HC Deb 26 July 1983 vol 46 cc1042-3
20. Mr. Gould

asked the Secretary of State for Social Services in which areas of National Health Service expenditure he anticipates further reductions in the level of resources available.

Mr. Kenneth Clarke

Total net expenditure on the NHS for 1983–84 will scarcely be affected by the Chancellor's statement of 7 July. There will be increases in expenditure on the family practitioner services; reductions in the cost of the NHS drugs bill; and revised, lower cash limits for the hospital and community health services and centrally financed services. No further changes are planned.

Mr. Gould

In view of the demands of the Chancellor of the Exchequer for a further £5 billion worth of cuts, may I ask how the Secretary of State will take action to make good his party's election promise that the National Health Service is safe with a Conservative Government?

Mr. Clarke

The hon. Gentleman knows that we cannot anticipate the Government's discussions on public expenditure for future years, which will take place in the usual way later this year. I reiterate the promise that the National Health Service is safe with us. That is the promise that we gave when faced with ridiculous allegations by Labour candidates that we were seeking to abolish it.

Mr. Forman

As the Health Service is likely always to need extra funds for the foreseeable future because of the growth in demand for its services, and as it is likely to be under continuing pressure from the Treasury, why does the Department of Health and Social Security not seek to implement the James report on health and diet, which it is estimated might lead to savings in the health bill of up to £1,000 million, which could then be allocated to other priority tasks within the Health Service?

Mr. Clarke

There will always be growing demands on the Health Service. They will be met in part by new funds which it will be within the country's ability to provide, and by improved efficiency and better value for money within the resources that we have available. The James report is a controversial document, which is not yet approved by the main committee, which commissioned it and which has not yet reached the Government. There is wide controversy over all issues of diet but we shall look with interest at any recommendations which achieve wide acceptance and might lead to better health standards being achieved by the population and lower demands on health care.

Mr. Norman Atkinson

Is it not the case that when the Minister answers a question that appears late on the Order Paper he will announce the closure of over 50 hospitals in the four London regions? Does he accept that the announcement will be made at a time when hospital waiting lists are lengthening? Why is he so proud of the policy of shifting resources from inner London to outer London, where it is far easier to get an acute bed than in inner London, as waiting times are shorter?

Mr. Clarke

I explained a few moments ago in response to another question the basis of the policy that we follow in London. To some extent we are shifting resources from inner London to outer London in following the population. It is the population that needs the treatment that we must provide. Within the area that the hon. Gentleman represents we must shift resources from surplus acute provision into the development of community services, which many of his elderly constituents very much need.

Dr. Mawhinney

Does my hon. and learned Friend accept that the level of resources available in the Health Service would be increased if he were to require all doctors in the service to prescribe drugs generically?

Mr. Pavitt

Hear, hear.

Mr. Clarke

My right hon. Friend has already referred to the reduction in the Health Service's drugs bill that we have achieved this year. We are considering closely the workings of the price system and the recommendations of the Greenfield report. We accept that, when looking for economies and better value for money, we must seek sensible economies in the drugs bill, as we seek sensible economies in the use of other resources.