§ Mr. Hooley> asked the Secretary of State for Social Services what was the aggregate cost of estate management expenditure within the National Health Service in each of the past 10 years; and what percentage of total National Health Service expenditure for all purposes this represents
§ Mr. Geoffrey FinsbergThe accounts submitted by health authorities in England give the following:
Financial Year Expenditure on Estate Management £ million Percentage of Total Expenditure 1974–75 238.5 7.1 1975–76 310.4 7.2 1976–77 349.6 7.2 1977–78 427.1 7.9 1978–79 471.2 7.6 1979–80 558.1 7.6 1980–81 695.3 7.4 803.1 1981–82 (Provisional) 7.6 Comparable figures for the period prior to 1974–75 are not available.
§ Mr. Hooleyasked the Secretary of State for Social Services what is the approximate percentage of buildings currently in use in the National Health Service which were constructed prior to 1914; and what is the percentage, including the above, prior to 1939.
§ Mr. Geoffrey FinsbergPrecise information in the form requested is not held centrally. The last detailed survey of the NHS estate in England was carried out in 1972, when it was estimated that 49 per cent. of buildings were constructed before 1919 and 71 per cent. before 1949.
§ Mr. Hooleyasked the Secretary of State for Social Services what surveys, or sample surveys, of the condition 158W of buildings currently in use in the National Health Service have been made during the past 15 years; and what in broad terms were the findings.
§ Mr. Geoffrey FinsbergRecords of the state of health buildings are a matter for the individual health authorities who have responsibility for their maintenance. "Estmancode", the Departmental guidance on estate management, recommends that health authorities survey their buildings on a regular basis to determine maintenance programmes. A national survey of the condition of health buildings was carried out in 1972. In this broad brush survey the views of health authorities were obtained on the cost of the maintenance works required to bring their estates to a locally acceptable condition. The survey showed that at March 1982 prices £295 million was required.
§ Mr. Hooleyasked the Secretary of State for Social Services what is the capital value of new buildings and major works currently under construction in the National Health Service.
§ Mr. Geoffrey FinsbergIt is estimated that the capital cost of major schemes—each with a total cost of £5 million or more—currently under construction in the National Health Service is £500 million at 1981–82 prices. Health authorities have numerous smaller schemes under way for which full information is not held centrally.
§ Mr. Meacherasked the Secretary of State for Social Services if he will publish the figures for total current expenditure on the National Health Service for each of the last five years, in both constant and actual prices; and what are the inflation assumptions upon which each of those cash limits were based.
§ Mr. Kenneth ClarkeThe figures are as follows: million
–million Constant (November 1980) prices Cash 1977–78 9,595 5,689 1978–79 9,811 6,455 1979–80 9,800 7,712 1980–81 9,920 9,917 1981–82 10,268 11,193 Technical adjustments have been made to the figures for total current expenditure at November 1980 prices which account for the small difference between these figures and the figures for these years in my answer to the hon. Member on 8 July.—[Vol. 27, c. 190–1.]
The figures include family practitioner service expenditure which is not cash limited. The average pay and price increases each year over the previous year were as follows:
Per cent. 1978–79 11.0 1979–80 19.6 1980–81 27.0 1981–82 9.1 Note: All figures are outturn figures with the exception of those for 1981–82 which are estimated outturn.
§ Mr. Meacherasked the Secretary of State for Social Services if he will publish figures for each of the last five years to show the proportion of National Health Service 159W total current expenditure met from Exchequer funds, and the proportion met from charges of all kinds, including prescription charges and payment to the National Health Service made by pay-bed patients.
§ Mr. Kenneth ClarkeTable A shows the proportion of the gross cost of NHS current expenditure met from charges over the last five years. Table B shows the proportions of NHS expenditure met from exchequer funds, charges, and the NHS element in the national insurance contribution. Expenditure from exchequer
Table B Sources of gross NHS expenditure (capital and current) in percentage terms Exchequer Funds Charges NHS contributions Miscellaneous 1977–78 87.5 2.3 9.9 0.3 1978–79 87.5 2.2 10.0 0.3 1979–80 87.5 2.3 9.9 0.3 1980–81 88.7 2.5 8.5 0.3 1981–82 87.4 2.7 9.6 0.3
§ Mr. Meacherasked the Secretary of State for Social Services if he will publish the figures for total National Health Service expenditure, both capital and current, for each of the last 10 years expressed as a percentage of (a) gross national product, (b) gross domestic product.
§ Mr. Kenneth ClarkeThe table shows total NHS expenditure as a percentage of GNP and GDP at factor cost over the last 10 years.
Total net NHS expenditure (United Kingdom) as a percentage of GNP at factor cost Total net NHS expenditure (United Kingdom) as a percentage of GDP at factor cost 1972 4.73 4.78 1973 4.58 4.67 1974 5.18 5.27 1975 5.53 5.57 1976 5.52 5.58 1977 5.43 5.46 1978 5.36 5.41 1979 5.38 5.45 1980 6.07 6.10 1981 6.46 6.49
§ Mr. Meacherasked the Secretary of State for Social Services if he will publish figures, for each regional health authority and for the United Kingdom as a whole, to show the amount of annual growth required in National Health Service current expenditure to meet only the changing demographic structure of the population, with particular reference to the increasing numbers of the elderly.
§ Mr. Kenneth ClarkeThe 1982 public expenditure White Paper (Cmnd. 8494) included an estimate of about 0.6 per cent a year over the next three years for increased demand for hospital and community health services in England as a result of demographic change. It is not possible to make worthwhile estimates of this kind for individual regional health authorities.
In the family practitioner services future growth is determined by demand, and demographic factors are not separately identified. 160W sources and the health element in the NI contribution is not separately identifiable between current and capital, so Table B gives total NHS expenditure.
Table A Percentage of gross NHS current expenditure met by charges 1977–78 2.5 1978–79 2.4 1979–80 2.5 1980–81 2.7 1981–82 3.0 The positions in Scotland, Wales and Northern Ireland are matters for my right hon. Friends the respective Secretaries of State.