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NHS Bureaucracy
Mr. Simon Hughes: To ask the Secretary of State for Health what criteria his Department will use to measure the savings achieved from the elimination of excess NHS bureaucracy; and by what date he expects to achieve his target for these savings. [16663]
Mr. Milburn: The Government are committed to reducing National Health Service bureaucracy. As a first step, we are tackling the worst features of the internal market and reducing NHS management costs in Great Britain by £100 million in 1997-98. The NHS Executive has set targets for 1997-98 with every health authority and trust in England to reduce their management costs.
The NHS Executive calculates the costs of managing the NHS using two measures: health authority costs; and trust management costs. Health authority costs are monitored quarterly through regional offices. Where there is significant deviation from plan, it is for the NHS Executive regional offices to negotiate recovery plans for those health authorities concerned. Trusts report their management costs in their annual accounts. It is for the regional offices to ensure that trusts are taking the necessary steps to deliver the savings by the end of the year. Current information indicates that both health authorities and trusts are on target to achieve their 1997-98 plans by the end of the year.
We will shortly be announcing further actions to reduce NHS bureaucracy linked to functional and structural change, as part of our plans to replace the internal market.
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Mr. Simon Hughes:
To ask the Secretary of State for Health how many contracts have been made between purchasers and providers in the NHS in each of the last five years; and how many GP fundholder contracts with providers have been made since fundholding began.[17341]
Mr. Milburn:
Information on the number of contracts between purchasers and providers and on general practitioner fundholders' contracts is not collected centrally. Some data have been held at a regional level but this has not been collected or validated on a consistent basis.
Ms Julie Morgan:
To ask the Secretary of State for Health what plans his Department has to include consideration of targets for the diagnosis of clinical depression in a future review of health policy. [17196]
Mr. Boateng:
We have no such plans.
Ms Julie Morgan:
To ask the Secretary of State for Health what estimate he has made of the cost of treating clinical depression, broken down into costs (a) of actual treatment, (b) associated with sickness benefit, (c) of working days lost to illness resulting in lost income revenue and (d) of community care. [17198]
Mr. Boateng:
We have made no estimate of these costs.
Ms Julie Morgan:
To ask the Secretary of State for Health when he last had meetings within the Department of Social Security, the Treasury and the Department for Education and Employment to discuss policy on the treatment of clinical depression. [17194]
Mr. Boateng:
Treatment of clinical depression is a matter for the relevant bodies. We hold meetings with other Government departments as and when appropriate.
In recent months, officials have had discussions with colleagues at both the Department of Social Security and the Department for Education and Employment on the problems mentally ill people face on securing employment.
Ms Julie Morgan:
To ask the Secretary of State for Health what plans he has to set up a task force to examine the diagnosis and treatment of clinical depression. [17195]
Mr. Boateng:
We have no such plans. The Clinical Standards Advisory Group, a statutory body that advises United Kingdom Health Ministers on standards of clinical care, began work in March this year to review the clinical management of depression in primary and secondary care. We expect to receive its report early in 1998.
Mr. Simon Hughes:
To ask the Secretary of State for Health if he will list by (a) health authority and (b) region, the total savings made by general practitioners and the percentage of savings spent in each year since the inception of fundholding. [17334]
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Mr. Milburn:
Information held centrally on savings made on general practitioner fundholder budgets, and on spending from these savings (excluding savings voluntarily returned by fundholders to their health authorities), has been placed in the Library.
For 1991-92 and 1992-93, these are savings made at regional health authority level. From 1993-94 to 1995-96, data are available at family health services authority/health authority level on both savings made and spending from savings.
"Retained savings" are savings made on fundholders' budgets, excluding amounts voluntarily returned to the health authority, retained for spending in future years. "Accumulated savings available for spending" are all savings made since entry to fundholding less any savings spent.
In 1995-96, fundholders in England retained £84.8 million or 2.4 per cent. of their budgets in savings, and spent £47.6 million (32 per cent.) of their £150.9 million accumulated savings.
