HC Deb 30 June 1983 vol 44 cc134-7W
Mr. Murphy

asked the Secretary of State for Social Services if he will give details of Government plans to ensure the best value for money spent on the National Health Service.

Mr. Kenneth Clarke

The reorganisation of the NHS structure came into effect in April 1982, removing a tier of administration by abolishing area health authorities and enabled the proportion of resources spent on management to be reduced by 10 per cent. by 1984–85.

The Government have recently set in train a number of initiatives to ensure that the NHS makes the most efficient use of its money and manpower resources, including the introduction of better controls over NHS manpower, accountability reviews of authorities, the inquiry into NHS management by Mr. Roy Griffiths, encouraging health authorities to contract out support services where this is most cost-effective, the introduction of Rayner scrutinies in the NHS, and a review of NHS collection and use of management information being conducted by Mrs. Edith Körner.

Mrs. Dunwoody

asked the Secretary of State for Social Services whether his Department has participated in a study to assess the viability of means-tested charges for National Health Service patients with incomes above certain levels.

Mr. Kenneth Clarke

No.

Mr. Chapman

asked the Secretary of State for Social Services when he will be able to announce future resource assumptions for the National Health Service.

Mr. Fowler

I am today issuing a circular announcing longer term revenue and capital assumptions as a basis for NHS planning.

These resource assumptions are intended as a guide for the next 10 years, and by replacing the unrealistic ones issued in 1978 will enable health authorities to plan ahead with more confidence. The future levels of resources for health services will depend on the success of the national economy and other demands, but I have told health authorities to assume for planning purposes that resources for hospital and community health services could grow at the rate of around 0.5 per cent. a year. This is not a commitment and health authorities must ensure that their plans are flexible enough to cope with more or less resources.

The long-term planning assumptions for each region, which I am appending to this answer, are designed to remove steadily the inequalities in the resources allocated to regions which have persisted since the Health Service was instituted 35 years ago.

I also expect all parts of the Health Service to make more resources available for direct patient care by continuing to make better use of existing resources. These efficiency savings will be retained by regions in addition to resources provided by the taxpayer. The document which I published in March "Health Care and its Costs" shows how over the last few years the number of patients treated in the Health Service has increased faster than the additional resources put into it. I have taken a number of initiatives to improve performance further — for example, accountability reviews, manpower controls, performance indicators, special attention to audit, and most recently the setting up of the management inquiry under Mr. Roy Griffiths.

Table 1: Long-term Revenue Resource Assumptions
RHA 1983–84 DFT* Annual growth per cent.
1. Northern -3.7 +0.5
2. Yorkshire -4.3 +0.8
3. Trent -5.0 +1.1
4. East Anglian -6.4 +1.6
5. NW Thames +10.7 -0.5
6. NE Thames +8.7 -0.3
7. SE Thames +6.0 -0.3
8. SW Thames +6.4 -0.3
9. Wessex -4.9 +1.4
10. Oxford — +1.4
11. South Western -4.3 +1.3
12. West Midlands -3.8 +1.0
13. Mersey -1.5 +0.2
14. North Western -4.0 +0.4
Total — +0.5
* DFT=distance from target share of national resources.

Table 2: Long-term Capital Resource Assumptions
RHA 1983–84 share 1988–89 share 1993–94 share
per cent. per cent. per cent.
1. Northern 6.4 6.1 5.8
2. Yorkshire 8.4 7.4 7.7
3. Trent 8.8 10.5 10.2
4. East Anglian 3.5 4.6 5.5
5. NW Thames 5.8 5.8 6.0
6. NE Thames 6.8 6.8 6.9
7. SE Thames 6.5 7.1 7.8
8. SW Thames 5.3 5.9 6.6
9. Wessex 8.0 7.3 6.7
10. Oxford 4.0 5.5 6.7
11. South Western 7.4 9.0 7.6
12. West Midlands 12.2 12.2 10.2
13. Mersey 4.6 4.4 4.4
14. North Western 12.3 7.7 7.9
Total 100 100 100

Note: Distributions for 1988–89 and 1993–94 are the RAWP component of allocations projected under the present capital resource allocation method.

Table 3: Redistribution of Efficiency Savings 1984–85 and 1985–86
RHA Annual growth per cent.
1. Northern 0.55
2. Yorkshire 0.60
3. Trent 0.90
4. East Anglian 1.70
5. NW Thames —
6. NE Thames —
7. SE Thames —
8. SW Thames 0.05
9. Wessex 0.90
10. Oxford 1.20
11. South Western 0.75
12. West Midlands 0.65
13. Mersey 0.10
14. North Western 0.60
Total 0.50

Note: The table illustrates how the first half per cent. of each Authority's efficiency savings are to be redistributed.

Table 4
Capital Planning Assumptions 1984–85, 1985–86 £ million cash
1984–85 1985–86
RHA RAWP cash Percentage share Total* cash RAWP cash Percentage share Total* cash
1. Northern 34.5 6.16 39.8 36.9 6.16 42.0
2. Yorkshire 44.7 7.98 48.4 46.0 7.68 49.7
3. Trent 51.2 9.14 58.4 56.0 9.34 65.1
4. East Anglian 19.7 3.52 21.2 21.9 3.65 23.0
5. NW Thames 32.4 5.78 39.9 34.7 5.79 40.8
6. NE Thames 38.1 6.79 44.2 40.7 6.79 44.9
7. SE Thames 36.6 6.53 43.4 39.7 6.62 45.9
8. SW Thames 30.1 5.37 33.4 32.5 5.42 37.1
9. Wessex 46.8 8.35 56.0 50.2 8.34 58.6
10. Oxford 22.4 4.00 26.5 25.2 4.20 24.5
11. South Western 44.4 7.92 47.5 50.3 8.39 53.4
12. West Midlands 71.9 12.83 81.9 78.6 13.10 88.1
13. Mersey 25.3 4.50 28.2 27.0 4.51 27.7
14. North Western 62.3 11.12 70.2 59.8 9.98 67.6
Total 560.4 100 639.0 599.5 100 668.4
* Includes RAWP plus inner cities bias; dental hospitals re-equipment; strategic shift and brokerage; and teaching hospital support.

Note:

The distribution for each year is that projected under the present capital resource allocation method.