§ 17. Mr. Nellist
asked the Secretary of State for Social Services if he will make a statement on the financing of the National Health Service.
§ Mr. Kenneth Clarke
Between 1978–79 and 1983–84 we doubled expenditure on the Health Service. Spending will increase this year by £1 billion to a record £16½ billion. These extra resources together with greater efficiency stemming from our management initiatives will enable the NHS to expand and build upon the substantial gains we have already made. Since we took office provision has increased to the extent that hospitals in England alone treated 900,000 more inpatient and day cases and had 2½ million more outpatient attendances in 1983 than in 1978.
§ Mr. Nellist
Will the Government consider a change in current NHS policy so that cervical cytology can be provided by general practitioners to women under the age of 35? In addition, will they give extra financial resources to Coventry city council to enable workplace screening for breast cancer to take place for women under 35?
§ Mr. Clarke
I congratulate the hon. Gentleman on his wisdom in moving away from the substance of his original question, the reply to which reveals how much more we are spending and how many more patients we are treating than did the Labour Government. We take screening for cervical cancer extremely seriously and at present there is nothing at all to prevent a general practitioner from providing a screen for a younger woman. We do not provide a special additional item-of-service fee for that, but concentrate that fee on priority groups — older women and those who have had a number of pregnancies. We expect GPs to provide a wide range of services to their patients but do not expect to provide a special item-of-service fee for every item.
§ Mr. Latham
When he is making financing decisions, will my right hon. and learned Friend tell regional health authorities to get away from the idea that all babies must be born in district general hospitals, and that they should put proper support behind rural maternity units?
§ Mr. Clarke
There is often a conflict between the medical opinion of consultants, who, rightly or wrongly feel that it is safer for a mother to have her baby in a large 548 district general hospital, and the preference of would-be parents for local, much-loved traditional hospitals. Often, the conflicts come to Ministers for decisions, and we have to decide each one on its merits, weighing up the respective claims on both sides.