MEMORANDUM
SUBMITTED TO THE HEALTH COMMITTEE
Public Expenditure Questionnaire 2002
Where questions are identical to those included
in the 2001 PEQ, last year's question number is given in square
brackets at the end of the question.
1.1 NHS medical workforce
1.1.1 Could the Department provide information
(a) on numbers of GP trainers for each of the last five years,
(b) on current numbers of GP trainees, (c) on numbers completing
training this year?
1.1.2 In view of the impact of the medical
workforce on future NHS costs and effectiveness, could the Department
provide an age breakdown of hospital consultants and of unrestricted
GP principals? Could the Department also provide estimates for
the period 2003 to 2010 of the numbers of: (a) newly graduating
medical school graduates; (b) registrars; (c) consultants and
(d) GPs expected to reach retirement age.
1.2 Comparative health spending levels
1.2.1 Could the Department provide estimates
of how current levels of NHS spending compare with the European
average, and estimates of changes assuming planned rates of growth
in spending from now to 2007?
1.2.2 Would the Department explain how it
measures total health care spending, private as well as public,
for its estimates of spending as a percentage of GDP? Has the
definition of what is included within health care spending changed
since 2000 and, if so, in what way?
1.3 Concordat activity
1.3.1 How much NHS expenditure has there
been on health care purchased from independent UK providers in
each of the years 1999-2000, 2000-01 and 2001-02? Can these figures
be broken down between acute and non-acute care and by specialty?
1.3.2 How do prices paid by the NHS in 2001-02
for independently provided inpatient and day case treatment compare
with NHS reference costs for the same treatments and procedures?
1.3.3 How many NHS patients were treated
in the private sector under the Concordat by doctors who also
work in the NHS, and what proportion of all patients treated under
the Concordat does this represent? How many were treated by the
same doctor or surgical team they would have been treated by in
the NHS, and what proportion of all patients treated under the
Concordat does this represent?
1.3.4 In a letter to the Committee of 9
January 2002, the Department reported briefly on a survey commissioned
in September 2001, the purpose of which was to understand the
volume, cost and nature of elective treatment provided to the
NHS by the independent sector. Would the Department give a more
detailed account of the findings of this survey, including tables
where appropriate, and in particular the type of procedures making
up the volume of cases commissioned, and the prices obtained by
the NHS, and how these vary between different regions of the country?
Does the Department intend to make the survey data available to
independent researchers? When does the Department intend to re-run
the survey, and when does it expect to make the results available
publicly?
1.4 Buying from non-UK providers
1.4.1 How much has the NHS spent on health
care provided outside the UK, for how many patients and for what
treatments, in each of the years 1999-2000, 2000-01 and 2001-02?
What is the likely spending on health care outside the UK for
2002-03? If possible, distinguish between emergency (E111) care,
non-emergency (E112) care and other purchases from non-UK providers.
1.5 Information for health
1.5.1 Could the Department provide an annual
breakdown of NHS expenditure on IM&T since the launch of `Information
for Health' in 1999, for: IM&T infrastructure; Electronic
Patient Records; clinical governance system; and staff training?
1.5.2 Could the Department state what progress
has been made on the Maternity Care Data Project? Is it on track
to achieve the overall aim of having standardised and consistent
recording of data relating to maternity and childbirth, for women
and patients, within electronic patient record systems in all
affected NHS organisations by April 2003? If this is not likely,
what is the revised date for achieving this aim? What steps have
the Department and the NHS Information Authority taken to achieve
this aim? What resources will be made available to NHS Trusts
and maternity units to upgrade their IT to record data in the
ways defined, and to link their IT systems to those of other NHS
systems?
2. GENERAL EXPENDITURE
ISSUES
2.1 NHS Financial Balance
2.1.1 Based on current forecasts, what will
be the likely financial performance of the NHS in 2002-03 in terms
of financial balance, "deficit" organisations and performance.
[1.1]
2.2 Overall Expenditure
2.2.1 Could the Department provide an updated
version of Table 2.1.1, and of the Department's commentary which
accompanied it? Could it also show this data in graphical form?
