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The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson): I congratulate my hon. Friend the Member for Manchester, Blackley (Mr. Stringer) on securing the debate and I acknowledge the considerable interest that he and hon. Friends in his area have in issues that affect the national health service, including the subject of today's debate. They have raised them with Ministers on several occasions, both recently and over a longer period.
I want briefly to deal with some specific issues, but I am sure that my hon. Friend agrees that we should first acknowledge the good work that is being undertaken in the city of Manchester and in the Greater Manchester area generally, and pay tribute to all the staff who are involved in providing health services in the city and the wider conurbation. Several colleagues in the health team had the pleasure of visiting them at the end of January and seeing the wide range of facilities and projects in the Greater Manchester area.
My hon. Friend raised concerns about the impact of the 2001 census on health funding in Manchester. As he rightly said, I cannot respond on some of the issues to which he refers as they are matters for the Treasury and the Office for National Statistics. However, I am aware that several colleagues have raised the issues on a number of other occasions.
The key to distributing funding fairly is the count of the number of people that each PCT serves. It is important that the best available population data are used for PCTs to meet the health needs of their populations. The aim is to enable each PCT to commission similar levels of health services for populations in similar need.
For the 2003 to 2006 round of allocations, which was announced in December 2002, the decision was made to use population estimates based on the 2001 census. Those were the most robust population data available at the time of announcing the allocations, if we bear it in mind that the alternative was updated figures from the previous decade or so. The Advisory Committee on Resource Allocation, which oversees issues relating to equity and the allocation of resources to the NHS, supported the decision to use the population estimates.
Since the announcement of the 2003 to 2006 allocations, the Office for National Statistics has made a series of revisions to the initial 2001 population estimates. The biggest change to the figures, to which my hon. Friend referred, were to those for Manchester, which has experienced an increase in population of some 26,200. I appreciate that it will come as a disappointment to my hon. Friends, but the decision has been made not to revisit the 2003 to 2006 allocations. We do not make retrospective changes to revenue allocations because of the uncertainty that that would introduce into PCT funding in general.
My hon. Friend asked about the intellectual rationale for that. It would create considerable uncertainty if the goal posts were moved retrospectively at the same time as future figures were presented to the PCT for planning. It would make life difficult. Money has to come out of a finite budget and when it has already been spent and allocated, finding the retrospective money could cause problems. I fear that my hon. Friend is wrong to say that other areas would not have similar claims, albeit
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sometimes on grounds other than the ONS statistics and the census figures, such as, data lag when there is a rapid increase in populations. We therefore have to make the best estimates that we can at the time. We may well have made different decisions about pace of change and movement to targets had different data been provided. The changes that my hon. Friend assumes might not therefore have happened.
We are confident that using the data in the 2003 to 2006 allocation was the right thing to do because they were the best data that we had at the time. For the latest round of allocations covering 200607 to 200708, the Advisory Committee on Resource Allocation recommended using 2003-based population projections as a basis. Although these population data are again based on the 2001 census, the census has been revised to correct the earlier undercounting in areas such as Manchester. This means that we now have a more accurate count of the population. In addition, these figures take account of the challenges faced in areas with growing populations. We are therefore using the best available population data, which take account of the undercount and of changing trends in population.
I want to describe the picture of the health services in the Greater Manchester area, so as to set this issue in context. Waiting times are falling. No patient now has to wait more than nine months for in-patient treatment. That compares well with 1997, when more than 8,000 patients were waiting for in-patient treatment. In March 1998, more than 23,000 patients were waiting over 13 weeks for an out-patient appointment. Our latest data show this figure to have fallen to 3,536 patients. Furthermore, 99.8 per cent. of urgent referrals for suspected cancer are now seen by a specialist in two weeks in Greater Manchester. We have also seen a large increase in the numbers of consultants, GPs, nurses and health care assistants since 1997, and the list of capital developments and improvements to the equipment of the major services is too long to go through in the time available to us today.
My hon. Friend mentioned health inequalities. He will realise that the Secretary of State and Iin my capacity as the Minister responsible for the northern region and for the public health agenda, including health inequalitiesare keen to see that such inequalities are addressed. He is right to cite the different figures for life expectancy in Manchester and in those areas in which people are better off. The main causes of death in Greater Manchester are cancer and coronary heart disease, and the death rates involved are significantly higher than the rate in England as a whole.
I am sure, however, that my hon. Friend will be content that, overall, we are making massive improvements in driving down deaths from cancer, with a 12 per cent. cut in such deaths across the country since we have been in Government, and a 27 per cent. reduction in deaths from coronary heart disease across the country over the same period. However, inequalities such as those that my hon. Friend outlined are unacceptable, which is why we have established the biggest programme to tackle health inequalities ever seen in this country. I want to put it up in lights that it
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is very important for us to make progress on this issue. Indeed, our performance targets reflect the need to address inequalities. We have identified the areas most at risk from health inequalities, and the Manchester area is one of them. The three Manchester PCTs are part of the so-called spearhead group of 88 PCTs in which we are focusing on driving that progress forward.
My hon. Friend has been generous enough to acknowledge that the latest round of allocations represents a record level of extra investment. In the Manchester area, this equates to an average increase of 9 per cent. for 200607 and 9.4 per cent. for 200708an average of 19.5 per cent. over the two years. As a result, there will be record increases in funding in the Manchester area. The Central Manchester PCT will receive an increase of £62 million; North Manchester PCT will receive an increase of £50 million; and for South Manchester PCT, the increase will be £51 million. So considerable increases are going into the Manchester area.
We have ensured, however, that we reflect the fact that there has been some discrepancy in regard to what has been done. The Minister of State, Department of Health, my right hon. Friend the Member for Barrow and Furness (Mr. Hutton), has had correspondence with my hon. Friend the Member for Manchester, Blackley, and I believe that he has also met him to discuss these subjects on a number of occasions. My right hon. Friend wrote to my hon. Friend recently to explain that we had done something on what is called the capacity adjustment for the two years, 200607 and 200708, which has led to an additional £20 million a year going to the Manchester PCTs. That adjustment would previously have ended with 2006, and has been extended and made recurrent for 200607 and 200708. We have reflected that as far as possible in terms of additional money, and a sizeable additional amount is going into the Manchester area. In addition, both the 26,000 extra people and the capacity adjustment have been reflected, and full account has been taken of the deprivation and health inequalities needs of the Manchester area, which, as my hon. Friend rightly says, are enormously important and need to be addressed.
The current position is that we use the best available data to make revenue allocations. For the reasons that I have given, we cannot revisit the allocations for 2003 to 2006. We have now used the updated population data for 200607 and 200708, and correct revisions for the undercounting in areas such as Manchester. Allocations for 200607 include projected increases in populations, which means that we have included the best available population data. As my hon. Friend rightly acknowledged, we have also made a record additional investment in the health service. We know that the Manchester health service does a fantastic job generally on a number of fronts, and my right hon. and hon. Friends were very impressed on their recent visit. I trust that the primary care trusts and other partners will work together with local MPs to use this record amount of money to continue to improve the health of the Manchester population in the next few years.