | 2,272
| 2,722 | 2,910 |
| 1 | This excludes asset sales. It includes IT resources, which will in practice be a mixture of current and capital expenditure—pending further information we have allocated all IT investment to capital expenditure.
|
| 2 | Includes Departmental Administration capital of £10 million, £9 million of which is provision for set-up costs of the Food Standards Agency.
|
7.4 In addition to this direct investment, there will
be more funding within the settlement to help develop the quality
of primary care infrastructure.
Investing in reform to rebuild the NHS
7.5 The CSR provides the stable funding base needed to
deliver the Government's commitment to rebuild the National Health
Service. But, in return, the NHS will reform aspects of the way
it works, so as to make the best possible use of the funds available,
to maximise the improvement in services for patients.
7.6 To ensure that the Government's modernisation programme
is taken forward effectively, there will be a NHS Modernisation
Fund of £5 billion or more over three years to fund new developments,
which will take place over the Parliament:
— cutting waiting lists. New investment, coupled
with reform in working practices, will help deliver the Government's
commitment to reduce waiting lists to 100,000 below the level
for March 1997;
— modernising hospitals and systems. By making a
reality of the Private Finance Initiative, the Government has
embarked upon the largest hospital building programme in the history
of the Service. The new plans provide a 50 per cent boost for
publicly funded capital investment to help modernise hospitals,
cutting the number of mixed sex wards and buying new equipment;
— investing in NHS staff. The plans allow for more
education and training and continuing professional development
to enable staff to make full use of the opportunities in new technology
and new treatment patterns;
— ensuring safe and effective mental health care.
New funding, linked to a new performance management system will
reverse long years of under-investment in mental health services,
including setting up more specialist teams based in the community;
— providing better primary care. Investment in primary
care will be concentrated in deprived areas to increase the number
of staff, develop training, and improve premises. There will be
more investment in information technology, so that all GPs and
hospitals can be linked up by 2002; and
— improving health promotion. There will be more
resources for health promotion, including more community nurses.
7.7 The Government is also determined to improve performance
by:
— improving quality and effectiveness. The Government
is determined to raise the standards of treatment throughout the
NHS. The new quality agenda set out in the consultation paper
A First Class Service will be delivered through national
service frameworks, the new National Institute for Clinical Excellence,
and the Commission for Health Improvement;
— improving efficiency. To improve value for money,
and reduce the variations in efficiency across the NHS, the Government
is setting a target for value-for-money improvements of some 3
per cent a year. This will generate about an extra £1 billion
a year for patient care. There will be further measures to improve
the value delivered from spending on medicines. The NHS is setting
new targets for asset sales, to help fund future investment. The
campaign against fraud will be intensified.
— Pay. Pay settlements will be funded from within
the three year spending plans. The additional funds made available
are for improving health services. Responsibility in pay will
continue to be necessary. Chapter 4 sets out new arrangements
for Departmental Ministers to respond to pay review body reports
in the context of their service targets.
A new approach to Social Services spending
7.8 The key principles behind the Government's new approach
to social services are to increase independence and dignity for
adults who need long-term social services support, including helping
people to work where appropriate, and to give children looked
after by local authorities the best possible start in life. Social
Services have a big part to play in tackling social exclusion,
and in following up the conclusions of the Young Children's review
(chapter 21). The Government's new approach to social services
will be set out shortly in a White Paper.
7.9 The Government is increasing resources by over 3
per cent a year in real terms, on average, (after taking account
of the transfer of responsibility for grants for asylum seekers
to the Home Office). But in return for the investment, the Government
is looking for reforms in a number of areas:
— setting clear objectives for the outcomes and
standards it expects social services to achieve;
— expecting social services authorities to make
a step improvement in the use they make of those resources: a
new set of performance measures, consistent with the Best Value
initiative, will enable local managers and elected members to
monitor performance and benchmark their services against those
of similar authorities, and will enable central government to
assess performance against the overall outcomes and standards
set; and
— taking steps to make it easier for the NHS and
social services to improve the way they work together, to deliver
seamless care for the public.
7.10 As well as enabling social services to raise standards
generally, the new plans provide funds to address the recommendations
of the independent Utting report on improving services for children
looked after by local authorities and care leaver.
16 July 1998
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