§ Mr. Ralph Howellasked the Secretary of State for Social Services if, in the manner of the answer to the hon. Member for Norfolk, North of 21 December 1984, at columns 412–14, he will provide figures for expenditure by the family practitioner services, the Dental Estimates Board, the Prescription Pricing Authority and other special health authorities providing National Health Service central services for 1983–84; and if he will also publish comparable figures, at current and at 1983–84 prices, and comparable percentages for 1960 and 1970, for the above categories and those in the original answer.
§ Mr. Hayhoe[pursuant to his reply, 15 May 1986, c. 533]: The figures for 1983–84, and those for the earlier years at 1983–84 prices, were given in my predecessor's reply to my hon. Friend on 19 March 1985, at columns 452–58. I assume that my hon. Friend requires the equivalent information for 1984–85. This is given in the tables.
The figures for 1960–61 and 1970–71 at 1984–85 prices are calculated from the base year's figures by adjusting for general inflation as measured by the gross domestic product deflator at market prices.
Comparisons over this long period cannot be entirely reliable because of changes in the structure of GDP and in the organisation of the National Health Service.
619W
620W621W
Table 1 Current expenditure by health authorities analysed subjectively (ie by type) 1960–61 1970–71 1984–85 From annual accounts At 1984–85 prices Proportion of total From annual accounts At 1984–85 prices Proportion of total From annual accounts Proportion of total £ million £ million Per cent. £ million £ million Per cent. £ million Per cent. PAY NHS Staff salaries and wages n.a. n.a. 6,697.9 73.32 Non-NHS staff (Agency etc.) 78.5 0.86 Chairmen's remuneration 2.0 0.02 Total 286.2 2,101.6 69.23 706.0 3,390.3 74.49 6,778.4 74.20 NON-PAY Drugs 14.8 108.7 3.58 27.4 131.6 2.89 278.8 3.05 Medical Gases 10.9 0.12 Dressings 6.2 29.8 0.65 50.0 0.55 Medical and surgical equipment—purchases and maintenance contracts 16.4 120.4 3.97 43.4 208.4 4.58 306.0 3.35 X-Ray equipment, film and materials— purchases and maintenance contracts 51.6 0.57 Patients' appliances 63.0 0.69 Laboratory equipment, instruments and materials—purchases and maintenance contracts and services 80.6 0.88 Provisions—purchases and contract catering 37.5 275.5 9.08 46.0 220.9 4.85 178.0 1.95 Staff uniforms and patients clothing 3.6 26.4 0.87 6.8 32.6 0.72 44.5 0.49 Fuel, light and power 29.4 215.9 17.1 42.1 202.2 4.44 301.7 3.30 Laundry-equipment, materials and contracts 12.7 0.14 Cleaning-equipment, materials and contracts 39.4 0.43 Engineering maintenance-equipment, materials and contracts 24.5 179.9 5.92 38.6 185.4 4.7 110.3 1.21 Building maintenance-equipment, materials and contracts 91.8 1.00 Grounds and Gardens maintenance-equipment materials and contracts 5.8 0.06 Computers—purchases, maintenance and licencing fees 5.9 43.3 1.43 15.0 72.0 1.58 21.9 0.24 Office equipment 31.1 0.34 Printing, stationery and postage 70.6 0.77 Telephone-rental etc. and call charges 70.2 0.77 Transport—fuel and oil. maintenance-equipment, materials and contracts etc. 2.0 14.7 0.48 4.7 22.6 0.50 53.7 0.59 Travelling, subsistence and removal expenses 1.4 10.3 0.34 2.8 13.4 0.29 152.8 1.67 Rates 6.2 45.5 1.50 14.1 67.7 1.49 137.0 1.50 Rent 22.0 0.24 Contractual arrangements for patient care 2.9 21.3 0.70 5.0 24.0 0.53 39.5 0.43 Other expenses 11.2 82.2 2.71 19.4 93.2 2.05 311.1 3.41 Total 155.8 1,144.1 37.69 271.5 1,303.8 28.64 2,535.0 27.75 Total Pay and Non-Pay 442.0 3,245.7 106.92 977.5 4,694.1 103.13 9,313.4 101.95 Less direct credits (Staff lodging charges, canteen and other sales etc.) (28.6) (210.0) (6.92) (29.7) (142.6) (3.13) (178.5) (1.95) Total 413.4 3,035.7 100.00 947.8 4,551.5 100.00 9,134.9 100.00 Notes to table 1 1. The figures for 1960–61 and 1970–71 do not include expenditure on community health and ambulance services which prior to NHS re-organisation on 1 April 1974 were the responsibility of local government authorities. 2. The administrative expenses of executive councils which were responsible for the administration of family practitioner services are included in the table as such costs are reflected in the annual accounts of health authorities from 1974–75. For 1960–61 an apportionment of composite England and Wales figures was necessary to derive figures for England only. 3. For years prior to 1974–75 the analyses of expenditure by type provided by the annual accounts are less detailed than those for later years. 4. "Other expenses" for 1960–61 and 1970–71 includes the total non-pay expenditure on the blood transfusion and mass radiography services for which component details are not readily available—£1.0 million 1960–61 and £1.8 million 1970–71 (£7.3 million ad £8.6 million at 1984–85 prices). 5. Total capital expenditure by the authorities whose current expenditure is included in the table was £25.1 million in 1960–61, £119.2 million in 1970–71 (£184.3 million and £572.4 million at 1984–85 prices) and £795.4 million in 1984–85.