Could the Department provide a brief commentary, explaining what
expenditure is included under each section of the table? Can the
footnote to table 2.1.1 explain the measures and their applications
for lines D to G? [2.1a]
2.2.2 Could the Department identify significant
changes between forecast and actual outturn for 2000-01 and between
the planned level of spending and forecast outturn for 2001-02,
by comparing figures in Table 2.1.1 with current figures. For
each programme the planned level of spending in 2001-02 and actual
outturn expenditure should be shown in tabular form.[2.1b]
2.2.3 What is the Department's assessment
of each programme's performance in 2000-01 against plans for that
year, and anticipated performance in 2001-02 against plans for
that year and outturn in 2000-01? [2.1d]
2.2.4 The supply estimates are now presented
in a simplified form which does not disaggregate the different
sources for appropriations in aid. This is now presented only
in an annex to the Departmental Report (Annex D, Information formerly
in Supply Estimates). For the sake of clarity, could the Department
give a detailed reconciliation between table 2.1.1 and appropriations
in aid for each year since 1995-96 by sub-programme and source
(ie miscellaneous, charges, sales of assets, capital repayments,
trust debt remuneration). [2.1e]
2.2.5 Any commentary which the Department
wishes to append would be welcome, including information about
efficiency gains and a table showing changes in the Hospital and
Community Health Services cost-weighted index of activity for
the latest ten years for which figures are available.[2.1f]
2.2.6 Could the Department provide a breakdown
of what the additional NHS expenditure in 2001-02 as compared
with 2000-01 has been spent on? The impacts on expenditure of
additional staff, increased pay levels, medicines, capital and
other expenditures should be distinguished where possible.
2.3 Programme Budgets
2.3.1 Could the Department update the information
on expenditure on Programme Budgets provided in Tables 2.2? [2.2]
2.4 Special Allocations
2.4.1 Could the Department list any special
allocations and likely allocations in 2002-03, and indicate any
likely allocations in 2003-04? [2.5]
2.5 Expenditure on Community Care
2.5.1 Could the Department provide a table
showing, by service, net expenditure in real terms by central
and local government on community care, broken down by residential
and non-residential care (taking into account relevant service
pay and price increases), over the most recent five year period
for which such data are available? Could this data include Social
Security and Housing expenditures contributing to Community Care
objectives? Could it also show this data in graphical form? [2.3]
3. NHS RESOURCES
AND ACTIVITY
3.1 General
3.1.1 Could the Department provide tables
showing health authority gross expenditure on HCHS by service
sector and age group for the latest year for which data are available?
[4.1a]
3.1.2 Could the Department provide a table
showing gross expenditure on Family Health Services in 2000-01
and 2001-02? [4.2]
3.1.3 Could the Department provide tables
which integrate expenditure on HCHS and FHS (Table 2.2.2. and
4.2.1) thus aligning data much more closely to PCTs' span of responsibilities?
Could this integrated information also be provided by Strategic
Health Authority area?
3.1.4 Could the Department give an account
of the funding streams for the General Medical Services budget
and provide a trend analysis? [4.3a]
3.2 Inflation
3.2.1 Could the Department give an explanation
as to the level of funding set aside for inflation in 2002-03?
In particular, can it give the average pay awards to each (subjective)
staff group and the inflation assumptions for non pay including
capital charges? [4.4a]
3.2.2 Could the Department provide a breakdown
of the components of the health specific inflation indices for
revenue spending on HCHS and Family Health Services respectively,
together with capital spending on HCHS, for 1999-2000 and 2000-01,
together with estimates for 2001-02? The tables for the HCHS should
show separate inflation indices for Review Body staff and non-Review
Body staff pay, and whatever other breakdowns of staff are available.[4.4b]
3.2.3 Would the Department state what the
increase in expenditure on the NHS has been since 1992 in cash
terms, real terms (GDP deflator) and real terms (NHS deflator)?
[4.4c]
3.2.4 Would the Department provide a table
showing the construction of the NHS inflation index from main
sub-indices of pay and other factor costs since 1992, and comment
on the assumptions underlying this construct? Would the Department
provide the weights used for each sub-index, for each year? [4.4d]
3.3 Hospital and Community Health Services
Allocations and Distance from Targets
3.3.1 Could the Department provide a table
showing for each health authority or primary care trust:
(i) allocations for resident populations
for 2001-02 (cash) and 2002-03 (cash and at 2001-02 prices);
(ii) 2002-03 Distance From Targets (DFT)
in cash and percentage terms;
(iii) growth in percentage terms;
(iv) net adjustment (cash) for Primary Care
Groups and Primary Care Trusts;
(v) net adjustment for out of area treatments;
(vi) inherited deficits. [4.5a]
3.3.2 Could the Department include a commentary
explaining the key factors that determined those percentage growth
increases shown in the table? [4.5b]
3.3.3 Could the Department update the Committee
on recent developments in allocations of HCHS resources and provide
the timetable for any planned changes? [4.5c]
3.3.4 Could the Department provide data
on expenditure covering HCHS and FHS for each SHA area together
with estimates of distances from target needs based expenditure?
