APPENDIX 37
Supplementary memorandum by the Department
of Health (MH 1C)
COSTS OF MEDIUM AND LOW SECURE FACILITIES,
AND OF A PRISON PLACE
1. COST OF
MEDIUM SECURE
PLACE FOR
A PERSON
WITH MENTAL
ILLNESS
In a straw poll carried out recently on nine
units, the cost of a medium secure place varied from £86,126
to £146,831 per annum. The average cost was £111,497
per annum.
2. COST OF
A LOW
SECURE PLACE
FOR A
PERSON WITH
MENTAL ILLNESS
Up to date costs are not readily available for
services at lower levels of security. The following costing was
compiled using a sample of 30 units in 1997. It showed that the
average cost of a low secure place (including local intensive
care units, as well as regional secure units and one independent
sector provider) was £96,816 per annum. The lowest cost was
£67,937 and the highest was £182,625 per annum. This
considerable variation in costs from one establishment to another
is due in part to the variety of services covered by the low security
definition.
3. COST OF
A PRISON
PLACE
In 1998-99 the average cost of an uncrowded
prison place, ie calculated with reference to the total of the
certified normal accommodation across the prison estate, was £25,096.
The average cost per prisoner for the same year was £24,260.
It is not possible to give an exact figure for the health care
component of this average cost. The assessments of costs in the
Report on the future organisation of prison health care, published
in March 1999, indicated that the health care element represents
5-15 per cent of prison budgets, depending on the prison, ie between
about £1,200-£3,600 on average per prisoner per year.
These costs would largely cover only the provision of a broadly
primary healthcare service, and cost comparisons with secure mental
health service providers would be of little validity.
HOW ARE
THE VACANCY
RATES CALCULATED?
ARE THEY
AVAILABLE BY
HEALTH AUTHORITY?
The vacancy rate given by Secretary of State
was the three month vacancy rate—2.1 per cent being the
rate for qualified nurses within psychiatry and 2.6 per cent being
the rate for all qualified nursing, midwifery and health visiting
staff. The percentages were calculated using whole-time equivalents.
All NHS Trusts in England were included in this survey (the 1999
Department of Health Recruitment, Retention and Vacancies survey)
and these results are based on all but three NHS trusts.
The number of vacancies lasting three months
or longer is normally used as a way of distinguishing between
those vacancies that are part of normal staff turnover, and those
which NHS trusts are finding difficult to fill. Vacancies that
NHS trusts are not actively trying to fill can arise for a number
of reasons, for example, where there is an expectation of filling
vacancies later when newly qualified staff become available or
staff return from courses. Resources are available to fund all
these vacancies.
More detailed results eg about the recruitment
and retention problems faced by NHS trusts, and a geographical
breakdown of the figures in the attached tables, will be available
at a later date. Detailed results by Health Authority area were
published in November. These are at Annex A.
June 2000
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