§ Mr. CousinsTo ask the Secretary of State for Health if he will publish a table showing the allocations to National Health Service regions from 1982–83 to 1990–91228W were 119,000 people receiving income support in residential care homes and 57,000 claimants in nursing homes.
§ Mr. ChurchillTo ask the Secretary of State for Health (1) how many in-patients and out-patients, respectively, were treated, and what was the hospital's revenue, in respect of(a) the Christie hospital, Manchester, and (b) the Royal Marsden hospital, London, in the most recent year for which figures are available; and if he will make a statement about the cost-effectiveness of treatment in the case of each of those hospitals;
(2) if he will publish the cost (a) per in-patient case and (b) per out-patient attendance at the Christie hospital, Manchester, and at the Royal Marsden hospital, London, in respect of the most recent year for which figures are available; and what are the reasons for the disparity in cost between these two cancer treatment hospitals.
§ Mr. Freeman[holding answer 14 December 1989]: For the purposes of specialty costing, financial returns from health authorities provided to the Department categorise expenditure on direct patient services according to the main specialty of the consultant in charge of the treatment, rather than upon the specific treatment received.
Under this categorisation, the expenditure on patient treatment of the Royal Marsden special health authority is categorised under "other medical", which includes medical oncology amongst other specialty functions. Christie hospital, Manchester, however, undertakes work covering a wider range of specialties in addition to those categories which include treatment of cancer, so direct comparisons of cost are not practicable centrally.
Following is a table of data derived from financial returns held by the Department.
There are often good reasons for differences between hospitals in particular costs which can arise from differences in the particular diagnoses of the patients treated, the severity of the condition treated and length of time required for treatment, and whether treatment can be provided on an out-patient basis or requires admission to a hospital bed.
in current and standard prices in the case of each region indicating the value of these allocations in standard prices on a per capita basis.
229W
§ Mr. Freeman[holding answer 10 January 1990]: The information requested is shown in the tables, at current cash levels and at 1990–91 cash levels using the GDP deflator. The allocations shown relate to the main
Allocations £000s at cash Region 1982–83 1983–84 1984–85 1985–86 1986–87 1987–88 1988–89 1989–90 1990–91 Northern 479,616 539,388 560,701 601,519 639,403 679,482 735,253 817,311 884,179 Yorkshire 537,778 606,123 629,450 676,116 720,831 767,080 829,677 920,376 999,322 Trent 631,328 717,046 746,789 810,705 866,468 926,641 1,010,146 1,126,131 1,227,583 East Anglian 269,985 307,251 321,224 345,723 371,144 400,572 437,676 488,050 539,690 North West Thames 581,173 626,483 649,174 686,495 723,116 748,568 808,071 895,111 968,446 North East Thames 681,128 792,648 806,429 853,455 900,051 933,655 1,007,139 1,114,489 1,197,287 South East Thames 628,878 697,381 715,293 756,200 796,566 830,504 897,538 1,000,077 1,092,602 South West Thames 505,602 544,658 558,782 590,095 620,117 690,592 745,778 828,304 900,756 Wessex 383,805 434,435 454,024 491,471 527,732 564,636 614,551 687,346 757,653 Oxford 307,453 345,704 357,430 386,127 412,181 440,700 482,415 548,386 595,806 South Western 505,602 528,459 550,356 594,068 634,384 672,786 731,564 818,155 896,046 West Midlands 749,136 841,616 875,293 944,388 1,015,057 1,088,488 1,185,562 1,316,619 1,419,349 Mersey 395,333 442,733 457,822 486,642 513,227 542,546 585,517 652,367 699,175 North Western 661,535 742,325 771,417 826,052 875,174 928,848 1,004,859 1,117,456 1,199,999 Total 7,281,698 8,166,250 8,454,184 9,049,056 9,615,451 10,215,098 11,276,275 12,330,178 13,377,893 Notes:
1. To allow for consistency of comparison the allocations shown above exclude the special allocations such as the Service Increment for Teaching and Supra Regional Services etc.
