Capital Programme (Hansard, 15 April 1975)

§ Mrs. Castle

I informed the House during the debate on the National Health Service on 2nd December last—[Vol. 882, c. 1214.1—of the financial constraints within which I have had to work in formulating the health capital programme for 1975–76, and also of the developments in the National Health Service to which I attach particular priority.

We faced the prospect when we took office in March 1974 that if we could not restore some of the 20 per cent. cut announced in December 1973 by the previous administration, we would have faced a complete moratorium on all major scheme starts for two or three years. In deciding the capital programme for this year, 1975–76, the Government have also had to take into account the further restrictions on public expenditure for 1976–77 announced by the Chancellor in his Budget Statement today, and the prospects for future years. It has nevertheless been possible to lift the moratorium on all hospital starts, but even so, many highly desirable schemes have had to be postponed and some will have to be redesigned. The programme will, however, provide for continuing expansion of 86W health centre construction, a tolerable level of work on essential minor schemes, maintenance of our medical student intake targets and of some priority for psychiatric and geriatric programmes. For the first time a sum of £5 million will be earmarked for specific action on those aspects of reducing waiting lists which can be resolved by capital provision. I am also making provision for the expenditure during the year of considerable sums on energy saving schemes designed to conserve fuel and reduce operating costs in future years.

I am notifying regional health authorities of their allocations. These are listed in the following table which indicates, subject to approval of estimates by Parliament, the total capital expenditure which I estimate will be incurred in each region in 1975–76:

RHA	£million
Northern	19.0
Yorkshire	24.9
Trent	35.1
East Anglia	12.2
North West Thames	19.7
North East Thames	23.3
South East Thames	24.1
South West Thames	19.8
Wessex	21.0
Oxford	16.6
South Western	16.8
West Midlands	29.8
Mersey	18.7
North Western	25.1
Boards of Governors	4.3

I have indicated to regional health authorities that I would be willing to authorities a start on the major schemes listed below—that is, schemes with a total cost of £350,000 or more—subject to receipt of suitable tenders. The schemes are substantially those which, after consulting authorities on their priorities, were considered to be possible within the provisional allocations notified to them in December. If, however, an authority wishes to substitute an alternative to any of the major schemes listed below I shall consider this, provided the change can be accommodated within its allocation and the effect on the programme as a whole over the next few years is not significantly altered.

I shall be notifying to individual authorities the planning assumptions for capital which they should adopt for the years 1976–77 to 1978–79. It is clear that we cannot allocate more revenue during this period than will ensure that as far as 87W possible the health service can meet demographic and other inescapable commitments and maintain existing standards, and this has meant that the capital allocations have had to be restricted and are likely to be lower than in 1975–76. The resources available for major new starts must not therefore be planned to be greater than in the current year's programme. If authorities can cut costs and achieve significant continuing savings on revenue I shall look sympathetically at proposals for transferring revenue to the capital side of the expenditure budget.

There is a considerable interaction between the health and personal social services programmes and I shall be arranging for urgent consultation with the local authority associations about the consequences for their capital programme of the expenditure restrictions announced by the Chancellor. Large Main Programme and Teaching Hospital Schemes proposed for a Start during 1975–76 Regional Health Authority and Scheme Northern South Cleveland District General Hospital. Scheme 1. Darlington Memorial Hospital. Residences. Yorkshire Grimsby District General Hospital. Phase I. York District Hospital.Residences. Trent Leicester General Hospital. Maternity. Leicester Royal Infirmary. Residences. Nottingham University Hospital. Phase II. St. George's Hospital, Lincoln. Services. East Anglia Jenny Lind Hospital, Norwich. Young Disabled Unit. Peterborough Mental Handicap Unit. North West Thames Luton and Dunstable Hospital. Phase 1. North East Thames Princess Alexandra Hospital, Harlow. Maternity. Royal Free Hospital. Clinical. Sciences etc. Stages H and III. University College Hospital, London. Pathology. South East Thames Cheyne Hospital, West Wickham. Mental Handicap Unit. South West Thames Regional Computer, St. George's Hospital, Tooting. Springfield Residences. St. Peter's Hospital, Chertsey. Psychiatric. 88W Wessex Queen Alexandra Hospital, Cosham. Residences. Royal South Hants Hospital, Southampton. Mental Illness. Southampton General Hospital. Maternity Unit. Oxford Milton Keynes Hospital. Phase I. South Western North Devon Infirmary, Barnstaple. Residences. West Midlands Hallam Hospital, Sandwell. Residences. Kidderminster General Hospital. Acute Ward. Regional Computer. Selly Oak Hospital. Phase I. Mersey Liverpool Teaching Hospital. Residences. Liverpool Teaching Hospital. Residences for Maternity Staff. North Western Ashton under Lyne General Hospital. Theatres. Barnes Hospital, Cheadle. Geriatric Unit. Hope Hospital, Salford. Improvements. Preston New Hospital. Phase I. Sharoe Green Hospital, Preston. Mental Illness etc.