The National Health Service: Increase in Funding (Hansard, 19 May 1982)

§ Baroness Gardner of Parkes
My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Trefgarne)
My Lords, between 1979–80 and 1981–82 expenditure on the National Health Service increased by about 4.75 per cent. in real terms. After allowing for the savings which we asked authorities to make in 1981–82 by more efficient use of resources, growth in services amounted to about 5 per cent. We plan a further real increase in services of just over 1 per cent. in the current financial year. This will come very largely from new resources, but we are again asking authorities to make a contribution through further efficiency savings.

§ Baroness Gardner of Parkes
My Lords, while I thank my noble friend the Minister for his reply, I wonder whether he can tell us what proportion of the expenditure goes on wages and salaries, and will he also comment on the cost in terms of wasted and lost resources—apart from the very considerable human anxiety and suffering—which may result from today's industrial action? What will be the loss to the health service in terms of unused resources today?

§ Lord Trefgarne
My Lords, in answer to my noble friend's first supplementary question, I can say that about 75 per cent. of National Health Service expenditure goes on salaries and wages. With regard to my noble friend's second supplementary question, I have to say that it would be difficult to determine that figure—at least until we have a better idea of the effect of today's unfortunate action.

§ Lord Wells-Pestell
My Lords, may I ask the noble Lord the Minister whether he will be good enough to expand on the Answer he has given his noble friend and indicate whether the service given by the National Health Service is as good today as it was in 1979? Will he say whether or not the patient care, as a result of shortage of money, is as good now as it was three years ago?

§ Lord Trefgarne
My Lords, as I have said, the increase in expenditure in real terms since 1979–80 is a figure approaching 5 per cent. The answer to the noble Lord's question must therefore be that the standard of service has indeed improved.

§ Lord Byers
My Lords, may I ask the noble Lord what would be the cash sum reouired to meet the Government offer to the hospital workers, and how much extra in cash would be required to meet their demands?

§ Lord Trefgarne
My Lords, if we were to meet the full demands of the Health Service unions I think the figure would be—I am speaking from memory on this—something like £300 million or £400 million.

§ Lord Molloy
My Lords, as a previous report submitted that the increase in Health Service expenditure would have to be about 5 per cent. in order to enable the service to stand still, to meet the cost of inflation and other impositions they are suffering from, does the noble Lord not agree that, although this is not a bad performance on the part of the Government, we are not moving forward as rapidly as we should? Would it not be a much better idea if the Government, instead of waiting for the employees of the Health Service to get exasperated, were to meet them and see if they could meet some of their demands in a more rational way, rather than let the situation continue as it has been doing?

§ Lord Trefgarne
My Lords, I think we have met the demands of the Health Service employees in a rational way. For example, we have provided additional funds over and above those that were originally earmarked for this purpose for the nurses and midwives. Their offer, as the noble Lord will know, is in excess of 6 per cent. The figure I gave for the increase in Health Service expenditure generally since 1979–80 was, of course, the figure which had already taken account of inflation.

§ Lord Molloy
My Lords, is the noble Lord aware that much of that money is coming from the increased prescription charges and that the Government are giving with one hand and taking away with the other? With regard to the point on industrial action, I believe—

Noble Lords
Question!

§ Lord Molloy
My Lords, is the Minister aware that, on information I have previously received, I have in this House asked the Government to meet the leaders of the trade unions involved in order to avoid the industrial action that is now taking place? It is still not too late for the Government to make a move.

§ Lord Trefgarne
My Lords, there has been no lack of communication between my right honourable friends and the trade union leaders in this matter, but of course the question of industrial relations between the workers and the management is a matter for the health authorities themselves and is not primarily a case for ministerial intervention.

§ Lord Rochester
My Lords, do not these exchanges demonstrate the need for a pay policy which caters not only for employees in the National Health Service but for those employed in public services generally?

§ Lord Trefgarne
My Lords, my recollecton is that in previous times when a pay policy of one sort or another has been in operation we have not avoided difficulties of this kind.

§ Lord Wells-Pestell
My Lords, may I ask the noble Lord the Minister whether it is not a fact that in the last three years there have been ward closures owing to lack of money and curtailment of services for the same reason?

§ Lord Trefgarne
My Lords, it is sometimes the case that Health Service facilities that have been in existence for some time, such as hospitals that have been built for many years, do actually need to be closed, but in general the aggregate result of Government policy in this matter is an increase in expenditure, which I described in the original Answer.

§ Baroness Gardner of Parkes
My Lords, would the noble Lord the Minister confirm that when the pay policy which has been referred to was in force the review bodies' recommendations at that time for people working in the Health Service were actually set aside and not implemented? Can he tell me in how many years those review body recommendations have not been honoured, and will he say whether he is considering setting up a nurses' review body?

§ Lord Trefgarne
My Lords, as my noble friend will be aware, my right honourable friend the Secretary of State discussed development of permanent arrangements for nurses' pay with the Nurses and Midwives Whitley Council on 17th March. As a result of that meeting, a small working group, on which both sides of the Whitley Council will be represented, has been asked to produce more detailed proposals. We are most anxious to move forward on this complex issue and I hope that the working group will meet shortly.

§ Baroness Gardner of Parkes
My Lords, I would ask the Minister to answer the other part of the question, concerning the failure of various Governments to implement review body recommendations.

§ Lord Trefgarne
My Lords, I have not got that information to hand. Perhaps I could write to my noble friend.

§ Lord Molloy
My Lords, is the noble Lord aware that, while he is quite right when he says that there are certain old hospitals that have been closed, and it may be that that was necessary, what causes frustration is that a brand spanking new hospital, of which I am sure he is aware of will be when I have finished, was not allowed to be opened to the full, but only half of it—

Noble Lords
Order, order!

§ The Lord Privy Seal (Baroness Young)
My Lords, will the noble Lord, Lord Molloy, please put a question correctly and not make a short speech?

§ Lord Molloy
My Lords, I will immediately respond to the noble Baroness the Leader of the House and put the question quite fairly. I thought I put it quite fairly, anyway. As the noble Lord said, certain old hospitals have been closed, and maybe that was quite right and proper, but is he aware that what is causing frustration is this: there is a brand new hospital of 702 600 beds in Ealing, with all facilities—it is only 18 months old—and only half of it is allowed to function because of the action of the Secretary of State? Many people find that totally irresponsible.

§ Lord Trefgarne
My Lords, as the noble Lord will know, the day-to-day management of the health service rests with the regional health authorities and the district health authorities. It is not always the case, however, that difficulties such as the one which the noble Lord has described are the result only of lack of resources.

§ Lord Beswick
My Lords, would the noble Lord the Minister not agree that, on the face of it, there seems to he something wrong with our society, which offers in the case of the most civilised institution in the country, namely, the health service, a salary increase of 4 per cent. or 6 per cent. to the workers, whereas at the same time the most decadent of the organisations in the country, namely, the Sun newspaper, has just settled at 9½per cent.?

§ Lord Trefgarne
My Lords, I do not think that I could be asked to comment on that matter, which, of course, goes pretty wide of the Question on the Order Paper. Clearly the Government have no responsibility for the matter to which the noble Lord refers.