§ Mr. Dobsonasked the Secretary of State for Social Services if he will give for each health authority wholly or partly within Greater London and for each year since 1979 (a) the total joint finance expenditure and (b) the total overspend or underspend for joint finance.
452W
Joint finance expenditure Area health authorities 1978–79 £000 1979–80 £000 1980–81 £000 1981–82 £000 District health authorities 1982–83 £000 1983–84 £000 1984–85 £000 Barnet 324 395 493 761 Barnet 592 617 478 Brent and Harrow 320 379 500 590 Harrow 332 412 389 Brent 451 500 548 Ealing, Hammersmith and Hounslow 540 667 911 1,045 Hounslow and Spelthorne 685 516 494 Ealing 610 533 624 Hillingdon 153 187 182 358 Hillingdon 234 469 429 Kensington, Chelsea and Westminster 338 261 575 827 Paddington 309 304 297 Hammersmith and Fulham 301 296 360 Victoria 338 398 418 Barking and Havering 244 273 450 602 Barking, Havering and Brentwood 921 808 817 Camden and Islington 350 477 643 823 Hampstead 249 87 435 Bloomsbury 403 417 241 Islington 479 401 528 City and East London 561 855 680 1,420 City and Hackney 637 460 220 Newham 707 413 647 Tower Hamlets 358 547 651 Enfield and Haringey 400 490 698 740 Enfield 477 483 436 Haringey 631 434 475 Redbridge and Waltham 341 433 772 692 Redbridge 386 378 585 Forest Waltham Forest 484 466 500 Greenwich and Bexley 189 431 657 191 Greenwich 437 452 356 Bexley 354 275 367 Bromley 239 217 362 458 Bromley 498 404 401 Lambeth, Southwark and 408 655 1,018 1,924 West Lambeth 560 682 532 Lewisham Camberwell 689 603 792 Lewisham and North Southwark 645 799 978 Croydon 241 245 415 471 Croydon 597 753 751 Kingston and Richmond 147 219 348 406 Kingston and Esher 409 411 431 Richmond, Twickenham, Roehampton 254 252 224 Merton, Sutton and Wandsworth 513 571 609 1,173 Wandsworth 520 462 606 Sutton and Merton 451 541 581
§ Mr. HayhoeThe tables show total joint finance expenditure by area health authorities for the years 1978–79 to 1981–82, and by district health authorities for the years 1982–83 to 1984–85.
I regret that information on overspending and underspending of joint finance at area and district level is not held centrally. The hon. Member may wish to approach the chairmen of the Thames regional health authorities for further information.
453WNotes:
1. The figures are derived from health authorities' summarised accounts.
2. The 1982 reorganisation of the National Health Service resulted in substantial and complex boundary changes and changes in management responsibility, and it is therefore not possible to make direct comparisons between the pre- and post-1982 authorities.
§ Mr. Dobsonasked the Secretary of State for Social Services (1) if he will give, drawing from the regional plans for each health authority wholly or partly within Greater London and for each year up to 1994, the proposed expenditure per head of population (a) in cash terms and (b) in real terms;
(2) if he will give, drawing from the regional plans, for each year up to 1994 the proposed increase or decrease in expenditure expressed (a) in cash terms and (b) in real terms; and if he will give in each case the proportion of the change attributable to (i) national Resource Allocation Working Party and (ii) subregional resource allocation policies.
§ Mr. HayhoeRegional strategic plans do not contain year by year detail of the kind requested; they are intended to provide a broad framework, within which there remains some flexibility to respond to changing circumstances. The plans themselves are not rigid, and regions continue to review and update them as necessary. The hon. Member may wish to approach the chairmen of the Thames regional health authorities for such information as is available.
§ Mr. Dobsonasked the Secretary of State for Social Services if he will give for each health authority wholly or partly within Greater London and for each year since 1979 the expenditure per head of population (a) in cash terms (b) deflated by the gross domestic product deflator and (c) deflated by the National Health Service deflator.
§ Mr. HayhoeExpenditure per head of population is not a good basis for comparison between health authorities: it does not reflect the greater demands made on health services by the very young and the elderly, or differing patterns of morbidity. Nor does it take account of patient flows across health authority boundaries, which are particularly significant in a metropolitan area. The information requested would therefore be of limited value and disproportionately costly to prepare.
