§ 3. Tom Brake (Carshalton and Wallington) (LD)What estimate he has made of the total projected deficits in NHS trusts in England for the end of this financial year. [148786]
§ The Secretary of State for Health (Dr. John Reid)Audited information on the financial position of national health service trusts will be published in their individual annual accounts. These data will be available centrally in the autumn. We have no plans to publish unaudited information.
§ Tom BrakeI thank the Secretary of State for his response. Does he agree that many strategic health authorities, primary care trusts and acute trusts are suffering from years of underinvestment? Will he tell the House what assessment he has made of waiting times and of the number of beds and operations, in terms of requiring acute trusts such as my own, which I understand has a deficit of £8 million, to achieve financial balance in the year 2003—04?
§ Dr. ReidI accept the hon. Gentleman's assertion that for many years—indeed, for decades—the NHS had been suffering from underinvestment. That is why the largest and longest ever sustained increases in investment under this Government are only now beginning to show distinct improvements: to some extent, trusts have been back-filling for the underinvestment that occurred in the years of the previous Government. I know that trusts in the hon. Gentleman's own area—Epsom and St. Helier, for instance—have been forecasting a deficit position for several months. However, with additional support provided by the local strategic health authority and local primary care trusts, it is expected to break even by the year end.
1199 It goes without saying that, despite those difficulties, the increased investment in the same area has resulted in 15 additional consultants in the past three years; 13 more modern matrons appointed; and a 15-bedded stroke unit, which opened at St. Helier in June 2002. The forecast income for the primary care trust—the most important matter there—has increased by £12.5 million, which is just over 6 per cent. Yes, there are difficulties because of the decades of underinvestment, but we should congratulate NHS staff on taking the investment and doing such a good job in carrying out significant improvements in every area.
§ Mr. Lindsay Hoyle (Chorley) (Lab)Is my right hon. Friend aware that some of the budget problems can arise, as in Chorley, where there has been a huge increase in population that has not been reflected in the NHS budget? We are talking about 10 per cent. growth year on year, so what can we do to ensure that the budget reflects that population growth?
§ Dr. ReidAs my hon. Friend knows, in the last internal redistribution of moneys to NHS trusts throughout the country, we tried to take a number of factors into account. For instance, need has now become a more important benchmark than in the past, which has affected the redistribution. In the next round, in addition to need, I shall have regard to demographic trends. If my hon. Friend can point me in the direction of any inequities of distribution resulting from under-assessed demographic trends, I shall certainly bear them in mind.
§ Mr. Tim Yeo (South Suffolk) (Con)Everyone knows that more money is being spent on the national health service, and, alas, everyone knows that far too much of that money is not reaching the front line. That is why a 37 per cent. increase in spending has produced only a 5 per cent. increase in activity. Will the Secretary of State now admit that many individual trusts do indeed face deficits as they approach the year end—including the trust where the chairman of the British Medical Association himself works? James Johnson warned in the autumn of a possible £7 million deficit in his trust's budget. Is it not the case that tackling that problem at the individual level can only be done at the expense of services to patients in areas that are not covered by one of the Government's numerous targets through which the Secretary of State determines the priorities that local managers have to follow?
§ Dr. ReidI know the hon. Gentleman has double the jobs of anyone else, but he must try to get to grips with at least half of his portfolio—the health service. It is absolute rubbish to say that there has been a 37 per cent. input and a 5 per cent. output in productivity. [HON. MEMBERS: "Your figures."] They are not our figures. They are figures that relate only to hospital consultants. They ignore, for instance, the 42 NHS walk-in centres and the 6.3 million calls made to NHS Direct—completely new services, only in existence for the past few years. They even regard the 25 per cent. reduction in deaths from coronary heart disease—because they result 1200 not from hospital consultants but from new drugs—as a fall in productivity in the health service. How perverse is that? The hon. Gentleman should at least give credit to NHS staff by accepting that in millions of ways—through NHS Direct, walk-in centres, more operations being performed in primary care trusts, better purchases of drugs, a 25 per cent. fall in mortality from cardiac-related disease, a 10 per cent. reduction in deaths from cancer—[Interruption.] Conservative Members sneer, but they should give some credit to NHS staff.
§ Mr. Bill O'Brien (Normanton) (Lab)When the forecast for debts for NHS trusts is considered, what part will the strategic health authorities play in ensuring that such debts are not incurred? Will the debts of any local trust influence the future building of new hospitals in that area?
§ Dr. ReidAs I said earlier, we are confident that each trust, and indeed the NHS as a whole, will be in a position of balance at the end of the year. As in every business, certain trusts will be under pressure and will face temporary deficits. The rule is that they must be in balance over a cycle of up to five years. In the interim, they will be assisted either by savings found inside the trust in forthcoming years, or from the local strategic health authority, or from the primary care trust or from the NHS bank. That is perfectly normal business practice in the outside world. The NHS as a whole, and the individual trusts to which my hon. Friend refers, will be in balance by the end of the year.
§ Sir Nicholas Winterton (Macclesfield) (Con)I accept that the Government are desperately trying to reduce waiting lists and provide operations and treatment for those whose lives are in danger. However, if, after audit, it is clear that a hospital trust has created a deficit for itself because it has been doing precisely that—treating the people who need to be treated and providing life-saving operations and treatment—will the Secretary of State ensure that that trust has the resources so that it does not have to turn away those who need urgent treatment to save their lives?
§ Dr. ReidYes, of course. The point of the vast increase in resources that we are putting in is to enable more people to be treated more quickly across a whole further range of services. That is precisely what we are doing. When the hon. Member for South Suffolk (Mr. Yeo) attacks targets from the Opposition Front Bench, he forgets that, although the targets are general, they apply to what people want. They include reducing deaths from heart disease and ensuring faster access to heart surgery and clot-busting drugs. Which of those targets does the hon. Gentleman disagree with?
We are trying to ensure that the increased investment is matched by reform inside trusts from top to bottom so that they are more productive at any given level of capacity. I think Conservative Members should occasionally welcome that. For goodness' sake, it would be nice if Conservative Front Benchers just once thanked the people who work in the NHS for the significant improvements that they have achieved.