§ 26 Mr. Marquandasked the Minister of Health by how much the money spent for capital purposes by regional hospital 2417 boards in the years 1952–53 and 1953–54 taken together fell short of the amount so spent in the financial years 1950–51 and 1951–52 taken together.
§ Mr. Iain MacleodI expect that the figure will be about half a million pounds.
§ Mr. MarquandIs the right hon. Gentleman aware that the figures which he gave me previously for allocations suggested a shortfall in the same period of no less than £2,600,000, and how is it possible to say that the expenditure was almost the same while the allocations were so widely divergent, unless it be explained by the action of his predecessor in failing to use the money which we provided for building hospitals?
§ Mr. MacleodOn the contrary, it is explained by the action of the right hon. Gentleman, who has fallen into his own pit. It is one thing—and it may look quite impressive—to put allocations into an Estimate and to underspend them considerably, as the right hon. Gentleman did. It is another thing to do as my right hon. Friend the Leader of the House and I have done, to give accurate figures, as far as possible, and to spend fully up to them. That explains substantially the difference between the allocations. If the right hon. Gentleman will look at his own Question, however, it asked for the money spent. The difference in the money spent is only £500,000.
§ Mr. MarquandYes, but is it not true that the money allocated for 1951–52 could only have been spent by his predecessor and could not have been spent during my term of office?
§ Mr. MacleodThe underspending of the larger part of the allocations made for 1951–52 was in respect of the term of office of the right hon. Gentleman.
Miss WardMay I ask my right hon. Friend if he is aware that the North-East coast makes a magnificent contribution to the general welfare and productive effort of the nation? [HON. MEMBERS: "Wrong Question."] No, I do not think I am referring to the wrong Question. May I say to the Minister that I think it is about time we had our fair share of what is going?
§ 28 Mr. Pannellasked the Minister of Health the financial allocation to the Leeds hospital board for the last financial year, the current financial year, and for the next financial year.
§ Mr. Iain MacleodAs the reply contains a number of figures I will, with permission, circulate it in the OFFICIAL REPORT.
§ Mr. PannellCan the right hon. Gentleman say in advance of my seeing the figures whether there is any truth in the statement of the chairman of the board, which I have here? It is:
We cannot find any money for development …We are having to economise to the uttermost and use up any reserves we have to carry on during the next 12 months.
§ Mr. MacleodThe figures are higher for this year. It is true that I have sought, and am still seeking, for all possible economies in the National Health Service. It is right to say, because it is relevant to many Questions on the Order Paper today, that it is virtually impossible, for a variety of reasons, to look at a figure for one year and a figure for another year and say that the difference represents the extra amount available for the hospital services. One can only do that if one knows the assumptions—and they run into dozens— which have been made by the Minister in framing the Estimates.
§ Following is the reply:
§ The sums allocated to this board for each of the years in question, and also the actual expenditure for the last financial year, are as follows:
| — | Allocation | Expenditure |
| £ | £ | |
| 1952–53 | 14,588,000* | 13,894,336 |
| 1953–54 | 14,845,000† | — |
| 1954–55 | 15,022,000‡ | — |
| Notes: | ||
| *Included £222,869 in respect of salary and wage awards which was not required. | ||
| † Includes £128,170 in respect of salary and wage awards which was not required by 31st December, 1953. | ||
| ‡Includes £57,000 in respect of salary and wage awards which may be announced between 1st January, 1954, and 31st March, 1955. |
§ 30 Dr. Strossasked the Minister of Health the sum allocated to the Birmingham Regional Board for the present year and for the past three years.
§ Mr. Iain MacleodAs the reply contains a number of figures, I will, with permission, circulate it in the OFFICIAL REPORT.
