§ Ms. HarmanTo ask the Secretary of State for Health if he will give for the North West Thames region and for each of its districts, for each year from 1978–79 onwards, current expenditure on the hospital and community health services(a) in cash terms and (b) adjusted using the appropriate national health service pay and prices index.
§ Mr. DorrellTables I and II show the information requested for, respectively, North West Thames region and its individual districts for each year since 1982–83. Information on a comparable basis is not available for earlier years because:
- (i) North West Thames covered a wider area before 1 April 1982.
- (ii) District health authorities did not exist before 1 April 1982.
Table III, however, shows figures for spending in the years 1978–79 to 1981–82 by the North West Thames region as it was then constituted.
All tables show expenditure in cash and in input volume terms. Changes in input volumes are however an inadequate guide to the level of service the National Health Service can be expected to achieve, since they do not reflect the continuing success of the National Health Service in increasing the efficiency with which it uses resources. The third column of each table therefore shows the relevant expenditure figures in real terms, ie adjusted by the gross domestic product deflator.
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Table I North West Thames region revenue expenditure on hospital and community health services Cash Input volume terms Real terms £ million £ million £ million 1982–83 620 1,070 969 1983–84 652 1,070 974 1984–85 687 1,066 978 1985–86 718 1,058 968 1986–87 766 1,056 999 1987–88 833 1,059 1,031 1988–89 946 1,088 1,092 1989–90 1,025 1,101 1,112 1990–91 1,103 1,103 1,103
Table II North West Thames Region—revenue expenditure on hospital and community health services HCHS) 1982–83 1983–84 1984–85 Cash Input volume terms Real terms Cash Input volume terms Real terms Cash Input volume terms Real terms £000 £000 £000 £000 £000 £000 £000 £000 £000 North West Thames RHA 20,336 35,080 31,940 21,103 34,630 31,528 22,546 34,969 32,079 North Bedfordshire DHA 29,879 51,541 46,928 31,517 51,719 47,087 33,484 51,934 47,642 South Bedfordshire DHA 30,796 53,123 48,368 34,518 56,644 51,570 36,550 56,689 52,004 North Hertfordshire DHA 19,771 34,105 31,052 21,064 34,566 31,470 22,339 34,648 31,784 East Hertfordshire DHA 24,926 42,997 39,149 25,633 42,064 38,296 27,480 42,621 39,099 North West Hertfordshire DHA 42,484 73,285 66,725 45,181 74,142 67,501 48,310 74,929 68,736 South West Hertfordshire DHA 32,795 56,571 51,508 34,736 57,002 51,896 36,733 56,973 52,264 Barnet DHA 59,777 103,115 93,886 61,836 101,473 92,384 64,054 99,348 91,137 Harrow DHA 34,701 59,859 54,501 35,961 59,012 53,726 36,643 56,833 52,136 Hillingdon DHA 46,374 79,995 72,835 48,423 79,462 72,344 52,147 80,880 74,196 Hounslow and Spelthorne DHA 45,497 78,482 71,458 47,580 78,079 71,085 50,207 77,871 71,435 Ealing DHA 34,522 59,550 54,220 36,235 59,462 54,135 39,602 61,423 56,346 Riverside DHA1 112,258 193,645 176,312 117,019 192,028 174,827 122,419 189,872 174,180 Parkside DHA2 99,099 170,946 155,645 104,629 171,696 156,317 108,656 168,525 154,598 Total 633,215 1,092,296 994,526 665,435 1,091,979 994,166 701,170 1,087,515 997,638 1 Hammersmith and Fulham DHA and Victoria DHA in 1984–85 and prior years. 2 Brent DHA and Paddington DHA in 1987–88 and prior years.
Table II North West Thames Region—revenue expenditure on hospital and community health services (HCHS) 1985–86 1986–87 1987–88 Cash Input volume terms Real terms Cash Input volume terms Real terms Cash Input volume terms Real terms £000 £000 £000 £000 £000 £000 £000 £000 £000 North West Thames RHA 23,531 34,685 31,730 21,720 29,952 28,355 8,671 11,021 10,736 North Bedfordshire DHA 33,936 50,022 45,760 37,037 51,074 48,351 39,791 50,574 49,268 South Bedfordshire DHA 39,211 57,797 52,873 42,174 58,158 55,057 47,225 60,023 58,472 North Hertfordshire DHA 23,349 34,416 31,484 25,352 34,960 33,097 27,633 35,122 34,214 East Hertfordshire DHA 28,513 42,028 38,447 30,732 42,379 40,120 34,799 44,230 43,087 North West Hertfordshire DHA 50,752 74,808 68,435 66,945 92,317 87,396 73,990 94,041 91,611 South West Hertfordshire DHA 38,540 56,808 51,968 28,206 38,896 36,822 30,924 39,304 38,289 Barnet DHA 65,574 96,656 88,421 74,283 102,436 96,975 80,456 102,260 99,617 Harrow DHA 36,573 53,909 49,316 39,549 54,538 51,631 43,600 55,416 53,984 Hillingdon DHA 54,951 80,998 74,097 59,962 82,688 78,279 65,194 82,862 80,721 Hounslow and Spelthorne DHA 51,572 76,017 69,541 54,667 75,386 71,367 59,419 75,522 73,570 Ealing DHA 40,265 59,351 54,294 44,131 60,857 57,612 46,772 59,447 57,911 Riverside DHA1 128,455 189,343 173,211 133,418 183,983 174,175 145,660 185,134 180,350 Parkside DHA2 113,626 167,485 153,215 119,605 164,935 156,142 128,641 163,503 159,278 Total 728,848 1,074,322 982,791 777,781 1,072,560 1,015,380 832,775 1,058,457 1,031,109 1 Hammersmith and Fulham DHA and Victoria DHA in 1984–85 and prior years. 2 Brent DHA and Paddington DHA in 1987–88 and prior years. 540W 541W
