§ Mr. Meadowcroftasked the Secretary of State for Social Services if he will make a statement on the Lancet's survey on deaths from chronic renal failure.
§ Mr. John PattenThe number of new patients starting treatment each year in the United Kingdom for end stage renal failure increased by 51 per cent. between 1978 and 1982, from 1,094 to 1,651. The total number of patients on treatment increased in the same period by 71 per cent., from 2,331 on 31 December 1978 to 3,994 on 31 December 1982. We regard the further improvement of services for these patients as a major priority. We have asked regional health authorities to submit proposed targets by the end of May for developing their services and we are allocating an extra £1 million to health authorities in 1984–85 for special developments in this field.
The study that appears in the Lancet for 31 March concludes that the number of patients treated by haemodialysis could be increased substantially by more intensive use of existing facilities, and we expect health authorities to consider this among other possible ways of expanding their services. However the major expense in the provision of dialysis is not the capital outlay on buildings and equipment but the running costs, and capital savings from more intensive use may need to be balanced against the advantages of having facilities more widely dispersed and the difficulty of recruiting staff. It is for 646W health authorities to decide what local pattern of services best meets their patients' needs and represents the best use of the resources available.
The leading article in the Lancet of the same date states incorrectly that our Department intends to "privatise" the management of two new dialysis units. My hon. Friend the Under-Secretary of State for Wales stated in his reply to the hon. Member for Carmarthen (Dr. Thomas) on 26 March, at column 30 that the private, voluntary and public sectors were being invited to make proposals for the operation of two subsidiary care units at Bangor and Carmarthen. It is open to health authorities in England to contract with outside bodies for the provision of dialysis or other services, but it is for them to decide whether this is a cost-effective and clinically satisfactory means of meeting their patients' needs.