3.4 Public Health
3.4.1 Saving lives: our healthier nation
set targets in 4 areas: cancer, CHD and stroke, accidents and
mental health. How is the Department monitoring individual primary
care trusts' progress towards the targets set in Saving lives?
What assessment is being made of the effectiveness of any additional
spending committed in response to these targets? What progress
has been made to date? [3.1a]
3.4.2 How many public health posts were
there in English HAs in each year between 1998-2002? How many
public health posts are there now in a) PCTs and b) Strategic
Health Authorities?
3.5 Care of Mental Health and Learning Disability
Patients
3.5.1 Could the Department update the information
given in Tables 2.4, on patients under the care of a learning
disability or mental illness consultant, discharges by length
of stay, ages and destination, and residential and other places
available? Could the Department identify the number of individuals
concerned, and hence the number of repeat discharges? [2.4a]
3.5.2 Could the Department provide a table
showing:
(i) number of people sectioned, by trust
and by type of section?
(ii) number of people sectioned in proportion
to HA population? If the data are not available, will the Department
consider obtaining it from the HES?
(iii) number of people sectioned in proportion
to number of admissions?
(iv) proportion of people who appeal against
being sectioned and the outcomes of the appeals? [2.4b]
3.5.3 Could the Department provide a table
showing, over the last four years, the numbers of people with
mental health problems and with learning disabilities who have
been in special hospitals, prisons and regional secure units?
[2.4c]
3.6 Expenditure on Prescribing
3.6.1 Could the Department provide information
on total NHS expenditure on pharmaceuticals for the past four
years, including a breakdown by sector and by generic/branded
drugs? Could the Department please state what data are available
on pharmaceuticals in the non primary care sector, and how they
are monitoring drug spending and cost pressures in the acute hospital
and community sectors? [4.10a]
3.6.2 Could the Department provide information
on (i) total Family Health Services expenditure on prescribing
for each year from 1992-93 to 2001-02, (ii) the average expenditure
per capita, (iii) the total number of items prescribed and average
number per capita, and (iv) the average cost per prescription?
Any commentary which the Department would wish to append would
be welcome, including an assessment of progress in meeting its
stated target of restraining the growth in the drugs bill to sustainable
and affordable limits. In particular, could the Department provide
an update on the measures being taken to control NHS expenditure
on generic drugs in primary care following the price increases
in 1999-2000? [4.10b-c]
3.6.3 Could the Department give an update
on progress in getting the pharmaceutical industry to reduce drug
costs by 4.5 per cent (as agreed in the PPRS)? Could the Department
comment on issues such as volume, price and substitution? Has
monitoring information improved since last year, and has this
helped cost control?
3.6.4 Could the Department provide estimates
of the likely costs of NICE recommendations for the current financial
year?
3.6.5 Could the Department provide figures
for the amount of money spent on statins per year over each of
the last four years, if possible broken down by Trust and Health
Authority.
3.7 Allocations to National Specialist Services
3.7.1 What was the total allocation in 2000-01
and 2001-02 to each of the supra regional services and what is
the planned allocation for 2002-03; and what significant changes
have there been in the overall pattern of expenditure? [4.11]
3.8 Management and Administration Costs
3.8.1 Could the Department provide a commentary
on the progress it has made in defining management costs in PCTs,
Strategic Health Authorities and NHS trusts? Could the Department
update Table 4.11.1? [4.12]
3.8.2 Could the Department provide figures
for annual redundancy costs as a result of restructuring broken
down by Health Authority and Trust, over the last 10 years?
3.9 Activity and waiting times
3.9.1 Could the Department update the information
given in Tables 4.13 showing activity data by region for 2000-01
and 2001-02, including: total activity, with trends; activity
by Inpatient, Day-Case and Outpatient; maternity and simple access
data? Could the Department provide figures for the ratio of Finished
Consultant Episodes (FCEs) to hospital spells by Region for the
same period? To what extent do a relatively small number of providers
depart from the overall pattern? Could the Department report on
the progress made by the NHS Information Authority in reviewing
clinical information, including the use of the FCE as a measure
of activity? [4.13]
3.9.2 Could the Department update the data
provided in table 4.14 on 10 year trends in bed availability and
patient throughput for each major hospital sector and for each
Region? Could information on bed occupancy (collected for the
first time in 1996-97) and occupancy rates also be included? [4.14a]
3.9.3 Could the Department provide figures
for the number of delayed discharges of patients from acute settings?