2. 1989–90 is based on the allocations for services provided in the region using the Resource Allocation Working Party Formula (RAWP)
3. 1990–91 is based on the allocations for resident population, calculated using the new allocation formula, adjusted for the effect of cross boundary flows, so that they are on a comparable basis to 1989–90.
Allocations £000s at constant 1990–91 cash levels Region 1982–83 1983–84 1984–85 1985–86 1986–87 1987–88 1988–89 1989–90 1990–91 Northern 728,268 782,485 774,894 788,940 811,287 818,742 826,057 858,177 884,179 Yorkshire 816,584 879,297 869,906 886,780 914,605 924,293 932,142 966,395 999,322 Trent 958,634 1,040,211 1,032,070 1,063,304 1,099,392 116,566 1,134,899 1,182,438 1,227,583 East Anglian 409,956 445,726 443,935 453,443 470,915 482,669 491,729 512,453 539,690 North West Thames 882,476 908,833 897,165 900,393 917,504 901,987 907,868 939,867 968,446 North East Thames 1,034,252 1,149,887 1,114,493 1,119,375 1,142,003 1,125,008 1,131,521 1,170,213 1,197,287 South East Thames 954,914 1,011,684 988,542 991,817 1,010,699 1,000,716 1,008,384 1,050,081 1,092,602 South West Thames 767,726 790,130 772,242 773,957 786,817 832,129 837,882 869,719 900,756 Wessex 582,785 630,231 627,466 644,604 669,597 680,358 690,448 721,713 757,653 Oxford 466,849 501,509 493,972 506,436 522,983 531,021 541,993 575,805 595,806 South Western 767,726 766,630 760,597 779,168 804,919 810,673 821,912 859,063 896,046 West Midlands 1,137,518 1,220,924 1,209,664 1,238,640 1,287,925 1,311,574 1,331,979 1,382,450 1,419,349 Mersey 600,289 642,268 632,715 638,270 651,193 653,741 657,828 684,985 699,175 North Western 1,004,501 1,076,883 1,066,106 1,083,433 1,110,438 1,119,215 1,128,959 1,173,329 1,199,999 Total 11,056,822 11,846,697 11,683,767 11,868,561 12,200,277 12,308,682 12,668,895 12,946,687 13,377,893
Allocation per capita £s At constant 1990–91 cash levels Region 1982–83 1983–84 1984–85 1985–86 1986–87 1987–88 1988–89 1989–90 1990–91 Northern 236.28 251.30 249.42 256.79 264.64 267.60 269.19 282.08 289.12 Yorkshire 228.01 244.81 241.84 246.99 254.64 257.40 258.60 266.22 276.77 Trent 210.45 226.44 224.43 229.88 237.34 241.47 243.80 250.07 262.45 East Anglian 217.97 235.22 231.86 233.10 240.37 245.76 243.55 240.59 262.74 North West Thames 257.44 261.89 260.08 260.94 265.37 259.71 258.45 262.78 274.37 North East Thames 279.96 306.03 298.59 297.70 303.44 301.25 299.64 306.10 316.12 South East Thames 269.07 281.26 275.81 276.77 281.63 278.85 276.31 281.63 297.63 South West Thames 268.59 281.05 262.15 262.61 266.47 281.86 280.46 285.31 300.14 Wessex 215.61 232.25 225.98 227.35 234.41 237.10 236.26 235.32 255.39 Oxford 202.43 215.42 208.88 208.44 213.11 216.31 216.62 216.83 232.36 South Western 238.12 236.28 246.57 249.99 257.31 258.20 256.58 258.44 276.57 West Midlands 220.70 235.65 233.43 238.42 247.53 253.50 256.16 263.10 272.20 Mersey 245.20 261.83 259.00 264.67 270.96 272.03 273.47 287.57 291.81 North Western 250.99 266.85 265.33 271.65 278.49 281.63 283.44 294.72 301.51 England 237.95 253.21 249.66 252.78 259.34 261.87 266.77 267.65 280.16 Note. Calculated using actual populations within regional boundaries.
230Wpopulation based allocations and do not include additional special allocations such as the service increment for teaching.