§ 8. Mr. ForthTo ask the Secretary of State for Scotland if he will give the expenditure per head in real terms on health services in Scotland in 1979 and 1987; and if he will make a statement.
§ Mr. Michael ForsythGross expenditure on the National Health Service in Scotland in 1979–80, at 1987–88 prices, was £354 per head of population. The corresponding figure for 1987–88 is expected to be £454.
These figures for Scotland are some 25 per cent. higher than the equivalent figures for England, and Scotland has 39 per cent. more health staff and 59 per cent. more hospital beds than England on a population basis.
§ Mr. ForthI thank my right hon. Friend for those impressive but not surprising figures. Can he tell the House whether he believes that there has been a commensurate dramatic increase in the quality of patient care, particularly in the light of the article on the front page of today's Glasgow Herald? Can he explain that?
§ Mr. ForsythI share my hon. Friend's concern about that article, and I have had inquiries made. The injuries suffered by the reporter concerned can be treated by a padded crepe support bandage or short plaster. [HON. MEMBERS: "Dr. Forsyth?"] May I ask hon. Members to listen? Contrary to what is printed in the Herald the reporter expressed a wish not to have a plaster, so that he could drive to Stirling. I am reliably informed that this was recorded and witnessed.
Had a plaster been essential, the medical staff in the accident and emergency unit could have applied one. This is a scurrilous and inaccurate piece of reporting, and I deplore such an unwarraned attack on the excellent facilities and staff at the Western infirmary in Glasgow.
§ Mr. DouglasI believe that we should get back to the main question. I want the Minister to deal with the relevant aspects of expenditure, that is the proportion of GDP spent on health care in England and Wales and in Scotland. Is it not a fact that for the United Kingdom as a whole expenditure on health care is good value for money, and that attempts to undermine that by stupid proposals such as contracting out are to be deplored by hon. Members on both sides of the House?
§ Mr. ForsythI am very grateful to the hon. Gentleman for asking about GDP. He will know that health expenditure in England as a proportion of GDP is 6.2 per cent. In Scotland it is 8.2 per cent. That means that we have significantly more resources. The point of competitive tendering is to ensure that we make the maximum possible provision for patient care.
§ Mr. Bill WalkerThese interesting figures provided by my hon. Friend show clearly that the Government are concerned with health care and that health care really matters. Will he confirm that the Government will look very carefully at these matters to ensure that we receive value for money throughout the Health Service in Scotland, and in particular will he consider the great value for money provided by community hospitals?
§ Mr. ForsythI am grateful to my hon. Friend. The Government are determined to ensure value for money in the Health Service and at the same time to provide additional resources. Next year's additional allocation of expenditure for the Health Service in Scotland, at some £120 million, will be the biggest ever in cash terms in the history of the Health Service in Scotland. I wish that Opposition Members would acknowledge that.
§ Mr. WilsonIn view of the Minister's very recent, very personal and very profitable connections with the private health sector, is it not time that he was seen to get his sticky 301 fingers off the Scottish Health Service? Will he accept that it is doubly offensive to loyal servants and low-paid workers in the National Health Service to see someone trying to do them out of their jobs when they know that that individual has such strong, personal, vested interests in the destruction of public sector employment and its replacement with cheapskate contract labour?
§ Mr. ForsythI have no vested interest. I deplore the hon. Gentleman's offensive attack on those workers because, by implication, he is arguing that competitive tendering will put them out of work. That means that he thinks they are providing inefficient services. They have nothing to fear from competitive tendering if their services are providing value for money. Any savings that are achieved will result in improved patient care for the hon. Gentleman's constituents, whom he should seek to represent.
§ Sir Hector MonroDoes my hon. Friend agree that since 1979 the Government have provided 5,770 new beds and that in the 34 new projects under construction there will be another 4,484? Is that not a splendid achievement, which shows that the Government have every intention of maintaining a close interest in the Health Service?
§ Mr. ForsythI am grateful to my hon. Friend. He has drawn attention to the biggest capital investment programme in the history of the Health Service in Scotland undertaken by this Government because of the success of our economic policies and the priority that we have placed on the Health Service. When Opposition Members formed the previous Labour Government they presided over the biggest ever cut in the capital programme in the Health Service in Scotland.
§ Mr. DewarDoes the Minister not share my sharp concern about the crisis in the Health Service and the frustration that is growing daily among those committed to the delivery of a comprehensive and adequate service to those in need? Will he accept that if we are to avoid industrial action—which no hon. Member wants to see —it is important that he makes his contribution to that process? Will he look again at the circular on privatisation, because it is resented by the boards, which, in many cases, are seeing their professional judgment on how they manage their areas being overturned? It is also resented by the staff whose jobs are at risk and by the public who know that contracting out is depressingly irrelevant to the real problems facing the Health Service.
§ Mr. ForsythI noted that the hon. Gentleman has aligned himself with those calling for industrial action in the Health Service, and his photograph appeared in the Glasgow Herald. It is in the interests of the Health Service to maximise the resources available for patient care. [Interruption.] If the hon. Gentleman is saying that he does not align himself with those calling for industrial action in the Health Service, I welcome that.
Since 1983 the boards have been asked to carry out competitive tendering in Scotland. They have not done so. Health authorities in England have, and as a result the Health Service in England has had £100 million a year extra to spend on patient care. Is the hon. Gentleman really arguing that patients in Scotland should be denied those extra resources simply to keep his friends in the trade unions happy?