§ 5. Mr. Michael
To ask the Secretary of State for Health what steps he is taking to ensure that adequate resources are available to meet the need for (a) health service provision and (b) community care as a result of demographic changes.
§ Mrs. Virginia Bottomley
We shall increase resources for the national health service in the United Kingdom by £3.2 billion in 1991–92. At the same time, the standard spending figure for local authorities' personal social services will rise by 23 per cent.
§ Mr. Michael
Does the hon. Lady recognise that Ministers are continually playing the old record which was left behind by the Secretary of State's predecessor? Since 1982, inflation in the health service has been 49.9 per cent., compared with a less than 35 per cent. increase in the retail prices index. Do the Government recognise that the health service is treading water where it is not drowning, that demographic changes and the increasing numbers of elderly people are flooding over our services and that it is not enough to mouth platitudes? Resources are needed if community care is to be more than merely moving people out of institutions and if it is to mean providing adequate services for carers and those who are cared for in the community. Can we have the resources so that the job can be done?
§ Mrs. Bottomley
This is the largest ever increase in resources for the national health service—a cash increase of one third over the past three years. I recall that when the Labour party was last in power, long ago, the total cost of the health service was £8 billion. There has been an extra £8 billion in the past three years alone. As for demographic factors, over the past 10 years the number of elderly people has increased by 8.4 per cent. Hon. Gentlemen might like to know that over that period the number of geriatric in-patients increased by 75 per cent.
§ Mr. Winterton
I am grateful for the reception by the House, but I am not on the ballot paper upstairs——
§ Mr. Winterton
Does my hon. Friend agree that it is unacceptable for 50 beds to be closed in a relatively new, modern district general hospital in Macclesfield when there are surgeons and consultants waiting to carry out treatment and operations, theatres available for those operations and waiting lists of people wanting operations? The Mersey regional health authority has allocated insufficient resources to Macclesfield, given the growing number of elderly people and the growing population of the area.
§ Mrs. Bottomley
The enemy of the health service is waste. It is a waste not to have people fully using the skills that they have been trained to deploy. It is a major 127 challenge to health authorities to live within their resources. We take great pride in the substantial increase in resources that we have provided for the health service, but we do not underestimate the financial and management skills that health authorities need to deploy so that they do not let their work outstrip the resources to meet that work. We need further improvements in that area.
§ Mr. Rooker
The Minister will agree that the demographic changes make a difficult situation far worse, so it is more important than ever to look at the way in which resources are moved about. How is it possible that Exeter health authority seems to have lost £60 million, which was released by the sale of two psychiatric hospitals at Digby and at Exminster, not £1 of which has gone into community care for the mentally ill? How is it possible that the Midland nerve hospital has closed a psychiatric ward with a staff of 15 who have been replaced by only three staff working in the community? Where have all those resources gone? Local people cannot find the information and they have been told that it is not available locally. We presume, therefore, that the information is available centrally. Can we be told?
§ Mrs. Bottomley
I welcome the hon. Gentleman to his new role. He will know that there is concern about the extent to which provision for the mentally ill has kept up with our wishes and expectations. That is why my hon. Friend the Parliamentary Under-Secretary of State has responsibility for the specific grant for the mentally ill which will commence next April. Next year, £30 million will be spent by local authorities, with the agreement of health authorities, to ensure that there is close collaboration in the provision of services for the mentally ill. Over the past 10 years, there has been almost a doubling in the number of places in homes for the mentally ill. We believe that there is scope for further provision by social services to ensure that they do as well with the mentally ill as, in many cases, they have with the mentally handicapped.