[4.14b] Could the Department provide an estimate of the number
of bed days in 2001-02 for which Social Services Departments would
have been expected to reimburse the NHS, had the proposed scheme
for incentivising the release of beds been in force in that year?
3.9.4 How many maternities were registered
in each NHS region in 2000-01 and how many records in the Maternity
Hospital Episode System had (i) maternity tails and, (ii) maternity
tails containing data? Could the Department also update the information
given in Tables 4.14.3-4.14.7? [4.15a]
3.9.5 Could the Department provide figures
on the Caesarean Section rate by Trust over the past five years,
plus such figures for other maternity interventions as are available.
3.9.6 Could the Department provide a commentary
on, and show evidence of, the progress Trusts and Regions are
making in improving data quality and on the steps the Department
has taken to ensure improvement? [4.15b]
3.9.7 Could the Department provide information
about waiting lists, both distribution by waiting time as well
as mean and median average time, on a district of residence basis
and on a provider unit basis? Could the Department update Figure
14.16.1 showing changes in mean and median waiting times since
March 1988? [4.16]
3.9.8 Could the Department provide an update
of Tables 4.16.4 to 4.16.8 on outpatient waiting times? [4.16b]
3.9.9 Can the Department provide information
about current levels and past trends of patients' total waiting
times from first referral to a specialist to eventual inpatient
or day case treatment?
3.9.10 Could the Department provide figures
on how many people were removed from waiting lists for day case
treatment and for in-patient treatment (i) because of admission
for treatment and (ii) for reasons other than treatment? How many
people were self-deferred in each six-month period since September
1988? What rules apply to ensure consistent interpretation of
these figures? Has the Department made any assessment of the extent
to which people removed for reasons other than treatment in that
hospital had either been admitted, died, been treated in another
hospital, or no longer required treatment? [4.16c]
3.9.11 Could the Department provide charts
and figures showing how trends in emergency and waiting list,
booked and planned activity have moved with waiting lists sizes
since June 1991? Could the Department provide both indices and
actual numbers in each case? [4.16d]
3.9.12 Can the Department provide a comparison
of total numbers of people waiting for outpatient appointments
for each year for which figures are available, separately identifying
trends in the average wait for an outpatient appointment? [4.16e]
3.9.13 Can the Department estimate the number
of people at each access point of the elective care system broken
down to show:
(a) numbers of GP consultations
(b) numbers of referrals to specialist outpatient
clinics
(c) numbers of attendances at specialist
outpatient clinics
(d) numbers of placements on waiting lists
(differentiated by (i) "waiting list", (ii) "booked"
and (iii) "planned", and
(e) numbers of elective episodes of care,
for each year since 1991-92 [4.16f]
3.9.14 Would the Department provide a commentary
on changes over time in numbers waiting at each stage, and the
conversion rates between each stage? [4.16f]
3.9.15 What additional mechanisms have been
put in place since last year's response to deal with waiting lists?
How is the success of each of these measured? What assessment
have you made of the effectiveness of each? What has been the
cost of each of these? [4.16g]
3.9.16 Could the Department supply information
on readmission rates to acute hospitals over the past ten years?
3.9.17 Would the Department provide figures
on the number of people on NHS waiting lists whose treatment has
been paid for in the independent sector over the last 10 years?
Would the Department explain how these patients are dealt with
when calculating average waiting times for NHS patients? Are private
patients treated in NHS hospitals included in the figures used
by the Department to calculate total NHS elective activity, numbers
admitted from NHS waiting lists and average NHS waiting times?
3.10 Commission for Health Improvement
3.10.1 Would the Department provide the
latest figures on the total expenditure by the Commission for
Health Improvement (CHI) in each year since it was established
in April 2000? Would the Department provide figures on the set-up
costs of CHI in 1999-2000? Would the Department provide the latest
planned expenditure figures for CHI in 2002-03 and 2003-04?
3.10.2 Would the Department provide figures
for the number of people employed each year by CHI since it was
established in April 2000?
