§ 8. Mr. Peter Morrisonasked the Secretary of State for Social Services what was the percentage increase in the revenue cost in real terms of the NHS hospitals between 1965 and the latest available date; and what was the percentage change in the number of beds occupied daily over the same period.
§ Mr. EnnalsBetween the financial years 1965–66 and 1974–75 there was an increase of about 35 per cent. in the revenue cost of NHS hospitals and the number of beds occupied daily decreased by about 14 per cent.
§ Mr. MorrisonCan the Secretary of State explain why this deterioration has taken place. What is he going to do about it?
§ Mr. EnnalsI would call it not deterioration, but exactly the opposite. The increase in real terms in the cost of National Health Service hospitals in this period depends on a number of factors. A more intensive use of beds has led to 16 per cent. more in-patients a year being treated in 14 per cent. fewer beds. That is an achievement. The number of outpatients treated has increased by 8 per cent. and the number of day patients has trebled—that is not bed occupancy. New and improved methods of diagnosis and treatment often involve higher costs. It is an achievement and not a deplorable situation.
§ Mr. Patrick JenkinDoes the Secretary of State agree that one of the increases he is currently facing is that of junior doctors' pay? Does he accept that the cost of paying overtime under the agreement reached last September may now be over £31 million compared with the £14.2 million estimated at the time of the settlement? What advice has he given to regional health authorities on how to meet this staggering increase?
§ Mr. EnnalsThe cost estimated by the Review Body was £14.2 million and it looks as though the current estimate will be £28 million—twice the original estimate. I am not laughing the matter off: it is a fact. One must recognise that the employing authorities—the health boards—have contracted for longer hours of work and a greater degree of availability for junior staff than previously. For the 177 future we are making arangements to obtain more detailed information on the cost of the allocation of A and B class unions. It has been made clear to the health authorities that the cost of the new junior doctors' contracts must be met from within their budgets. It is for the health authorities to decide on the priorities within their existing budgets.
§ Mr. WardWill the Secretary of State confirm that if Conservative Members are going to use statistics for bed occupancy and National Health Service costs as a subject for criticism, that is an even greater condemnation of the pay bed sector where the occupancy is smaller and is a less effective use of health resources?
§ Mr. EnnalsI am new to this subject in the House. I was staggered by the attitude and the ignorance of Opposition Members in their use of pay bed occupancy rates as though they were a test of efficiency in the health service.
§ Mr. PowellHas the Secretary of State yet learned what all occupants of his office discover—that there is no satisfactory unit of measurement of quantity or quality in medical care?
§ Mr. EnnalsYes.