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25 Feb 2005 : Column 619
Manchester Health Finance (Census Data)
Motion made, and Question proposed, That this House do now adjourn.—[Paul Clark.]
2.29 pm
Mr. Graham Stringer (Manchester, Blackley) (Lab): It is now established without a shadow of a doubt that the 2001 census was a total shambles. The Public Accounts Committee, the Treasury Committee, the Office of the Deputy Prime Minister Committee and a large number of academic studies have shown that the 2001 census was not carried out accurately. After receiving a number of reports, the Office for National Statistics had to adjust the figures upwards by almost a million people—a million men who, it had claimed, had gone to the Balearic islands at the time of the count. That was one of the ONS's ludicrous suggestions.
The million people who had been missed as a result of the census being maladministered were not evenly distributed around the country. It is worth noting that the enumerators were not paid, helplines were not set up accurately and there was evidence that some enumerators had dumped the follow-up forms in waste paper bins, where they were found afterwards. The whole process was chaotic. The areas where people were missed were, by and large, poorer areas, inner-city areas and areas that had high numbers of students or ethnic minorities.
When we in Manchester looked at the list, we realised almost immediately that the census was inaccurate because there were more people paying council tax in the city than Mr. Cook from the Office for National Statistics, who ran the census, believed lived in Manchester. That would lead one to the ludicrous proposition that people were volunteering to pay council tax even though they did not live in Manchester. It was an absurd situation. When we checked accurate lists for the number of children of school age in Manchester, the lists accounted for many more children than were counted in the census, and likewise when GP lists were checked. It was obvious that there were fundamental flaws.
After much argument with Mr. Cook of the ONS, it was agreed that there would be a property matching exercise. That exercise showed that at least 26,200 people had been missed. One can only establish a minimum. My personal belief is that the figure should have been even higher, but the figure of 26,200 was agreed by the Office for National Statistics and Manchester city council.
I understand that Mr. Len Cook has now left his job and is going back to New Zealand, presumably to practise counting the numerous sheep there. It was not a happy time for Mr. Cook at the ONS. He had sectors of the economy shrinking when, in fact, they were growing. He made fundamental errors in the calculation of pension funds and carried out the most inaccurate census in 200 years, so I am very pleased that he is on his way out of the public sector payroll. There are lessons for Ministers, particularly Treasury Ministers, about how, when something goes wrong, they deal with an obviously incompetent official.
Once the figures had been established, it was clear that there were two areas of direct impact where Government funding streams are directly related to
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population. One is local government, administered by the Office of the Deputy Prime Minister, and the other is health. After some discussion with the Minister of State at the Office of the Deputy Prime Minister, it was agreed that there would be an adjustment to the revenue support grant settlement. It was agreed that the money that would have been paid relating to those 26,000 or so people in Manchester would be paid. I think that 16 or 17 other councils, including Westminster, most prominently, as well as Derby, Plymouth and others, were similarly affected.
I thoroughly expected similar treatment from the Department of Health, because the funding of the health service is also simply and directly related to population. Before I deal with that point, however—I have had a number of discussions with Health Ministers about the issue, for which I thank them—I want to mention another issue that I do not think has been thoroughly understood in respect of the census and health funding. I refer to the part of the census form that asked about self-diagnosed disability. People could say on the form that they were suffering from allergies or that their children suffered learning disabilities or behavioural problems, and some of the health funding follows that self-diagnosed illness.
Where people were missed by the census, there could be no self-diagnosis, so the funding will never come to them, even if they had allergies or their children had other problems. There is also some evidence that those in more affluent areas and better-educated people filled in the forms in more detail. When we look now at the funding flows in respect of allergies and similar self-diagnosed conditions, we find that areas such as Surrey and Barking are getting more money than poorer areas such as inner-city Leeds or inner-city Manchester. I do not think that that issue has been thoroughly discussed, but it is important and it arises directly from the way in which the census was handled.
As I said, I expected the Department of Health to say, "Yes, you can have the money", which amounts over the funding period 2003 to 2006 to about £21 million for the three primary care trusts in Manchester. In my meetings and correspondence with Health Ministers, they have said no. I think that they have done so for two reasons, which I can summarise from that very long correspondence. The first reason, which is undoubtedly true, is that the Department had used the best known figures in coming to the settlement. I cannot dispute that, but I do not think that it is a reason for not making changes when the figures are known to be in error. Secondly, it was pointed out that there had been large increases in funding over the period and that, since that time, there has been an even larger increase in funding, while the proportion involved is relatively small. That is true, but I do not think that it is an answer to the basic point about equity: why that £21 million should not come to Manchester and other primary care trusts that have been similarly affected.
Virtually all the affected primary care trusts are in the poorest parts of the country. Just after his appointment in February 2004, the Secretary of State for Health said:
"One of the facts I heard when I became Secretary of State has truly shocked me. The fact that a boy born in Manchester lives eight and a half years less than a boy born in East Dorset is a staggering failure and a disgrace and is palpably unequal."
I can only wholeheartedly agree. In Manchester, the areas that have lost the £21 million—I am not proud of this, but it is a fact—are top of the list in terms of cancer, heart disease and heart attacks, and their mortality and morbidity rates are among the worst in the country. Similarly, the other primary care trusts affected tend to come from the poorest areas.
It would be fair for the Department of Health to pay that money, because those people exist and have not received funding through the system and because the areas affected are poor. It is strange that one major Department replaces lost funding while another does not. Replacing the lost funding would also help achieve the Government's targets on health inequalities, to which the Secretary of State is completely committed.
It is true that the Secretary of State's settlement to primary care trusts on 9 February was generous. It brought every PCT in the country to within 3.5 per cent. of target, and I have no doubt that it was the best settlement in the history of the NHS. In his statement, the Secretary of State said:
"A key factor in distributing funding fairly is the count of the number of people served by each primary care trust."—[Official Report, 9 February 2005; Vol. 430, c. 1503.]
Who could disagree with that? If it is true from 2006, however, it is absolutely true from 2003 to 2006.
I will finish with two points. First, It could be argued that, because every PCT has been taken to within 3.5 per cent. of target from 2006, the money from the census is there. In many cases, however, PCTs are in deficit because of underfunding, so some of the money from that generous settlement in 2006 will not go directly to the care of patients and into the health service, but be used to pay for a deficit caused by underfunding, because the Office for National Statistics did not do its job as accurately as it might have done.
Secondly, I and the Health Ministers to whom I have spoken do not disagree about the facts of the case. What is the intellectual or political justification for continuing to withhold £21 million from the health care budgets of those three PCTs in Manchester when it has been established that, had the ONS done its job properly, the money would have followed?
I can think of no precedent for one Department saying that it will adjust figures because it got the facts wrong and another Department saying that it will not. That is not fair. It is not good administration but arbitrary administration. The Secretary of State said that the settlement is generous, and I agree with him, but this money is not allocated personally like an elderly aunt giving her own money. The money is public money that people in Manchester are entitled to see in their services, but they have not received it. If the ODPM has recognised the situation, it must be an arbitrary and unfair judgment not to replace the money. Not only will the impact be felt over the three years but, because the extra money will pay for deficits, it will be felt for five or six years. I therefore appeal to my hon. Friend the Minister to be as positive as possible in responding to the debate. Although £21 million is not a huge percentage of the primary care trust budget, it represents a significant amount of health care anywhere in the country.
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2.45 pm
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