HC Deb 15 April 1986 vol 95 cc361-3W
Mr. Irving

asked the Secretary of State for Social Services if he will set out in the Official Report the policy objectives of the Council of Ministers with regard to health provision in the European Community.

Mr. Whitney

The Council of Ministers as such has not adopted policy objectives with regard to the general level of health provision in member states because this is not a matter which falls within the formal competence of the Community. Recent informal meetings of European Community Health Ministers have discussed relative provision in specific fields, such as measles vaccination and action against drug misuse and have also discussed ways of containing the growth of expenditure on health services and obtaining better value for money.

Mr. Irving

asked the Secretary of State for Social Services what was the total expenditure on health provision in each of the member countries of the European Community in (a) 1975 and (b) 1985; and if he will express these figures as a proportion of gross domestic product in respect of each member state.

Mr. Whitney

The following tables give the information, which my hon. Friend requested. The expenditure figures, which include health expenditure by both publicly and privately financed bodies, have been converted into sterling by using purchasing power parity exchange rates for the year in question. Expenditure figures for Luxembourg are not available. The figures are presented for 1975 and 1982, since 1982 is the most recent year for which figures are available for the other members of the European Community. According to the 1985 edition of the National Accounts, the United Kingdom spent 6.1 per cent. of the gross domestic product on health care in both 1983 and 1984. Although the United Kingdom spends less on health as a proportion of GDP than most other member states, its life expectancy and infant mortality usually fall in the middle of the Community's range.

Total Expenditure on Health Provision (£ million)*
1975 1982
United Kingdom 5,879 16,347
France 8,356 29,175
Germany 10,412 29,439
Italy 6,056 18,557
Belgium 1,094 3,387
Netherlands 2,198 6,588
Denmark 693 2,035
Ireland 298 1,000
Greece 379 1,242
Spain 2,564 8,545
Portugal 471 1,337
* Expenditure in national currency units has been converted into sterling by means of general purchasing power exchange rates for the year in question.

Total Expenditure on Health Care Expressed as a Percentage Share of the Gross Domestic Product
1975 1982
United Kingdom 5.5 5.9
France 7.6 9.3
Germany 8.1 8.2
Italy 6.7 7.2
Belgium 5.5 6.2
Netherlands 7.7 8.7
Denmark 6.5 6.8
Ireland 7.7 8.2
Greece 4.0 4.4
Spain 5.1 6.3
Portugal 6.4 5.7

Mr. Irving

asked the Secretary of State for Social Services what information he has as to the total numbers of people employed in the state-run health services of the member countries of the European Community; if he will break down by categories the number of people employed in these services; and if he will compare the present position with the situation in 1975.

Mr. Whitney

I regret detailed information is not available on the number of staff employed in all the agencies involved in providing health care in the different member states. It would not in any event enable meaningful comparisons to be made because of the substantial differences between national health systems. In some, health services are provided entirely on a contractual basis, with hospitals and general practitioners contracting with state and private insurance funds to provide services to insured members. In others, services are provided by both directly employed and contracted services, the mix varying from member state to member state.

Mr. Irving

asked the Secretary of State for Social Services if he will estimate the number of beds in state-run hospitals in each of the member countries of the European Community; and what was the position in 1975.

Mr. Whitney

In Belgium, Germany, France, Luxembourg and the Netherlands hospitals are not run directly by the state but provide services on a contractual basis to insured members of state and private insurance funds. For these countries no precise data are readily available on the proportion of the total number of beds in public, private and voluntary hospitals used to provide services to members of state insurance schemes. On the assumption that the proportion is the same as the proportion of expenditure on health care generally by the public sector relative to total health care expenditure, the following rough estimates can, however, be made (the years indicated are the latest for which total bed figures are readily available):

Country and Year Number
Belgium (1977) 68,850
Germany (1976) 580,000
France (1975) 314,000
Netherlands (1976) 115,450
Luxembourg (1976) 4,000

For the remaining countries, the number of beds in state-run hospitals for the latest year for which figures are readily available is as follows:

Country and Year Numbers
Denmark (1977) 53,000
Ireland (1974) 24,600
(1984) 21,300
Italy (1975) 480,000
Spain (1982) 135,400
Portugal (1980) 32,000
Greece (1981) 27,500

(Comparable figures for the United Kingdom for 1975 and 1983 were 491,000 and 440,600 respectively).

These figures underestimate, in some cases considerably, the number of beds available to the public hospital sector because of the contractual arrangements made by the state health sector for the use of beds in private and voluntary hospitals

I regret that more comprehensive and up to date data on the lines requested could be obtained only at disproportionate cost.