NHS Expenditure (Hansard, 17 July 1990)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, the projected National Health Service expenditure in the United Kingdom for the financial year 1990–91 is £29.1 billion.

§ Lord Gridley
My Lords, I thank my noble friend for that Answer. Does not the figure represent in real terms provision of more than £500 per head for the population of Great Britain?

§ Baroness Hooper
Yes, indeed, my Lords. We spend more than £500 per head on the National Health Service each year compared with £360, at today's prices, when we came to power. That is almost £10 a week for each and every one of us.

§ Lord Molloy
My Lords, does the figure include money which will be set aside for much needed modernisation of many hospitals and for the construction of new ones in various parts of the country where they are urgently needed?

§ Baroness Hooper
Yes, my Lords, they are figures for total expenditure.

§ Lord Grimond
My Lords, does the figure include propaganda and advertisements? If so, can the Minister tell us what the costs will be? I notice that The NHS Reforms and You cost £3 million.

§ Baroness Hooper
My Lords, it cost almost £3 million but each booklet works out at less than 10p for each household which receives it. If one considers £10 per head of expenditure each week, 10p per household is a very modest sum for getting the correct information across to people about how their National Health Service works.

§ Lord Ennals
My Lords, is it not clear to everyone that with a steadily ageing population and with improved but more costly medical treatment the objective must be to spend a higher proportion of gross domestic product on our National Health Service, as does almost every other industrialised country? If we were, for instance, to spend 7 per cent. of GDP instead of 6.1 per cent.—still a much lower percentage than the United States, France or Germany—roughly how much would that cost?

§ Baroness Hooper
My Lords, it is always extremely difficult to make accurate comparisons when methods of financing health care and clinical practices vary so considerably and when medical costs are much higher in some countries. It is also misleading when a number of the figures quoted are based not only on public spending but also on private sector spending. I emphasise that what matters is the level of resources available, the efficiency with which they are used and, above all, the outputs that are delivered. Those have risen substantially. For example, since 1978–79 acute in-patient services are up by 20 per cent.; acute day cases are up by 80 per cent.; maternity in-patient cases are up by 20 per cent.; geriatric in-patient cases are up by 80 per cent.; and geriatric out-patient cases are up by 60 per cent.

§ The Earl of Shrewsbury
My Lords, can my noble friend say how much of this expenditure is channelled towards the hospice movement?

§ Baroness Hooper
No, my Lords; I am afraid I cannot provide that information without prior notice.

§ Lord Mellish
My Lords, the figures which the Minister has given are very exciting. However, is she aware that no matter how much money is spent, it will never be enough?

§ Baroness Hooper
My Lords, I tend to agree with the noble Lord, Lord Mellish, as is so often the case. Spending on the National Health Service has never been higher. However, we recognise the challenge and we shall always be running behind the opportunities for more spending.

§ Earl Russell
My Lords, will Her Majesty's Government consider the possibility that they might have fewer unexpected shortfalls as regards the funding of the National Health Service if they were to base Funding on the actual inflation figure of the previous year rather than on forecasts of inflation for the coming year which almost invariably prove to be optimistic?

§ Baroness Hooper
My Lords, my reply to that question must be that the National Health Service is not under-funded.

The Viscount of Oxfuird
My Lords, is my noble friend aware that morale in an organisation like the National Health Service does not necessarily depend 758 upon funding but to a very large degree on job satisfaction? Having recently been in hospital, I went back to visit the surgeon and asked him what was the rate of recovery of those in intensive care. He told me that 30 per cent. of people who went into intensive care units did not come out, other than in an unfortunate state. The main factor seemed to be that there were teams of people working very hard who never received any thanks from the people whose lives were, in many cases, saved by them. It is rather a discouraging situation.

§ Baroness Hooper
My Lords, my noble friend has made an important point based on his own recent experience. Therefore, I take this opportunity to acknowledge the very valuable service carried out by the employees—that is, the doctors, the nurses and the many others involved—of the National Health Service.

Viscount Tonypandy
My Lords, will the noble Baroness also express her gratitude to the countless people who are raising money because they realise, as pointed out by the noble Lord, Lord Mellish, that there never will be enough money for the health service? For instance, people in the valleys of South Wales are raising great sums of money for scanners and for other ancillary purposes connected with hospitals.

§ Baroness Hooper
My Lords, I am very happy to be able to acknowledge the individual contributions made by many people in this area. At the same time, I take the opportunity to acknowledge the fact that many people have more money available to give in this way as a result of the Government's excellent economic policies.

§ Lord Leatherland
My Lords, may a 92 year-old Member of your Lordships' House be allowed to suggest to the Government that there should never be any tampering with the National Health Service? It is one of the best services ever placed on the statute book.

§ Baroness Hooper
My Lords, we wholeheartedly agree with the views of the noble Lord; that is why we are aiming to improve the service.