CAB129-78 — Page 174

4.

NATIONAL HEALTH SERVICE

1880

Page 174

The forecast provides for bringing into use additional hospital accommodation arising from the building programme; for improving, where necessary, facilities for diagnosis and treatment and taking advantage of new drugs and techniques; for raising standards, for example of staffing and diet where they are at present low; and it assumes that the number of in- and out-patients will be increased. In recent years an annual increase averaging about £ 54 millions (2 per cent) has been allowed for such improve- ments in England and Wales, and the forecast assumes an annual increase of £8 millions (the upper limit of a range of £6-8 millions indicated by the Ministry of Health), together with an allowance rising to about £ million for bringing new major works into operation. For Scotland the rate of increase assumed is proportionately a little more than the lower limit for England and Wales.

For England and Wales the forecast assumes that in each of the years 1958-59, 1959-60 and 1960-61, £10 millions worth of major hospital building schemes will be started. This is the rate already announced for 1957-58, and by 1960-61 will result in an annual expenditure of £10 millions. To this is to be added £13 millions in 1960-61 on lesser works, making an annual total of £23 millions. Expenditure on hospital building in 1955-56 is running at £10 millions. For Scotland it is assumed that the expenditure on capital works, large and small, will rise from £2.3 millions in 1955-56 to £3.9 millions in 1960-61, at which level it would still be proportionately above the expenditure for England and Wales.

The number of general practitioners is assumed to increase over the five-year period by 7 per cent with the result that £4 millions more will be required on this account. Local health authorities' services are expected to develop, partly to assist in the treatment of patients in their own homes and so help in relieving pressure on the hospitals; the Health Departments' grants are expected to increase by £4 millions (17 per cent). Superannuation payments are expected to increase by the same amount, owing to a larger number of retirements. No provision is made for new services (e.g. vaccina- tion of children against poliomyelitis).

5.

EDUCATION

The number of children in school (England and Wales) is likely to reach its peak in 1958, and in five years from now the total is likely to be little larger than at present, and will be falling. The forecast of the Ministry of Education thus implies an increase in cost per child in primary and secondary schools of the order of 25 per cent. This follows from the assumption that teachers will continue to be recruited by local authorities at the present net rate of 6,000 a year, so that the total number of teachers would rise by about 15 per cent over the period. Some additional teachers are required to maintain the present ratio between pupils and teachers in secondary schools, which by 1960-61 will have a much increased population because of the "bulge". If all the other additional teachers went into primary schools, the number of children per teacher then would fall from 35 now to 30 in 1961, and all over-size primary classes could be abolished.

The forecasts allow for the cost of implementing "equal pay" but assume the passage of legislation to increase teachers' superannuation contributions. It is assumed that the present level of educational building Pagu koptfigel partly to accommodate the increase in Panda10fg pills,

partly to provide for children in new housing areas and partly to improve conditions in other parts of the educational field.

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