§ 6. Mr. Lawson
asked the Secretary of State for Social Services on what grounds she has placed the Countesthorpe health centre project fifteenth in the list of health centre priorities for the Leicester area for 1976 and beyond, after the Leicester Area Health Authority had placed the project at the top of the list and whether she will explain the criteria she uses in determining such priorities.
§ Dr. Owen
Countesthorpe health centre was not among the list of priority schemes put forward by Trent Regional Health Authority for consideration for inclusion in the 1975–76 programme. Selection of health centre programmes is based upon the criteria which I will, with permission, circulate in the Official Report. The regional health authority has discussed priorities beyond 1975–76 as a basis for planning but no decisions have been taken about the order of starts.
§ Mr. Lawson
Is the Minister aware that his answer is wholly inadequate? Although I shall wait with interest to see the list of criteria when they are circulated in the Official Report, may I ask whether the hon. Gentleman is also aware that the Department asked the Leicester Area 237 Health Authority to assess priorities for Leicestershire, that it placed the Countesthorpe health centre at the top of the priority list but that this was rescinded, without any reason being given, by the Secretary of State for Social Services? Does the Minister appreciate that this will put the centre down to fifteenth place, despite the fact that the village concerned has a population of 6,000, which is rapidly increasing, and that there are a further 2,000 in the catchment area? Will he bear in mind that all these people are now being served by a surgery in a single room in the private home of the senior doctor of a panel of three? Is not this a disgraceful situation?
§ Dr. Owen
The hon. Gentleman speaks for a Government which in December 1973 cut the health service and health centre expenditure by 20 per cent. The present Government have increased expenditure, particularly on the health centre building programme. I repeat that the centre in question was not among the list of priority schemes put forward by Trent Regional Health Authority.
§ Mr. Greville Janner
Is my hon. Friend aware that the Secretary of State for Social Services has already assured Leicester Members of Parliament that when the priorities in the National Health Service are being considered the tremendously underprivileged position of Leicester hospitals will be taken into account? Will my hon. Friend give some assurances on health centres and domiciliary services, especially in view of the cuts made in those services by the Conservative Government?
§ Dr. Owen
It is part of the present Government's policy to concentrate limited resources on areas of need. In the National Health Service we are trying to define areas of health deprivation. This is one of the most important criteria used in the allocation of health centres. Inasmuch as there are in the Trent Regional Health Authority a number of areas of hospital and health deprivation, the autho- 238 rity can expect to see that situation reflected in allocation policies.
§ Mr. Norman Fowler
Is it not a fact that the Government are planning cuts in capital expenditure on hospital building between now and 1977? Does the Minister agree that public expenditure is a matter of priority and that some of us believe that the Government's priorities —the present level of food subsidies, nationalisation and municipalisation of land—do not represent the best use of available resources?
§ Dr. Owen
Is the hon. Gentleman challenging the priorities for health care and the building of health centres? If he is, perhaps he will give us different priorities. Will he explain how, despite the fact that we inherited considerable financial difficulties, we have still managed to lift the moratorium on the hospital building programme which otherwise would have resulted from the 20 per cent. cut and also how we have been able to restore part of the services which had been cut?
§ Mr. Lawson
I am happy to do so, Mr. Deputy Speaker. I am grateful to you for your courtesy. In view of the wholly unsatisfactory nature of the Minister's reply to my question a few moments ago I beg to give notice that I shall seek to raise the matter on the Adjournment at the earliest possible moment.
Following is the information:Proposals for health centre developments should be based on the following criteria:
- a. Proposed centre is situated in urban zone where the organisation of primary medical care has so far made little progress.
- b. General practitioners are committed to leave present premises and are dependent upon a health centre for new premises.
- c. Proposed centre is part of a larger development (including hospitals university teaching units) progress on which is dependent upon the health centre proceeding.
- d. Proposed centre is situated in a new town or other new community where delay
239 in provision would seriously hamper the development of family practitioner service.
- e. General practitioners have strong desire to develop primary health care but are frustrated by lack of suitable accommodation.
- f. Present general practitioner premises are well below modern standards and other means of improvement are not feasible.
- g. Proposed centre is sited where there is at present inadequate accommodation for community based nursing staff or for preventive health activities.
- h. The proposed location is in a "health deprived" area [a health deprived area should for the time being be interpreted as a locality in which the level of primary health care services falls well below the average obtaining in the Region].