To ask the Secretary of State for Social Services what is the percentage change in expenditure on hospital and community health services in real terms, respectively, using the National Health Service pay and prices deflator, in the four Thames regional health authorities in total, between 1981–82 and the most recent year for which figures are available.
Between 1981–82 and 1986–87 gross revenue expenditure in the four Thames regions rose by 29–4 per cent. Compared with the rise in general inflation, this represents a real terms increase of 1–2 per cent. National Health Service pay and price inflation was comparatively high across this period. Compared with that measure Thames regions' expenditure dropped by some 2.8 per cent., although this was more than offset by increased efficiency. Taking this into account, the purchasing power of the Thames regions rose in real terms by 2 per cent., and, most important, the numbers of cases treated in all specialties rose between 1982 and 1986 by 8.7 per cent. in Greater London.
I am grateful for those figures, but if we look at them carefully do they not confirm that the most crucial part of the answer is that, as we have suspected for a long time, over the last five years in the south-east of England and the Thames regions there has been a cut in real terms in expenditure in the Health Service? Will the Secretary of State confirm that the Health Service is in such difficulties in the south-east, putting aside efficiency improvements and the rest, because the double effect of RAWP on inner London and south-east of England health districts means that they have suffered most from cuts? The consequences that we now see, in bed closures and the like, are the result of those figures, which have hit this part of Britain worse than any other.
First, let me remind the hon. Gentleman that, as I said, there has been a real terms increase. He will want to look at the figures with care, and I explained them with care. Secondly, he will not want to deny what his right hon. Friend the Member for Plymouth, Devonport (Dr. Owen) did when he was involved in government, which was agreed by all parts of the House, when the RAWP process was introduced in 1977. Like the hon. Gentleman, I represent a London area constituency, so I am conscious of the Thames regions' position on RAWP. The reality for 10 years has been that, despite the increase to which I referred, and despite the happy increase in patient activity, London's population has fallen and its relative overprovision, as seen by the then Labour Government, has produced a pattern of acute bed reductions, which has continued ever since that period on roughly the same basis. But—this is the curcial point for hon. Members who represent London areas — in 1993, at the end of the strategic planning period, London will still have more beds per head of population than the national average.
Will the Minister consider urging one of those Thames authorities, namely, South East Thames—in the interests of efficiency and of increasing its income, on which expenditure depends—urgently to start realising the income from the numerous empty properties throughout the region for which it has no further use?
I bow to my hon. Friend's distinguished past and detailed knowledge of these matters. As she will know, in the new Health and Medicines Bill we are specifically encouraging the generation of income from health authorities' resources. I shall draw the attention of the region and the area to her remarks.
Such political partisan nonsense does the House and the country no service at all. The resources that have gone into the National Health Service over the past eight years have been immense. The essence of the question related to the nature of patients served.
It is interesting to note that between 1974 and 1979 in the area in question—the Thames region—the increase in acute patients and in-patients treated was 4 per cent., whereas since 1979 acute patient activity has increased by 15 per cent. That is the measure of real care about which we are concerned.
I have listened carefully to my right hon. Friend's remarks and, as he will recall, I have raised this matter with him in the past. However, is it not clear that if, as is alleged, 1,400 fewer beds are available in the Thames regions this year than were available last year, there is at least the implication of a threat of a reduction in patient care in constituencies in those areas? Does that not mean that we should at least speed up the review of RAWP, which, I remind my right hon. Friend, his predecessor promised in October 1986?
Like me, my hon. Friend represents a Thames region health authority area. However, he will know from the facts that I have given him that the long-term pattern of acute bed decline since the introduction of RAWP in 1977 has proceeded apace since then without a reduction in patient activity—indeed, quite the reverse. The RAWP review is very near completion and, like my hon. Friend, I look forward to the advice that will be given in it.
The Minister claims that patients are in a happy position. If that is so, can he explain why Whipps Cross hospital in my constituency is now on red alert, which means that patients cannot get routine surgery? That is a scandal, and the state of red alert is likely to persist throughout the winter, which is certainly not a happy state of affairs for that hospital's patients.
Unlike the hon. Gentleman, I was in this House in the winter of 1978–79 and I shall never forget what happened in London hospitals during that winter. Having said that, I again remind the hon. Gentleman that no one denies the constant and growing needs in the Health Service. The question is how we can fulfil those needs and create good patient care.
Will my right hon. Friend consider the example of Mayday hospital in Croydon, which is in a Thames region? Whatever Opposition Members say, that hospital has had a magnificent record of treating patients over the years. It treated about 27,500 in-patients in 1986 and thousands more day patients. In short, every year more and more patients are treated in that hospital, which my right hon. Friend knows so well.