HC Deb 31 January 1977 vol 925 cc30-2W
Mr. Brotherton

asked the Secretary of State for Social Services, in the light of evidence to the Royal Commission on the National Health Service from the Society of Civil Public Servants, he will make a statement on the over-management, delays, wastage and high costs in the running of the Health Service and regional and area health authorities.

Mr. Ennals

It is not my policy to comment on all the evidence submitted to the Royal Commission on the National Health Service, and I have not seen any evidence that the Society of Civil and Public Servants may have submitted. However, the views of this Government on the Conservative Government's reorganisation of the National Health Service are well known.

Health authorities in England are reviewing their administrative costs in all disciplines so as to streamline the management system of the National Health Service within existing legislation and to eliminate possible duplication of effort between the various tiers of the service.

Mr. Brotherton

asked the Secretary of State for Social Services what would be the saving to public expenditure in a full year if his Department authorised hotel charges of £20 per week in hospitals, £2 charges for visits to family doctors, £5 charges to visit hospital casualty departments and 50p prescription charges, as suggested in the McKinsey Report on the National Health Service.

Mr. Ennals

It is estimated that an increase in the prescription charge to 50p, with existing exemptions, would reduce net public expenditure in England by £45 million a year. New charges would require primary legislation; on certain assumptions about exemptions—for example, for children, those on low incomes, the chronically sick—the gross revenue is estimated at about:

£ million
Hotel charge at £20 per week (Less offset of existing social security benefits 90
£2 charge for visits to family doctors 110
£5 charge for visits to Accident and Emergency Departments 10

The increase in administrative staff necessary to run these charges would be very large and would take up a significant proportion of this revenue. In the case of the hotel charge it might be necessary either to introduce compulsory insurance cover or to accept a high level of bad debt. The introduction of these charges would also lead to serious hardship to many individuals and the postponement of treatment, with consequently worse health problems later and heavy indirect costs to the country.

Taxing the sick would be unacceptable to the Government, which remains committed to the ultimate objective that the Health Service should be free at the point of need.

Mr. Brotherton

asked the Secretary of State for Social Services if, in the light of reports of his comments on the McKinsey Report on the National Health Service, he can explain how those people with the ability to pay are currently presented with opportunities to pay directly for hotel care in hospitals and for visits to casualty departments and family doctors.

Mr. Ennals

Any patient who can afford it and who wishes, as an expression of gratitude to or support for his local hospital or for local health services, may give or bequeath money to a health authority for the benefit of any institution or service he chooses to nominate. Such donations and legacies—which in the financial year ended 31st March 1976 amounted to £8,849,000—are administered by health authorities as trust funds in accordance with the wishes of the donor. Such help is greatly appreciated and can be a significant source of addi- tional revenue for the National Health Service.

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