HC Deb 28 July 1988 vol 138 cc540-5W
Mr. Worthington

To ask the Secretary of State for Social Services (1) when he will provide a substantive reply to the questions on health charges tabled by the hon. Member for Clydebank and Milngavie for priority written answer on 25 May;

(2) when he will provide a substantive reply to the questions on health charges tabled by the hon. Member for Clydebank and Milngavie for priority with written answer on 7 July.

Mrs. Currie

I replied to the hon. Member today.

Mr. Worthington

To ask the Secretary of State for Social Services if he will publish in theOfficial Report a table, consistent with the reply of 27 May, Official Report, columns 375–76, indicating the receipts in the years 1982–83 to 1990–91 classified as charges in respect of running costs expenditure, together with a supplementary analysis indicating, separately, the amounts of receipts in respect of programme expenditure and of running costs expenditure estimated to have been met from other public expenditure programmes.

Mrs. Currie

I shall write to the hon. Member.

Mr. Worthington

To ask the Secretary of State for Social Services (1) if he will publish in theOfficial Report tables which provide for (a) pharmaceutical services, (b) general dental services and (c) general ophthalmic services covering the period 1979–80 to 1988–89, gross expenditure, details of income analysed by source, and net expenditure incurred on Supply Votes and public expenditure programmes;

(2) if he will publish in the Official Report tables which provide, for (a) pharmaceutical services, (b) general dental services and (c) general ophthalmic services covering the period 1979–80 to 1988–89, gross expenditure, details of income analysed by source and net expenditure incurred on Supply Votes and public expenditure programmes.

Mrs. Currie

[holding answers 25 May and 7 July 1988]: The information requested is given in the table. The figures for 1987–88 are the latest forecasts of outturn for that year and differ from those underlying the public expenditure White Paper, Cm. 288-II, which were based on Winter Supplementary Estimates for that year. The figures for 1988–89 are the planning figures underlying Cm. 288-II and are necessarily indicative. They form the basis of the Main Estimate for the year currently before Parliament. They will be reviewed in the light of up-to-date information during the course of the year and if necessary supplementary estimates submitted to Parliament at the appropriate stage.

Estimated plans1 out.turn
1979–80 1980–81 1981–82 1982–83 1983–84 1984–85 1985–86 1986–87 1987–88 1988–89
(2) Dispensing doctors -1.734 -3.161 -3.934 -4.847 -5.294 -5.969 -7.057 -7.718 -7.892 -7.645
Prepayment certificate sales -2.862 -7.334 -8.769 -10.458 -10.883 -12.303 -13.540 -14.628 -15.700 -15.918
Less (1) Prescription charge refunds 0.275 0.528 0.900 1.385 1.479 1.381 1.531 1.352 2.183 2.095
(2) Charges collected in respect of prescriptions written by hospital doctors and dispensed by community pharmacists 0.290 0.471 0.578 0.638 0.674 0.671 1.441 1.131 0.966 0.943
Total charge income -38.646 -70.753 -86.620 -102.792 -110.044 -120.748 -127.756 -147.884 -159.765 -154.196
Net 751.473 902.947 1,038.105 1,187.255 1,320.531 1,430.001 1,529.376 1,639.187 1,816.364 2,017.580
(b) General denial services
Gross 336.404 419.120 481.083 538.445 584.440 640.379 660.026 741.744 827.366 889.200
Income Charges collected by dentists -69.777 -92.633 -115.521 -141.709 -1560.80 -171.321 -196.866 -221.670 -237.409 -286.482
Charges collected by Health Centres -0.072 -0.108 -0.127 -0.144 -0.154 -0.177 -0.187 -0.186 -0.200 -0.246
Charges collected by Family Practitioner Committees -0.015 -0.022 -0.030 -0.039 -0.040 -0.034 -0.041 -0.044 -0.060 -0.054
Less Refunds 0.180 0.276 0.571 0.844 0.994 1.031 1.016 0.949 0.900 1.482
Total charge income -69.684 -92.487 -115.107 -141.048 -155.280 -170.501 -196.078 -220.951 -236.769 2-285.300
Net 266.720 326.633 365.976 397.397 429.160 469.878 463.948 520.793 590.597 603.900
(c) General Ophthalmic services
Gross3 89.868 104.033 125.713 201.096 161.657 172.880 143.099 128.716 151.065 160.300
Income Charges collected by opticians -27.613 -28.915 -32.253 -380.86 -43.783 -44.140 -11.798 -0.782
Charges collected by Family Practitioner Committees -0.010 -0.012 -0.018 -0.013 -0.023 -0.016 -0.022 -0.019
Less4 Refunds 0.103 0.116 0.166 0.253 0.368 0.388 0.297 0.291
Total charge income -27.520 -28.811 -32.105 -37.846 -43.438 -43.768 -11.523 -0.510 -0.000 -0.000
Net 62.348 75.222 93.608 163.250 118.219 129.112 131.576 128.206 151.065 160.300
1 These are the figures underlying the public expenditure White Paper (Cm. 288.11) and are subject to in.year review.
2 The basis is given in the reply to the hon. Member for Peckham (Ms. Harman) on 12 April, at columns 104.5.
3 Certain amounts appropriated in aid are offset against gross expenditure on the Phs and GOS (for example, receipts from drug manufacturers)
4 The cessation of supply of NHS glasses in 1985.86 following the introduction of the voucher scheme resulted in the reduction, then cessation of GOS charge income.