Table II cont. 1988–89 1988–90 1990–91 Cash Input volume terms Real terms Cash Input volume terms Real terms Cash Input volume terms Real terms £000 £000 £000 £000 £000 £000 £000 £000 £000 North West Thames RHA 12,454 14,322 14,387 14,529 15,604 15,762 18,672 18,672 18,672 North Bedfordshire DHA 43,537 50,068 50,294 47,611 51,134 51,651 50,807 50,807 50,807 South Bedfordshire DHA 51,974 59,770 60,040 57,034 61,255 61,873 62,079 62,079 62,079 North Hertfordshire DHA 32,224 37,058 37,225 35,899 38,556 38,945 40,445 40,445 40,445 East Hertfordshire DHA 39,833 45,808 46,015 44,191 47,461 47,940 47,733 47,733 47,733 North West Hertfordshire DHA 83,519 96,047 96,481 89,881 96,532 97,507 95,516 95,516 95,516 South West Hertfordshire DHA 35,612 40,954 41,139 39,198 42,099 42,524 42,610 42,610 42,610 Barnet DHA 90,204 103,735 104,204 100,785 108,243 109,336 110,319 110,319 110,319 Harrow DHA 48,407 55,668 55,920 52,870 56,782 57,356 56,497 56,497 56,497 Hillingdon DHA 74,483 85,655 86,043 81,347 87,367 88,249 90,636 90,636 90,636 Hounslow and Spelthorne DHA 67,316 77,413 77,764 73,744 79,201 80,001 77,550 77,550 77,550
1988–89 1988–90 1990–91 Cash Input volume terms Real terms Cash Input volume terms Real terms Cash Input volume terms Real terms £000 £000 £000 £000 £000 £000 £000 £000 £000 Ealing DHA 53,102 61,067 61,343 58,157 62,461 63,091 62,729 62,729 62,729 Riverside DHA 165,903 190,788 191,651 171,387 184,070 185,928 176,262 176,262 176,262 Parkside DHA 147,144 169,216 169,981 158,079 169,777 171,491 170,883 170,883 170,883 Total 945,712 1,087,569 1,092,488 1,024,712 1,100,541 1,111,654 1,102,738 1,102,738 1,102,738
Table III North West Thames region revenue expenditure on Hospital and Community Health Services (HCHS) Cash Input volume terms Real terms £ million £ million £ million 1978–79 380 1,165 963 1979–80 451 1,146 979 1980–81 580 1,153 1,065 1981–82 650 1,194 1,088 Notes to the tables:
1. Expenditure on the HCHS covers services directly managed and/or accounted for by the health authorities (at the relevant time) including hospital, community health, patient transport (i.e. ambulance), blood transfusions and other services.
2. The figures are derived from the annual accounts of the health authorities in the region. 1990–91 figures are subject to audit.
3. The figures for the period 1982–83 to 1986–87 shown in Table I have been adjusted, by excluding as far as practicable revenue expenditure relevant to services for which the health authorities ceased to hold management and/or accounting responsibility, in order to make them comparable with figures for more recent years. (The exclusions consist primarily of a proportion of the total costs of
Winter death rates1 for the last 10 rears for England and Wales, Scotland and Northern Ireland and the last 5 years for the EC countries for which figures are available Country 1989–90 1988–89 1987–88 1986–87 1985–86 1984–85 1983–84 1982–83 1981–82 1980–81 1979–80 1978–79 1977–78 1976–77 England and Wales 12.7 11.7 12.2 11.7 12.9 12.7 10.7 11.2 11.3 11.0 — — — — Scotland 212.7 212.7 212.8 212.5 213.7 212.9 212.8 213.4 214.1 212.9 213.1 — — — Northern Ireland 29.9 29.9 210.8 210.1 211.2 210.7 210.7 210.8 211.1 211.2 211.4 211.3 — — Belgium n/a n/a n/a n/a n/a n/a 11.6 11.9 11.7 12.1 11.9 — — — Denmark n/a n/a n/a n/a n/a n/a 11.5 11.4 11.1 11.6 11.1 — — — France n/a n/a n/a n/a n/a n/a n/a n/a 10.4 11.0 n/a n/a n/a 10.4 Germany. F. R. n/a n/a n/a n/a n/a n/a 11.8 12.1 12.1 12.0 11.9 — — — Greece n/a n/a n/a n/a n/a n/a n/a 9.9 9.2 9.6 10.1 9.1 — — Irish Republic n/a n/a n/a n/a n/a n/a n/a 10.1 10.6 10.5 10.4 10.8 — — Italy n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 10.5 10.1 10.3 10.6 Luxembourg n/a n/a n/a n/a n/a n/a 11.7 11.5 11.6 12.3 11.3 — — — Netherlands n/a n/a n/a n/a n/a n/a 8.5 8.4 8.5 8.3 8.3 — — — Portugal n/a n/a n/a n/a n/a n/a n/a 10.9 9.8 10.9 10.3 10.2 — — Spain n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 8.4 8.6 8.6 1 Calculated from deaths, October to March. (Rates expressed per 1,000 population). 2Data tabulated by date of registration rather than occurrence.