3.10.3 Would the Department give a brief
commentary on the work and achievements of CHI including the total
number of clinical governance reviews, investigations and national
studies that have been completed? Would the Department provide
an estimate, by year if available, of:
— Cost per clinical governance review
— Cost per national study
3.10.4 Would the Department explain how
it has evaluated CHI to ensure that it is delivering value for
money and improvements to the quality of care in the NHS?
3.11 Race Relations (Amendment) Act 2000
3.11.1 Would the Department explain what
the additional responsibilities of NHS bodies are under the Race
Relations (Amendment) Act 2000, and what steps the Department
is taking to ensure that NHS bodies meet these responsibilities?
3.11.2 Would the Department provide figures
on the number of NHS bodies, by type of body, which have met the
requirement under the Race Relations (Amendment) Act 2000 to publish
a Race Equality Scheme by 31 May 2002?
3.11.3 Would the Department like to provide
any commentary on its own response to the Race Relations (Amendment)
Act 2000?
3.11.4 Would the Department provide figures
on ethnic minority representation at board level in NHS bodies
over the last five years, by health authority, NHS trust, or PCT,
as appropriate? Would the Department also provide figures at Departmental
and regional level?
3.11.5 Would the Department provide figures
on the numbers and proportions of ethnic minority staff employed
by NHS bodies, by staff group, over the last five years, by health
authority, NHS trust, or PCT as appropriate? Would the Department
also provide figures at Departmental and regional level?
3.11.6 All populations served by NHS bodies
should receive equal treatment according to their needs. Would
the Department explain what steps it has taken to ensure that
people from minority ethnic groups receive equal treatment from
NHS bodies? What evidence does the Department have to show that
people from minority ethnic groups receive equal treatment from
NHS bodies?
4. PERSONAL SOCIAL
SERVICES RESOURCES
AND ACTIVITY
4.1 Could the Department provide a table
showing the latest figures on waiting times for receipt of care
packages in each social services department?
4.2 Could the Department provide a breakdown
by PCT of time taken to issue first payments of free nursing care?
4.3 Could the Department set out the Standard
Spending Assessments (SSAs) for social services in the latest
year, by local authority, and SSA sub-block, in cash, per capita,
per capita of relevant population and per client? Could the Department
also provide a table comparing the change in the total PSS SSA
between the last two years for each local authority? [5.1]
4.4 Could the Department describe any changes
to the SSA formulae introduced in this year and provide details
of any plans the Department has to review PSS SSAs further? Could
the tables include sub-totals for type of authority and averages
(so that individual authorities figures can be seen in context)?
[5.1]
4.5 Could the Department provide a table
comparing PSS SSAs with the corresponding budget for each local
authority for the latest two years for which comparable information
is available? Could the Department illustrate how the total of
PSS SSAs and budgeted expenditure in PSS have compared at the
national level over the latest five years? Could the Department
provide a commentary on any trends shown by these figures? [5.2]
4.6 Could the Department set out in a table
how the unit costs of the main social services for children and
adults have changed over time? Could the Department quantify the
degree of variation in these unit costs between authorities? Could
the Department provide a commentary on these figures? [5.3]
4.7 Could the Department provide a table
showing for each authority the latest information on the proportion
of social services for adults which are purchased from the independent
sector rather than being provided directly? Could the Department
supply a commentary on these figures? [5.4]
4.8 Could the Department provide a table,
by local authority, comparing the number of children fostered,
with the number of children placed in community homes? [5.5]
4.9 Could the Department provide data on
the number of children involved in schemes which are specifically
designed to support families? [5.5]
4.10 Could the Department provide figures
showing how the delivery of non-residential social services has
changed over the last five years and comment on these trends?
[5.6]
4.11 Could the Department provide details
of the specific inflation index calculated for social services,
and an assessment of the financial effect of demographic pressures
on social services? [5.7]
4.12 Could the Department provide a breakdown
by client group of gross expenditure for the latest available
two years on the main items of social services activity? Could
the Department also update Tables 5.8? [5.8]
4.13 Could the Department provide details
of any forthcoming changes to statistical information the Department
collects on personal social services? [5.10]
4.14 Could the Department provide details
of any research work not reported last year that is currently
being sponsored by the Department on the outcomes and effectiveness
of social care? [5.11]
4.15 Fees, charges and grants
4.15.1 Could the Department update Tables
5.12 providing separate figures on residential care for each client
group? Could the Department quantify the degree of variation in
domiciliary charges between authorities? Could the Department
provide a commentary? [5.12]
4.15.2 Could these figures be listed by
LA, including any differential rates?
