HL Deb 16 July 1984 vol 454 cc1173-4

2.42 p.m.

Baroness Lane-Fox

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

The Question was as follows:

To ask Her Majesty's Government what progress has been made since 1979 in reducing regional variations of health service provision under the RAWP system.

The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Glenarthur)

My Lords, since 1979–80 we have reduced the gap between the best and worst funded RHA by more than a third—from 22 per cent. to 14 per cent. This represents substantial progress towards our aim of achieving a fairer distribution of resources across the country.

Baroness Lane-Fox

My Lords, I thank my noble friend the Minister for that very informative reply and ask two more questions. First, what are the current plans for adapting resource allocations where there are population changes? Secondly, where there is depopulation in London, what are the measures to protect the finances of the London teaching hospitals, having due regard to their international role of leading the world in medical research and care of the sick?

Lord Glenarthur

My Lords, in the past RAWP targets were calculated on historical population data, although we did take account of population growth in making actual allocations. Next year we shall be using population projections in the formula, and this should take a better account of expected population growths. I hope that that answers my noble friend's first question.

So far as medical teaching in London is concerned, certainly London's health authorities fully recognise the importance of reconciling teaching and service needs. So far as closures and things like that are concerned, proposals that are referred to Ministers will be carefully scrutinised, and the effects of any change on the Secretary of State's duty to provide reasonable facilities for medical education will be taken into account.

Lord Leatherland

My Lords, does the noble Lord the Minister realise that the Question refers to the RAWP system? What is it?

Lord Glenarthur

My Lords, RAWP stands for the Resource Allocation Working Party.

Lord Ennals

My Lords, does the noble Lord accept that we are satisfied that the RAWP fair shares policy, which was initiated by the previous Labour Government, has been continued to the real advantage of the traditionally deprived regions, and that we are grateful for his indication that the gap has been narrowing? Does he also accept that the benefit for the other regions is being achieved at the expense of real cuts in services in the overfunded Thames regions at a time when in real terms growth is virtually nil?

Lord Glenarthur

My Lords, we do not accept that, because the Thames regions are receiving no growth this year, and can expect reduced allocations in future, they have no scope for improving services. That is of course the important fact. We are requiring all authorities to undertake a sustained cost improvement programme to release resources for improving patient service, and we shall look to the Thames regions to tackle that vigorously. I think that there is still too much emphasis on the need for additional resources without making the best use of what we already have.

Lord Bruce of Donington

My Lords, the noble Lord will correct me if I am wrong, but am I right in believing that it was always the avowed policy of the party opposite to level up rather than down?

Lord Glenarthur

Yes, my Lords, but we are talking about the fact that historically London has been overprovided because there has been a move away from London, and the regions have been underfunded. That is why it is necessary to do it this way.

Lord Molloy

My Lords, is the noble Lord aware that that answer will not do, with the best will in the world? All over the country there are vast lists of people waiting for things, and the RAWP provision is not being fulfilled. Simply to meet demands by cutting back resources and closing hospitals is not a sensible way to tackle the difficult problem that the Government face.

Lord Glenarthur

My Lords, perhaps progress towards RAWP has been too slow. As the noble Lord will appreciate, the fact is that it is not a perfect science. He will also know that I have on many occasions rehearsed the achievements towards not just increased expenditure to the National Health Service throughout the country, but also, in particular, as against closing hospitals, opening new ones.