§ 2.45 p.m.
§ Lord KilmarnockMy Lords, I beg leave to ask the first Question standing in my name on the Order Paper.
§ The Question was as follows:
§ To ask Her Majesty's Government whether they propose to deduct the estimated savings on their limited list of NHS drugs from their commitment to 1 per cent. growth in real terms in NHS expenditure; and, if so, how they propose to calculate the relevant sum for 1985–86.
§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Glenarthur)No, my Lords. The intention behind the introduction of the selected list is to reduce the drugs bill by reducing costs. Planned expenditure already takes account of these savings.
§ Lord KilmarnockMy Lords, while I thank the noble Lord for that reply, it is not quite so illuminating as I should have expected. On Budget day of all days, cannot we have a little financial clarity? Is it not the case that according to the Government's expenditure White Paper, Cmnd. 9428, at Section 10 on page 158, planned expenditure in the family practitioner services in 1985–86,
reflects revised forecasts of demand but also takes account of measures already announced to limit the drugs bill".How is this to work? How will we measure what is saved on the drugs bill? The noble Lord estimates £75 million. This is widely thought to be an over-estimate. If the savings are only £40 million, as widely predicted, will the £35 million shortfall be deducted from the allocation to the hospital service?
§ Lord GlenarthurMy Lords, on the basis of current forecasts of inflation, the figures in the public expenditure White Paper published in January, which the noble Lord has quoted, show that total NHS expenditure is planned to remain broadly level in economic cost terms in the year 1985–86. Health authority expenditure is planned to increase by about 1 per cent., as I am sure the noble Lord is aware, in recognition of the growing number of elderly people. There is a planned fall in expenditure on family practitioner services in economic cost terms but this is 399 due to measures taken by the Government to reduce the drugs bill and to the change in the provision of the general ophthalmic service. In other respects, inflation and forecast demand for the family practitioner services have been fully provided for. As to the noble Lord's doubt about the estimate of £75 million, I have to say, of course, that this is a new departure. The estimates of likely savings must be subject to a degree of error, but we think that they are probably about right.
§ Lord EnnalsMy Lords, in the light of the Minister's last reply, can he help to create some clarity out of what I believe to be chaos in the primary health care field? With greatly increased prescription charges and dental charges, changes in the NHS optical service, limited list prescribing, vouchers for people on supplementary benefit to pay for their NHS spectacles, the failure to publish the Binder Hamlyn report and the Government's own Green Paper, can we now be assured that the rumours that seem to be circulating of a voucher scheme for paying to general practitioners is untrue? Will he say that?
§ Lord GlenarthurMy Lords, I can read the papers as well. I have noted the remarks referred to. I do not believe them any more than I think the noble Lord should believe them. The Government record on the health service stands on its own. I have quoted it many times from this Dispatch Box. If the noble Lord would like me to give the figures for the family practitioner services and other parts of the health service, I shall willingly do so.
§ Lord EnnalsMy Lords, I was really asking whether the noble Lord could give the assurance that the rumours were not true. I certainly read what appeared in the newspapers and I hope it is not true. I drew attention to it following an extraordinary number of changes in the primary health care scheme. Does he understand that this is causing great concern?
§ Lord GlenarthurMy Lords, the noble Lord knows that we are considering the Green Paper. It will be published in due course. I beseech him not to believe everything that he reads in the papers.
§ Lord Nugent of GuildfordMy Lords, is my noble friend aware that the Secretary of State specifically stated in the other place last evening that these rumours were untrue?
§ Lord EnnalsMy Lords, why not say so?
§ Lord GlenarthurMy Lords, I am grateful to my noble friend. I was personally convinced that they would not be true. I was not sure whether my right honourable friend had said so because I have not caught up with all that he said yesterday. We are dealing with the same matter later today. I am delighted to hear it. I was sure that it would be the case.
§ Lord KilmarnockMy Lords, the noble Lord has referred to the planned savings on the family 400 practitioner services. He has himself been good enough to admit that this is a trial run and that it is not clear how it is going to come out. for the sake of argument, only £50 million was saved rather than £75 million, can the noble Lord say what effect that would have on general planned National Health Service expenditure for the coming year?
§ Lord GlenarthurMy Lords, as I indicated, we estimate that the savings will be about £75 million. If it is the case that they do not match up to that figure then we shall have to consider the situation; but I do not think there is any point in speculating now about what has not happened.
§ The Countess of MarMy Lords, can the noble Lord say where the £45 million handout going to chemists, for their expected shortfall after 1st April 1985 because doctors wrote fewer prescriptions in 1983, is coming from?
§ Lord GlenarthurMy Lords, with respect, I believe that that is another question.
§ Lord KilmarnockMy Lords, would the noble Lord care to guarantee the 1 per cent. real growth for the hospital service in the Government's own expenditure White Paper?
§ Lord GlenarthurMy Lords, I am sorry, but I did not hear the first part of the noble Lord's supplementary question.
§ Lord KilmarnockMy Lords. I asked the noble Lord whether he will guarantee the 1 per cent. growth in real terms for the hospital service projected in the Government's own expenditure White Paper.
§ Lord GlenarthurMy Lords, it is already in the White Paper. I do not think it needs a greater guarantee than that.