§ 2.56 p.m.
§ Lord Gainfordasked Her Majesty's Government: By how much expenditure on the National Health Service will change in 1990–91 and on which areas any increase in resources will be targeted.
§ Baroness HooperMy Lords, in 1990 to 1991 the National Health Service in the United Kingdom will have an increase in resources equivalent to £2.6 billion. Gross expenditure will be £28.8 billion compared with just over £26 billion in 1989 to 1990. This additional funding will be used to maintain, develop and improve existing services.
§ Lord GainfordMy Lords, I thank my noble friend for that useful information. Will she say how much the Government will facilitate the proposed reforms of the National Health Service in the forthcoming years?
§ Baroness HooperMy Lords, within the increase that I have referred to, around £300 million will fund developments connected with the implementation of proposals contained in the National Health Service and Community Care Bill. These will include the costs of the first 70 doctors appointed under the "100 consultants" initiative in England; the establishment of a comprehensive medical audit system; the extension of the resource management initiative; the costs of establishing the first group of self-governing hospitals; the introduction of the capital system; training for a wide range of staff groups; additional finance and personnel staff.
§ Lord EnnalsMy Lords, does the Minister accept the estimate given by the National Association of Health Authorities in England and Wales that health authorities need each year funds which are 4.3 per cent. above inflation in order to achieve even a modest increase in services, and particularly services for the growing numbers of the elderly? Does the Minister further accept that current estimates of inflation were set at 5 per cent., and that that is now totally unrealistic? Does the Minister therefore accept that the figure of 7.4 per cent. is a much more realistic estimate on which the health service has to operate? If that is the case, is not the noble Lord, Lord Alport, right that the likelihood is that we shall once again see closures of wards, beds and operating theatres during the course of the next few months unless some more money is provided?
§ Baroness HooperMy Lords, as I said in answer to a previous question, the Government are spending more on the National Health Service than ever before. The additional funds that the Government have provided are intended to be sufficient to allow services to be increased by more than would be needed simply to keep pace with the growing numbers of elderly people, for example, The question of whether this is enough assumes that the demand for health care is a fixed figure that can be measured. That is clearly nonsense. What is important is that the extra funds provided show the priority that the Government have given to health service spending within public spending generally.
§ Lord EnnalsMy Lords, does the Minister accept that over the past 43 years every year has shown a higher figure for health expenditure than ever before? There is nothing exceptional about having the highest figure ever. That is the case every year.
§ Baroness HooperMy Lords, the increase in resources for the National Health Service as a whole in the UK will be equivalent to a cash increase of nearly 11 per cent., and a real terms increase of nearly 5.5 per cent. I think that is good news.
§ Lord Dormand of EasingtonMy Lords, will the Minister say what is to be done in the field of health education? While we appreciate the work being done by the Health Education Council, does not the Minister agree there is a great deal of work to be done yet on matters such as excessive smoking, alcohol abuse, the need for physical exercise and other matters? Is the Minister further aware of the depressing reports that have been written about physical education and health education in schools? Those reports have been written by the Central Council of Physical Recreation and the Sports Council. They show there has been a great reduction in what is being done in those areas in schools. That bodes ill for the future.
§ Baroness HooperMy Lords, that question strays a little from the Question before us. However, I can reassure the noble Lord that my department is continuing to co-operate with the Health Education Authority in the important areas to which he referred.
§ Baroness Fisher of RednalMy Lords, can the Minister give the House information about the extra resources that are urgently needed for those people who have been discharged from mental hospitals and are now homeless and on the streets, not only in London but elsewhere? Is she aware that many have been discharged from psychiatric hospitals, having literally been thrown out without any resources? Will the Minister look at that as a very serious problem with a view to providing resources in the future?
§ Baroness HooperMy Lords, of course we are looking at that aspect. That area of community care is a very important part of the Government's current programme of reforms.
§ Lord Dean of BeswickMy Lords, is the Minister aware that in areas such as the large cities —for example, Manchester —the number of deaths of children below the age of 12 months and at birth is still twice the national average, and that the number of fairly young men dying from heart disease is also twice the national average? Will those factors be taken into account in the distribution of resources with a view to redressing the imbalance?
§ Baroness HooperMy Lords, the Government's programme of reforms is intended to ensure that local needs are met through the structures that are available to assess the needs of particular communities. I believe that once that programme has been fully implemented the noble Lord's anxieties will be met.
§ Lord Cocks of HartcliffeMy Lords, will the Minister use some of those resources to endorse the 264 efforts of the Health Education Council in order to establish a distinguishable unit of alcohol, in terms of wine, so that people who like an occasional social drink may be quite safe when they embark upon driving on the road?
§ Baroness HooperMy Lords, the problem of alcohol abuse is one of my departmental responsibilities. The noble Lord may be sure that I shall take note of his remarks.