Expenditure, North West Thames Region

To 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.

Tables 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.

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.

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

²12·8

²12·5

²13·7

²12·9

²12·8

²13·4

²14·1

²12·9

²13·1

—

Northern Ireland

²9·9

²10·8

²10·1

²11·2

²10·7

²10·8

²11·1

²11·2

²11·4

²11·3

—

Belgium

n/a

11·6

11·9

11·7

12·1

11·9

—

Denmark

n/a

11·5

11·4

11·1

11·6

11·1

—

France

n/a

10·4

11·0

n/a

10·4

Germany· F· R·

n/a

11·8

12·1

12·0

11·9

—

Greece

n/a

9·9

9·2

9·6

10·1

9·1

—

Irish Republic

n/a

10·1

10·6

10·5

10·4

10·8

—

Italy

n/a

10·5

10·1

10·3

10·6

Luxembourg

n/a

11·7

11·5

11·6

12·3

11·3

—

Netherlands

n/a

8·5

8·4

8·5

8·3

—

Portugal

n/a

10·9

9·8

10·9

10·3

10·2

—

Spain

n/a

8·4

8·6

¹ Calculated from deaths, October to March. (Rates expressed per 1,000 population).

²Data tabulated by date of registration rather than occurrence.

Volume 202: debated on Tuesday 28 January 1992