NHS: Funding Proposal (Hansard, 16 February 1988)

§ The Earl of Cork and Orrery
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)
My Lords, while the review of the National Health Service is in progress, the Government welcome constructive suggestions on its future funding. We will consider carefully every such suggestion put forward, including this one.

§ The Earl of Cork and Orrery
My Lords, I thank my noble friend for that somewhat non-committal reply. Does he realise that all over the country, probably outside the ranks of the Government, there are people who are convinced that the National Health Service is in a state of crisis and who wish to do what they can in small and large groups in the way of raising money? Will he not pay attention to these people who wish to help and who realise that their money can be used, even in small ways, for specific purposes within the NHS?

§ Lord Skelmersdale
My Lords, yes, most certainly. However, although I accept that every little helps and that this proposal enjoys popular support at the present time, it would be unreasonable to expect a national lottery to make more than a marginal difference to NHS funding. The Health Services Act 1980 gave health authorities powers to raise money locally but did not extend to local lotteries. As I said, that matter will be given our active consideration.

§ Lord Ennals
My Lords, although I agree with the noble Earl that the National Health Service is in a state of crisis, does the Minister really feel that this proposal is constructive? Would it not be a device that would enable the Treasury to save money from the finances that it puts at the disposal of the NHS, inadequate though they may be? Do not the Government accept the conclusion of doctors, nurses and indeed the public at large, that health care is a national responsibility paid for by the people in the fairest way; namely, by taxation and not by lotteries, sweepstakes, coffee mornings, T-shirts and so on?

§ Lord Skelmersdale
My Lords, I made it quite clear that in the Government's view every little helps. In 1986–87 fund-raising activities by health authorities generated around £3 million, but that was only a small proportion of all their charitable income, which totalled nearly £117 million. Charitable fund-raising 494 has been going on for a very long time; governments of all persuasions have welcomed it and will continue to do so.

§ Baroness Lane-Fox
My Lords, is my noble friend aware that when I had the chance to debate this subject on radio with the noble Lord, Lord Ennals, I received a vast number of letters showing that, although people hate paying their taxes, they want to give to the National Health Service provided they can have a gamble on it?

§ Lord Skelmersdale
My Lords, yes, but the Treasury currently receives £800 million from taxation on gambling, and it is important for that sum not to be endangered by the new sort of gambling proposed. Having said that, I also believe that the £117 million which is already raised from charitable income for the hospital service should equally not he put in danger.

Lord Winstanley
My Lords, while the National Health Service would welcome additional funds from any source, I ask the Minister to ponder very carefully the advisability of appearing to give government or NHS approval to gambling, which some of us believe is as potentially damaging to the citizen and indeed to society as other forms of addiction. Will he also bear in mind the possibility of the thin end of a rather large wedge? This could lead to the installation of fruit machines in hospitals and doctors' waiting rooms.

§ Lord Skelmersdale
My Lords, there are some Members of your Lordships' House, and indeed many people outside, who would not object to that. Clearly such matters would have to be considered extremely carefully. However, I am aware that the recommendations of the Royal Commission on Gambling, which were debated in this House in October 1978, concluded that it would be inappropriate to use a national lottery to help fund services such as the NHS which have a statutory source of funding, and many of your Lordships agreed at the time with that view.

§ The Earl of Kimberley
My Lords, if my noble friend cannot answer me now, will he be good enough to write to me to tell me how much money is invested in the Pools every week, because that same amount of money might just as well go to a national health lottery?

§ Lord Skelmersdale
My Lords, I shall have to write to my noble friend. I have not the slightest idea how much money is invested in the Pools every week, but taxation of the Pools is around 40 per cent. and already raises vast amounts of money for general disbursement by the Government.

§ Lord Mellish
My Lords, in his reply to the noble Earl's Question the Minister said that this review was going on. Will he be good enough to tell us when it is likely to be completed and whether it will be published?

§ Lord Skelmersdale
My Lords, no, I am afraid not. The review, as I have said on many occasions, will be wide-ranging and fundamental. We are concerned with the development of health services to meet the country's needs for many years to come and we shall bring forward proposals in due course.

§ Baroness Robson of Kiddington
My Lords, the noble Lord will correct me if I am wrong, but I thought he said that the health authorities raised about £3 million in extra money for the services. I may have the figure wrong. I should be very grateful if he would pay special tribute to the 1,360 Leagues of Friends in Britain. He was kind enough to address our conference. Would he be kind enough to pay tribute to the £15 to £16 million they raise for the health services every year?

§ Lord Skelmersdale
My Lords, yes, most certainly. I recall only too well addressing the conference chaired by the noble Baroness in the autumn. However, the money that she refers to would be comprised in the £117 million which comes to the health service from charitable income from all sources at the moment.

§ Lord Harmar-Nicholls
My Lords, with regard to the question from the Liberal Benches about gambling being the thin end of the wedge, can my noble friend tell us how much of the income from the biggest gamble of all, Premium Bonds, goes to the National Health Service and other matters?

§ Lord Skelmersdale
My Lords, not for the first time my noble friend puts me in some difficulty. I have never heard of a lottery where one can have one's stake money refunded.

§ Lord Molloy
My Lords, various forms of fundraising for various aspects of the health service have been welcomed, by all governments, as the Minister rightly said. However, will he state quite clearly for the professional people in the National Health Service that at all times the Government accept full responsibility for maintaining the efficiency and general strategy of Britain's National Health Service?

§ Lord Skelmersdale
My Lords, of course we do, and that is why that is enshrined in various Acts of Parliament.

Lord Wallace of Coslany
My Lords, referring to the supplementary question of the noble Baroness, Lady Robson, is the Minister aware that any move to bring in a national lottery would negative tremendously the amount of voluntary work being put in today which enables a good deal of equipment to be bought for the health service that should be provided by the taxpayer?

§ Lord Skelmersdale
My Lords, one of my cautionary remarks this afternoon on the idea of a lottery has been that whatever we do should not endanger the £117 million which is currently provided from charitable sources.