§ Mr. JesselTo ask the Secretary of State for Health when he will be in a position to announce regional allocation figures for the recent increases in National Health Service expenditure.
§ Mr. Kenneth ClarkeSpending in the hospital and community health service in England will increase by £1.1 billion in 1989–90, with over £1 billion going to regional health authorities as part of their initial allocations. This
Revenue allocations to regional health authorities 1989–90 (£ million) Main allocation1 Regional Health Authority Cash increase Percentage real terms increase Supra regional services Service increment for teaching2 AIDS3 Measles mumps and rubella vaccine4 Breast cancer screening5 Total cash increase6 Northern 59.2 2.5 0.3 0.8 3.4 0.5 0.6 64.7 Yorkshire 66.7 2.5 0.4 1.1 4.4 0.6 0.8 73.9 Trent 85.3 2.9 0.1 2.3 5.3 0.7 1.0 94.8 East Anglian 38.1 3.1 1.5 2.3 2.2 0.3 0.3 44.7 North West Thames 64.9 2.5 1.1 1.5 4.8 0.6 0.7 73.6 North East Thames 80.9 2.5 0.2 2.8 5.2 0.7 0.8 90.5 South East Thames 72.4 2.5 0.8 1.8 5.4 0.6 0.8 81.8 South West Thames 60.0 2.5 0.1 0.8 3.7 0.5 0.5 65.5 Wessex 49.7 2.5 0.2 0.5 3.5 0.5 0.5 54.8 Oxford 46.1 3.8 0.3 0.4 3.0 0.4 0.4 50.7 South Western 59.2 2.5 0.0 0.9 4.3 0.5 0.6 65.5 West Midlands 96.2 2.6 2.1 0.8 5.7 0.9 1.3 106.9 Mersey 47.2 2.5 0.2 0.4 2.9 0.4 0.5 51.6 North Western 81.1 2.5 0.6 1.3 5.2 0.7 0.9 89.7 Total Regional Health Authorities 907.0 2.7 7.8 17.7 58.9 7.8 9.7 1,008.8 Notes:
1Includes share of £237 million savings resulting from the reduction in employers' superannuation contributions.
2Cash increase shown in 1989–90 current SIFT over actual 1988–89 SIFT.
3£68 million extra is available for AIDS bringing the total provision in 1989–90 to £129.53 million. The table shows the additional funds health authorities will receive above this year's allocation. Some of the additional £68 million will be allocated to other hospital and community health services groups, for example, the Public Health Laboratory Services Board.
312Wwill be supplemented by some £175 million from new cost-improvement schemes and higher income generation receipts.
Regional health authorities' main allocations will increase in 1989–90 by an average of 2.7 per cent. in real terms. This substantial increase will be distributed so that all regions benefit to the largest possible extent. No region will receive less than 7.7 per cent., or 2.5 per cent. in real terms, an increase well above the figures authorities have so far been using in planning next year's service growth. Some regions, especially those with growing populations, will get slightly more because otherwise they would move away from their resource allocation working party target.
In addition to the increase in main allocations an extra £68 million will be provided for the fight against AIDS, bringing the total central provision to £130 million. As a result we will not only continue to underpin the cost of treatment and care but will give a major boost to work on prevention.
A total of £7.8 million will be provided separately for the costs of the new measles, mumps and rubella vaccine following the successful introductory campaign. The waiting list fund will go into its third year in 1989–90, and a further £30 million has been set aside for distribution to regional health authorities. A sum of £49 million will be provided for expenditure on specialised high technology services provided from a few national centres (supra-regional services). The breast cancer screening programme will be supported with an additional £11 million.
In addition, main capital allocations will increase by £85 million to £730 million. The increase will be distributed using the RAWP formula. Land sales are forecast to raise £290 million. Together these sums will more than sustain the hospital building and improvement programme which already includes over 500 schemes each costing over £1 million at various stages of planning, design and construction.
Details of the increases in authorities' revenue and capital allocations in 1989–90 are shown in the tables.
313W4Sum shown is each Region's share of £7.8 million available.
5The additional funds available for breast cancer screening total £ million. A further £1.347 million will be allocated later.
6Total cash/percentage increase shown includes each Region's share of £237 million savings resulting from the reduction in employers' superannuation contributions.
