HC Deb 23 October 1984 vol 65 cc542-4
10. Mr. Tony Banks

asked the Secretary of State for Social Services whether he is satisfied with the level and quality of health service provision in Greater London.

Mr. Kenneth Clarke

Health authorities in London face the difficult challenge of adjusting their services to match the movement of population in recent years. Some districts, particularly in inner London, need to reorganise acute provision to free resources for development of local services for the elderly, the mentally ill, the mentally handicapped and to improve primary care.

Mr. Banks

Is that not a way of saying that, in London, we must make serious health service cuts? Did not hospital waiting lists in London increase between September last year and March this year? During the past two years the four Thames regions have suffered cuts and are to suffer more in the next two years to the tune of more than £22 million. Is not the Minister being complacent about the situation in London?

Mr. Clarke

The hon. Gentleman has skilfully selected his dates and figures. Spending in the Thames regions has more than kept pace with inflation since we have been in office, although regions are planning some reductions in inner London districts. The problem is that the population has moved away. There is a clear surplus of acute beds in inner London as reports to the Labour Government and to us have shown. We must move resources to where the population is—in the suburbs and home counties—and develop services of which inner London is short. London has 15 per cent. of the country's population and gets 20 per cent. of health spending. It does not always spend that money in the best interests of its inhabitants. There must be much change to get the type of service that we require.

Mr. Sims

Does my right hon. and learned Friend agree that there is scope for making more funds available for direct health care by contracting out ancillary services, as Bromley health authority does with its catering service?

Mr. Clarke

Bromley authority has made spectacular savings on its catering service, all of which are devoted to patient care. Hammersmith hospital is saving more than £500,000 on changes to its ancillary services, all of which is available for patient care. I wish that the hon. Member for Newham, North-West (Mr. Banks) would put pressure on his political friends to stop them choosing to spend money on keeping up the cost of cleaning and instead to spend it on developing patient care.

Mr. Pavitt

Will the Minister call for papers from his Department to show the large number of Departments that are being consulted either about closing or transferring in the London region and take his personal time to examine them? Does he recognise that much of the savings envisaged for 1984–85 will cause double the amount of expenditure during the following five years?

Mr. Clarke

At our request all the regions are drawing up strategies for the next 10 years. I should have thought that that was invaluable for knowing where we were going and for making well-judged decisions for future health services in London. The disputed cases will eventually come to Ministers for a decision. We shall not approve those which fail to make financial sense. Most important, we shall not approve any which do not result in an improved service to patients either through the facilities of a more modern unit or by releasing resources whose value can be better realised elsewhere.

Mrs. Rumbold

I take comfort from my right hon. and learned Friend's response to the question in so far as he relates the moving of resources from inner London areas to suburban areas. Will he confirm that he will give kind approval to those schemes which involve certain health services and voluntary and community services?

Mr. Clarke

I am grateful for my hon. Friend's comments. It makes sense to plan for the future of health services on the basis of where the population now live rather than to retain surplus provision of acute accommodation where the population used to live—in the teeming slums of inner London, before we began to make happy progress clearing them. The voluntary and community services must also be involved. We need to improve joint planning for the future between health authorities, local authorities and voluntary and community bodies.

Mr. Dobson

Does the Minister accept that people living in Greater London who want an operation are sick to death of him talking about plans for the future? They want plans for the present, to reduce hospital waiting lists in Greater London. Will he confirm what my hon. Friend the Member for Newham, North-West (Mr. Banks) said, which is that hospital waiting lists have increased during the last six months for which there are records? Does he accept that in the Bloomsbury health district the number of people awaiting operations has increased by 2,000 during that period so that 12,000 people are waiting? Does he accept that in Hackney there are now 1,100 people who have been waiting for urgent operations for more than a month? Despite that, he still proposes to shift resources from those areas and thus cause an extension of hospital waiting lists.

Mr. Clarke

As I said the hon. Member for Newham, North-West was doing, the hon. Gentleman is making a careful selection of dates for his figures. Throughout the country the underlying trend is that the number of people on hospital waiting lists is steadily decreasing and the numbers of those being treated in hospital is increasing. The hon. Gentleman's comments about how authorities cope with these problems in Greater London must be set alongside the needs of other parts of the country where people are also on waiting lists and where services are provided from far lower resources per head than is the case in inner London.