4.15.3 Could the Department provide an analysis,
to include chart, tables and commentary, of (i) the recent national
trend in the percentage of gross expenditure on residential accommodation
for older people recouped through fees and charges and (ii) the
recent national trend in the percentage of gross expenditure on
home care/home help for all client groups recouped through fees
and charges? [5.12]
4.15.4 Could the Department provide an analysis,
to include chart, tables and commentary, of (i) the local authority
variations in the latest year in the percentage of gross expenditure
on residential accommodation for older people recouped through
fees and charges and (ii) the local authority variations in the
latest year in the percentage of gross expenditure on home care/home
help for all client groups recouped through fees and charges?
[5.12]
4.15.5 Could the Department supplement this
with a breakdown of proportion of patients on each social services
rate (eg £35, £70, £105) per PCT?
4.15.6 Could the Department provide details
of the volume of specific or special grants made available, by
the Department, to social services departments for the years 1997-98
to 2002-03? Could the Department provide a full explanation of
any changes, introduced this year, to the volume, the purpose
or the monitoring arrangements for any of the grants? [5.13]
5. CAPITAL EXPENDITURE
AND INVESTMENT
5.1 General
5.1.1 Could the Department provide a table
showing planned capital spending from 2001-02 to 2003-04? [4.1b]
5.2 Primary care capital investment and facilities
5.2.1 Could the Department provide an account
of capital allocations for primary care investment and the sources
of funding (both HCHS capital and revenue and Family Health Services
budgets) over the last eight years for England and by health authority?
Can they reconcile the General Medical Services budgets against
the HCHS and Family Health Services budgets? [4.3b]
5.2.2 Could the Department provide a trend
analysis of the costs of the rental reimbursement schemes (in
graphic form) by category (eg notional, actual etc) and an explanation
for any changes? [4.3c]
5.2.3 Could the Department provide an account
of the total value of the asset base in primary care by category
of owner, eg HA, LA, GP, private provider? [4.3d]
5.2.4 Could the Department provide an account
of estimates of backlog in repairs and maintenance for primary
care nationally and by health authority? [4.3e]
5.2.5 Could the Department provide baseline
data on the changing ownership of primary care premises and provide
details of the top ten new provider companies? [4.3g]
5.2.6 Could the Department please provide
data on all grants, public loans and capital receipts used to
fund or finance primary care facilities on an annual basis since
1997? [4.9a]
5.2.7 Could the Department please provide
a list of primary care premises which have signed or in the process
of signing up for the use of PFI, together with their total capital
cost, the length of contract, the annual unitary charge and availability
fee and FM fee. Where projects are bundled with non-NHS facilities,
could they also provide details of the other income streams eg
from commercial and retail, local authority? [4.9b]
5.2.8 Could the Department please provide
a full account of the revenue implications of using private finance
for all primary care schemes annually for the next ten years?
[4.9c]
5.2.9 Could the Department provide data
on practice premise size (single handed, 1-4, 4-8, 8-12, 12 plus
and average list size) by ownership category? [4.3h]
5.3 Hospital and Community Health Services
capital prioritisation
5.3.1 Could the Department list the criteria
used by the Capital Prioritisation Advisory Group in its assessment
of which projects to prioritise for major investment? Which schemes
were assessed last year, and which were prioritised for investment?
Of these, which have been allocated public and private funding?
Could the Department give examples of schemes which have been
turned down, and explain why? [4.7]
5.4 Long Term Capital Projects and PFI
5.4.1 Could the Department provide a table
showing all publicly funded capital projects with a total cost
above £10 million which are under construction during 2002-03?
Could this also show the original and current estimated completion
dates along with a percentage figure for any additional time overrun/saving?