All data are taken from audited accounts, returned by National Health Service Executive Regional Offices. Information is not yet available from 1996-97 audited accounts.
Mr. Burns:
To ask the Secretary of State for Health how many people in the Mid-Essex Hospital Trust area had been waiting for treatment for more than (a) 24 months, (b) 18 months and (c) 12 months, (i) on 31 March and (ii) at the latest available date. [17029]
Mr. Milburn:
Information on patients awaiting admission to Mid-Essex Hospital National Health Service Trust on 31 March 1997 and 30 September 1997 is given in the table.
| Number waiting | At 31 March 1997 | At 30 September (17)1997 |
|---|---|---|
| For 12 months or more | (16)104 | 441 |
| For 18 months or more | 0 | 3 |
| For 24 months or more | 0 | 0 |
(16) Figure is final one and differs from provisional figure supplied in the reply given to the hon. Member for West Chelmsford on 11 June 1997 at column 479.
(17) Figures for 30 September 1997 are provisional.
Minister for Public Health
Mr. Maples: To ask the Secretary of State for Health when the Minister for Public Health informed him of her concerns over a potential conflict of interest arising out of her family links with the motor racing industry; and if he will publish (a) the advice he offered her and (b) the advice she received from the Permanent Secretary. [16747]
Mr. Dobson:
My hon. Friend the Minister for Public Health first raised this issue with me when we discussed the division of responsibilities within the Ministerial team at the start of May.
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Both the Permanent Secretary and I are fully satisfied that no conflict of interest arises for my hon. Friend the Minister for Public Health and that she has fully observed my right hon. Friend the Prime Minister's guidance to Ministers on conduct and procedures.
It is not the practice to publish internal advice on such matters.
Mr. Burnett:
To ask the Secretary of State for Health in what ways his Department's proposals to change the funding formula used to allocate National Health Service funds between health authorities reflects the sparsity of areas; and if he will make a statement. [17453]
Mr. Milburn:
A geographical cost adjustment for emergency ambulance services was introduced into the national weighted capitation formula used to inform 1998-99 revenue allocations to health authorities. This includes a measure of rural sparsity.
Mr. Simon Hughes:
To ask the Secretary of State for Health what estimate he has made of the numbers and cost of elderly patients blocking beds. [17335]
Mr. Boateng:
I refer the hon. Member to the reply I gave the hon. Member for North Devon (Mr. Harvey) on 12 November 1997, Official Report, column 602.
Specific information on the cost of delayed discharges is not collected centrally and we have no plans to change this. The Department is seeking to reduce the burden of data collection by the National Health Service and rationalise data flows within the NHS and between the NHS and the centre. The amount of information required to calculate the average cost of delayed discharge would not be in line with this policy.
Mr. Simon Hughes:
To ask the Secretary of State for Health how many trusts have been assessed by his Department in respect of their long-term financial viability; and what has been the outcome in each case.[17333]
Mr. Milburn:
The financial viability of all trusts is assessed as a part of each trust's annual business planning cycle. The financial monitoring process and independent auditing of accounts are also elements in the assessment framework. The outcome in the vast majority of cases has been the continued existence of the trusts as they were established.
Trusts are merged or reconfigured for a number of operational reasons. The majority of reconfigurations are to improve local service provision although a small number have resulted principally from concerns over their long term financial viability. These are:
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the merger of West Dorset Community Health NHS Trust with West Dorset Mental Health NHS Trust to form the Dorset Community NHS Trust on 1 April 1994;
the merger of Royal Liverpool University NHS Trust and Broadgreen NHS Trust to form Royal Liverpool University and Broadgreen NHS Trust on 1 April 1995;
the merger of Louth and District Healthcare NHS Trust and Lincoln Hospitals NHS Trust to form Lincoln and Louth NHS Trust on 1 April 1996;
the merger of Royal Free NHS Trust and the Royal National Throat, Nose and Ear Hospital NHS Trust on 1 April 1996;
the dissolution of Anglian Harbours NHS Trust on 30 September 1997.
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