HL Deb 25 October 1982 vol 435 cc321-4

2.58 p.m.

Baroness Lane-Fox

My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government whether the total expenditure on health and personal social services represents an increase in real terms compared with 1978–79.

Lord Trefgarne

Yes, my Lords, In 1978–79 total Goverment expenditure on the National Health Service in England was £61 billion. Last year we spent over £11 billion. This represents growth in services of about 5 per cent. in real terms and there will be further growth this year. Over the same period net current expenditure on personal social services grew by some 7 per cent. in real terms.

Baroness Lane-Fox

My Lords, in thanking the Minister for that reassuring reply, may I ask him to confirm that, under this Government, more is being spent in real terms on the National Health Service than in any year of the previous Labour Government or, indeed, of any previous Government?

Lord Trefgarne

My Lords, my noble friend is quite right. If I may underline what I said just now, we are spending more now in real terms on the National Health Service than ever before.

Lord Wallace of Coslany

My Lords, following the very helpful supplementary question to the Government by the noble Baroness, which almost reminded me of a planted question, I should like to ask the noble Lord what "real terms" means? "Real terms" to me means an expansion of services, yet the Government say that they are spending more and the services are getting less and less. The noble Lord should have a look at the South-East Metropolitan Regional Health Authority's proposals to reduce services by millions, and the proposals of other metropolitan authorities as well. So "real terms" in the sense that we regard it is a meaningless term when the Government use it in the way in which the noble Lord has used it.

Lord Trefgarne

My Lords, there is no region in the country which, in real terms, is suffering a cut in the funds which we are making available to it. By "real terms", I mean that we are providing more money than just the increase in inflation would necessarily require. That is what I mean by "real terms", and the increase in real terms over the time during which we have been in office is about 5 per cent.

The Earl of Lauderdale

My Lords, can my noble friend give comparable figures for Scotland? Does he have them?

Lord Trefgarne

My Lords, I confess that I have been asked that question before in your Lordships' House and I do not think that I have been able to give a satisfactory reply. The figures for Scotland are separately collated. I do not have them in front of me, but I shall write to my noble friend.

Baroness Jeger

My Lords, although the noble Lord has given us total figures, will he not agree that there are more old people and, sadly, very many more unemployed people, and that, therefore, the benefit per head is, if anything, reduced, especially in view of the Government's failure to reinstate the 5 per cent. abatement, which was imposed on benefits in 1980?

Lord Trefgarne

My Lords, I am not sure whether the question of unemployed people is particularly relevant, but I take the point about the question of elderly people. Certainly in some areas, there are more elderly people as a percentage of the population than there were before, and the distributions of funds that we make take that into account.

Lord Banks

My Lords, can the noble Lord say by what percentage the real value must increase in order to provide the same services for the increasing number of people? Can he say how much the increase per annum must be in order for us to stay where we are?

Lord Trefgarne

My Lords, the demographic changes, as they are called in the jargon of health service economics, are taken into account in the allocation of resources to the various regions. As for the increase in elderly people, to which the noble Baroness, Lady Jeger, referred and which I think is at the back of the mind of the noble Lord. I believe that would account for about 2½ per cent. of the 5 per cent. increase in real allocations to which I have referred.

Baroness Lane-Fox

My Lords, for the benefit of the many of us on all sides of this House who care deeply about conditions of work for nurses, will my noble friend confirm that 1980 to 1981 saw a reduction in the working week from 40 hours to 37½ hours for nurses and midwives in normal circumstances, giving scope for earning more for unsocial hours?

Lord Trefgarne

My Lords, my noble friend is right when she refers to the reduction in the nurses' working week, which took place about the time she mentioned. That was, of course, one of the reasons, but not the only reason, why the number of staff in the health service—and particularly of nurses—has increased since that time.

Lord Wells-Pestell

My Lords, is it not a fact that there are considerably more doctors unemployed now than there were three years ago?

Lord Trefgarne

My Lords, I have seen figures which purport that, but there is no shortage of doctors in the health service.

Lord Bruce of Donington

My Lords, is the noble Lord aware that the question of unemployment that was raised by my noble friend Lady Jeger is, of course, very relevant to the items that he has been quoting? Is it not a fact that, owing to increased unemployment and generally to the increased poverty and deprivation which has now come upon us since the Government have been in office, the demands on the social services have become much greater and are much greater than the percentage increase of the expenditure in real terms, to which the noble Lord referred?

Lord Trefgarne

My Lords, I am not sure that the noble Lord is right in that. I was replying earlier to the particular question of the health service and the relation of unemployed people to demands on the social services. But, of course, I agree that unemployed people very often find themselves in need of what the social services can provide. That is why we have seen an increase in the demands upon the social services and why we have responded to that increase with increased funds is real terms of about 7 per cent.

Lord Avebury

My Lords, is the noble Lord aware that what matters to the ordinary patient is not the amount of money that is spent on the National Health Service, but the ease with which he can get access to treatment and the length of time it takes him to get an out-patient consultation or to have an operation for a condition which is uncomfortable or painful, such as hernia or varicose veins? Can the noble Lord say whether the increase in the level of resources, which he say has been provided, has led to a reduction or an increase in the length of time that people wait for treatment?

Lord Trefgarne

My Lords, I am happy to say that the lengths of the waiting lists prior to the commencement of the present industrial action have been significantly reduced since we came to office. Unhappily, it is the case that since the recent industrial action started, the lists have lengthened again, but that, of course, is one of the inevitable consequences of this action.