Select Committee on Health Memoranda


MEMORANDUM

Memorandum by the Department of Health

Table 2.1.1

TRENDS IN ACTUAL AND PLANNED EXPENDITURE ON THE HEALTH AND PERSONAL SOCIAL SERVICES 1994-95 TO 2001-02 BY AREA OF EXPENDITURE (1) (2) (3)

£ million

1994-95 1995-961996-971997-98 1998-991999-20002000-01 2001-02
forecast
outturn outturnoutturn outturnoutturn planplan plan

Central Government
Expenditure

National Health Service Hospitals, community health, family health (discretionary) and related services (4)
Current (5)
A.Net spending21,326 22,44823,38124,872 26,81628,28829,879 31,571
B.Charges and receipts (6) (7) 1,2971,3561,502 1,7801,8681,939 1,9391,939
C.Total spending22,624 23,80424,88226,651 28,68530,22731,818 33,510
     
D. Change over previous year in cash (per cent) 5.15.2 4.57.17.6 5.45.3 5.3
E. Change over previous year in input unit costs (per cent) 2.64.0 2.81.7
F. D adjusted for E (per cent) 2.51.2 1.75.3
G. Change over previous years in terms (per cent) (gross) 3.72.2 1.44.55.0 2.82.7 2.7
H. Change over previous years in realterms (per cent) (net) 3.32.31.1 3.85.22.9 3.03.1
      
Capital (8)
A.Net spending1,840 1,7141,3181,068 8881,3991,714 2,004
B.Charges and receipts (6) 208282393 471561337 363351
C.Total spending2,049 1,9961,7111,539 1,4491,7362,077 2,355
     
D. Change over previous year in cash (per cent) 14.9-2.5 -14.3-10.0-5.9 19.819.7 13.4
E. Change over previous year in input unit costs (per cent) 4.94.5 3.24.2
F. D adjusted for E (per cent) 9.5-6.8 -17.0-13.6
G. Change over previous years in real terms (per cent) 13.3-5.3 -16.9-12.2-8.2 16.916.8 10.6

National Health Service family health services
(non-discretionary) (9)
Current
A.Net spending6,632 7,0037,4747,930 8,4109,0419,880 10,561
B.Charges and receipts 696694717 734763809 726726
C.Total spending7,327 7,6988,1908,664 9,1739,85010,606 11,287
     
D. Change over previous year in cash (per cent) 6.05.1 6.45.85.9 7.47.7 6.4
E. Change over previous year in input unit costs (per cent) 2.32.6 3.22.8
F. D adjusted for E (per cent) 3.62.4 3.12.9
G. Change over previous years in real terms (per cent) 4.52.1 3.23.23.3 4.85.1 3.8

Departmental administration
Current
A.Net spending316 311284268 253272272 274
B.Charges and receipts 20202227 331919 19
C.Total spending336 332306295 286291291 293
     
D. Change over previous year in cash (per cent) 4.3-1.3 -7.7-3.5-3.1 1.60.0 0.7
E. Change over previous years in real terms (per cent) 2.8-4.1 -10.4-5.8-5.5 -0.9-2.4 -1.8
     
F. Cost of Collecting NHS element of NI contributions (10) 383824 27101010 10

MCA Trading Fund (11)
Current0 000 0000
Capital0 000 8111
Total0 0007 111

Central health and
miscellaneous services
Current
A.Net spending452 487517505 471577600 644
B.Charges and receipts 789299114 154114114 114
C.Total spending530 579616619 624691714 758
     
D. Change over previous year in cash (per cent) 4.09.2 6.40.60.8 10.73.3 6.2
E. Change over previous years in real terms (per cent) 2.56.2 3.2-1.9-1.7 8.00.8 3.6

Other NHS Capital
A.Net spending25 222321 23271616
B.Charges and receipts 0000 000 0
C.Total spending25 222321 23271616
     
D. Change over previous year in cash (per cent) 3.7-12.1 5.0-7.510.0 15.9-40.0 0.0
E. Change over previous years in real terms (per cent) 2.2-14.6 1.8-9.77.3 13.0-41.5 -2.4
     
