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Community Care
Mr. Burstow: To ask the Secretary of State for Health what plans he has to alter the obligation on local authorities to place 85 per cent. of community care services with private and voluntary sector providers.[12005]
Mr. Boateng: Decisions on the future of the special transitional grant independent sector condition will be made within the context of the Government's overall policies and manifesto commitments.
NHS Estates
Mr. Khabra: To ask the Secretary of State for Health if he will make a statement on the future of NHS Estates.[12353]
Mr. Milburn: National Health Service Estates plays a key role in helping the NHS to improve patient care through better use of the estate. The previous Government announced in December 1994 that it planned to privatise the non-core functions of NHS Estates. I have decided that the agency should retain its current status.
Private Finance Initiative
Dr. Whitehead: To ask the Secretary of State for Health if he will list the private finance initiative schemes that are currently under consideration in the regions covered by the Government offices for the south-east and the south-west which pertain to the health service and are not the subject of the first prioritisation of 3 July 1997.[11362]
Mr. Milburn: Those national health service trust schemes in the regions covered by the Government offices for the south-east and south-west that have outline business case approval and are currently testing for private finance are listed. All schemes listed have a capital value of £1 million or over. Information is not collected centrally on schemes with a capital value below £1 million. The list excludes those major acute private finance initiative schemes that were part of the recent prioritisation exercise.
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Mr. Campbell-Savours: To ask the Secretary of State for Health how many health service private finance initiative agreements (a) have been approved and (b) are ready to proceed. [11140]
Mr. Milburn: Following the enactment of the National Health Service (Private Finance) Bill which received Royal Assent on 15 July, the private finance initiative scheme at Dartford and Gravesham national health service trust achieved financial close on 30 July. Norfolk and Norwich Healthcare NHS trust has reached agreement to proceed to financial close.
Mr. Campbell-Savours: To ask the Secretary of State for Health, pursuant to his answer of 21 July, Official Report, column 414, on the private finance initiative, if he will place in the Library copies of each of the business case PFI bid documents for those NHS facilities that were recently listed as approved for further consideration.[10673]
Mr. Milburn: I will write to my hon. Friend.
NHS Trusts (Private Activities)
Mr. Campbell-Savours: To ask the Secretary of State for Health (1) what procedures will be placed upon NHS trust private activities to ensure (a) that the income they generate is used for the benefit of the NHS and (b) that they do not interfere with the provision of health services to the community; [11141]
- (2) by what means his Department monitors compliance with directions to NHS trusts in respect of the limits on their private activities; and what steps are taken in the event of non-compliance. [11142]
Mr. Milburn: Procedures are already in place. The National Health Service and Community Care Act 1990 states that private practice must not interfere with the performance by a trust of any of its obligations under NHS contracts. Health authorities and general practitioner fundholders, backed up by regional offices of the Department, monitor the performance of trusts against contracts. Trusts are required to recover the costs of their private patient activity including an appropriate return on capital employed. Memorandum trading accounts are prepared and audited. My right hon. Friend the Secretary of State retains powers to give directions to a trust about the exercise of their powers to provide accommodation or services to private patients and the trust has a duty to comply.
NHS Expenditure
Mr. Jack:
To ask the Secretary of State for Health, pursuant to his answer of 16 July, Official Report, column 212, if he will make a statement on the term adverse operating variance. [11925]
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Mr. Milburn:
In line with generally accepted accounting practice, a National Health Service trust makes a charge against its income and expenditure account for the depreciation of its assets.
The prices a trust charges to its purchasers includes the depreciation charge, but changes in the value of a trust's assets may occur too late for the resulting change in depreciation to be reflected in the prices charged to purchasers.
Increases in depreciation will result in an increase in expenditure which is not matched by an increase in income from the trust's purchasers. In these circumstances, the trust may show a deficit in the income and expenditure account. This is not within the control of the trust's management; nor is it an indicator of financial problems. The operating variance is used to calculate the underlying financial position of the trust by adjusting its income and expenditure account for changes in depreciation caused by late changes in the trust's assets.
Where the variance is adverse, the underlying position will be investigated further.
Mr. Jack:
To ask the Secretary of State for Health if he will list the criteria that each NHS executive regional office uses to determine which health trusts and authorities are judged to have serious financial problems.[7759]
Mr. Milburn
[pursuant to his reply, 16 July 1997, c. 212]: I am now able to provide additional information. The full reply is as follows:
The National Health Service Executive assesses the seriousness of financial problems by initially looking at the scale of the financial problem reported--that is, over £1 million deficit or, if lower, a deficit of 1 per cent. of turnover in health authorities; and adverse operating variance of either £0.5 million or, if lower, of 0.5 per cent. of turnover in trusts. The NHS executive will supplement this with an assessment of additional factors such as the robustness of recovery plans.
Mr. Tredinnick:
To ask the Secretary of State for Health what research his Department has (a) commissioned and (b) evaluated into prostate cancer; and if he will make a statement. [11934]
Mr. Boateng:
The national health service research and development programme's health technology assessment programme has undertaken two studies into prostate cancer. These are:
These two studies have recently reported.
The next round of priorities for the HTA programme have been set and one of these is treatments for the spectrum of prostate cancers likely to be identified by a screening programme.
The Department's policy research programme is currently undertaking a systematic review of minimally invasive therapy for benign prostatic hyperplasia and
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cancer. The study is being undertaken at the university of Newcastle between 1 August 1996 and 31 July 1997 at a total estimated cost of £39,491.
Another study, a mortality study of cadmium exposed workers with particular reference to lung and prostatic cancer, was completed last year and has reported. The study was undertaken at Imperial college between 1 October 1994 and 31 May 1996 at a total cost of £32,070.
Mr. Tredinnick:
To ask the Secretary of State for Health how much his Department has spent in the last year for which figures are available on the treatment and cure of prostate cancer. [11935]
Mr. Boateng:
Expenditure on prostate cancer cannot be identified separately. Expenditure on cancer services generally is estimated to account for approximately 7 per cent. of national health service resources.
a systematic review of detection, management and screening for prostatic carcinoma, at a cost of approximately £54,000;
a review of evidence on the cost-effectiveness of different strategies for detecting and managing prostatic carcinoma, at an approximate cost of £13,000.
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