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Extra-contractual Referrals

Mr. Morgan: To ask the Secretary of State for Wales what assessment he has made of how the proposed changes in the extra-contractual referral system reducing the prior notification and approval system will affect the access to treatment of patients of (a) fundholding and (b) non-fundholding general practitioners; and if he will make a statement. [39691]

Mr. Hague: Proposed changes in the extra-contractual referral system will not reduce the access to treatment of patients of either fundholding or non-fundholding general practitioners.

Mr. Morgan: To ask the Secretary of State for Wales if he will list those making representations concerning the contents of the departmental letters of 12 and 20 June concerning extra-contractual referral administration. [39715]

Mr. Hague: In response to departmental letters of 12 and 20 June about extra-contractual referrals, commetns were received from the following:

Clwydian Community Care NHS Trust
Derwen NHS Trust
Rhondda NHS Trust
Carmarthen & District NHS Trust
Nevill Hall & District NHS Trust
Cardiff Community Healthcare NHS Trust

Mr. Morgan: To ask the Secretary of State for Wales (1) what estimate he has made of the (a) number and (b) cost of treatments no longer requiring to be notified to purchasers in advance of treatment by virtue of the 2 July letter of guidance to health authorities, trusts and fundholders (i) between 1 August 1996 and 31 March 1997 and (b) in a typical year; and what is the estimated net annual administrative cost saving; [39739]

(2) what assessment he has made of the level of extra-contractual referral activity in Wales in the financial years 1994-95 and 1995-96; what proportion of the total cost of extra-contractual referral was for (a) tertiary referral and (b) emergency reasons; what the total cost

24 Jul 1996 : Column: 388

was of administering the extra-contractual referral system for the latest available financial year; and if he will make a statement. [39710]

Mr. Hague: The information requested is not held centrally.

Mr. Morgan: To ask the Secretary of State for Wales what assessment he has made of the effect of the abolition of the requirement for notification of extra-contractual referrals from 1 August on the explicit exclusions from current contracts with trusts for certain interventions (a) on grounds of clinical ineffectiveness and (b) on all other grounds. [39743]

Mr. Hague: It is not anticipated that the abolition of the requirement for notification of ECRs from 1 August will have any effect on explicit exclusions from current contracts either on grounds of clinical ineffectiveness or on any other grounds.

Mr. Morgan: To ask the Secretary of State for Wales if he will list the current system for resolving disputed extra-contractual referral cases; and what proposals he has to revise the disputes procedure in the light of the new guidance letter of 2 July. [39705]

Mr. Hague: Disputed extra-contractual referral cases are referred to the Welsh Office for arbitration. Details were set out in guidance issued on 31 March 1995. It is not anticipated that these arrangements will be changed.

Mr. Morgan: To ask the Secretary of State for Wales what provision he is making to consult non-fundholding GPs on the proposed changes in the notification procedure on extra-contractual referrals which terminate the requirement for trusts to seek prior approval from health authorities before providing elective treatment to patients outside existing contracts.[39716]

Mr. Hague: Health authorities will be expected to work closely with all GPs in their area to agree suitable arrangements for dealing with extra-contractual referrals for elective treatments following the proposed abolition of the requirement for trusts to seek prior approval.

Mr. Morgan: To ask the Secretary of State for Wales (1) what arrangements he is making to publicise the changes in the extra-contractual referral system due on 1 August; [39712]

(2) what provision he made for non-fundholding GPs to be notified of the proposed changes in the extra-contractual referral system as regards (a) the termination of the requirement to notify purchasers of emergency or tertiary extra-contractual referrals and (b) the exceptions to the changes. [39714]

Mr. Hague: Health authorities, NHS trusts and GP fundholders received formal notification of changes in the extra-contractual referral system in departmental guidance issued on 2 July. In the normal way, health authorities will be expected to ensure that the information is brought to the attention of all general practitioners in their area.

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Mr. Morgan: To ask the Secretary of State for Wales what assessment he has made of the effect of the abolition of requirement for notification of extra-contractual referrals from 1 August on the practice of general practitioner fundholder contracts with trusts requiring prior authorisation in advance of elective tertiary referrals; and if he will make a statement. [39744]

Mr. Hague: The abolition of the requirement for prior notification of elective tertiary referrals will apply equally to general practitioner fundholder contracts and those of health authorities.

Emergency Hospital Beds

Mr. Morgan: To ask the Secretary of State for Wales what representations he has received from the Trust Executive Advisory Group in relation to the demand for medical emergency beds. [39674]

Mr. Hague: The chairman of the Trust Executive Advisory Group has written to my Department expressing a number of concerns about the allowance made for medical emergency care in health authority contracts for the present financial year.

A joint action plan was agreed earlier this year between trusts and health authorities to minimise the risk of hospitals closing to emergency patients next winter. Health authorities have recently confirmed their commitment to this action plan and that this area of care is their top priority and the first call on the additional £55 million made available to them for 1996-97.

Health authorities will shortly be sending my Department details of the allowance made for emergency admissions in their contracts for the present financial year. When this information is available, it will be possible to make an informed judgment of whether the concerns of trust chief executives are well based. If they are, health authorities will be asked to review their existing contracts and to adjust them accordingly.

St. David's Hospital

Mr. Morgan: To ask the Secretary of State for Wales what consultations he has had with the chairmen of the Cardiff Community Healthcare NHS trust and the Bro Taf health authority concerning the finalising of proposals for the replacement neighbourhood hospital on the St. David's hospital site. [39711]

Mr. Hague: None. My officials are in close touch with officers from both organistions who are responsible for preparing and agreeing the business case.

Mr. Morgan: To ask the Secretary of State for Wales if he will place a copy in the Library of the fifth version of the Welsh ambulance policy and advisory group's proposals for Welsh ambulance trusts mergers; when it was received in his Department; and if he will make a statement. [39850]

Mr. Hague: I have not received any formal proposals. My Department would consult publicly on any formal

24 Jul 1996 : Column: 390

application that was submitted and a copy would be placed in the Library of the House.

Bovine Spongiform Encephalopathy

Mr. Morgan: To ask the Secretary of State for Wales what representations he has received regarding the introduction of a deficiency payments system for the under-30-month clean beef trade pending the return of normal market conditions; and if he will make a statement. [39713]

Mr. Hague: I have received representations from the Farmers Union of Wales asking for a deficiency payment system for the under-30-month clean beef trade.

Resurgam Submarine Vessel

Sir Wyn Roberts: To ask the Secretary of State for Wales (1) if he will take steps to establish who (a) now owns the submarine vessel Resurgam and (b) has legal right of access to the vessel; and if he will make a statement; [39648]

(2) if he will ensure that appropriate arrangements are made to salvage the submarine vessel Resurgam and to place it on public display in a suitable place; [39647]

(3) what steps he is taking to protect against vandalism the British-powered submarine vessel Resurgam sunk off the north Wales coast in 1880 and found in October 1995. [39649]

Mr. Gwilym Jones: I will write to the hon. Member as soon as possible and place a copy of my reply in the Library of the House.

Child Abuse

Sir Wyn Roberts: To ask the Secretary of State for Wales, pursuant to his oral statement of 17 June, Official Report, columns 521-24, how long the tribunal of inquiry into north Wales child abuse is likely to sit. [40096]

Mr. Hague: I have discussed the question of a target date with Sir Ronald Waterhouse and have agreed with him that the aim should be for the tribunal to complete the taking of written and oral evidence by the end of 1997.

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