Mr. Worthington

To ask the Secretary of State for Social Services (1) if he will publish in theOfficial Report a table providing a detailed analysis of the various line entries for charges in the years 1982–83 to 1990–91 in table 14.1 of Cm. 288-II;

(2) if he will publish in the Official Report a table providing a detailed analysis of the various line entries for charges in the years 1982–83 to 1990–91 in table 14.1 of Cm. 288-II;

(3) if he will provide a detailed breakdown for the years 1982–83 to 1990–91, by nature of item and functional area of charge, of the receipts to his programme classified memberconstituency charges for the purposes of the public expenditure survey.

Mrs. Currie

[holding answers 25 May and 7 July 1988]: The requested information is given in the table.

Analysis of charge income in table 14.1 of Cm. 288–11
1982–83 1983–84 1984–85 1985–86 1986–87 1987–88 1988–89 1989–90 1990–91
estimated outturn plans plans plans
£ million £ million £ million £ million £ million £ million £ million £ million £ million
Hospital and community health services and central health miscellaneous services1
Prescription charges 5 6 6 7 7 7 7 8 8
Private patients 52 56 56 60 62 65 68 72 75
Overseas visitors 1 2 2 2 2 2 2 2
Road traffic accidents 6 7 7 8 8 8 9 9 9
Laboratory services 5 6 6 7 8 8 8 8 8
Special hospital receipts 1 1 1 2 2 2 2 2 2
Other 6 8 9 9 12 10 11 12 12
TOTAL2 75 85 87 95 101 102 107 113 116
Family practitioner service
Prescription charges 103 110 121 128 148 148 154 161 168

The 1987–88 income figures for prescription and dental charges in the family practitioner services underlying Cm. 288-II were based on winter Supplementary Estimates. Later forecasts of outturn are as given in my other reply to the hon. Member today.

The figures for 1988–89 and later years are the planning figures underlying Cm. 288-II and are necessarily indicative. Those for 1988–89 form the basis of the main Estimates for that year currently before Parliament. These figures for the family practitioner services will be reviewed in the light of up-to-date information during the course of the year and if necessary Supplementary Estimates submitted to Parliament at the appropriate Supply stage. The income in later years will be determined, where appropriate, by the level of charges, when these come to be set by Parliament, and by the volume of chargeable activity.

