§ 4. Mr. James Lamond
To ask the Secretary of State for Health how much has been spent so far by his Department, by district health authorities and family practitioner committees to prepare for the implementation of the National Health Service and Community Care Bill.
§ Mr. Kenneth Clarke
So far in 1989–90 expenditure on review-related initiatives in the NHS as a whole stand at just over £80 million.
§ Mr. Lamond
How is it that the Government can cheerfully find £85 million to set up a monstrous bureaucracy of accountants and clerks who will be busy pushing accounts and receipts across a table to one another, but cannot find one tenth of that to help to overcome the tremendous hardship that people are suffering as a result of the ambulance workers' dispute?
§ Mr. Clarke
I am sorry that one year after we produced the White Paper entitled, "Working for Patients", the hon. Gentleman has not yet found time to read it. If he did so, he would realise that it has nothing to do with employing large numbers of accountants and clerks. The expenditure that has so far been incurred, includes, for example, expenditure on 100 extra consultants to tackle the waiting lists, on introducing quality control of clinical services, known as medical audit, and on pilot projects to introduce a new system of contracts to be entered into between district health authorities and hospitals. That £80 million has to be set against expenditure on the Health Service as a whole of £29,000 million next year and the £5,000 million increase in two years alone that we are proposing for the NHS.
§ Mr. Sims
Will my right hon. and learned Friend consider spending more money on ensuring that the general public are acquainted with the Bill's proposals and philosophy, and thus counteract some of the misleading information that has been given by certain professional bodies and by the Labour party?
§ Mr. Clarke
The White Paper is still available. It is written with clarity and there are explanatory leaflets to accompany it. There are strict rules governing the use of taxpayers' money for publicity and advertising. I have never been able to match the advertising budgets of the people who spent so much money last year on disseminating misleading versions of the reforms. 766 Nevertheless, my experience of the Health Service tells me that the climate of opinion is changing rapidly among all groups of staff within the NHS, and I am sure that that will rapidly communicate itself to the general public.
§ Mrs. Wise
Why did not the Secretary of State answer the question, which relates to expenditureto prepare for the implementation of the Natioal Health Service and Community Care Bill"?Why does not the right hon. and learned Gentleman want the House to know the exact figure? Why does he prefer to muddle it up with expenditure on consultants? How can it be lawful to spend any money on implementing a measure that has not yet received the approval of the House?
§ Mr. Clarke
I answered the original question with precision and accuracy—[HON. MEMBERS: "Oh."] The question relates to the Health Service review, and the introduction of, for example, clinical audit is extremely important. As to the Bill itself, those aspects of it that require statutory changes will not be implemented until the Bill is passed. If I were to interpret the question as narrowly as the hon. Lady suggests, I should have to answer, "Nothing." I described the money that has been spent on the National Health Service review—on desirable things, not on the idiotic things that publicity earlier this year implied lay behind the White Paper.