§ Mr. Kenneth Clarke
The United Kingdom spent 5.6 per cent. of the gross domestic product on the National Health Service in 1983. The corresponding figure for 1978 was 4.8 per cent.
§ Mr. Clarke
They certainly do. They show where it counts most. Last year, hospitals treated 3.5 million more cases than were treated during the last year of the Labour Government.
§ Mr. Latham
In making these financial decisions, is my right hon. and learned Friend trying to persuade his Department away from the idea that all mothers-to-be must have their babies born in central areas? Maternity units are extremely important in rural areas.
§ Mr. Clarke
A great deal of clinical advice is that it is safer to have babies born where there is ready access to emergency provisions. However, the atmosphere in many small maternity units is much preferred by mothers-to-be and their families. Therefore, we try to balance those two considerations when difficult cases come before Ministers.
§ Mr. Campbell-Savours
Is the Minister aware that the most recent Health Service workers' settlement has left the West Cumberland health district with a bill of £175,000 to pay? The only way that it can find the money is by cutting back on the maintenance of hospital buildings. Does the Minister agree that that is a false economy? Is not the only solution to the problem for the Government next year to provide our health district with additional moneys to secure the future of our hospital?
§ Mr. Clarke
With respect, the hon. Gentleman's health district and others were provided with substantial extra funds to cover the additional cost of the pay settlement. The Government met about 80 per cent. of it by increasing cash limits. That leaves a contribution to be made in other ways. However, all local authorities are identifying cost improvement programmes and ways of increasing their efficiency, and the sums being saved by eliminating waste and improving performance easily cover any additional cost of the pay settlement and also provide for growth in patient services. I do not know enough about the details of West Cumbria, but I hope that none of our districts is resorting to false economies when real ones can be made.
§ Mr. Meacher
Is the Minister aware that under the Government's policy on the National Health Service, which he calls expansion, 193 hospitals have been closed and only 35 opened? If that is expansion, will he confirm 772 that next year there will be a contraction when, for the first time, he forces health authorities to cover the full cost of pay rises above 3 per cent. for Health Service workers? Does he expect Health Service workers, who are among the lowest paid, to subsidise the NHS by taking a real pay cut when thousands of rich people are being given massive tax handouts?
§ Mr. Clarke
We should all bear in mind the strictures of my hon. Friend the Member for Birmingham, Edgbaston (Mrs. Knight) about the figures that we use. The figures for hospitals opening and closing are amongst the silliest which the hon. Member for Oldham, West (Mr. Meacher) ever uses. He knows that we close small, old hospitals and open bigger new hospitals. The total number of new beds provided under this Government is almost equal to that of the total number of beds lost from the older hospitals. What is more important—as patients' stay in hospital are shorter—is that we treat more patients. The Health Service is not in the business of conserving buildings or providing empty beds; it is for treating patients, and 3½ million more patients each year are being treated than before. I hear what the hon. Gentleman says about next year's pay settlement. We plan for a cash increase of 5½ per cent. on top of this year's health spending. Out of that, of course the Health Service has to find its pay costs, just as every other major service has to.