§ Dr. StrossIs the Minister aware, however, that the Stoke-on-Trent Hospital Management Committee is dependent upon the Birmingham Regional Board for its funds, including money for capital expenditure; for improvements and renovations, that the management committee is short of money and that there is a very real need for further capital sums? Has the right hon. Gentleman now considered whether it may not be desirable to change the system and see that these sums do not come through the region at all but come directly from the Ministry, so that we can look after our own accountancy and bring our own grievances to the Minister's notice?
§ Mr. MacleodThe hon. Member's Question relates, of course, to the Birmingham Regional Board and not to the Stoke-on-Trent Hospital Management Committee. If he has any points to make on that subject, perhaps he will put a Question on the Order Paper or bring them otherwise to my notice. The other question involves the difficult matter of major financial policy and that is perhaps the first matter of all that is under the purview of the Guillebaud Committee at the present time.
Mr. I. O. ThomasWhy is it so difficult to give the figures for the four years now? Why say that they will be circulated in the OFFICIAL REPORT? Surely the Minister can mention the totals for four years without undue mental strain?
§ Mr. MacleodI can certainly do it. There are four years of allocation and three years of expenditure, but in addition to that—and this is part of the answer which I gave to the hon. Member for Leeds, West (Mr. Pannell)—it is wholly misleading to give figures in that way. I have, therefore, tried to help to some extent by providing notes which will be circulated in the OFFICIAL REPORT SO as to explain the figures in the list.
§ Following is the reply:
§ The sums allocated to this board for the maintenance of its services during each of the years in question, and also the actual expenditure for each of the years up to 1952ߝ53, were as follows:
| — | Allocation | Expenditure |
| £ | £ | |
| 1950–51 | 15,114,800 | 15,025,903 |
| 1951–52 | 16,940,050 | 16,729,720 |
| 1952–53 | 18,940,000* | 18,377,963 |
| 1953–54 | 19,691,000† | — |
| Notes: | ||
| * Included £205,761 in respect of salary and wage awards which was not required. | ||
| †Includes £136,893 in respect of salary and wage awards which was not required by 31st December, 1953. |
33 Miss Wardasked the Minister of Health if he is aware that the total revenue and capital allocations for the Newcastle region and teaching hospital were £2,800,000 less on a population 'basis than the average amount spent by, the country as a whole on the hospital (Service; and if he will take steps to readjust the position.
§ Mr. Iain MacleodI do not think that a population basis would be an equitable method of distributing the sums available for hospital running costs, but it is taken fully into account in distributing the sums available for hospital capital works.
Miss WardIs my right hon. Friend aware that this is not the view taken by the regional hospital board, and that the board is seeking to send a deputation to the Minister to repudiate emphatically that we should have less on a population basis for our hospital services than other parts of the country? Is it not time that my right hon. Friend paid a little more attention to the north-east and gave us what we are entitled to have?
§ Mr. MacleodThat argument does not appear to me wholly logical because, by definition, maintenance and running costs are given to establish and keep going the services and hospitals which are already there—
§ Mr. MacleodIt would clearly be impossible to have maintenance costs on a population basis, but I fully recognise that there is a case for taking population into account in respect of capital allocations. Indeed, capital allocations are made as to 95 per cent, on population and 5 per cent, on special needs. Newcastle, in the financial year 1954–55, as a result of that allocation, received £50,000, or 12 per cent, more than would have been received on a population basis alone.
Miss WardIs my right hon. Friend aware that there are more nurses nursing in London hospitals than there are in the north regional hospitals? Why should we have fewer nurses nursing our patients than there are in the hospitals in the south? Will my right hon. Friend look into that aspect? Is he also aware that the regional hospital board is not satisfied even with his additional allocation to it?
§ 36 Mr. Chetwyndasked the Minister of Health the reasons for his cut of nearly £1 million in the estimates of the Newcastle Regional Hospital Board for 1954–55.
§ Mr. Iain MacleodThe total sum available for 1954–55 to meet the running costs of hospital boards was less than the total amount requested in the boards' estimates, and the allocation to this board represents what is in my view a fair share of that total.
