When the Minister of State next meets the chairmen of health boards, does he intend to have the same discussion as Scottish Office officials recently had with the chief executives of trust hospitals? They impressed on them that they and their trusts should be concerned not about improving the health care of the people for whom they are responsible, but about implementing the promises in the last Tory manifesto up to the next general election.
We are determined to improve the health standards of everyone in Scotland. That was our commitment, and we are going to do it. The chief subject that I discussed with the chairmen of health boards was the need to ensure that contingency arrangements are put in place to meet peaks in demand throughout the winter. It is perfectly proper for a Government to implement the manifesto commitments that they gave the people before a general election.
Does my right hon. Friend agree that the current situation in the health service in Scotland is affected substantially by the way in which councils have used health service funds for care in the community? The inspection in Tayside revealed that it was costing more than £200 per head per week to keep individuals in local authority homes and that that was causing bed blocking in the health service, costing many millions of pounds.
My hon. Friend raises a matter of great relevance. The inspection showed that the three authorities could achieve long-term savings totalling between £3 million and £6 million a year by making more use of independent sector care and that local authority homes did not offer better standards of care overall than the independent sector.
Local authorities will in future be required to make available to the public and to councillors full information on the comparative cost to authorities of buying residential care and providing it in council-run homes. It cost the three authorities an average of £200 more per person per week to provide care for an older person in their homes than to buy care from the independent sector. Authorities should comply with the spirit of the directions issued by the Scottish Office, which would be greatly to the benefit of older people in Scotland.
Will the Minister discuss with the chairmen the declining number of national health service beds in certain specialties? For example, is he aware that the Forth Valley health board is planning to reduce the number of NHS beds for frail elderly people to such an extent that, by 2000, there will be a national health service bed for less than 0.6 per cent. of the elderly population?
On psychiatric services, will the Minister comment on the speech made last night by the respected judge, Lady Cosgrove, in which she said that there will be more suicides and murders unless we provide more national health service beds for psychiatric patients who are unable to cope in the community?
I have visited Lochgreen hospital in the hon. Gentleman's constituency; the closure of that hospital will not take place until all the other packages of care and accommodation are firmly in place. Two new developments in Falkirk, the Carrongrove and ANS nursing homes, are due to be completed by early 1997 and will provide an additional 168 places for the frail and elderly. Extensions to existing nursing homes in Bo'ness, Falkirk and Airth—
This is in the hon. Gentleman's constituency; what happens on his doorstep is extremely relevant. There will be a further 67 places in Bo'ness, Falkirk and Airth, which is more new places than are required to accommodate the patients at Lochgreen hospital. We believe strongly that sufficient places must be made available to meet any peaks in demand, and I have no doubt that the NHS will give priority in future to the most pressing needs.
Does my right hon. Friend prefer the Prime Minister's statement that he will increase national health spending above the rate of inflation year on year to the way in which the Opposition parties would plunder the funds to pay for their excesses, with more councillors and more of the things that they deem to be needed?
My hon. Friend is absolutely right. We have given a commitment to increase national health service funding year on year in real terms. The official Opposition have failed to match that, and the hon. Member for Falkirk, West (Mr. Canavan) is very welcome to take the matter up with his Front-Bench colleagues, who have not given as strong a commitment to the national health service as we have.
Have not the Government any sense of shame or constitutional propriety? They try to involve top civil servants and health service managers in promoting Tory party policy, and blame Labour local authorities for the bed blocking that Government policy has caused. The Government are behaving in a desperate and improper fashion, while waiting lists are at record levels, beds are being closed in spite of the looming winter bed crisis, £170 million has been spent each year on the bureaucracy of the internal market in Scotland and two-tierism is undermining the fundamental principles of the NHS—with the open support of the Minister as expressed earlier this month. Is it any wonder that people all over Scotland are saying, with sadness and anger, that enough is enough?
It will not do for the hon. Gentleman to throw mud at the national health service. I have not the slightest doubt that it is the best in the world and we are determined that it should remain so. It now treats far more patients and has far shorter waiting lists. The inspectors operate independently; the facts that accompanied their very thorough report cannot be denied. If certain people do not like that, it is because they do not necessarily like having to be efficient, but efficiency is in the best interests of patient care.