HC Deb 16 April 1985 vol 77 cc123-5
5. Mr. Favell

asked the Secretary of State for Social Services by how much productivity has increased in each region of the National Health Service since the end of 1980.

Mr. Kenneth Clarke

There is no simple measure of productivity. Nationally, the number of inpatient and day cases treated in hospitals in England rose by 7.7 per cent. between 1980 and 1983, while expenditure measured in cost terms rose by 2.3 per cent. I shall, with permission circulate details by region in the Official Report.

Mr. Favell

Does my right hon. and learned Friend agree that probably the best way to judge the performance of a region or a district is to publish the figures of each region and district so that they can be judged against each other?

Mr. Clarke

I agree with my hon. Friend. I am sure that we can do what he suggests. I can certainly give him his own region's figures. We increased spending on the north-west by 4 per cent. over and above inflation between 1980 and 1983. I am glad to say that that region increased the number of inpatients treated by 10 per cent. in the same period, which shows productivity as well as increased spending.

Mr. Campbell-Savours

Why do the Government insist on forcing the West Cumbria health authority to go out to tender on its services when the unions have offered a £100,000 productivity saving if their tender is accepted? Why does the Minister not accept that? Does he not realise that if the authority is forced to make further savings, support for patients will be reduced, standards will fall and the pay and conditions of health workers will be reduced?

Mr. Clarke

Throughout the NHS we are insisting that we do not spend any more than is necessary to maintain the standard of support services, because in that way we can spend as much money as possible on improved patient services. I cannot believe that the West Cumbria health authority, any more than any other authority, cannot find ways to improve its patient services. I do not believe that West Cumbria cannot think of anything on which it wants to spend money apart from accepting a second-best bid on its support services.

I trust that when we get in touch with West Cumbria we shall find that it intends to follow the national policy which has resulted in such success and such improvement in services for patients in other parts of the country.

Mrs. Currie

Does my right hon. and learned Friend agree that in the past we have tended in the Health Service to be obsessed with the measurement of inputs, such as the numbers of nurses, doctors and so on? Does he further agree that it is time that we established targets more in relation to outputs, such as the number of patients, particularly in relation to costs? May we have those figures, not just for regional health authorities, but for district health authorities as well?

Mr. Clarke

I wholeheartedly agree with my hon. Friend. We are constantly lobbied by people who go on about the amount we spend and the numbers we employ. All the figures in those respects are satisfactory. The Health Service is about patients. A dramatic increase is taking place all the time in the numbers of patients treated in and out of hospitals. That is the success of the service, and the attention of the public should be drawn to that aspect.

Mr. Meadowcroft

I note the Minister's comment about it being hard to find a definition of productivity. Is he prepared to examine the possibility — [HON. MEMBERS: "Speak up".] Oh, children, shut up. [Interruption.]

Mr. Speaker

Order. Mr. Meadowcroft.

Mr. Meadowroft

Does the right hon. and learned Gentleman agree that it is time for a follow-up to the Black report to take into account the levels of health among different sections of the public in different areas of the country so as to determine whether we have or do not have a healthier nation under the present Government?

Mr. Clarke

By all the indicators of health care, we compare well as a nation with other countries, including those which appear to spend much more than we do in this area. The trouble with the Black report was that it began by analysing differences in health standards— which, I agree, are important — but then came up with some extremely expensive propositions in the social security sphere which it seemed to imagine would provide the answer. We are redistributing resources between different parts of the country to try to iron out inequalities, and we will continue to seek to identify the most pressing priorities in terms of health care.

Mr. Dickens

Is my right hon. and learned Friend surprised to hear that when I visited the Oldham general hospital laundry last week, I discovered that 54,000 articles of clothing are processed there each week? Since the Conservatives came to power the hospitals have achieved much greater efficiency. Does he agree that that is the direction in which we should be moving, so making money available for patient care?

Mr. Clarke

I am sure that my hon. Friend brought considerable pleasure to those at the Oldham general hospital laundry on the occasion of his visit, and I am sure also that he took the opportunity to congratulate them on what they have achieved. I agree with my hon. Friend that we need to point out to those involved with the NHS just what they are achieving by means of increased efficiency and better patient care. Those facts should also be brought to the notice of the general public.

Following is the information:

Percentage Growth of HCHS Manpower 1980–1983 (September 30) (Whole time equivalents) (Including agency staff and locums)
Regional Health Authority 1980 1983 Percentage Growth
Northern 52,469 54,434 3.7
Yorkshire 58,871 61,504 4.5
Trent 70,455 74,301 5.5
Regional Health Authority 1980 1983 Percentage Growth
East Anglia 28,466 30,394 6.8
North West Thames 58,535 59,560 1.8
North East Thames 67,005 74,228 10.8
South East Thames 66,193 67,285 1.6
South West Thames 50,532 50,631 0.2
Wessex 41,455 44,043 6.2
Oxford 32,946 33,922 3.0
South Western 51,428 53,222 3.5
West Midlands 80,456 84,392 4.9
Mersey 43,742 44,699 2.2
North Western 71,524 76,141 6.5

Note. The figures for the Thames Regions are distorted by boundary changes.

Activity and Revenue Allocations (England) (Regional Health Authorities) 1980–1983
Regional Health Authority Percentage change in numbers of in-patient cases and day cases (calendar years) Percentage change in gross revenue expenditure (economic cost) (financial years)
Northern 6.1 3.5
Yorkshire 8.5 2.4
Trent 10.9 3.6
East Anglian 5.3 4.3
Thames Regions and Special* Health Authorities 6.8 0.6
Wessex 5.5 5.0
Oxford 5.1 1.0
South Western 9.1 3.4
West Midlands 9.0 3.1
Mersey 6.4 1.1
North Western 10.4 4.1
* Because of Boundary changes in 1982, which mainly affected these Regions and the Special Health Authorities, these Regions are combined.