The forecast outturn figure for Vote 33 in Table 1 of the Abridged Estimates Volume for 1999 is a net amount and is a snapshot at a particular time of the evolution of both income and expenditure on the Health Vote as the year goes on.
The health services are financed by taxation. About 90 per cent of the Health Vote is paid for by general taxes, such as PAYE or VAT. The remainder is paid for mainly by the health levy of 1.25 per cent on incomes above the threshold — £207 per week at present — which is a form of taxation. This appears as an appropriation-in-aid on the Health Vote. Each year money is allocated for the health services which is spent irrespective of what the yield from taxes turns out to be. What is important is the gross spending authorised each year. What matters is the level of service provided and I would stress that the current year's allocation provides for an increase in spending of £258 million — more than 9 per cent — over the 1997 outturn.
As the House is aware, the Minister for Health expects to introduce a Supplementary Estimate for the current year on Thursday next. My Department has been informed by the Department of Health and Children that that Department has throughout the year consistently underlined to agencies and the public the determination to operate both the letter and spirit of the accountability legislation. The Supplementary Estimate being considered will not, therefore, propose additional funding for increases in cost or activity which it has been made clear must, in any current year, be managed by agencies within the context of their service plan and annual determination.
I emphasise that I and my colleagues in Government fully support the Minister for Health and Children in his management of the health services and in particular in his efforts to maintain financial discipline and accountability in line with the provisions of the Health (Amendment) (No. 3) Act 1996.