The revenue expenditure of the five inner London area health authorities in 1978–79 was £482 million. In 1981–82, the latest year for which figures are available, revenue expenditure was £739 million. Both figures are at 1978–79 cash prices.
Is the Minister aware that those figures will be extremely puzzling to the many people concerned with the Health Service in inner London? Is he aware that every district health authority in the inner London area is now faced with swingeing cuts in expenditure and is unable to cope with the problems of providing a decent service? Will the Minister now give the real answer to the question?
The problem in inner London is that there needs to be a switch away from the provision of acute beds and acute services to further development of the priority services for the elderly, the mentally ill and the mentally handicapped. The process of switching involves some change. Local consultation has to decide where those changes should take place. The figures that I have given are accurate. People should realise that it is the pattern of service that needs to be changed. The overall level of expenditure is quite generous against a background of falling population.
Will my hon. and learned Friend undertake to study carefully the North-East Thames region proposals, which specifically favour inner London at the expense of outer London health authorities?
The problem faced by the region is that population has grown fastest in the suburban areas, where growth in services has been slower, while there has been over-provision of acute beds in inner London. The authority may have eased the flow of resources to follow patients and population to the suburbs. It is, nevertheless, steadily redirecting resources while at the same time trying to develop priority services for the elderly, the mentally ill and the mentally handicapped throughout the region.