Departmental Unallocated
Provision
100200 300

NHS Total
A.Net spending30,590 31,98632,99734,664 36,86039,70342,561 45,370
B.Charges and receipts (6) (7) 2,3002,4442,731 3,1273,3873,219 3,1613,149
C.Total spending32,890 34,43035,72837,791 40,24042,92145,722 48,519
     
D. Change over previous year in cash (per cent) 5.94.7 3.85.86.5 6.76.5 6.1
E. Change over previous year in input unit costs (per cent) 2.63.7 2.92.1
F. D adjusted for E (per cent) 3.21.0 0.83.6
G. Change over previous years in real terms (per cent) (gross) 4.41.7 0.73.23.9 4.13.9 3.5
H. Change over previous years in real terms (per cent) (net) 4.21.6 0.12.53.7 5.14.6 4.0

Central Government Personal
Social Services (12)
A.Net spending32 303032 32343434
B.Charges1 211 1111
C.Total spending32 323134 33353535
     
D. Change over previous year in cash (per cent) -5.9-0.7 -4.18.3-1.7 6.30.1 0.1
E. Change over previous year in real terms (per cent) -7.3-3.5 -6.95.6-4.1 3.8-2.4 -2.3

Central Government (specific and special) grants to local authorities
A.Net spending831 772638532 696553620 712
B.Charges0 000 0000
C.Total spending831 772638532 696553620 712
     
D. Change over previous year in cash (per cent) 27.1-7.1 -17.4-16.630.8 -20.612.1 14.8
E. Change over previous year in real terms (per cent) 25.3-9.7 -19.9-18.627.8 -22.59.4 12.0

Credit Approvals (LA capital)
A.Net spending140 14510569 545656 56
B.Charges0 000 0000
C.Total spending140 14510569 545656 56
     
D. Change over previous year in cash (per cent) 6.13.6 -28.0-34.4-20.8 2.60.0 0.0
E. Change over previous year in real terms (per cent) 4.60.7 -30.1-36.0-22.7 0.1-2.4 -2.4

Health and Personal Social Services Total
A.Net spending31,593 32,93333,76935,297 37,64340,34543,271 46,172
B.Charges and receipts (6) (7) 2,3002,4472,733 3,1283,3883,220 3,1633,151
C.Total spending33,894 35,38036,50238,425 41,02343,56546,433 49,322
     
D. Change over previous year in cash (per cent) 6.34.4 3.25.36.8 6.26.6 6.2
E. Change over previous year in input costs (per cent)
F. D adjusted for E (per cent) 6.34.4 3.25.36.8 6.26.6 6.2
G. Change over previous years in real terms (per cent) (gross) 4.81.4 0.12.74.2 3.64.0 3.6
H. Change over previous years in real terms (per cent) (net) 4.71.3 -0.52.04.0 4.64.6 4.1

Local Authority Personal Social Services current (13)
A.Net spending6,617 7,3147,9438,454 8,911
B.Charges and receipts 8861,0791,320 1,5301,717
C.Total spending7,503 8,3939,2639,984 10,629
     
D. Change over previous year in cash (per cent) 19.511.9 10.47.86.5
     
G. Change over previous years in realterms (per cent) 17.88.7 7.15.23.9

Port Health
A.Net spending4 444 4
B.Charges and receipts 2222 2
C.Total spending6 666 6

Local Authority Personal
Social Services capital
(14)
A.Net spending156 160137120 132
B.Charges and receipts 45405741 42
C.Total spending201 200194161 174
     
D. Change over previous year in cash (per cent) 8.6-0.5 -3.0-17.08.1
E. Change over previous years in real terms (per cent) 7.1-3.3 -5.9-19.05.4

Local Authority Personal Social Services total
A.Net spending6,778 7,4788,0848,578 9,047
B.Charges and receipts 9321,1211,365 1,5731,762
C.Total spending7,710 8,5999,46210,152 10,809
     
D. Change over previous year in cash (per cent) 19.211.5 10.07.36.5
G. Change over previous years in real terms (per cent) 17.58.4 6.84.73.9

