§ Dr. Evan HarrisTo 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]
670W
§ Mr. HuttonThe 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.
671W
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 672W 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.