National Health Service

HC Deb 31 January 1990 vol 166 cc292-4

1. Mr. Cran

To ask the Secretary of State for Scotland how much was spent per head of the population in Scotland on Health Service care in 1989; and what was the figure for 1979.

The Secretary of State for Scotland (Mr. Malcolm Rifkind)

In 1979 Health Service expenditure in Scotland was £205 per person. In 1989 it was £552 per person. That is a rise of 34 per cent. in real spending power.

Mr. Cran

Does my right hon. and learned Friend agree that by any objective examination of the facts, the Scottish Health Service is unquestionably second to none? That is illustrated by the fact that my father is receiving quite outstanding care at the Royal Infirmary in Aberdeen and the service at that hospital is open to anyone in that area. It is also shown in the quite astonishing building programme that has occurred since 1979 under this Government during which time there have been 54 major hospital building programmes with another 32 in train. If that is not enough, there has been a 32 per cent, increase in qualified nursing staff to look after the additional patients which the expansion has occasioned. Does not my right hon. and learned Friend agree—[Interruption.]

Mr. Speaker

Order. That question is far too long.

Mr. Rifkind

While the National Health Service continues to have certain difficulties, it is right to draw attention to what has been achieved over the years. In Scotland, the number of in-patients has increased by more than 20 per cent, over the past 10 years while the number of out-patients has increased by 12 per cent, and the number of day cases treated by hospitals has increased by no less than 119 per cent. It is right that that side of the story should be emphasised.

Mr. Ernie Ross

Has the Secretary of State had time to study the press release issued by his junior Minister, the Under-Secretary of State for Scotland, about the ambulance dispute yesterday in which the Under-secretary claimed that lives are put at risk? Given the amount of money that the Government are trying to claim that they have spent, exactly whose lives are put at risk? What is the Secretary of State doing about that?

Mr. Rifkind

The concern to which the Under-Secretary of State for Scotland, my hon. Friend the Member for Stirling (Mr. Forsyth) drew attention was that if there is not a proper response to 999 calls, and if ambulance officers do not accept the advice of their own unions in dealing with emergency cases, sadly there can be a risk to human life. I am sure that the hon. Member for Dundee, West (Mr. Ross) would join me in urging ambulance workers to respond to emergency calls in a proper and responsible fashion.

Mr. Sillars

Is not the pertinent measure the expenditure in relation to need at the present time? If that is the case and if the Secretary of State is so brilliant, why has the Greater Glasgow health board suffered a £12 million cut in its budget this year and faces a £16 million cut in its budget next year? Again if the Secretary of State is so brilliant, why have we managed to have a Health Service in which there are demoralised nurses, doctors, ambulance men and ancillary workers and a public who do not believe that the Health Service is any safer in the hands of the lady in Downing street than in the hands of the devil himself?

Mr. Rifkind

I do not accept for a moment the figures that the hon. Gentleman has been gratuitously introducing into the House. However, he may like to reflect on the fact that in his constituency, the health board in the city of Glasgow is, and continues to be, the best funded health board in the United Kingdom. Had the hon. Gentleman wanted to be fair, he might have prefaced his remarks by at least recognising and welcoming that point.

Sir Hector Monro

Does my right hon. and learned Friend agree that we cannot really judge patient care in terms of statistics? It must be true that we have far more doctors, nurses and specialist care in Scotland than were available in 1979. Does he agree that the Health Service is safe in our hands and will be developed effectively in years to come?

Mr. Rifkind

I do not question for a moment that there are still many things that the Health Service in Scotland would like to do but is unable to do even with the levels of funding that it has achieved. That goes without saying. The Health Service has continually been improving ever since it began in 1947. It is unfair that those who quite understandably call for even more improvements do not recognise the dramatic improvements that have taken place over the past 40 years or, indeed, over the past 10 years. Any fair debate on this subject should recognise that, as well as call for further improvements in the Health Service.

Mr. Wilson

How many scarce resources belonging to the National Health Service in Scotland have now been used up in trying to defeat the ambulance men and women and in forcing them to give up their rightful claims by starving them into submission? Would the Secretary of State care to contemplate the newspaper headline that I am showing him as an acceptable face of the ambulance dispute? No matter how the soldiers and police try to perform the duties that have been thrust upon them, they are simply not able to do so because they lack the necessary equipment and training. Will the Secretary of State confirm that twice as much money has been spent on trying to defeat the ambulance men in Scotland, and elsewhere in the United Kingdom as would be required to settle their pay claim in full and give them the just settlement that every humane man, woman and child in Scotland wishes them to obtain?

Mr. Rifkind

No one questions for a moment that the police cannot provide the same quality of service as the ambulance officers. If that is a matter of concern to the hon. Gentleman, I hope that he will join me in calling on ambulance officers to return to normal work. The hon. Gentleman knows perfectly well that there are recognised negotiating structures. He knows also that the offer that has been made to ambulance officers is compatible with what the vast majority of other people who work in the National Health Service have already accepted. Therefore, he must appreciate that we must be fair to the National Health Service as a whole. To give to ambulance workers, whose income has increased substantially over the past few years—

Mr. Wilson

Rubbish.

Mr. Rifkind

The hon. Gentleman says, "Rubbish." He should remember that an ambulance officer's income in 1979 was less than £3,000. If ambulance workers accept the offer that has been made, the figure will be more than £11,000. Even taking inflation into account, that is a major increase.

By all means let these matters continue to be discussed and negotiated, but if the hon. Gentleman has patients' interests at heart, as I am sure that he has, he should urge ambulance workers to return to normal work so that the public should not suffer because ambulance workers have a pay disagreement with their employers.