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Primary Care Trusts (Funding)

Volume 408: debated on Tuesday 1 July 2003

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2.

What assessment he has undertaken of the funding of different primary care trusts in relation to funding targets. [122417]

We consider our allocations policy for each round of allocations in the light of all the circumstances at the time. Allocations for the period 2003–06 were announced last December and took account of the position of all primary care trusts in relation to their target share. The allocations made were the biggest three-year increases to go into the national health service in its history.

Why do the Government persistently fund some PCTs at way below their own national formula for determining the health needs of an area, while funding others consistently above it? In my area, the Bedfordshire PCTs are £22 million below the Government's formula target, yet two PCTs in the same health authority are funded at £25 million above that target. When will the Government bring about a fair allocation of health resources?

First, I welcome any support from Conservative MPs for the idea of targets, as they are not always so supportive of them. Secondly, the hon. Gentleman will remember that we have to strike a balance between the amounts that we spread across all the PCTs, given the infinite demand for them and the limited resources. Thirdly, those resources are vastly increased over anything that the Conservative party, or anyone else, ever put in.

I am going to answer the question specifically in relation to Bedfordshire. [Interruption.] I am glad that Conservative Members are so keen to get the answer, because it is as follows: Bedford PCT's allocation will increase by no less than 32 per cent.; Bedfordshire Heartlands PCT's allocation will increase by 31.7 per cent.; and Luton PCT's allocation will increase by 32.74 per cent. Those are staggering increases. The truth of the matter is that by comparison with the 30 per cent. increases under this Government, Conservative Members would take 20 per cent. away.

Is my right hon. Friend aware that my local PCT, Barnsley, which is one of the biggest in the country, is moving further away from its target funding because of the deficit that exists and is about £6 million behind its budget position? Given that Barnsley is one of the areas of greatest need, yet one of those with the lowest funding, will he look again at that situation?

I am always prepared to look particularly at areas of need, because that is one of the elements that form the criteria by which we allocate money, so I shall do so. However, I think that my hon. Friend would be the first to admit that, both historically and in terms of what any of our international competitors are doing, the amount of investment that is going into the national health service is unprecedented—£45 billion for 2003–04, £49.3 billion for 2004–05 and £53.9 billion for 2005–06. Those are staggering amounts of money. Even in my first couple of weeks in the job, I have been absolutely staggered by the amount of investment. I can tell my hon. Friend that the three-year announcements on 11 December represented the biggest ever investment handout by the state in this country since the dissolution of the monasteries.

The dissolution of the monasteries was an early version of invest and reform. The investment is staggering in its historical context.

I am delighted to hear the Secretary of State say that he is prepared to look at specific areas of need. While he is considering the funding requirements of different primary care trusts, will he look specifically at the retinal laser treatment known as photodynamic therapy? Two of my constituents, a Mrs. Scott and a Mrs. Brooks, are expected by the brand new flagship Norfolk and Norwich University hospital to travel to Liverpool for that treatment, though they are elderly and find it difficult to see, because the local PCTs have not yet given their approval to have the treatment locally. Does he agree that it is unfair to expect elderly people to fund the costs of travelling so far, from Norwich to Liverpool, and will he look into it?

Obviously, I am not aware of the specific case that the hon. Gentleman raises, but yes, I will look into it.

On distance from targets, my right hon. Friend knows that I was part of a delegation of all Bedfordshire and Luton Members of Parliament who recently met his predecessor. While we acknowledge the considerable increase, year on year, in resources for the national health service throughout the country, including Bedfordshire, we highlighted three issues at the meeting. First, Bedfordshire health services have been below target for 25 years or so—indeed, they are near the bottom of the national league table. Secondly, that has contributed to weakness over the years in building decent primary and community care services. Thirdly, although the Government acknowledge that there is a gap and that it needs to be closed, on current figures, the pace of change means that it will take almost 20 years. Does my right hon. Friend accept that the needs of my constituents and residents in Bedfordshire and Luton, and the challenge of the NHS plan to modernise and improve require the gap to be closed much more quickly?

I know that my hon. Friend is a stalwart fighter for his constituents. I would expect nothing other than that. Of course, we pay great attention to need, which exists not only in Bedfordshire but throughout the country, especially after two decades of starvation of investment in the NHS. However, the allocation policy must take account of several factors, including the overall resources available and the priorities for their use. Although my hon. Friend finds Bedford's allocation unsatisfactory, it will increase by £34.7 million, or 32.1 per cent., in the next three years. As I said earlier, Bedfordshire Heartlands' allocation will be increased by 31.7 per cent., which is £52.1 million, over three years. Although my hon. Friend, like many others, does not find his allocation satisfactory, I believe that he would be the first to agree that, by historical and international standards, the increases are staggering in proportion and amount.

I welcome the Secretary of State to his latest challenge. He has held down the post for two weeks, which is good going, and he has clearly already discovered his predecessor's collection of scratched old records at the bottom of his desk.

My hon. Friend the Member for South-West Bedfordshire (Andrew Selous) asked how the relative funding problems in Bedfordshire have been affected by the Department's age-sex standardisation technique. Does the right hon. Gentleman have any plans to revise that formula?

I thank the hon. Gentleman for his overgenerous welcome. I have been here only two weeks—

As I look at the standard of the Opposition, I believe that I shall be here for much longer.

Of course, I shall continually review the criteria for allocating resources. Allocation is based on several criteria, including need, population and the start level of resources. I shall bear the hon. Gentleman's comments in mind.