7 Real terms increases have been calculated using the forecast GDP deflator.
8Figures may not sum due to rounding
Capital allocations to regional health authorities 1989–90 Regional Health Authority Per cent. share Cash £ million Northern 6.54 47.5 Yorkshire 7.9 57.4 Trent 9.6 70.3 East Anglian 4.1 30.1 North West Thames 6.4 46.7 North East Thames 7.2 52.9 South East Thames 7.5 54.5 South West Thames 6.2 45.0 Wessex 6.8 49.4 Oxford 4.7 34.0 South Western 7.2 52.3 West Midlands 11.6 84.7 Mersey 4.9 36.1 North Western 9.4 69.0 Total 100.0 729.9 Note:
Figures in the table exclude allocations for "top sliced" funding such as support for teaching hospital schemes, supra regional services, dental hospital re-equipment, inner cities bias, and projects funded jointly by health authorities and local authorities or voluntary bodies.
§ Ms. RichardsonTo ask the Secretary of State for Health what proportion of National Health Service expenditure was used for(a) staff wages, (b) salaries, (c) fees and (d) expenses for the latest available year.
§ Mr. MellorFollowing are figures for items of current and capital expenditure derived from the summarised accounts of health authorities in England for 1987–88.
At this stage the figures are provisional in that they are subject to audit.
314W
The new clinical grading structure for nursing, midwifery and health visitor staff Numbers of old clinical grades assimilated to each of the new clinical grades on the basis of duties and responsibilities on 1 April 1988: Trent RHA Numbers transferred to each new clinical grade Previous grade Staff in post1 A B C D E F 2G H I Nursing Auxiliary 9,076.50 8,209.54 856.96 10.00 — — — — — — Staff Nursery Nurse 217.92 — 208.36 9.56 — — — — — — Enrolled Nurse3 6,379.63 — — 2,749.84 3,129.68 499.11 1.00 — — — Enrolled District Nurse3 340.97 — — — 338.97 2.00 — — — — Senior Enrolled Nurse3 371.99 — — 4.40 223.29 142.09 2.21 — — — Staff Nurse3 6,632.21 — — — 1,544.90 4,649.31 438.00 — — — Staff Midwife3 701.90 — — — 115.14 577.67 9.09 — — — Deputy Sister3 395.20 — — — — 81.84 305.90 6.46 1.00 — Nursing Sister II3 3,801.63 — — — — — 1,726.45 1,956.47 114.71 4.00 Midwifery Sister II3 873.51 — — — — — 261.20 609.81 2.50 — District Nurse (Sister II)3 1,066.06 — — — — — 261.20 609.81 2.50 — Nursing Sister I 57.99 — — — — — 3.37 23.82 26.80 4.00 Midwifery Sister I 19.00 — — — — — 1.00 18—00 — — Health Visitor 878.35 — — — — — — 870.75 7.60 — Senior Nurse 8 331.48 — — — — — 2.00 59.13 177.35 93.00 Senior Nurse 8 (Midwife) 38.00 — — — — — — 12.00 13.00 13.00 Senior Nurse 7 300.40 — — — — — — 5.00 37.60 257.80 Senior Nurse 7 (Midwife) 36.93 — — — — — — — 13.00 23.93 Clinical Teacher 154.56 — — — — — — 3.00 151.56 — Fieldwork Teacher 121.65 — — — — — 1.00 0.53 120.12 — Practical Work Teacher 157.80 — — — — — — 3.00 154.80 — Tutor 197.93 — — — — — — — 1.00 196.93 Tutor Midwife 45.16 — — — — — — — — 45.16 Post Basic Students Enrolled 282.00 — — 282.00 — — — — — —
£000s Proportion of total current expenditure Per cent. Salaries and wages National Health Service staff 8,253,988 73.2 Non-National Health Service staff (agency, etc.) 211,436 1.9 Travelling and subsistence expenses 167,952 1.5 Removal expenses 23,290 0.2 Capital Expenditure 1987–88 Salaries and wages, etc. of staff of professional and technical departments (works, etc.) charged to capital account: National Health Service staff 35,877 3.6 Non-National Health Service staff (agency, etc.) 2,449 0.2 Professional design consultants fees (architects, quantity surveyors, etc.) 77,117 7.7 Source:
Annual accounts of regional and district authorities in England and those of the special health authorities for the London postgraduate teaching hospitals.