§ 10. Mr. Easthamasked the Secretary of State for Social Services what has been the average annual increase in the National Health Service budget in real terms since May 1979.
§ 12. Mr. James Lamondasked the Secretary of State for Social Services what has been the growth in the hospital and community services budget since May 1979 after taking account of pay and price movements in the Health Service.
§ 13. Mr. Freesonasked the Secretary of State for Social Services how much money has had to be spent over the past four years in the National Health Service budget to cope with the increase in demand caused by demographic change.
§ Mr. FowlerGrowth in services in the National Health Service as a whole between 1978–79 and 1982–83 is expected to be about 6 per cent. in real terms, an average annual increase of 1½ per cent. The hospital and community health services growth figure for the same period is 5½ per cent. in real terms. Demographic changes—notably the increased numbers of old and very old people—will have increased hospital and community health services costs by 3.4 per cent. Separate estimates of the cost of demographic changes to the family practioner services are not made, as expenditure on those services is determined largely by demand and therefore naturally allows for any extra costs arising from changes in the population structure.
§ Mr. EasthamIs not the Minister deceiving the House, as the figures clearly do not include inflation and pay rises? Since 1979 no fewer than 640,000 more pensioners have needed these services. There is an ever-increasing number of 75 and 85-year-old pensioners who place a terrific burden on the National Health Service. When will the Minister hand some real money to the National Health Service?
§ Mr. FowlerThe hon. Gentleman is absolutely and utterly wrong. Of course the figures include pay and 122 prices. If he wants the economic costs—the costs compared with the RPI—[can tell him that there has been a 16 per cent. expansion of the National Health Service in England over the past four years.
§ Mr. LamondAre not these figures prepared to try to conceal what the country knows, which is that health standards have deteriorated sharply under the Secretary of State's leadership? For example, is it understood that the Secretary of State includes in the figures, as increased investment in the National Health Service, prescription charges, which have increased sevenfold since the Government came to office? Does not this statistical distortion arouse a gasp of envy even from that wizard at distorting statistics—the Secretary of State for Employment?
§ Mr. FowlerI am not sure what response the Secretary of State for Employment would make. If the hon. Gentleman wants a further measure of the growth in hospital services over the past four years he has only to look at the number of medical staff. We are now employing 4,000 more doctors and dentists and 45,000 more nurses and midwives. That is this Government's record; a Government committed to the National Health Service.
§ Mr. FreesonIf one takes account of the enforced expenditure on demographic and other similar changes within the National Health Service and calculates that as a whole, one produces the net result that there has been a decrease in real terms in expansion of the service. Is that not having an effect on areas such as mine—an inner city area whose hospital and community services are under threat? When will the Minister do something about such areas?
§ Mr. FowlerThe right hon. Gentleman is coming to see us about conditions in his area. However, it is absurd to suggest that the provision of more services for more old people, and making modern treatments more widely available, somehow does not count as growth. Of course it does, and that is what we have been seeking to do with the National Health Service.
§ Dr. MawhinneyDoes my right hon. Friend accept that the fast growth in the population of new towns causes the population figures that he uses to allocate money to the regions to be, of necessity, out of date? What help can he give the third generation new towns with their health problems, which have been caused by this rapid expansion?
§ Mr. FowlerWe shall continue to review the system. However, as my hon. Friend is aware, we are trying to continue the Labour Government's policy, which was to reallocate resources to the most under-provided legions.
§ Mr. Mike ThomasDoes not the Minister's reply prove the old adage that there are
Lies, damned lies and statistics.Once demographic change, the effects of inflation and medical advances have been taken into account, the Government have cut public spending on the National Health Service. The only way in which they can claim an increase is by taking into account the dramatic increase in charges to patients, who are paying for the increased services instead of it coming from public expenditure?
§ Mr. FowlerThe hon. Gentleman is, as always, wrong. He got it wrong when he went to the Darlington by-election and attacked us on the same ground, when he said:
Mr. Fowler's claims for Health service spending are only true in the sense that the words he uses are literally correct".
§ Mr. Mike ThomasThat is right.
§ Mr. WallerI congratulate my right hon. Friend on the way in which he has ensured that the Government have maintained finance for the National Health Service. Bearing in mind the high cost of keeping people in hospital, does he agree that the best way forward is to encourage people to live a lifestyle that will give them the best chance of avoiding going into hospital? Will he devote more resources to preventive medicine?
§ Mr. FowlerThat is plainly important. We have a new chairman and director of the Health Education Council and I look forward to a new effort in this area.