1982–83 1983–84 1984–85 1985–86 1986–87 1987–88 1988–89 1989–90 1990–91
estimated outturn plans plans plans
£ million £ million £ million £ million £ million £ million £ million £ million £ million
Dental charges 141 155 171 196 221 245 3285 334 361
Ophthalmic charges 38 43 44 12 1
TOTAL2 282 308 336 336 370 393 4439 495 529
Personal social services5
Residential care 274 287 296 352
Support services 36 40 44 50
Day care 22 24 24 25
Administration 3 3 3 4
Other 1 1 1 2
TOTAL2 336 355 368 433 474 472 493 510 530
1 Hospital and community health services and Central health miscellaneous services totals have been combined to overcome the effect of transfers of services between the two sub-programmes.
2 Differences between totals in the analysis and table 14.1 are due to roundings in individual items. The convention used in Cm. 288–11 was to round the last two years to the nearest £10 million.
3 The basis is given in the reply to the hon. Member for Peckham (Ms. Harman) on 12 April, at columns 104–5.
4 Differs from table 14.1 which included assumed receipts of £80 million from the reconstitution of the GPFC.
5 Total receipts only are indicated for the years 1986–87 to 1990–91. They are estimates based on the proportional relationship between gross and net expenditure in previous years and a breakdown of this figure would be meaningless.

Mr. Worthington

To ask the Secretary of State for Social Services if he will publish in theOfficial Report a table showing for the period 1958 to 1988, in a form consistent with the written answer of 29 March 1982, Official Report, columns 27–30 (a) prescription charges per form or item (b) the real charge, as measured after adjusting by (i) the retail price index and (ii) the gross domestic product deflator (c) the proportion of prescriptions for which the nominal payment was in fact made (d) the proportion of patients receiving prescriptions exempted from the nominal payment and (e) the estimated proportions of the (y) adult and (z) total population estimated to liable to make the nominal payment.

Prescription charge per item1 Prescription charge per item revalued to 1987 prices using: Proportion of prescriptions
RPI GDP Deflator paid3 2
£ £ £ per cent.
1 December 1956 5p per item 1958 0.05 0.41 0.44
1959 0.05 0.40 0.44
1960 0.05 0.40 0.42
1 March 1961 10p per item 1961 0.09 0.71 0.75
1962 0.10 0.76 0.79
1963 0.10 0.75 0.78
1964 0.10 0.72 0.74
1 February 1965 charges abolished 1965 0.01 0.06 0.06
1966
1967
10 June 1968 12.5p per item 1968 0.07 0.42 0.44
1969 0.125 0.73 0.75
1970 0.125 0.68 0.69
1 April 1971 20p per item 1971 0.18 0.90 0.92
1972 0.20 0.93 0.94
1973 0.20 0.84 0.88
1974 0.20 0.71 0.73
1975 0.20 0.57 0.58
1976 0.20 0.50 0.52
1977 0.20 0.44 0.45 37
1978 0.20 0.40 0.41 37
16 July 1979 45p per item 1979 0.31 0.55 0.55 36
1 April 1980 70p per item 1980 0.66 0.99 0.98 30
1 December 1980 £1.00 per item 1981 1.00 1.34 1.35 25
1 April 1982 £1.30 per item 1982 1.23 1.53 1.54 25
1 April 1983 £1.40 per item 1983 1.38 1.64 1.65 22
1 April 1984 £1.60 per item 1984 1.55 1.76 1.78 22
1 April 1985 £2.00 per item 1985 1.90 204 2.06 20
1 April 1986 £2.20 per item 1986 1.90 1.98 2.00 18

Mrs. Currie

[holding answer 7 July 1988]: The requested information on the prescription charge per item, together with the proportion of prescriptions for which such charges were paid, is given in the table. In addition, some 5 per cent, of all prescriptions dispensed are covered by pre-payment certificates.

Information is not available on the estimated proportion of patients, or of the population who are exempt from the single item prescription charge. It is thought however that approximately half the population is exempt from all prescription charges.

Prescription charge per item1 Prescription charge per item revalued to 1987 prices using: Proportion of prescriptions
RPI GDP Deflator paid3 2
£ £ £ per cent.
1 April 1987 £2.40 per item 1987 2.35 2.35 2.35 18
1 April 1988 £2.60 per item 1988 2.55 2.45 2.44 *
1 For years for which the charge was changed in the course of the year, the values above are weighted averages according to the number of months at each rate.
2 Relates to prescriptions for which the single item charge was made.
3 Data not available prior to 1977.
* Not yet available.