HC Deb 01 July 1986 vol 100 cc806-8
3. Mr. Chapman

asked the Secretary of State for Social Services what recent representations he has received about the effects of the application of the resource allocation working party formula and the current review; and if he will make a statement.

The Secretary of State for Social Services (Mr. Norman Fowler)

I have received a number of representations concerning various aspects of resource allocation and the review of the RAWP formula. Consultation on the review ended yesterday and I am expecting an interim report by the end of this year and then a full report.

Mr. Chapman

As RAWP was introduced nine years ago, will my right hon. Friend say whether it has succeeded in what it set out to do, or whether it is to be a permanent way of allocating resources in the Health Service? Whatever his answer, will the review consider the effect of RAWP applied not only between regional health authorities but by regional health authorities, because some district health authorities seem to be badly done by in the double application of the formula?

Mr. Fowler

I give consideration to those points. The principle of RAWP is basically to put money where the people are. I think that that principle is accepted by both sides of the House. On sub-regional allocation, clearly the review's findings will be relevant not only when dealing with matters such as patient flow, but for regions in distributing money.

Mr. Ashley

Before there are any changes in the RAWP formula, will the Secretary of State bear in mind that the crisis in north Staffordshire hospitals is infinitely worse than the problems in south-east England? Last winter there was one red alert in a London hospital, but there were continuous red alerts throughout the whole of north Staffordshire.

Mr. Fowler

As I have just made clear, there is no question of abandoning the RAWP principle. The whole point is to try to get equal access to health care for people in equal need. We shall stand by that principle.

Mr. McCrindle

Will my right hon. Friend take note of the fact that, although few of us object to the transfer of resources to areas that have been ill-served in the past, there are some signs that in London and the south-east the position is becoming difficult? Without in any way suggesting that we should withdraw the extra allocation of resources to areas away from London, when my right hon. Friend has the review's report, will he consider increasing the resources to the Thames regional health authorities, which in some respects have larger waiting lists than some places far away from London?

Mr. Fowler

We are considering that and other issues concerned with RAWP. Clearly it is important that the RAWP formula should reflect need as far as possible. That was the purpose of setting up the review.

Mr. Kirkwood

Will the Secretary of State assure the House that, when he has had time to study the RAWP review, he will consider the important report by the Faculty of Community Medicine, which was published today, about some of the bad aspects of the way in which we measure up on the league table of health in relation to other countries? Will he also assure the House that he is now fighting his departmental corner to get more money so that, when the interim and final reports are available, he can do something about the problem?

Mr. Fowler

I shall certainly be happy to respond to the report of the Faculty of Community Medicine. We would agree with a number of its points. We agree that the prevention of disease and promotion of health are vital. However, some of the statistics used by the faculty were selective. It took life expectancy figures from the age of 45, but if life expectancy figures from birth are taken, the United Kingdom is near the top, not the bottom, of the league.

Mr. Carter-Jones

Will the Secretary of State bear in mind that the complaints from Hope hospital in Salford down to St. Thomas's hospital in London are not so much about RAWP as about the total cuts in the Health Service?

Mr. Fowler

The hon. Gentleman knows enough about this position to be aware that there have been no cuts in resources going into the Health Service. He knows perfectly well that the budget, which was 0.75 billion, has been increased to £18.75 billion. However he does the arithmetic, that cannot be regarded as a cut.

Mr. Sims

Does my right hon. Friend accept that in times of increased costs—with the reasons for which we are both familiar — even relatively well-resourced authorities need substantial increases in funds each year simply to maintain, let alone to improve, the services that they already operate?

Mr. Fowler

Clearly, demographic factors and medical advances have to be taken into account. My hon. Friend will acknowledge that health authorities must also use the resources at their disposal to the best effect.

Mr. Meacher

Is not the misapplication of RAWP one major reason why the Royal College of Physicians reported yesterday that, after seven years of Tory Government, Britain is now one of the unhealthiest countries in the developed world, with low life expectancy and high rates of disease and handicap? Is not the other major reason the fact that the Government are now spending 50 per cent. less on health as a proportion of gross national product compared to the French, the Germans and the Americans? When will the Secretary of State recognise that RAWP cannot work properly while the NHS remains so grossly under-funded by the Government?

Mr. Fowler

I wonder why the hon. Gentleman never compares it with the Labour Government. As he well knows, the Government are spending 24 per cent. more in real terms than the previous Labour Government. We are treating more patients, the capital building programme has been restored and the Health Service is developing into a better Health Service. We will stand not only on our record but on a comparison of that record with the record of the previous Labour Government.