§ Mr. ChetwyndIs the Minister aware that the very minute increase in the funds available for next year compared with this year will be quite inadequate for the hospital board to improve its standards and keep pace with the rise of pay and prices which it will have to meet? Will he reconsider this, otherwise we shall be in a worse position in the north-east compared with other parts of the country?
§ Mr. MacleodThere again we are in the sort of difficulty that I indicated earlier because the figures do not indicate, for example, what provision has been made and kept back for any Whitley awards that may arise. It is virtually impossible to make comparisons figure by figure and year by year in the hospital service, but I do not deny that the regional hospital boards will have to work very closely to the Estimates I am laying in detail before the House.
§ Mr. MarquandIn view of the special requirements of the north-eastern area— the rapidly increasing population, heavy incidence of industrial injury, heavy incidence of tuberculosis and so on—will the right hon. Gentleman watch with special care to see that no beds are closed in that region? The hospital board is really afraid, as it has said, that the right hop. Gentleman is making some change in policy by this small allocation.
§ Mr. MacleodI am certainly not making any change in policy in this matter. I think that if the figures I gave the House a few weeks ago are studied, that becomes quite clear. As a matter of fact, the percentage increase over the last few years in the Newcastle region has-been substantially higher—I will not say than that of any other part of the country, 'but a long way above the average.
§ 37 Mr. Chetwyndasked the Minister of Health how many of the proposed additional hospital beds in the Newcastle hospital region will be removed from the development programme as a result of the cut in the financial estimates for 1954–55.
§ Mr. Iain MacleodFirm provision has been made by the board for 263 extra beds during 1954–55. Final decision on the remaining beds, which total 138, has not yet been taken.
§ Mr. ChetwyndAre not those beds for which firm provision had been made now in jeopardy because of the cut in estimates? Is the right hon. Gentleman aware of the very grave need for additional 'beds in the north-east? Is he further aware that the whole of the plans of the regional board will have to go into cold storage if it cannot get more funds?
§ Mr. MacleodNo, I am assured that the answer which I gave is accurate, and the firm provision for the 263 beds stands. It is, of course, true that this region, like every other region, would like to do more. I should be more than ready for them to do more if it could be done within the allocation. But, as I have said, beyond the 263 beds there are 138 beds which will have to be considered in the light of the allocation.
§ Mr. J. JohnsonOn a point of order, Mr. Speaker. What defence have we against a loquacious Minister who makes 2423 such long answers? We have only reached Question 37, and have nearly reached the end of Question Time.
§ Mr. SpeakerThat is not a point of order.
§ Sir H. WilliamsWill my right hon. Friend say what grant would have to be made to the Medical Research Council in order to allow hon. Members to draft shorter supplementary questions to which the Minister can make shorter answers?
§ Mr. PopplewellWhen he was in the north-east the Minister agreed that there was a very severe shortage of beds; will he look into the matter again in order to get the north-east up to an equal strength with the rest of the country in regard to the number of beds?
§ Mr. MacleodIf the hon. Member studies the answer which I gave to my hon. Friend the Member for Tynemouth (Miss Ward), he will see that special attention is paid to Newcastle in regard to capital.
§ 38 Mr. Blenkinsopasked the Minister of Health if he is aware that the revenue funds made available for the Newcastle Regional Hospital Board for 1954–55 represent an increase of only £ per cent, over the current year; and whether he will review the matter in view of the need for more hospital beds in the region.
§ Mr. Iain MacleodThe answer to the first part of the Question is "Yes," but the sum allocated to the board for hospital running costs in 1954–55 represents, in my view, a fair share of the total sum available, and its capital allocation takes account of the region's need for hospital beds.
§ Mr. BlenkinsopDoes not the right hon. Gentleman think that he might have saved some time by answering the last three Questions together? Do they not also show how urgent the problem of the north-east is?