HC Deb 06 August 1980 vol 990 cc498-501
5. Mr. Strang

asked the Secretary of State for Scotland what representations he has received from health boards about the effect which strict adherence to their 1980–81 financial allocations will have on the level of National Health Service provision; and if he will make a statement.

16. Mr. John Home Robertson

asked the Secretary of State for Scotland if he will make a statement on the effect of cash limits on the National Health Service in Scotland.

Mr. Fairgrieve

At their request, the Secretary of State and I met the chairmen of health boards on 25 July. They indicated that at least some boards would have to make savings in order to comply with the cash limits for this year. My right hon. Friend said that these limits could not be increased and accepted that in some areas savings would have to be made. We are satisfied that essential services to patients can be maintained and that there is scope for worthwhile savings that will not affect services to patients.

Mr. Strang

What does the hon. Gentleman mean by "essential services"? Do he and his right hon. Friend now accept, following that meeting, that the only way in which certain health boards can stay within these financial allocations is by seriously cutting the level of staffing in the Health Service in Scotland and by reducing sharply the level of health care in many areas of that Service?

Mr. Fairgrieve

I am satisfied that no responsible health board in Scotland will have to cut essential services. With regard to the meeting with Lothian MPs and our meeting with the health board chairmen, whilst I accept that in the share formula Lothian is second from the bottom, with only a 0–7 per cent. increase in real growth, I remind the hon. Gentleman that it is not the health boards that are responsible for the increase in staff by the Lothian region of 3,520 in one year, or for an increase in rates of 40 per cent. The fact that the Lothian health board may be having to curtail recruitment might not be unconnected with the fact that Lothian regional council has taken on over 3,000 more employees.

Mr. McNamara

On a point of order, Mr. Speaker. I am sorry to interrupt Scottish questions, but it seems to me to be an important point of principle that if a Minister is able to quote from a newspaper when answering a question, a Member asking a supplementary question should be able to do the same.

Mr. Speaker

The ruling has been given many times. Ministers are free to quote. The rest of the House is not free to do so.

Mr. Home Robertson

As the Minister has repeatedly told the House that the real level of spending on the Health Service in Scotland is not to be cut, will he now face the reality that no amount of phoney arithmetic can conceal the fact that there will be real and savage cuts in the level of Health Service provision in many areas, and particularly in the area of the Lothian health board? Will he now apologise to the House and to the people of Scotland for having sought to conceal that information from them?

Mr. Fairgrieve

I shall not apologise, because I have nothing for which to apologise.

Mr. Home Robertson

Shame!

Mr. Fairgrieve

It is not the Government's fault that Lothian region decided to raise its rates—

Mr. Home Robertson

It is.

Mr. Fairgrieve

—by 40 per cent. As I have said, essential services to patients will not be affected. In Scotland we have made provision for a 1.1 per cent. average real growth in the Health Service—

Mr. Home Robertson

Rubbish.

Mr. Fairgrieve

—and there is only one thing that can interfere with that—inflation. The Government's No. 1 priority is to bring down the rate of inflation.

Mr. Sproat

Will my hon. Friend take every opportunity to emphasise to the people of Scotland that there is no need to cut any essential medical services? What there is need to cut is the number of administrators in the Health Service, which, incredibly, rose last year.

Mr. Fairgrieve

My hon. Friend is right. The Clegg Commission suggested possible savings in 1979–80 of £400,000—a gross amount of £1 million in a full year. We put back this amount in the present figures for 1980–81 without asking health boards to take note of it. This sum is, therefore, also available.

Mr. Eadie

Is the Minister aware—he must be so—that his defence is a pretty puny one which merely amounts to shouting "It wasn't me"? Since he is seeking to argue that there will be no effect or impact on the Lothian health service, and that cuts can be made that will have no effect on that service, will he say what cuts should be made and how these will affect the Health Service?

Mr. Fairgrieve

I do not think it was a puny defence. It was a puny attack.

Mr. Peter Fraser

Will my hon. Friend, in making restrictions on financial allocations to health boards, seek to make the distinction which his right hon. Friend the Secretary of State is seeking in relation to local authorities, and make a distinction between health boards that are wasting money and those that are using it properly in promoting the correct services within the National Health Service?

Mr. Fairgrieve

I thank my hon. Friend for that remark. It is difficult for us to interfere because when we appoint health boards and their chairmen and members we trust them to decide on the proper use of their rescources. It is for them to decide how to look after those for whom they are responsible. It is not the wish of my right hon. Friend and myself to interfere.

Mr. Millan

Will the Minister say whether services to patients will be cut?

Mr. Fairgrieve

Essential services to patients will not—

Hon. Members

Answer the question.

Mr. Fairgrieve

I could have said "No", but. I was trying to be fair. Essential services to patients will not be cut. There may be some cut in services at the periphery in certain areas.

Mr. Millan

Will the Minister say what are essential and what are not essential services?

Mr. Fairgrieve

These are matters for clinical decisions by health boards.