§ 4. Mrs. Maureen Hicks
To ask the Secretary of State for Health if he will make a statement on future funding of regional health authorities under the resources allocation working party.
§ 19. Mr. Colin Shepherd
To ask the Secretary of State for Health what plans he has to make changes to the resource allocation working party formula.
§ The Secretary of State for Health (Mr. Kenneth Clarke)
I hope to be able to announce the 1989–90 resource allocations to regional health authorities shortly. When the National Health Service management board's report on the review of the resource allocation working party formula was published, the then Secretary of State for Social Services said that the Government would consider the report within the context of the wider review of the NHS. That remains the position.
§ Mrs. Hicks
Does my right hon. and learned Friend agree that a mockery is made of the assessment formula for regional health authorities when Brighton and Wolverhampton are placed in the same league of social deprivation? May I have his much-needed assurance that if the RAWP is genuinely to fulfil its aim of reflecting the relative needs of the population, as I know that he would wish, he will consider most carefully the method of assessment, and especially its implications for the west midlands? Under current figures the west midlands stands to lose £23 million, which would be a disaster.
§ Mr. Clarke
My hon. Friend has raised this matter with me on a previous occasion. I know that she and other west midland Members are concerned. We are considering the review body's recommendation of a package of changes. It is true that the west midlands sees itself losing some of its proposed share of resources under the RAWP formula. We thought it best to examine the re-allocation of resources within the context of the review of the service, which is now taking place. We shall present our conclusions when we are able to announce the results of the review.
§ Mr. Shepherd
Does my right hon. and learned Friend agree with the concept that morbidity is a better measure of the needs for the elderly than the standard mortality rate, especially in Herefordshire where there is a much greater than average number of elderly and very elderly among the population? Is he aware that there is substantial concern that a national expenditure rate as a means of measurement does not accurately reflect the different economic health of the elderly, for example, of Eastbourne, Hereford and Sandwell? Will my right hon. and learned Friend give careful consideration to these matters and engage in more work on them before he accepts the review?
§ Mr. Clarke
With allocations that are based on complex formulae, it is always possible to have serious argument on precisely what criteria should be used. My hon. Friend makes two valid points, especially from the point of view of the Hereford health authority, which comes within the 755 West Midlands regional health authority. In the past, the RAWP allocation has helped to remove some of the wide variations in allocations between different parts of the country. We must be sure that future allocations proceed on a fair basis and accurately reflect, as far as possible, varying needs across the country.
§ Mr. Ashley
Is the Minister aware that Stoke-on-Trent hospitals are already operating a red alert, before the onset of winter? They desperately need assistance from the resource allocation working party. Any changes in the formula that help better-off areas are bound to damage Stoke-on-Trent and other poorer areas. Surely that is unacceptable.
§ Mr. Clarke
Stoke-on-Trent and many other areas were historically under-provided compared with more prosperous parts of the country. Since the Government have been in office, they have done extremely well. That is because we have applied the RAWP formula to the distribution of resources. We have brought all regions much closer together financially than they were before we took office. Most of the disparities between districts have been narrowed to a large extent. We must now examine the recommendations and ensure that we arrive at the fairest system possible for the allocation of resources.
§ Mr. Campbell-Savours
Can the moneys that are made available under the RAWP formula be re-examined in the light of the recent public hysteria over salmonella, and can additional resources be expended in particular areas? Bearing in mind the statement by the Secretary of State's junior Minister, is it not about time that the hon. Lady was sacked? She has frightened the British people.
§ Mr. Clarke
The future of the RAWP formula is of serious concern to those who live in the Northern regional health authority areas and in areas within the hon. Gentleman's constituency. He does no service to his patients or constituents by taking the opportunity to ask a frivolous supplementary question on a serious topic.
§ Mr. Andrew Mitchell
In any review of the RAWP procedure, will my right hon. and learned Friend bear in mind that the Nottingham health authority, which covers the areas which he and I represent, is still about 5 per cent. short of the RAWP target? Will he bear in mind that if it is able to make up that percentage, it will be able to do much more in furtherance of the excellent progress that has been made over the past seven years to secure an even better health service in Nottinghamshire?
§ Mr. Clarke
I am grateful to my hon. Friend for reminding me that Trent will do even worse than the west midlands under the proposals that have been made by the RAWP review procedure. Reactions vary according to which part of the country people come from and the impact that the review procedure proposals will have on their region. We have done a great deal in the past, and this has helped Nottingham to open a new teaching hospital. That has been possible with the extra moneys that it has received. We must now hold the balance and arrive at the fairest method of distribution for the future. That will not he a method that reverses all that we have done over recent years to remove the old inequalities.
§ Mr. Robin Cook
Does the Secretary of State appreciate that it is rather a weird definition of deprivation that has the net effect of taking cash away from the north-east and 756 the north-west and redistributing it to the south coast and East Anglia on the ground that those areas are more deprived than Merseyside and Tyneside? Does he not also appreciate that he will bring the whole RAWP process into disrepute if that formula is now to be fixed in exactly the same way as the rate support grant formula is now rigged?
§ Mr. Clarke
The Health Service management board comprised a wide range of people including the regional chairmen of regions the length and breadth of England. Its report is an attempt to revise the criteria of the original RAWP allocation to reflect objective scientific study. It proves that it is almost impossible for anyone to get it right. There are losers and gainers in the north and the south and we have to ensure that whatever method we finally arrive at is fair and broadly acceptable to the bulk of the population.