Health Boards (Hansard, 26 March 1986)

§ 7. Mr. Maxton
asked the Secretary of State for Scotland when he next intends to meet the chairmen of the Scottish health boards to discuss the budgets for the next financial year 1986–87.

§ Mr. Rifkind
My hon. Friend the Minister with responsibilities for Home Affairs, Health and Social work met health board chairmen on 10 March, when the financial provision for hospital and community health services in 1986–87 was discussed in general terms. The next regular meeting with chairmen is to be held in June.

§ Mr. Maxton
When that meeting takes place, will the Secretary of State, if he is there, take the chairman of the Greater Glasgow health board, Mr. Donald McQuaker, to one side and tell him whether he agrees with his junior Minister, who said that even if the Treasury gave him £10 million extra tomorrow for health in Scotland,, he would not give the Greater Glasgow health board one brass farthing of it? If that is the case, is it not a disgrace that a junior Minister should express such a view about a city which has the appalling health record of Glasgow in terms of heart disease and lung cancer, which suffers all kinds of deprivation and which provides services for all the areas around Glasgow and for the whole of Scotland in terms of expensive expertise?

§ Mr. Rifkind
I was under the impression that the hon. Gentleman spoke from that Dispatch Box on behalf of 940 Scotland's interests, not the interests of any one locality. He knows perfectly well that a SHARE formula is worked out to ensure that all parts of Scotland receive a fair share of the resources available. He also knows perfectly well that Greater Glasgow health board is the health board with the best endowment of health resources in Scotland. Therefore, it is not unreasonable that my hon. Friend and the Government should be seeking to ensure that other parts of Scotland also receive a fair share of the resources available.

§ Mr. Michael Forsyth
Will my right hon. and learned Friend take the opportunity when he next meets the chairmen of the health boards to discuss with the chairman of the Forth Valley health board whether adequate resources are being provided to deal with the disgraceful, Dickensian conditions that exist in the Royal Scottish national hospital for the mentally handicapped at Larbert? It is a Scottish facility which is in a disgraceful condition. Will my right hon. and learned Friend satisfy himself personally that sufficient resources are being put forward to deal with the problem?

§ Mr. Rifkind
My hon. Friend is right to draw attention to that particular difficulty. The matter is under consideration at present.

§ Mr. Tom Clarke
When the Secretary of State's hon. Friend meets the chairman of the Greater Glasgow health board, will he draw his attention to the deteriorating conditions at Woodilee hospital and remind the chairman of the conditions of the staff who are living in health board houses? Will the Secretary of State accept that nobody in my constituency will regard him as generous so long as those intolerable conditions remain?

§ Mr. Rifkind
The hon. Gentleman will be well aware that the health authority to which he refers will be entitled to growth this year to ensure proper provision. Each health board can consider how the SHARE formula operates for its particular locality. I think that the hon. Gentleman's authority is one that will benefit from that, and I can assure him that the resources that will be made available will be based on the formula, which the health boards as a whole see as a reasonable approach to the matter.

§ Mr. Fallon
Will my right hon. and learned Friend remind health board chairmen that health spending in Scotland last year was 26 per cent. higher per head than in England? Is that not a generous and formidable difference?

§ Mr. Rifkind
For many years the Secretary of State for Scotland has been able to determine within the overall resources made available whether he wishes to give priority to one area of expenditure at the expense of other areas. My hon. Friend will be aware that the total resources made available to the Scottish Office are based on a formula system which allows that flexibility. Scotland has traditionally allocated a significant share of resources to health in particular, because of the emphasis on dental and medical education and other factors. That has led successive Secretaries of State to give priority to that area.

§ Mr. Strang
Does the Secretary of State recognise that the SHARE formula should be implemented against a background of real growth in the Health Service, to match, not just the increased, technological advances, but the increased needs arising from higher unemployment and more elderly people? Does he recognise that the problems 941 in Glasgow are similar to those that we have to face in Edinburgh? Is it not a scandal that new geriatric facilities and other facilities which have been invested in have been standing idle in Edinburgh because of the Government's failure to provide adequate resources to the Health Service generally?

§ Mr. Rifkind
The hon. Gentleman does not know what he is talking about. Next year the provision for health services in Scotland will increase by 6.8 per cent., which is 2.3 per cent. above the forecast level of inflation. Since 1979 the number of medical and dental staff nurses and midwives in Scottish hospitals and health services has increased by 11 per cent. The hon. Gentleman might like to reflect on that.

§ Sir Hector Monro
In welcoming the fact that expenditure on the Health Service is the highest ever in real terms, may I ask whether my right hon. and learned Friend has been able to discuss with the chairman of health boards the provision of renal dialysis facilities away from the main centres of population, such as in Dumfries and elsewhere, where patients must travel enormous distances for appropriate treatment?

§ Mr. Rifkind
I thank my hon. Friend for the first part of his question. Regarding renal dialysis, the Department is considering that at present.

§ Mr. Steel
Will the Secretary of State explain to my constituents why the Government provide the capital for the long-overdue building of the new district general hospital, but not the revenue to enable the board to open the 30-bed geriatric unit as planned?

§ Mr. Rifkind
The right hon. Gentleman must appreciate that when the health authority to which he refers seeks the provision of a new hospital, and is aware of the resources available to it and of the SHARE formula, which ensures that it receives an increasingly fair share of the resources available, it is for the health board to decide on the utilisation of those resources to meet its commitments.

§ Mr. Dalyell
Is the Secretary of State aware that it costs up to £15 for a course of treatment? Is he worried about the way in which dentists have to make decisions, not on the basis of their own clinical judgments, but on their assessment of the depth of a patient's pocket if a patient is not drawing benefit?

§ Mr. Rifkind
The hon. Gentleman knows quite well that a high proportion of patients in Scotland do not make any payment at all for the dental services that they receive. He should also take into account the fact that most dentists, and indeed most doctors, would consider it perfectly proper and responsible that they should have some consideration for the overall costs of the treatment they are giving. We have to consider the best use of health resources, and that applies as much to dentists as to anyone else.