HC Deb 29 January 1985 vol 72 cc168-70W
Mr. Soames

asked the Secretary of State for Social Services (1) if he will list the principal achievements of the National Health Service in 1984;

(2) what are his principal objectives for the National Health Service in 1985.

Mr. Kenneth Clarke

[pursuant to his reply, 16 January 1985, c. 169–70]: Although detailed figures for 1984 are not yet available to us, we expect the substantial increases of the previous five years in the number of patients treated in England to have been maintained. We also expect the service to have achieved further improvements in the quality of care, particularly for our priority groups — the mentally ill, the mentally handicapped, and the elderly. I regret that no precise measure of the growth of the service will be available until we have the full figures.

Planned expenditure in the National Health Service is up in 1984–85 by more than 7 per cent. over the previous year. Our latest figures show that in the year to March 1984 hospital inpatient waiting lists fell by some 33,000. In the six months following the launch in February 1984 of a new campaign on kidney donation, kidney transplants rose by 40 per cent. over the equivalent period in 1983. We funded improvements in primary care in inner cities and promoted better joint planning of local services among the statutory and voluntary bodies and the development of community care. Health authorities were asked to take urgent action to improve services for drug misusers. In line with our policy on prevention, over 30 districts which were previously without a health education service established one. Also in 1984, seven major capital schemes, costing £5 million or more each and providing a total of 1,380 new beds and full supporting services, were completed and 11 major schemes were started on site.

The service's drive for better management continued in 1984. Of the 13 general managers now appointed by regional health authorities, 12 were in post by the end of the year; 63 of the 192 district health authorities and five of the eight special health authorities had also appointed their general managers. Progress was made in the development of management budgeting in four demonstration districts. Latest figures indicate that NHS manpower was lower at 30 September 1984 than a year previously whilst we expect the number of patients treated to have continued to rise. Health authorities identified current expenditure savings of about 1 per cent. in 1984–85 through cost improvement programmes which released about £100 million to improve patient services. We also published six reports of Rayner efficiency scrutinies carried out by staff in the service which identified potential recurrent savings of up to £40 million a year plus substantial scope for one-off savings. Following instructions to health authorities in September 1983, health authorities are making very worthwhile savings by putting their domestic, catering and laundry services out to competitive tender. The savings achieved by all these various means release resources for better patient care.

In 1985 we shall be looking for these encouraging trends of the past year to continue and for further improvements in the quantity and quality of service provided to the public. The Government have already announced that we shall be spending over £600 million more on the NHS in England in 1985–86. We shall also be examining carefully health authorities' plans for service development and for the better use of financial, manpower and capital resources. We shall be publishing a Green Paper on the development of primary care services. We shall continue to promote joint planning and the care in the community programme. We hope that by the end of 1985 all districts will have, or have access to, a health education service. Seven more major capital schemes are expected to be completed in 1985.

We shall be looking to health authorities: to complete the appointment of general managers at regional and district level and the revised management structures to complement this and to carry forward the establishment of the general management function into hospitals and other units; to identify an increased level of savings through their cost improvement programmes; and to complete a further round of efficiency scrutinies. We intend no overall rise in NHS manpower but will achieve growth and improvement in services by better productivity. We shall be giving priority to improving training for management in the service and to bettering the quality and use of management information. Management budgets will be extended to a further limited number of demonstration districts. The new family practitioner committees, directly accountable to my right hon. Friend, will come into being in 1985 and we shall be looking to them to play a major part in promoting and improving primary health care.