For resource allocation purposes, population figures are weighted to take account of these factors, and adjusted to reflect cross boundary flows. Expenditure in proportion to districts' weighted population provides a better measure
454W
Revenue expenditure out-turns cash £ thousand Area Health Authorities 1978–79 District Health Authorities 1984–85 Barnet 33,681 Barnet 64,054 Brent and Harrow 43,366 Harrow 36,643 Brent 49,465 Ealing, Hammersmith and Hounslow 76,165 Hounslow and Spelthorne 50,207 Ealing 39,602 Hammersmith and Fulham 49,685 Hillingdon 26,152 Hillingdon 52,147 Kensington, Chelsea and Westminster 89,844 Paddington 59,191 Victoria 72,733 Barking and Havering 33,411 Barking/Havering/Brentwood 68,424 Camden and Islington 82,975 Hampstead 65,016 Bloomsbury 116,946 Islington 44,185 for comparison both between authorities and over time. I regret that this information is not available centrally in respect of health authorities in Greater London, but the hon. Member may wish to approach the chairmen of the Thames regional health authorities for further details.
The London postgraduate special health authorities do not serve a specific resident population.
§ Mr. Dobsonasked the Secretary of State for Social Services if he will give for each health authority wholly or partly within Greater London the percentage change in expenditure since 1979 expressed in (a) cash terms, (b) deflated by the gross domestic product deflator and (c) deflated by the National Health Service deflator; and if he will give in each case the proportion of the change attributable to: (i) national resources allocation working parties and (ii) subregional resource allocation policies.
§ Mr. HayhoeThe table shows expenditure by area health authorities and board of governors for the London postgraduate teaching hospitals in 1978–79 and by district health authorities and special health authorities in 1984–85 in cash terms. This information, expressed at 1978–79 price levels as measured by the gross domestic product deflator, was given in my reply to the hon. Member on 17 December 1985 at columns145 to 148. As I explained to the hon. Member in my reply to him on 23 May at columns 385–386, it is not appropriate to revalue district health authority expenditure by reference to centrally assessed movements in pay and prices.
I regret that, because of the boundary changes and changes in management responsibility which resulted from the 1982 reorganisation of the National Health Service, it is not possible to make direct comparisons between authorities' expenditure over this period.
It is not possible from the information available centrally to determine how far changes in expenditure are attributable to national and sub-regional resource allocation decisions respectively, or to other factors such as the level of transfers from revenue to capital. The hon. Member may like to seek further information from the regional chairmen concerned.
455W
Area Health Authorities 1978–79 District Health Authorities 1984–85 City and East London 92,218 City and Hackney 78,683 Newham 34,180 Tower Hamlets 64,748 Enfield and Haringey 37,989 Enfield 33,473 Haringey 38,127 Redbridge and Waltham Forest 47,376 Redbridge 35,347 Waltham Forest 59,072 Greenwich and Bexley 50,204 Bexley 34,445 Greenwich 57,826 Bromley 27,090 Bromley 51,244 Lambeth, Southwark and 125,568 West Lambeth 76,426 Lewisham Camberwell 61,440 Lewisham and North Southwark 104,312 Croydon 28,085 Croydon 56,569 Kingston and Richmond 24,366 Kingston and Esher 39,062 Richmond/Twickenham/Roehampton 33,189 Merton, Sutton and Wandsworth 91,192 Wandsworth 87,365 Sutton and Merton 63,699
Boards of Governors 1978–79 Special Health Authorities 1984–85 Hospital for Sick Children 13,936 Hospital for Sick Children 27,908 National hospitals for nervous diseases 8,559 National hospitals for nervous diseases 16,308 Royal National Throat, Nose and Ear hospital 3,880 — — Bethlem Royal and Maudsley hospitals 7,456 Bethlem Royal and Maudsley hospitals 16,845 Moorfields Eye hospital 6,372 Moorfields Eye hospital 12,344 St. John's hospital for Diseases for the Skin 1,496 — — National heart and chest hospitals 12,947 National heart and chest hospitals 27,650 Royal national orthopaedic hospital 5,889 — — St. Peter's hospitals 3,550 — — Royal Marsden hospital 9,676 Royal Marsden hospital 19,892 Queen Charlotte's hospital for women 4,921 Hammersmith and Queen Charlotte's hospital for women 22,878 Eastman dental hospital 1,937 Eastman dental hospital 4,503 Notes:
1. The figures are derived from health authorities' summarised accounts.
2. The 1982 re-organisation of the National Health Service resulted in substantial and complex boundary changes and changes in management responsibility. In addition to these changes there was a major restructuring of the boards of governors for the London postgraduate teaching hospitals as follows:
(a) Bloomsbury health authority now manages the Royal National Throat, Nose and Ear hospitals, the Royal National Orthopaedic hospitals and St. Peter's hospitals;
(b) West Lambeth health authority now manages St. John's hospital for Diseases of the Skin;
(c) Hammersmith hospital was given special health authority status.