HC Deb 25 July 1986 vol 102 cc734-7W
Mr. Dobson

asked the Secretary of State for Social Services how much Health Service expenditure as an absolute figure and as a percentage of total National Health Service expenditure for each of the past 10 years was spent on (a) elderly and geriatric services, (b) community services, (c) the mentally handicapped, (d) the mentally ill, (e) obstetric services and (f) acute hospital services.

Mr. Hayhoe

The requested breakdown by client group is available only for hospital and community health services current expenditure which accounts for about two thirds of total National Health Service expenditure. The table shows estimated gross current expenditure by health authorities, in cash and as a percentage of total hospital and community health services expenditure, on the main client groups each year between 1975–76 and 1984–85, the latest year for which these estimates are available. These estimates of health authorities' spending are valid for monitoring broad trends, but not for making close comparisons between individual programmes. They are derived from my Department's programme budget analyses which have been provided to the Social Services Committee each year since 1980 and have been published in minutes of evidence associated with the Committee's, reports. The latest analysis at constant prices, together with notes of caution on the limits of its accuracy, are given in the Committee's Fourth Report (HC 38741) which was published earlier this month.

Hospital and Community Health Services Expenditure (£ million cash)—England
1975–76 1976–77 1977–78 1978–79 1979–80 1980–81 1981–82 1982–83 1983–84 1984–85*
Geriatric Services† 269 311 356 410 489 649 714 763 804 860
(percentage of total) (8.7) (8.9) (9.1) (9.3) (9.2) (9.5) (9.4) (9.4) (9.4) (9.5)
Community Services 260 294 329 370 449 598 665 728 780 856
(percentage of total) (8.4) (8.4) (8.4) (8.4) (8.5) (8.7) (8.8) (9.0) (9.1) (9.4)
Services for mentally handicapped people 162 181 205 229 275 355 389 419 437 462
(percentage of total) (5.3) (5.2) (5.2) (5.2) (5.2) (5.2) (5.1) (5.2) (5.1) (5.1)
Services for mentally ill people‡ 354 389 444 490 593 775 860 916 965 1,029
(percentage of total) (11.5) (11.1) (11.3) (11.1) (11.2) (11.3) (11.3) (11.3) (11.3) (11.4)
Obstetric Services 167 188 207 224 273 353 392 427 435 457
(percentage of total) (5.4) (5.3) (5.3) (5.1) (5.1) (5.2) (5.2) (5.3) (5.1) (5.0)
Acute Hospital Services 1,455 1,653 1,833 2,052 2,459 3,163 3,505 3,745 3,958 4,163
(percentage of total) (47.2) (47.1) (46.7) (46.6) (46.3) (46.2) (46.2) (46.3) (46.2) (45.9)
Other Services 414 495 548 631 772 958 1,057 1,087 1,182 1,235
(percentage of total) (13.4) (14.1) (14.0) (14.3) (14.5) (14.0) (13.9) (13.4) (13.8) (13.6)
Total Hospital and Community Health Services (excluding Joint Finance) ║ 3,081 3,511 3,923 4,406 5,310 6,849 7,582 8,085 8,561 9,062
* (provisional).
† includes expenditure on non.psychiatric day patients.
‡ includes expenditure on psychiatric day patients.
║ as given in health authorities summarised accounts.

Mr. Knox

asked the Secretary of State for Social Services what has been the total current expenditure on the National Health Service in each year since 1970, at constant prices.

Mr. Fowler

Total gross current expenditure on the National Health Service in England, at 1985–86 prices*, was as follows:

£ million
1970–71 8,361
1971–72 8,588
1972–73 8,985
1973–74 9,461
1974–75 10,744
1975–76 11,233
1976–77 11,374
1977–78 11,761
1978–79 †11,412
1979–80 11,652
1980–81 12,771
1981–82 12,954
1982–83 13,249
1983–84 13,443
1984–85 13,814
1985–86 ‡||13,809
1986–87 ‡14,304
* Expenditure figures revalued in line with the movement in the GDP deflator at market prices.
† From 1978–79 expenditure is recorded on a cashflow basis rather than the earlier accruals basis. If expenditure were recorded for 1978–79 on the same basis as in 1977–78, it would be £11,481 million.
‡ Provisional figures, dependent partly on the outcome of any revenue to capital transfers.
║ Takes account of expected transfer of £35 million from current to capital expenditure.

