§ 50. Mr. Eyreasked the Secretary of State for Social Services whether he intends to implement in full the recommendations of the Resource Allocation Working Party with regard to the allocation of revenue to regional health authorities in the year 1977–78.
§ 51. Mr. John H. Osbornasked the Secretary of State for Social Services what steps he will take to increase capital and current expenditure on health services per capita in the Trent Region, following representations from the Trent Regional Health Authority; and whether or not there can be a greater relief from the proposed cuts within the Sheffield Area Health Authority at the expense of other authorities in the county.
§ Mr. EnnalsSince the Resource Allocation Working Party reported to me in September on how to share out health service funds across the country, there has been some misunderstanding about what was proposed; in particular there have been rumours about a threat to our major London hospitals—particularly the teaching hospitals. There is no truth in these rumours.
It is nonsense to imagine that any of our famous teaching hospitals is in danger. These hospitals are doing the vital job of training the doctors and consultants of the future. They are national institutions which treat patients from outside as well as inside their regions.
Now that the Cabinet has settled the level of public spending, I want to put an end to the anxieties and explain the principles I shall follow in determining the distribution of resources to health authorities in England for next year. The planned increase in expenditure on services to patients of about 1½ per cent, in real terms nationally has been left intact despite the recent cuts in public 92W expenditure as a whole but the capital programme is to face a cut.
There must be no doubt about the Government's long term commitment to a fairer allocation of money between the different regions of the country. And not only between regions: some of the biggest inequalities, the worst injustices, are within regions, with large gaps between rich and poor areas or districts. Some of the inner city areas for example are recognised as relatively deprived areas by the criteria used by the Working Party.
We must gradually close the gap. But how quickly we move towards the Working Party's targets depends on how much money we have. If the NHS budget was growing fast it would be easy: we could give rapid growth to the poorer areas and still give considerable growth to the richer ones to take full advantage of all improvements in medical technology. The present constraints on resources make things harder.
Some have argued that I should give all the extra money available to the poorer regions and give no extra money at all to the richer regions which include the four London-based Thames regions. But the London regions, like other regions, are having to meet the needs of an ageing population. They too have had to absorb some extra costs this year which were not known when the allocations were made. Next year they like other regions will have to meet the extra costs caused by the Jubilee holiday and will be taking over the lion's share of the first 1,000 private beds which the National Health Service will be free to use for NHS patients. On top of this, they are beginning to get to grips with the major redeployment of hospital resources which will over a period include the closure of small hospitals which are no longer viable so as to provide a more efficient service for London's population—which has fallen by about a tenth in the last 10 years. Some new hospital projects will also be opening in London during the coming year.
I have therefore decided that the best-provided region will get a ¼ per cent. increase next year in real terms in its revenue allocation. The other three Thames regions will get somewhat higher increases. And at the other extreme the most deprived regions will get about 3 per cent. increase in real terms. I shall 93W be announcing precise allocations to regions early next year. I recognise however that an increase of a fraction of a per cent. really represents a cut in a region's ability to meet the growing demand arising from demographic change, and in some places actual reductions in some services are likely to be unavoidable.
As regards capital, major schemes or phases of schemes which have already started will not be stopped but the start of a substantial number of schemes will need to be deferred. I am still considering the effect on distribution of capital in 1977–78.
I hope that this statement will put an end to the misunderstandings which have arisen about the redistribution of resources for the hospital and community health services.