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Nhs (Costs)

Volume 114: debated on Tuesday 7 April 1987

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1.

asked the Secretary of State for Social Services what was the per capita cost of the National Health Service throughout the United Kingdom in 1986; and what it was in real terms in 1978–79.

6.

asked the Secretary of State for Social Services what percentage of the gross domestic product was spent on the National Health Services in the most recent year for which figures are available; and what the percentage was in 1978.

Between 1978 and 1985 the proportion of the United Kingdom gross domestic product spent on health care rose from 5·2 to 6·0 per cent. Over the same period, health spending increased from £301 to £384 per head at 1986–87 prices.

Is not this 26 per cent. increase per person throughout this country one of the most accurate indicators of health provision, suggesting vastly improved services and better health care for all? How does this increase compare with other Western countries?

I entirely agree with my hon. Friend. The real growth in total health spending per head in the United Kingdom between 1978 and 1983 was about 21 per cent. and according to OECD data—1983 is the latest comparison that we have—that growth rate was higher than in any other Western industrialised country, with the exception of the United States.

Does my right hon. Friend agree that these figures provide an interesting reflection on the priorities of Conservative and Labour Governments?

Indeed. The base figure that I am quoting in the figures is the base figure that we inherited from the Labour Government. If we want to go back to cuts in the NHS, we must go back to the last Labour Government and their cuts in the hospital building programme.

Is the Minister aware that when similar claims were made in Scotland yesterday the genteel members of the Royal College of Nursing howled the Minister down? Nobody in the country, not least the 1986 Select Committee report on expenditure in the social services, believes a word of the boasts that the right hon. Gentleman continually makes about the Health Service. Is he aware that if we take into account the index used by the NHS with regard to pay and prices, and take account of demographic and technological changes we see that there has been a decrease in real expenditure on the Health Service between 1979 and today?

What the hon. Gentleman said is typically absurd. Quite apart from the figures on finance, which he has entirely wrong, the real figures on health care, showing the number of patients treated, have shown a real—

Well, surely the hon. Gentleman is most interested in health care, in treating patients and in providing for better health care. That is what the Government are providing through the Health Service.

I remind the hon. Gentleman that since 1979 nurses' pay has increased by 23 per cent. in real terms, and that contrasts with the fall of 21 per cent. under the last Labour Government.

The Secretary of State should come clean with the House and confirm that the United Kingdom spends a lower proportion of its gross domestic product on the Health Service than any European Community country, apart from Greece an d Portugal.

Does he accept that the logic of the argument that he and his colleagues adduced yesterday—that if one increases the total cake everybody gets a bigger share—is that we should increase the total expenditure on the Health Service as a proportion of GDP? That is the answer to the health inequalities from which Britain is devastatingly suffering. In that way, we would remove some of the horrendous inequalities that his Government were embarrassed to admit only a week ago.

I do not accept for one moment that there are horrendous inequalities, and the report that the hon. Gentleman is holding is no objective indication that there are. The policy of the reallocation of resources and the resource allocation working party has meant a redistribution of resources to those areas which were deprived of them under the last Labour Government, supported by the hon. Gentleman's party.

Would not that excellent record on increased health expenditure mean even more in terms of better health care if steps were taken to control the escalating cost of pharmaceuticals on the NHS? Are not some doctors still wasteful in their prescribing habits, and will my right hon. Friend take steps to encourage them to prescribe generically where possible?

We adivse doctors on good dispensing and good practice, but I am sure my hon. Friend recognises that the selected list introduced by the Government has meant a saving to the NHS of about £75 million. That policy has been entirely vindicated, despite all the opposition from the Opposition.

If the nurses are doing so well under the Government, why did 30,000 qualified nurses and 6,000 nurses in training leave the NHS last year?

That must be put against the total nursing strength of about 380,000. It is relevant to consider the proportion. The hon. Gentleman must explain why the nursing profession had to wait for this Government to introduce an independent pay review body, which it was never given by the last Labour Government, whose record on nurses' pay was a disgrace.

May we have briefer supplementary questions, which will lead to briefer answers?