Mr. Knox

asked the Secretary of State for Social Services what has been the total capital expenditure on the National Health Service in each year since 1970, at constant prices.

Mr. Fowler

Total gross capital expenditure, including capital receipts, on the National Health Service in England, at 1985–86 prices*, was as follows:

Total expenditure
1970–71 651.0
1971–72 760.5
1972–73 882.8
1973–74 1,013.2
1974–75 859.2
1975–76 896.7
1976–77 863.6
1977–78 677.7
1978–79 702.5
1979–80 673–5
1980–81 771.6
1981–82 856.2
1982–83 829.2
1983–84 830.1
1984–85 894.3
1985–86 †914.4
* Expenditure figures revalued in line with the movement in the GDP deflator at market prices.
† Provisional figures.

Mr. Knox

asked the Secretary of State for Social Services if he will publish a table showing, for the European Economic Community as a whole, for each present member state of the European Economic Community, the United States of America and Japan, the percentage of the gross domestic product in constant prices devoted to health and social security expenditure in each year between 1979 and 1986.

Mr. Newton

I shall write to my hon. Friend.

Mr. Meacher

asked the Secretary of State for Social Services if he will update the information on the National Health Service and personal social services expenditure per capita given in his answer of 11 November 1985, Official Report, column 96, so as to give data for 1984–85 and 1985–86.

Mr. Hayhoe

[pursuant to his reply, 21 July 1986, c. 99]: Estimates of health and personal social services expenditure per capita for 1984–85 are expected to be available by mid-August and comparable estimates for 1985–86 at about the same time next year.

Mr. Meacher

asked the Secretary of State for Social Services if he will update the information on National Health expenditure provided in his answer of 1 July 1985, Official Report, column 47, to include 1985–86 and an estimate for 1986–87.

Mr. Hayhoe

[pursuant to his reply, 21 July 1986, c. 103]: The available information is set out in the following tables. Since the reply to the hon. Member last year there have been a number of technical changes to the figuring to reflect a revised Vote structure and a change in accounting for hospital and community health services spending. I have therefore provided figures on a comparable basis from 1978–79 onwards. The figures now also include income from land sales. Fully comparable figures for earlier years are not available.

The figures for spending deflated by the services own pay and price increases are not an adequate measure of the resources available for patient care as they exclude the very significant improvements in efficiency which have been made.

Hospital and Community health services gross current and capital expenditure (including land sales)
£million cash Percentage change in real terms (GDP deflator) Percentage change deflated by the Retail Price Index Percentage change deflated by NHS pay and prices
1978–79 4,772
1979–80 5,684 +1.9 +2.9 -1.2
1980–81 7,519 +11.4 +13.7 +3.5
1981–82 8,351 +1.0 .0.4 +3.0
1982–83 8,935 .0.1 +0.8
1983–84 9,381 +0.5 +0.3 +0.2
1984–85 9,965 +1.9 +11 +0.6
1985–86* 10,552 -0.1 +0.7
1986–87† 11,314 +3.3 n/a n/a
Family practitioner services gross current and capital expenditure
1978–79 1,473
1979–80 1,731 +0.5 +1.5 +0.3
1980–81 2,178 +5.9 +8.2 +0.5
1981–82 2,509 +4.7 +3.3 +2.1
1982–83 2,900 +8.0 +7.9 +3.6
1983–84 3,117 +2.9 +2.7 +2.0
1984–85 3,426 +5.5 +4.7 +2.8
1985–86* 3,659 +0.7 +0.8 +1.1
1986–87† 3,910 +3.0 n/a n/a
Central health and miscellaneous services: gross current and capital expenditure (including land sales)
1978–79 181
1979–80 225 +6.4 +7.3 +6.2
1980–81 275 +2.9 +5.0 +1.1
1981–82 324 +7.1 +5.7 +8.1
1982–83 361 +4.1 +4.0 +4.2
1983–84 423 +121 +11.9 +11.8
1984–85 483 +9.6 +8.6 +8.7
1985–86* 513 +0.2 +0.3 +1.4
1986–87† 537 +0.9 n/a n/a
n/a = Not available.
* Provisional.
† Estimated.
‡ Indicates insignificant change.