§ 3. Mr. Knowlesasked the Secretary of State for Social Services what further savings he envisages can be made by health authorities from cost improvement programmes in 1986–87.
§ 8. Mr. Michael Forsythasked the Secretary of State for Social Services if he will make a statement on the progress made in obtaining value for money in the National Health Service.
§ The Secretary of State for Social Services (Mr. Norman Fowler)Health authorities in England have made substantial progress in obtaining improved value for money in recent years. Cost improvement programmes have yielded savings of over £250 million in the last two financial years. This is a direct increase in the resources available to develop and improve service to patients. For 1986–87, authorities plan further cash savings of some £150 million.
§ Mr. KnowlesI thank my right hon. Friend for that answer. Would the public be right to conclude that the substantial savings already made—and those still to be made — have contributed to the largest ever capital building programme in the NHSS?
§ Mr. FowlerYes, Sir. Over £130 million is to be spent on the capital building programme this year. We are restoring the cuts in the capital building programme made by the last Labour Government. In view of the pathetic 931 story in ihe Dairy Mirror today I must say that over the next three years we plan to complete more than 100 major new hospial schemes. Altogether, we have 380 hospital schemes in the hospital building programme.
§ Mr. ForsythCan my hon. Friend confirm that the contracting out process in the National Health Service has produced substantial savings which are being used for patient care?
§ Mr. FowlerThe latest figures show that that has produced £63 million, with about half the operation completed. All those savings are going into direct patient care, which shows the worth of the competitive tendering process.
§ Mr. Willie W. HamiltonIs the Secretary of State aware that the millions of people throughout the country who saw the television programmes broadcast last night and last week surely cannot believe a word that the right hon. Gentleman says about the NHS, either with regard to savings or any other matter? Does the right hon. Gentleman realise that the evidence given in those programmes shows the rapid decay of the Health Service throughout the country?
§ Mr. FowlerRecord resources are being devoted to the Health Service. Even more important, a record amount of health care is being provided through the NHS under this Government. No amount of television programmes can deny that fact.
§ Mr. PavittHas the Secretary of State studied the report of the British Medical Association and the Royal College of Nursing, which shows that cost efficiency savings—which are really disguised cuts—have reached the end of their lives? Therefore, would it not be absolute nonsense to suggest that in 1986 and 1987 there will be greater patient care from savings that simply cannot be made?
§ Mr. FowlerQuite simply, the hon. Gentleman is wrong. The health authorities are planning on a cost improvement programme of £150 million for the year 1986–87.
§ Mr. Willie W. HamiltonCuts.
§ Mr. FowlerThey arc not cuts, but resources that are now being directed into patient care. I would have thought that that was what the Health Service was all about.
§ Mr. SimsHas my right hon. Friend noticed that a number of hospitals in the private sector appear to be able to operate at lower true operating costs than hospitals in the public sector? Are there not lessons to be learnt from that?
§ Mr. FowlerI am sure that there are lessons to be learnt, but, to give credit to the NHS, we must recognise the enormous improvements that it has made over the past four or five years in effectiveness, especially in management within the service.
§ Mr. MeacherIs the Secretary of State aware that both the National Association of Health Authorities and the BMA believe that under current financing plans the NHS will be £650 million short this year to maintain even its existing standards? How will the Government pay for the promises made by the right hon. Gentleman at the Tory party conference to increase the number of hip operations, heart bypass operations, bone marrow transplants, 932 cataract operations and cervical cancer screening, which, in total, will cost an additional £150 million a year? Why cannot the right hon. Gentleman be honest and admit that those improvements can he afforded only by major cuts elsewhere in the NHS?
§ Mr. FowlerThe hon. Gentleman's claim is wholly untrue. The money and resources for those improvements are already in our plans and they build on the improvements that we have made since 1978. For example, since then heart bypass operations have risen by more than 7,000—an increase of 230 per cent. over the last Labour Government — hip replacements have risen by almost 10,000—an improvement of 35 per cent. over the last Labour Government — and cataract operations have risen from 35,000 to 55,000. All those are vast improvements over the last Labour Government.
§ Mr. MeadowcroftIs the Secretary of State aware that in Leeds and other areas hospital authorities are making savings in their budgets by giving patients prescriptions for only seven days, so that they have to obtain repeat prescriptions from a doctor at additional cost to themselves? Is the right hon. Gentleman further aware that in some cases chemists 'are advising patients not to have their prescriptions dispensed but to ask their doctors for one prescription for a longer period to try to avoid the patient having to bear that additional cost? Surely it is nonsense to transfer money in that way so that in the end the patient has to pay?
§ Mr. FowlerI shall certainly study any real evidence that the hon. Gentleman can supply on that matter. I know of no general evidence to suggest that prescription charges are having such an effect.