Greater Glasgow Health Board (Hansard, 26 March 1986)

§ 4. Mr. Craigen
asked the Secretary of State for Scotland if he will make a statement on the financial problems facing the Greater Glasgow health board and on any discussions he has had with the board's chairman.

§ 11. Mr. Millan
asked the Secretary of State for Scotland if he will make a statement on the financial position of the Greater Glasgow health board.

§ Mr. Rifkind
The total revenue allocation that I have made to the board for 1986–87 is £380.3 million. That is £21 million higher than in 1985–86. My hon. Friend the Minister with responsibility for home affairs, health and social work has regular meetings with the chairmen of all health boards, including Greater Glasgow.

§ Mr. Craigen
If the Secretary of State thinks that the health board is doing so well, why does it seem that there will be a £3 million overspend this year because of the costs that it has to bear? Does the Scottish Office feel that the Greater Glasgow health board receives sufficient recognition of the amount of in-patient and out-patient work that it is doing on a wider scale for the rest of the region, or is it simply that the Scottish Office has it in for the Greater Glasgow health board because of its pragmatic approach to privatisation?

§ Mr. Rifkind
The hon. Gentleman must have a persecution complex, either on his own behalf or on behalf of the health board, because the Greater Glasgow health board is the best-funded health board in Scotland. Indeed, the allocation that it is receiving for 1986–87 is 5.8 per cent. higher than what it received for the previous year. As the hon. Gentleman will be aware, that represents a sum greater than the rate of inflation.

§ Mr. Millan
Is the Secretary of State aware that, far from being adequately financed, the board is now facing a financial crisis? Is he further aware that in an answer that he gave on 17 March he said that, in real terms, expenditure in Scotland on the hospital services between 1978–79 and 1988–89—a 10-year period—would rise by only 6.8 per cent., which is less than 1 per cent. per year? That is inadequate for the Health Service as a whole in Scotland. Glasgow's share of that amount is diminishing because of the operation of the Scottish health authorities revenue equalisation formula, although the actual demands on the service in Glasgow are continuing to increase. When will the right hon. and learned Gentleman recognise that there is a genuine financial crisis in health services in Glasgow, that we need more money, and that unless more money is made available there will be severe cuts in services?

Mr. Rikfind
The right hon. Gentleman does not seem to realise that not only does the Greater Glasgow health board receive more on a per capita basis than any other health authority in Scotland, but that it receives more per capita than any regional health authority in England. Therefore, if the health board is in financial difficulty, that must be primarily its own responsibility. At the moment it receives a sum that represents £405 per capita. The next highest authority in Scotland is Tayside, with £369 per capita, and other health authorities receive smaller sums. Therefore, it is simply not credible for the right hon. Gentleman or his hon. Friends to suggest that Greater Glasgow health board receives other than a very generous provision.

§ Mrs. McCurley
Does my right hon. and learned Friend agree that the redistribution or re-allocation of funds in the Health Service away from Greater Glasgow has greatly contributed to the benefit of other health authorities, such as Argyll and Clyde in my constituency? Will he ensure that that trend continues, as other health boards need the cash?

§ Mr. Rifkind
My hon. Friend is quite correct. As Glasgow has been treated so generously, authorities such as that referred to by my hon. Friend, and other authorities in Scotland, will next year be given a provision for growth. The provision for Greater Glasgow health board will allow it to maintain its existing services. Other health authorities 936 will have the opportunity to catch up with Glasgow, because they have been given a slightly greater share of the overall resources:

§ Dr. Godman
Has the right hon. and learned Gentleman at any time discussed with the chairman of the Greater Glasgow health board the appalling design failures in the Royal Infirmary development?

§ Mr. Rifkind
No, I have not. I am sure that my hon. Friend the Under-Secretary of State and the Scottish Home and Health Department will be familiar with any problems of that kind to which their attention may be drawn.

§ Mr. Fairbairn
Will my right hon. and learned Friend tell the Greater Glasgow health board that if it wishes to increase its finance it should not, as the hon. Member for Glasgow, Maryhill (Mr. Craigen) has done, take such a pragmatic—or even dogmatic—attitude to privatisation? Does he agree that if the health authorities in England can manage to raise £40 million by privatisation—a saving of 25 per cent.—the Scottish health boards, if they did not have such politically perverse attitudes, could also increase their own funding?

§ Mr. Rifkind
If any health boards have not properly examined the opportunity for savings to be made by tendering out to private contractors certain services which in the past have been carried out within the Health Service, those boards will have forgone a possible means of making savings which could be used to improve services to their patients.

§ Mr. Dewar
Does the Secretary of State recognise that the per capita comparison that he used a few minutes ago is shamelessly misleading because it does not properly take into account the enormous inflow of patients from other areas to the hospitals and specialist facilities in Glasgow? The right hon. and learned Gentleman said that the Greater Glasgow health board had been generously treated. If so, has he been able to convince its members — the people whom he has trusted with the administration of the Health Service in Glasgow and who presumably carry his confidence—about the fairness of the formula?
I want the Secretary of State to be specific in his reply to my next question. Does he accept the point fairly put by my right hon. Friend the Member for Glasgow, Govan (Mr. Millan), that if we look at expenditure between 1978–79 and 1988–89, as revealed in the answer to me on 17 March, and apply the hospitals and community health service pay and price deflator, that proves conclusively that the increase in real terms is substantially below any figure that has been mentioned by any interested group to take account of demographic factors and the increase in medical expertise?

§ Mr. Rifkind
The various factors to which the hon. Gentleman has drawn attention are indeed taken into account in the SHARE formula. The fact that Greater Glasgow provides services for those outside its area is not unique to Greater Glasgow and is taken into account in the way that I have shown.
I am happy to tell the hon. Gentleman that health services in Scotland have experienced an increase in resources in real terms of 16.4 per cent. compared with 1979.