The estimated revenue cost per birth of hospital maternity services rose by over 19 per cent. at constant prices between 1970–71 and 1973–74. These increases are in part the result of the sharp fall in the number of births, while staff numbers increased and facilities were under-used.
As there has been no change in the technology of the process, surely the large increase in cost per birth must be attributed to the increase in the bureaucracy. What will the hon. Gentleman do about it?
I think that it is one of the areas of inefficiency in the health service. Attention was drawn to this in the consultative document. There is room for sensible economies. Some increases in technology have taken place, particularly in trying to reduce perinatal mortality and to improve the care of children born rather sick. But in the main the hon. Gentleman is right. Bed occupancy fell from 72 per cent. to 65 per cent. during that period.
Is not some of the increase in cost due to the higher incidence of induced births, many of which are done not because of the wish of the mother, or for medical reasons, but solely for the convenience of the obstetricians concerned? Could that be contributing in some way to the extra costs per birth?
I do not think that it is causing an increase in costs, but it causes increasing concern to many mothers and doctors. We are doing research into the whole subject of induction policy.
There are areas where economies can be made in the National Health Service. I welcome the hon. Gentleman's support in looking at the rationalisation of maternity services, which will undoubtedly mean the closure of some small units, particularly those close to large hospitals. The other question relates to establishment figures, which are often above what can be currently afforded. In some areas we want staff and are finding it difficult to recruit them and in others we have considerable overstaffing.