Regional Health Authorities (Hansard, 24 January 1983)

§ Mr. Fowler

The Government have once more been able to provide the means to expand services for patients. The additional 1.2 per cent. growth represents nearly £100 million more over the year. It is subject to each region increasing efficiency by at least half per cent. as announced in the circular I issued last July. As well as allowing for inflation we have been able to make sure that there can be continued development throughout the NHS—with most resources going to the worst off regions.

Under the allocation for 1983–84 there will be increases of 2.9 per cent. extra (or £8.7 million) for the East Anglia regional health authority, 2.4 per cent. extra (or £16.9 million) for the Trent regional health authority and 2.1 per cent. more (about £9 million) for Wessex region. Detailed tables of the increased allocations to the fourteen regional health authorities are attached. The figures are of course provisional pending approval of my Department's estimates for 1983–84. They follow the formula laid down by the resource allocation working party—RAWP—based on relative health care needs of different regions. For the first time the census figures for 1981 have been used.

It has been possible to continue the Government's policy of putting more resources into the health services as a result of the increased expenditure announced by my right hon. and learned Friend the Chancellor of the Exchequer on 8 November 1982, the settlement of the NHS pay dispute, the fall in inflation and increased efficiency in the health service. The growth figures for each region are now significantly higher than the assumptions shown in the July circular.

Next year's increase means that we will have increased the resources available to health authorities steadily since 1979. The additional growth of 1.2 per cent. is on top of 5.5 per cent. over the last three years.

I have today sent a circular to health authorities giving them guidance on the use of the growth money. This emphasises the need to give particular consideration during the coming financial year to the improvement of buildings and the maintenance of the estate—something which has generally been neglected in the health service while priority was being given to other matters. By devoting more resources to upgrading existing buildings, 285W authorities can improve the quality of patient care—for example, by brightening up wards—and by bringing into good shape buildings that have a long working life ahead of them, they can help make better use of their total resources. Authorities should consider using both minor capital as well as revenue for this purpose.

The circular also asks authorities to use the remainder to improve the quantity and quality of services. It places a particular responsibility on regional health authorities to ensure that the right priority is given to those services which provide for a wider population than the district in which they are located—for example, renal dialysis and coronary artery surgery.

The cash provision for the hospital and community health service capital programme is based on the Government's spending plans set out in the last Public Expenditure White Paper Cmnd. 8494. The cash provision will allow a capital programme some 12 per cent. larger in real terms than in 1978–79.

Revenue Cash Limits 1983–84
Regional health authority	Revenue cash limits^* excluding joint finance	Development addition in col(1)	Percentage growth†
	£ million	£ million
	(1)	(2)	(3)
Northern	551.546	6.463	1.20
Yorkshire	617.655	9.623	1.60
Trent	746.218	16.901	2.40
East Anglian	312.021	8.702	2.90
North West Thames	659.806	1.945	0.30
North East Thames	831.815	2.504	0.30
South East Thames	725.479	2.466	0.35
South West Thames	554.693	1.926	0.35
Wessex	442.178	8.995	2.10
Oxford	351.984	4.947	1.45
South Western	538.263	8.603	1.65
West Midlands	854.036	10.901	1.30
Mersey	455.953	4.873	1.10
North Western	762.556	9.200	1.25
Total	8,404.203	98.049	1.20
^* Subject to Parliamentary approval of the Department's supply estimate.
† Column 3 represents the distribution for 1983/84 of 0.5 per cent. efficiency savings and 0.7 per cent. growth in resources calculated on the recurring cash allocations (excluding SIFT) for 1982/83.