HC Deb 12 April 2002 vol 383 cc669-72W
Dr. Evan Harris

To ask the Secretary of State for Health what increased resources have been spent in the last year on(a) primary care and (b) secondary care in (i) each English health authority and (ii) England. [43609]

Mr. Hutton

The increase in primary care and secondary care expenditure for each English health authority and for England, between 1999–2000 and 2000–2001, is shown in the table.

Health authority 1999–2000 to 2000–2001
Primary Care £000 Secondary Care £000
Avon 10,373 66,133
Barking and Havering 4,046 16,495
Barnet 1,486 64,112
Barnsley 3,310 15,551
Bedfordshire 10,040 21,605
Berkshire 6,955 42,842
Bexley and Greenwich 4,679 26,467
Birmingham 13,310 27,665
Bradford 11,746 3,470
Brent and Harrow 5,703 (1,643)
Bromley 2,739 343
Buckinghamshire 11,103 39,563
Bury and Rochdale 3,436 16,530
Calderdale and Kirklees 6,214 32,030
Cambridgeshire 38,678 20,253
Camden and Islington 6,354 79,677
Cornwall and Isles of Scilly 10,057 9,701
County Durham and Darlington 7,695 23,001
Coventry 3,584 19,412
Croydon 4,124 61,354
Doncaster 3,534 6,254
Dorset 38,408 133,761
Dudley 2,620 15,027
Ealing, Hammersmith and Hounslow 6,245 46,124
East and North Hertfordshire 5,258 26,027
East Kent 10,318 30,717
East Lancashire 6,942 2,904
East London and The City 4,945 30,474
East Riding and Hull 7,481 29,270
East Surrey 4,967 14,626
East Sussex, Brighton and Hove 9,660 (3,788)
Enfield and Haringey 5,897 42,469
Gateshead and South Tyneside 3,925 20,665
Gloucestershire 5,052 20,214
Herefordshire 2,045 (14,484)
Hillingdon 3,333 (1,282)
Isle of Wight 1,903 8,390
Kensington, Chelsea and Westminster 4,585 50,144
Kingston and Richmond 2,762 20,044
Lambeth, Southwark and Lewisham 13,516 37,013
Leeds 10,493 23,345
Leicestershire 10,298 25,906
Lincolnshire 9,784 15,479
Liverpool 12,384 24,234
Manchester 10,455 24,128
Merton, Sutton and Wandsworth 9,869 (20,754)
Morecambe Bay 2,476 5,758
Newcastle and North Tyneside 4,303 1,878
Norfolk 9,103 24,346
North And East Devon 6,273 22,433
North and Mid Hampshire 5,930 39,556
North Cheshire 4,317 9,311
North Cumbria 6,171 14,516
North Derbyshire 5,570 11,458
North Essex 26,404 41,688
North Nottinghamshire 11,597 6,547
North Staffordshire 11,133 17,619
North West Lancashire 7,175 10,488
North Yorkshire 9,090 27,029
Northamptonshire 3,149 24,348

Health authority 1999–2000 to 2000–2001
Primary Care £000 Secondary Care £000
Northumberland (718) 4,965
Nottingham 10,046 33,316
Oxfordshire 8,869 26,430
Portsmouth and South East Hampshire 5,328 30,116
Redbridge and Waltham Forest 4,506 32,521
Rotherham 4,135 9,834
Salford and Trafford 13,418 16,505
Sandwell 2,629 10,899
Sefton 5,041 87,121
Sheffield 5,247 367
Shropshire (1,311) 13,658
Solihull 2,098 8,038
Somerset 6,129 23,294
South and West Devon 8,347 21,196
South Cheshire 6,710 21,620
South Essex 8,743 43,993
South Humber 6,090 (2,047)
South Lancashire 2,391 10,284
South Staffordshire 5,990 21,507
Southampton and South West Hampshire 7,136 23,504
Southern Derbyshire 6,028 20,659
St Helens and Knowsley 6,052 17,754
Stockport 3,262 5,818
Suffolk 7,774 27,844
Sunderland 2,838 24,112
Tees 7,392 20,740
Wakefield 10,303 23,669
Walsall 3,939 3,780
Warwickshire 5,209 17,493
West Hertfordshire 7,156 26,648
West Kent 6,286 (5,853)
West Pennine 5,718 19,536
West Surrey 7,578 9,754
West Sussex 11,687 33,752
Wigan And Bolton 7,899 34,635
Wiltshire 17,347 7,237
Wirral 4,226 11,909
Wolverhampton 5,420 9,488
Worcestershire 7,840 32,900
England total 729,780 2,227,439

Notes:

1. In many health authorities there are factors which distort the expenditure. These include:

the health authority acting in a lead capacity to commission healthcare on behalf of other health bodies;

asset revaluations in NHS Trusts being funded through health authorities;

some double counting of expenditure between health authorities and primary care trusts within the health authority area; and the calculation is not precise as relevant expenditure in primary care trusts is not analysed completely into the purchase of primary and secondary healthcare. Prescribing services expenditure has been added in to primary health care expenditure but there may he other elements of expenditure which cannot be identified which should be incorporated within the answer.

Expenditure cannot therefore be reliably compared between health authorities.

Allocations provide a much more reliable measure to identify differences between funding of health authorities.

2. Source: Health authority audited summarisation forms 1999–2000 and 2000–2001 Primary care trust audited summarisation schedules 2000–2001

3. Expenditure is taken from health authority and primary care trust summarisation forms which are prepared on a resource basis and therefore differ from cash allocations in the year. The expenditure is the total spent on primary and secondary healthcare by the health authority and by the primary care trusts within each health authority area. The majority of General Dental Services expenditure is not included in the health authority or primary care trust accounts and is separately accounted for by the Dental Practice Board. An element of expenditure on pharmaceutical services is accounted for by the Prescription Pricing Authority and not by health authorities.

4. Health authorities and primary care trusts should account for their expenditure on a gross basis. This results in an element of double counting where one body acts as the main commissioner and is then reimbursed by other bodies. The effect of this double counting within the answer cannot he identified.

5 Major increases in expenditure and reductions in individual cases can be explained as follows:

The increase in Dorset health authority is due to the majority of expenditure being double counted between the health authority and primary care trusts (£38,408,000 primary, £133.761,000 secondary).

The £87,121,000 increase in secondary care expenditure in Sefton health authority is due mainly to an extra £63million included in its accounts as it was the lead body in the region for mental health secure commissioning in 2000–01.

The reduction in secondary care in Herefordshire is caused by Herefordshire PCT taking over the commissioning of community health services in 2000–01 from the health authority and netting off the expenditure against income, resulting in a £14,484,000 apparent reduction in 2000–01.

The apparent decrease in secondary care expenditure in Merton, Sutton & Wandsworth health authority of £20,754,000 is caused by the treatment of asset revaluations in NHS trusts. The reduction is solely a result of accounting practice agreed with their auditors.

Decreases in secondary care expenditure in Brent and Harrow, East Sussex, Brighton and Hove, Hillingdon. South Humber and West Kent health authorities are also caused by the treatment of asset re valuations in NHS trusts.

Decreases in primary care expenditure in Northumberland and Shropshire health authorities in principally due to lower drug costs in 2000–01.