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Treatment Costs
Mr. Andrew Turner: To ask the Secretary of State for Health what information he collates on (a) the cost of procedures in NHS hospitals and (b) the charges for procedures in private hospitals and private beds in NHS hospitals. [50063]
Mr. Hutton [holding answer 16 April 2002]: Reference costs data is the main source of cost data on individual treatments and procedures in the National Health Service. This information is collected annually from NHS providers (including primary care trusts) and is analysed to produce national average costs which are published.
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The level of detail is dependent on the services. Inpatient and day case episodes are sub-divided into over 500 Healthcare Resource Groups (HRGs). HRGs are groups of clinically similar procedures and treatments which are iso-resource. They are developed by clinicians, and signed off by the respective Royal Colleges.
Outpatient attendances are, at a minimum, analysed on the number of first and follow up attendances for each specialty. Some specialties are analysed using more sophisticated workload measures. Full details can be found on the Department's website and copies of the Reference Costs 2001 publication are in the Library.
The Department does not collect information on charges for procedures either in private or NHS hospitals for private patients. It has, however, carried out a survey of NHS health authorities and trusts on the acute elective activity they commissioned from the independent sector last year and the related costs, and will make available key results shortly.
NHS Finance
Mr. Andrew Turner: To ask the Secretary of State for Health what deficit or surplus was carried forward by each NHS trust, health authority and primary care trust and group in England at the beginning of financial years (a) 2000–01, (b) 2001–02 and (c) 2002–03. [50064]
Mr. Hutton [holding answer 16 April 2002]: Information relating to NHS trust surpluses and deficits for the 2000–01 financial year has been placed in the library. The NHS trust information requested for 2001–02 and 2002–03 will not be available until the annual audited accounts are completed and published for those financial years.
In anticipation of the introduction of Resource accounting and budgeting across all Government departments from April 2001, a change made to the format of the annual accounts from 2000–01 means that health authorities (including Primary Care Groups) and primary care trusts, are no longer required to account on an income & expenditure basis. The concept of income and expenditure deficits and surpluses is, therefore, no longer applicable, having been replaced by a measure which seeks to ensure that health authorities and primary care trusts live within the approved resource limits set by the Department.
Mr. Andrew Turner: To ask the Secretary of State for Health what powers regional NHS officials have to claw back (a) unspent allocations at the end of the year for which they have been allocated and (b) ring-fenced allocations and special purpose grants during the year for which they have been allocated. [50067]
Mr. Hutton [holding answer 16 April 2002]: HM Treasury allows the Department to carry forward under spends from one year to the next. In turn, the Department allows the NHS this same flexibility.
Section 97(6) of the NHS Act 1977 as amended provides for the Secretary of State to issue directions to ring fence specific allotments of funding. Ring fenced funding may only be used for the purposes specified in such directions. The Secretary of State may, under section
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97(5) of the NHS Act 1977 as amended, claw back under spends of ring fenced funding. However this has not been the recent practice.
Private Finance Initiative
Mr. Bercow: To ask the Secretary of State for Health what the difference was between the price offered in reaching preferred bidder stage and the final contract price
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for the five largest PFI contracts let by his Department in each of the last four years; and if he will make a statement. [45591]
Mr. Hutton [holding answer Monday 25 March]: The information requested is shown in the table (all figures are expressed in cash terms). Attention is drawn to the footnotes to the table as a lot of these early PFI schemes changed in functionality terms after the appointment of the preferred bidder.
| 1998 | Preferred Bidder Price | Final Contract Price |
|---|---|---|
| Greenwich | £15,355,000 (annual unitary charge) | £17,327,000 (annual unitary charge)(6) |
| Calderdale | £17,500,000 (annual unitary charge) | £14,500,000 (annual unitary charge)(7) |
| South Manchester | £539,000,000 (total cash flows over 45 years) | £519,000,000 (total cash flows over 35 years) |
| Norfolk and Norwich | £28,825,000 (annual unitary charge)(8) | £35,300,000 (annual unitary charge) |
| North Durham | £14,660,000 (annual unitary charge) | £11,960,000 (annual unitary charge)(9) |
| 1999 | ||
| South Tees | £20,300,000 (annual unitary charge) | £21,900,000 (annual unitary charge)(10) |
| Swindon and Marlborough | £8,575,000 (annual availability charge only)(11) | £10,914,000 (annual availability charge only)(12) |
| Worcester | £15,557,000 (annual unitary charge) | £18,302,000 (annual unitary charge)(13) |
| Hereford | £9,471,000 (annual unitary charge) | £9,517,000 (annual unitary charge) |
| King's | £6,439,000 (annual availability charge only)(14) | £7,211,000 (annual availability charge only) |
| 2000 (only 4 major schemes signed contracts in 2000) | ||
| St George's | No change in annual unitary charge between preferred bidder stage and final contract price | £6,804,000 (annual unitary charge) |
| Leeds Community | £9,090,000 (annual unitary charge) | £8,130,000 (annual unitary charge)(15) |
| Hull and East Yorks | £320,000 (annual unitary charge) | £1,400,000 (annual unitary charge)(16) |
| UCLH | Construction price for the 2 phases of the development was £153,000,000 | Construction price for the 2 phases of the development was £225,000,000(17) |
| 2001 (only 3 major schemes signed contracts in 2001) | ||
| West Berkshire | £4,019,512 (annual unitary charge) | £4,020,000 (annual unitary charge) |
| Dudley | £27,484,000 (annual unitary charge) | £25,954,000 (annual unitary charge) |
| West Middlesex | £8,595,000 (annual unitary charge) | £8,875,000 (annual unitary charge) |
(6) Final contract price includes interest rate adjustment.
(7) Initial proposal was for all new build; this was negotiated by the Trust to be a mix of new build and refurbished buildings, hence the reduction in price.
(8) Preferred bidder price for initial specification of 701 beds; final contract price for 809 beds.
(9) Sterile services was removed after the preferred bidder stage; the design also underwent some changes.
(10) Project underwent considerable service/build variations before contract close.
(11) The figures in both columns for Swindon and Marlborough exclude facilities management costs because at preferred bidder stage the range of services to be included in the scheme had not yet been decided.
(12) The scheme at preferred bidder stage was for the redevelopment of the existing Princess Margaret Hospital, whilst the charge at financial close is for a new build on a green field site i.e. a completely different type of project. The former had a substantial element of refurbished building and was around 10 per cent smaller.
(13) Incorporates addition of 74 beds at Kidderminster and equipment.
(14) Includes an adjustment to exclude the benefit of a capital sale receipt of £2.8 million to ensure a like-for-like comparison with final contract price.
(15) The reduction was due to negotiations with the bidder, reduction in interest rates of 1.7 per cent and the sale of land which reduced the unitary charge by £492,000 per annum.
(16) The scheme cost increased from £3.9 million to £8.1 million due to inclusion of additional facilities and "hard FM" services.
(17) Scheme cost increased due to addition of more beds to the scheme following the National Beds Inquiry Report in February 2000.
Mr. Bercow: To ask the Secretary of State for Health what estimate he has made of the total savings to public funds of the Private Finance Initiative contract for the Crawley Hospital Energy Management for the Surrey and Sussex Health Care NHS Trust by comparison with a non-Private Finance Initiative alternative. [49516]
Yvette Cooper: The Crawley scheme was set in April 1999 on a ten-year contract. It is a cost-neutral scheme (i.e. the costs of the scheme are offset by the energy savings generated).
The public sector comparator was made and showed the Honeywell Scheme to cost the Trust £400,000 less than pursuing a non-PFI alternative over the life of the scheme.
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