Likewise, the original total cost and current estimated out-turn
cost should be provided along with a percentage cost performance
figure.[4.8a]
5.4.2 Could the Department provide a commentary
on cases where there are significant discrepancies between original
estimates of completion dates and/or expenditures and current
estimates? [4.8a]
5.4.3 Could the Department provide details
of PFI projects with a capital value of £10 million or over
approved since 1992, including their current status? [4.8b]
5.4.4 Could the Department provide tables
showing the planned and actual annual contribution to capital
from PFI, and the forecast level of investment generated by schemes
over £10m plus an aggregate of those below £10m, since
1997-98? What revenue or transitional support is being given to
support the scheme? Could the Department provide further details
of locally agreed arrangements to provide revenue or transitional
support to schemes? [4.8c]
5.4.5 Could the Department provide a table
showing the increases to the capital cost of schemes since the
last expenditure questionnaire and provide a commentary on changes
of more than 10 per cent? In addition, could the Department provide
the initial costs of PFI schemes at outline business case (baseline
year) for those schemes reported in last year's questionnaire
and comment on increases? [4.8d]
5.4.6 Could the Department provide data
on the revenue consequences of schemes which have reached financial
close and represent long term contractual commitment over the
next 25 years? Could the Department provide an update of the Departmental
Report table showing the source and applications of HCHS capital,
giving the outturn position for 2000-01? [4.8e]
5.4.7 For major projects (currently defined
as those greater than £25m in value), could the Department
please provide a comparison between the PFI price and the publicly
financed option. The publicly financed comparator's costings should
be broken down as follows :
— Basic construction contract, broken
down between pre-implementation and post implementation costs;
— The value of risk adjustment, again
broken down between pre-implementation and post implementation
costs, in both pounds and percentage terms, and
— The final total real full life cost
of both options. [4.8f]
5.4.8 Where adjustments have been made to
the PFI costs (to bring prices to a like for like basis), these
should be broken down on the same basis as the publicly funded
option.[4.8f]
5.4.9 Could the Department also provide
a brief commentary on any apparent differences between the reported
schemes.[4.8f]
5.4.10 Could the Department specify to us
the cost of raising finance for a PFI hospital as compared to
that of a conventionally financed hospital (for which we would
expect the NHS would be able to borrow at a lower rate than the
private sector) both before and after adjustment for risk?
5.4.11 Could the Department update the information
given in Table 4.8g on donated capital additions by region only?
[4.8g]
5.4.12 Could the Department list, by scheme,
how much has been spent on developing business cases for a sample
of schemes worth over £1 million, identifying which schemes
are publicly financed and which financed through the PFI? Where
schemes have reached completion, could the estimated development
costs be compared with actual costs? [4.8h]
5.4.13 Could the Department detail for every
NHS trust with a hospital development, whether publicly or privately
financed, worth over £25 m (i) the number of NHS beds—general
and acute—currently provided by the trust and (ii) the number
of NHS beds—general and acute—to be provided when
the development is completed? [4.8i]
5.4.14 For each PFI scheme could the Department
provide the estimates of the unitary fee and split between the
availability and facilities management fee at outline business
case (baseline year) and the actual cost of the unitary fee split
as above on signing off the FBC? Could the Department comment
on how any increases were funded? [4.8j]
5.4.15 For each PFI scheme signed or given
approval in principle, could the Department provide income and
capital charges of Trusts which make up each PFI scheme prior
to signing and income, availability fee and capital charges on
retained estate for each scheme having signed, or estimates for
those schemes which have not yet signed? [4.8k]
5.4.16 What sums of money have been raised
by PFI consortia from selling off NHS assets such as medical equipment
and furniture that were handed over to them when they took over
responsibility for hospital buildings and equipment? Were these
sums taken into account during negotiation of the contract, and
in the costings of options presented in the Full Business Cases
so far approved for major PFI schemes?
5.4.17 Could the Department provide information
on capital costs in the current year of PFI schemes which are
actually completed such as the Norfolk and Norwich Hospital and
the Worcestershire Royal Hospital, on a basis that allows comparison
with capital costs in non-PFI hospitals. We would also like any
preliminary information on bed numbers actually in use in these
schemes and revenue costs per bed.
5.5 Capital investment in social services
5.5.1 Could the Department update the figures
provided last year on the acquisition, upgrade and sale of personal
social services assets? [5.9a]
5.5.2 Could the Department comment on the
outcome for personal social services of the Capital Challenge
Pilot Fund scheme? [5.9b]
5.5.3 Could the Department provide an update
on PFI projects currently supported, or being considered by the
Departments, and state its criteria for supporting such projects?
[5.9c]
5.5.4 Could the Department compare actual
capital spend by social services departments with the funding
provided through credit approvals and capital grants? [5.9d]
5.5.5 How many social services departments
have retained social services assets but changed their use? What
have been the net gains and losses to different socials services
sectors?
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