Table 2 Expenditure of family practitioner services 1960–61 1970–71 1984–85 From annual accounts At 1984–85 prices Proportion of total per cent. From annual accounts At 1984–85 prices Proportion of total per cent. From annual accounts Proportion of total per cent. £ million £ million £ million £ million £ million A. General medical services 1. Payments to general mecial practitioners a. Basic practice allowance and additions 38.4 184.4 9.50 232.1 7.59 b. Standard capitation fees 66.0 316.9 16.34 334.2 10.94 c. Payments or our of hours responsibilities 79.4 583.1 38.94 11.5 55.2 2.85 75.1 2.46 d. Direct payment for practice accommodation and ancillary staff 11.4 54.8 2.82 165.9 5.43 e. Other payments, fees and allowances 14.5 69.6 3.59 137.0 4.48 2. Superanuation contributions (authorities share) 4.9 36.0 2.40 7.1 34.1 1.76 38.6 1.26 3. Payments to contractors for disposable sterile syringes — — — 0.2 1.0 0.05 1.0 0.03 Total 84.3 6.19.1 41.34 149.1 716.0 36.91 983.9 32.19 B Pharmaceutical services 1. Supply and dispensing of drugs and appliances by pharmacists 75.3 552.9 36.93 167.8 805.8 41.54 1,434.4 46.93 Less charges to patients (retained by pharmacists) (10.8) (79.3) (5.30) (14.3) (68.7) (3.54) (104.3) (3.41). 2. Supply and dispensing of drugs and appliances by medical and dental practitioners 2.5 18.4 1.23 8.4 40.4 2.08 113.2 3.70 3. Bacic practice allowance — — — — — — 20.4 0.67 4. Superannuation contributions (authorities' share) 0.1 0.7 0.05 0.3 1.4 0.07 1.0 0.03 5. Other expenditure 0.3 2.2 0.15 — — — 3.9 0.13 Total 67.4 494.9 33.06 162.2 778.9 40.15 1,468.6 48.05 C. General dental services 1. Fees to dental practitioners 49.5 363.5 24.27 90.0 432.2 22.28 624.7 20.44 Less charges to patients (retained by dentists) (9.0) (66.1) (4.41) (16.2) (77.8) (4.01) (173.5) (5.68) 2. Salaries of dental practitioners practising at health centres, etc. 0.1 0.7 0.05 0.1 0.5 0.02 1.2 0.04 3. Superannuation contributions (authorities' share) 1.9 14.0 0.93 3.2 15.4 0.79 19.2 0.63 4. Other expenditure — — — — — — 1.1 0.04 Total 42.5 312.1 20.84 77.1 370.3 19.08 472.7 15.47 D. General opthalmic services 1. Fees for sight testing 4.7 34.5 2.31 8.9 42.7 2.20 82.3 2.69 2. Supply and repair of glasses 10.2 74.9 5.00 16.9 81.2 4.18 92.7 3.4 Less charges to patients (retained by opticians) (5.2) (38.2) (2.55) (10.2) (49.0) (2.52) (44.9) (1.47) 3. Superannuation contributions (authorities' share) — — — — — — 0.3 0.01 4. Other expenditure — — — — — — 0.6 0.22 Total 9.7 71.2 4.76 15.6 74.9 3.86 131.0 4.29 Total expenditure on family practitioner services 203.9 1,497.3 100.00 404.0 1,940.1 100.00 3,056.2 100.00 Notes to Table 2 1. The table shows payments made to doctors, pharmacists, dentists, opticians and others contracted to the NHS to provide family practitioner services (FPS). 2. Annual accounts of health authorities (and their predecessor executive councils) provide one analysis only of such expenditure which assigns it functionally to service. 3. The table shows 1960–61 and 1970–71 FPS expenditure categorised as far as practicable in the same format as that of the annual white papers on the summarised accounts of health authorities since 1974–75. Thus, charges to patients retained by pharmacists, dentists and opticians are reflected in the table but other items of FPS income collected by health authorities (or executive councils) such as charges to patients for dental treatment at heath centres and receipts from the sale of prescription charge pre-payment certificates, are excluded. 