HC Deb 25 July 1989 vol 157 cc845-6
8. Mr. Norris

To ask the Secretary of State for Health if he will make a statement on the allocation of the extra £40 million to help with the implementation of the White Paper "Working for Patients".

Mr. Kenneth Clarke

I have undertaken to ensure that the costs of implementing the NHS review will be met by the taxpayer over and above the resources provided to maintain the growth of services to patients. The provision of the additional £40 million brings the total available this year for the implementation of the review to £82 million, of which £70 million is for the hospital and community health services, £5 million for the family practitioner services and the remainder to meet administrative costs in my Department.

Mr. Norris

Does my right hon. and learned Friend agree that hard-pressed managers in the NHS deserve our full support, and that those additional resources are a welcome and constructive step towards implementation of the White Paper proposals? Does he agree that they are especially to be welcomed as new money that will leave untouched the existing record level of resources for patient care?

Mr. Clarke

I am grateful to my hon. Friend. As he knows, the great majority of managers in the service are very enthusiastic about the reforms proposed in the White Paper, and are working extremely hard to ensure their implementation. Some investment up front will, as I have said, be required, and we shall continue to provide it over and above the necessary increase in resources required to maintain the growth in patient care.

Mrs. Dunwoody

How much of that new money will be allocated to patient care, and how much to the provision of hardware, accountants and software to be employed in billing procedures? It is rather important for the patient to know what he is spending the money on.

Mr. Clarke

As the hon. Lady knows, in last year's public spending round we increased total spending on the National Health Service by £2 million. With additions during the year, we have brought the amount to be spent on the implementation of the review to £82 million. That covers a wide range of services, including grants for the training of more people with public health expertise who will be able to identify patient needs. Those needs will be resourced much better once the new system is in place.

Mr. Favell

Has my right hon. and learned Friend made any assessment of the savings that will be made by the streamlining of the decision-making process in self-governing hospitals? At present, as he well knows, major decisions must go first to the district health authority, then to the regional health authority, then to the Elephant and Castle and then all the way back down the line. Is it not true that savings will be made and that for all but the third rate, this will be a far better process?

Mr. Clarke

Over the years we have moved steadily towards replacing the second-guessing of decisions that has been traditional in the Health Service, when Ministers and their civil servants supervised the regions, which supervised the districts, which supervised hospital management. With self-governing hospitals, we shall put real responsibility into the hands of local people.

I agree with my hon. Friend that great improvements will be made in efficiency, and that at the same time the hospitals will be made even more responsive to local opinion, local patients' needs and perceived gaps in the present health care provision.

Mr. Robin Cook

Will the Secretary of State accept that we agree that this latest share-out shows the Government's priorities? Is he aware that three quarters of the new money has been spent on more finance staff and more computers for them, but only a couple of million pounds on the medical audit? Does it not speak volumes for the priorities of his White Paper that the accountants who treat no patients need 12 times the new resources that are given to doctors? Is not the truth that his priority is cost control, not patient care?

Mr. Clarke

The hon. Gentleman makes a specialty of picking out details of the White Paper that he blows up into misrepresentations. He knows perfectly well—[Interruption.]

Mr. Speaker

Order.

Mr. Clarke

This will be planned and brought in by the profession. The additional £2 million is extremely welcome to the profession and shows our good will to that development. We accept that more money will be required to finance medical audit when the profession has in place the mechanisms required to carry it out. We are talking about £2 million being spent on pump priming for that purpose this year.

Mr. Squire

Will my right hon. and learned Friend take all possible steps to implement the White Paper at the earliest opportunity so that my constituents, who are suffering excessive waiting lists in Barking, Havering and Brentwood, have the advantage of one of the White Paper's many proposals—that money should follow patients rather than some abstruse formula?

Mr. Clarke

I am grateful to my hon. Friend, and I reassure him that progress on preparation to implement the review is going steadily and very well at present. We seem well on target to deliver not only the review but, most important, its benefits to patients such as his constituents, who will experience a big improvement in how the service is delivered once the changes are in place.

Mr. Speaker

Order. It is difficult to hear questions against a background of discussion.