Local Authority, Health and Personal Social Services Total (15)
A.Net spending37,400 39,49441,11043,274 45,939
B.Charges and receipts (6)(7) 3,2333,5684,098 4,7015,150
C.Total spending40,632 43,06145,22147,976 51,082
     
D. Change over previous year in cash (per cent) 8.16.0 5.06.16.5
G. Change over previous years in real terms (per cent) 6.63.0 1.93.53.9

Change in GDP deflator (%) 1.432.913.07 2.472.502.50 2.502.50
(22 March 1999 assumption)


Footnotes:

1 Cash figures have been rounded to the nearest £ million and therefore totals may not sum.

2 Percentages are rounded to one decimal place.

3 Real terms growth figures differ from those given last year because of subsequent changes in GDP deflators. Where not otherwise specified, percentage change figures are calculated on gross expenditure figures and therefore differ from the Departmental Report, where increases are calculated on net expenditure.

4 HCHS figures differ from those used for allocations to health authorities, which include monies for minor capital items between £1,000 and £5,000 within HCHS current for accounting purposes.

5 HCHS currently exclude funding for that element of trusts' capital which they fund from charges to healthcare providers (£975 million in 1994-95, £1,053 million in 1995-96, £1,106 million in 1996-97, £943 million in 1997-98, £966 million in 1998-99 and £1,020 million for 1999-2000 and provisional figures of £1,267 million for 2000-01 and £1,458 million for 2001-02).

6 Includes trust charges and receipts (for current, £300 million in 1994-95, £331 million in 1995-96, £388 million in 1996-97 and £459 million 1997-98 to 2001-02; for capital, £50 million in 1994-95, £72 million in 1995-96, £116 million in 1996-97, £231 million in 1997-98, £135 million in 1998-99, £123 million 1999-2000, £213 million in 2000-01 and £226 million 2001-02.

7 Includes the receipts of interest on Interest Bearing Debt and dividends on Public Dividend Capital (PDC) paid by NHS trusts

8 HCHS capital includes NHS trust capital expenditure, ie that funded from charges to health care purchasers (see footnote 5) and that financed from their EFLs (£590 million in 1994-95, £400 million in 1995-96, £82 million in 1996-97, £85 million in 1997-98, £59 million in 1998-99, £167 million in 1999-2000, £220 million in 2000-01 and £264 million in 2001-02.

9 FHS non discretionary expenditure includes expenditure, met from discretionary funds, on drugs prescribed by GP fundholders of £1,009 for 1994-95, £1,296 in 1995-96, £1,794 million in 1996-97, £2,171 million in 1997-98, £2,593 million in 1998-99 and £2,895 million in 1999-2000 to 2001-02.

10 The cost of collecting the NHS element of NI contributions is shown as non-voted expenditure in Annex B of the Departmental Report (Cm 4203)

11 The MCA became a trading fund on 1st April 1993. It previously operated under net Running Costs control. Prior to 1993-94 MCA figures were included in DH admin. The MCA is funded from fees from the pharmaceutical industry.

12 The growth in PSS expenditure over this time period reflects the additional responsibilities taken on by local authorities as a result of the 1993 community care reforms.

13 There are no centrally generated "plan" figures for local authority expenditure, including personal social services. However, for 1999-2000, the Government has announced the amount of local authority revenue spending to which it is prepared to contribute grant support (including specific and special grants). Within this amount, the allowance for revenue spending on social services is £8811.8 million. For capital spending, the following provision has been made:

£ million
Annual capital guidelines 43.0
Supplementary credit approvals18.7
Direct capital grants6.2

Local authorities may additionally finance capital from receipts and transfers from revenue.

14 Included within the LA PSS Capital expenditure figures is the capital value of leased assets of £15 million for 1994-95, £16 million for 1995-96, £15 million for 1996-97, £13 million for 1997-98 (provisional) and £14 million for 1998-99 (provisional).

15 Local Authority, Health and Personal Social Services total excludes Central Government (Specific and Special) grants to Local Authorities and Credit Approvals (LA Capital) to avoid double counting. The total does still include an element of double counting (unquantifiable) with regard to joint working between hospitals and local authorities.






 
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Prepared 18 October 1999