4. For 1960–61 the accounts provide separate services totals for England and similar totals for Wales with detailed analyses of only the composite England and Wales totals. It has therefore been necessary to derive the detailed figures for England prorata. 5. All spending on FPS is regarded as current expenditure. Some relatively insignificant costs strictly of a capital nature (relating only to certain payments made to general medical practitioners for practice accommodation) are however included.
622W623W
Table 3 Expenditure by the Dental Estimates Board, the Prescription Pricing Authority and other special health authorities providing NHS central services 1960–61 1970–71 1984–85 From annual accounts At 1984–85 prices Proportion of total From annual accounts At 1984–85 prices Proportion of total From annual accounts Proportion of total £ million £ million Per cent. £ million £ million Per cent. £ million Per cent. 1. Expenditure by the Dental Estimates Board (a) Salaries and wages 0.7 5.1 87.50 1.9 9.1 73.08 10.7 90.68 (b) Non-pay 0.1 0.7 12.50 0.7 3.4 26.92 1.1 9.32 Total 0.8 5.8 100.00 2.6 12.5 100.00 11.8 100.00 2. Expenditure by the Prescription Pricing Authority (a) Salaries and wages 0.7 5.1 87.50 1.6 7.7 88.89 12.00 87.59 (b) Non-pay 0.1 0.7 12.50 0.2 1.0 11.11 1.7 12.41 Total 0.8 5.8 100.00 1.8 8.7 100.00 13.7 100.00
1960–61 1970–71 1984–85 From annual accounts At 1984–85 prices Proportion of total From annual accounts At 1984–85 prices Proportion of total From annual accounts Proportion of total £ million £ million Per cent. £ million £ million Per cent. £ million Per cent. 3. Expenditure by other special health authorities providing NHS central services (a) Salaries and wages n/a — — n/a — — 4.7 35.61 (b) Non-pay n/a — — n/a — — 8.5 64.39 Total n/a — — n/a — — 13.2 100.00 Notes to table 3 1. The table shows summaries of the detailed accounts of the Dental Estimates Board (DEB), the Prescription Pricing Authority (PPA) and its predecessor Joint Pricing Committee for England (JPC); together with a composite summary of the accounts for 1984–85 only of other special health authorities providing NHS central services. 2. (a) Other special health authorities providing NHS central services comprise: (i) the Central Blood Laboratories Authority (CBLA)—established 1 December 1982. (ii) the Mental Health Act Commission—established 1 September 1983. (iii) the Rampton Hospital Review Board—established 11 June 1981. (iv) the Rural Dispensing Committee—established 1 April 1983. (v) the National Health Service Training Authority—established 1 October 1983. (b) The expenses of the Health Service Supply Council (established on 14 July 1980) which are met in full from charges made to regional health authorities are excluded. (c) The functions of all these special health authorities are either new or were devolved by the Department and comparable figures for 1960–61 and 1970–71 are consequently not available. 3. Capital expenditure by the DEB and the JPC was not separately identifiable and is included in the totals for 1960–61 and 1970–71. The amounts are known to be insignificant except that there was substantial capital expenditure by the DEB in 1970–71. For 1984–85 the PPA and the CBLA recorded capital expenditure of £2.3 million and £16.6 million. These sums are excluded from the table.