§ Mr. Meacherasked the Secretary of State for Social Services (1) what has been the percentage change (i) each year since 1979 and (ii) in 1986 by comparison with 1979 in National Health Service expenditure in each of the National Health Service's regions and nationally (a) in real terms, (b) in real terms taking account of National Health Service pay and prices and (c) in real terms taking account of National Health Service pay and prices and in terms of constant standards after taking account of the annually growing numbers of elderly people;
(2) if, pursuant to the answer of 8 April, Official Report, column 83, he will now give a substantive reply to the original question put by the hon. Member for Oldham, West regarding Health Service spending in National Health Service regions; and if he will make a statement.
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TABLE 1 Growth of HCHS (Gross Revenue Expenditure) on previous year percentage 1979–80 1979–80 1981–82 1982–83 1983–84 1984–85 ‡1985–86 ║1986–87 Real growth* 2.5 11.0 0.3 0.3 0.6 1.4 -0.4 3.8 Of which: Pay and prices† 3.1 8.0 -1.7 -0.5 0.6 1.5 -0.8 Services -0.6 3.0 2.0 0.8 0.0 -0.1 0.4 Demography 1.2 0.9 0.3 0.3 0.5 0.6 1.1 1.0 * Real growth in hospital and community health services expenditure compared with general inflation as measured by the Gross Domestic Product Deflator. † Represents increases in HCHS pay prices compared with general inflation. ‡Figures for 1985–86 are provisional. ║ Figures for 1986–87 are provisional, and will be affected by revenue to capital transfers. The split between pay and prices and services cannot yet be forecast.
§ Mr. Hayhoe[pursuant to his reply, 8 April 1986, c. 83]: Total expenditure on the National Health Service in England has increased from £6,418 million in 1978–79 to £15,642 million in 1986–87; this represents growth in real terms of 24.2 per cent. In the period to 1985–86 growth in real terms was 20.6 per cent. of this 10.5 per cent. went to fund increases in pay and prices above general inflation and the remaining 9.1 per cent. was available for improved or additional services. For the hospital and community health services the real terms growth of revenue expenditure to 1986–87 is 20.7 per cent. In the period to 1985–86, real terms growth was 16.5 per cent.; of this 10.3 per cent. funded pay and price increases above inflation and 5.6 per cent. was available for services.
Nationally it is estimated that a growth of 5.2 per cent. in services was required in the period to 1985–86 to respond to demographic changes. Health authorities have also had the benefit of their growing cost improvement programme: cash released, including earlier efficiency savings, reaches a cumulative level of nearly £500 million a year in 1986–87, representing a substantial addition to the resources available for service development. These increased resources are reflected in the expansion in the level of services that has occurred since 1978; in 1984 hospitals in England treated 800,000 (15 per cent.) more inpatient cases, and 340,000 (61 per cent.) more day cases and there were 3 million more outpatient attendances than in 1978.
I regret that, despite detailed examination, it has not proved possible to provide all the information requested at regional level; in particular:
- (A) National Health Service spending includes family practitioner services and various central services, and could not meaningfully be split on a regional basis. The regional information below is therefore based solely on allocations to health authorities,
- (B) on demography, the Department does not hold a back series of the components of weighted populations used for the RAWP calculations year by year, and so the information requested at (c) can only be given at a national level.
The tables give the available information.
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TABLE 2 Percentage increase in health authority revenue expenditure 1978–79 to 1984–85 after taking account of general inflation as measured by the Gross Domestic Product Deflator 1979–80 1980–81 1981–82 1982–83 1983–84 1984–85 Cumulative growth 1978–79 to 1984–85 Northern a. real terms increase 4.3 8.8 0.3 0.9 1.7 1.7 18.8 b. increases available for services 1.1 1.0 2.0 1.4 1.1 0.1 6.8 Yorkshire a. 3.9 9.3 0.7 -0.4 1.5 1.9 17.9 b. 0.8 1.4 2.4 0.1 0.9 0.3 6.0 Trent a. 4.1 9.7 0.5 0.7 2.0 2.9 21.2 b 1.0 1.7 2.1 1.2 1.4 1.3 9.0 East Anglian a. 4.6 9.0 -0.1 0.5 3.5 3.1 22.0 b. 1.5 1.1 1.5 1.0 2.8 1.5 9.7 All Thames regions BG's and SHAs a. 1.3 8.7 0.7 -1.4 0.9 0.6 10.9 b. -1.7 0.8 2.3 -0.9 0.3 .10 -0.3 Wessex a. 3.8 8.4 1.1 0.6 2.7 3.3 21.3 b. 0.7 0.5 2.8 1.1 2.1 1.7 9.1 Oxford a. 4.3 6.9 -0.2 -0.1 0.9 3.9 16.5 b 1.2 -0.9 1.4 0.4 0.3 2.3 4.7 South Western a. 4.4 8.2 1.0 0.0 1.8 1.5 17.8 b. 1.2 0.3 2.7 0.5 1.2 -0.1 6.0 West Midlands a. 5.2 7.8 0.2 0.7 1.7 2.5 19.4 b. 2.1 0.0 1.8 1.3 1.1 0.9 7.4 Mersey a. 3.3 8.0 0.3 0.1 0.1 1.7 14.1 b. 0.3 0.2 1.9 0.6 -0.5 0.1 2.6 North Western a. 3.6 9.7 2.4 0.5 0.8 1.7 19.8 b. 0.5 1.8 4.0 1.0 0.2 0.1 7.7 Notes:
1. The table shows expenditure by regional and London Postgraduate Special Health Authorities only, and excludes central expenditure on hospital and community health services.
2. Regional expenditure on pay and price increases has been costed at national level (see table 1, row 2) because it has not proved possible to compile region-specific indices. Discrepancies in totals are due to rounding.
3. Percentages to 1984–85 are based on net revenue expenditure from health authorities' summarised accounts. These are on an accruals basis, unlike the national figures. Revenue to capital transfers affect different Regions differently.
4. Figures for the individual Thames Regions are distorted by 1982 boundary changes.
5. 1985–86 out-turn figures are not yet available.