I am happy to have the opportunity to respond to my hon. Friends the Members for Beckenham (Sir P. Goodhart) and for Chislehurst (Mr. Sims). I reciprocate the wishes for a peaceful, happy and prosperous Christmas for all of us and a healthy and well cared for new year for constituents in the Bromley area.
The concern of my hon. Friend the Member for Beckenham for the Beckenham hospital is well known and, as he has reminded the House, he has made sure that Ministers in the Department of Health and Social Security are well aware of his concern. That was particularly manifested by the presentation in December 1982 of a petition to the House signed by around 22,000 people.
I endorse the tribute that my hon. Friend paid to the skill and dedication of the staff at Beckenham hospital, and the loyalty of the local people to the hospital. That is the case in many hospitals. We should be proud of that and take advantage of it.
At the same time, we must improve and develop our health care. I leave aside the resource constraints and problems, which are inescapable. Progress in medicine, shifts in population and the need for more technical and clinical services to be grouped together must be taken into account. I hope that we all agree that there must be changes. Inevitably, we run into problems of the conflicts of old and justified local loyalties with the advances of modern technology. The Health Service must be concerned primarily with the delivery of service to our constituents.
The inescapable shadow of the distribution of resources must always hang over us. Neither of my hon. Friends will need reminding that nationally our record is good. Since 1979, we have increased expenditure on the National Health Service by 20 per cent., and, according to the Chancellor's autumn statement, next year there will be a further increase of 2·2 per cent., in real terms. Of course, there are pressures of pay and additional staff, but we always need to remind ourselves that they, too, are services. Some 70 per cent. of the cost of the NHS is staff pay. Staff are a valuable and crucial commodity in the delivery of health care. We have achieved real increases in pay and in the numbers of doctors and nurses. We are happy to have done so. All that is at the national level, and should be recognised.
Both my hon. Friends referred at length to the complicated resource allocation working party formula. I was glad to note that my hon. Friend the Member for Beckenham accepted that the move towards the RAWP objective of equalising services throughout the country was laudable. That proposition was supported by my hon. Friend the Member for Chislehurst. That is the Government's position, as it was of previous Governments.
We are moving towards that objective at a steady and measured pace, not at a helter-skelter pace. Long-term revenue plans assume annual reductions of 0·3 per cent. until 1993–94. That can be regarded in no sense as undue or immoderate haste or pressure. As my hon. Friend the Member for Beckenham was good enough to acknowledge, the pressures on several areas, particularly the four Thames regions, have been recognised in two ways—by the statement following the autumn statement and by the broad RAWP outlines announced by my right hon. Friend the Secretary of State on 17 December.
There was an increase in funding in the Thames regions to take account of the pressures to which both my hon. Friends referred. The management board of the Health Service was invited to review the operation of the RAWP formula. That is being done within the basic principles of RAWP, with which we all agree, but we recognise that an examination of the pressures is required. My hon. Friend rightly suggested that the examination be speedy. That is a fair point, and I take note of it. I hope that he will accept that we recognise those pressures.
I shall now deal with the proposition of Bromley health authority, and the future of Beckenham hospital. I stress that these are still proposals for discussion. As I understand it, a formal consultation process will begin next month. The proposals are revisions of proposals which have been around for some time.