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 £10 million plus an aggregate of those below £10
million, 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 million (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?
5.1 General
5.1.1 Could the Department provide a table
showing planned capital spending from 2001-02 to 2003-04? [4.1b]
1. The information requested is contained
in Table 5.1.1.
Table 5.1.1
NHS CAPITAL SPENDING 2001-02 to 2003-04 (Resources)
| 2001-02
Forecast Outturn
£ million
| 2002-03
Plan
£ million
| 2003-04
Plan
£ million
|
| Government Spending | 1,745
| 2,401 | 2,898 |
| Percentage Real Terms Growth |
| 34.2 | 42.7 |
| Receipts from Land Sales | 491
| 355 | 270 |
| Percentage Real Terms Growth |
| -29.5 | -25.8
|
| PFI Investment | 724 | 567
| 942 |
| Percentage Real Terms Growth |
| -23.6 | 62.1
|
| Total | 2,960
| 3,323 | 4,110
|
| Percentage Real Terms Growth |
| 9.5 | 38.1 |
Real Terms Growth calculated using GDP deflator of 2.5%.
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]
1. The majority of funding for capital in GMS or PMS
is made available through revenue funding streams: HA revenue
allocations which includes GMS discretionary and PMS funding and
GMS non-discretionary spend. Capital related expenditure in the
discretionary element includes cost rents, improvement grants
and computer purchases and PMS funding, while the non-discretionary
element includes GMS notional rents.
2. GMS capital is allocated as revenue because HAs do
not own the assets acquired. A transfer from HCHS capital to revenue
is made each year to fund an element of the total discretionary
GMS provision.
3. The table below shows the transfers of funds made
for years 1995-96 to 2002-03. Details of transfers for earlier
years are not available.
Transfer of HCHS Capital for HA Revenue Allocations for
1995-96 to 2002-03
| 1995-96 | £23m |
| 1996-97 | £24m |
| 1997-98 | £25m |
| 1998-99 | £26m |
| 1999-2000 | £26m |
| 2000-01 | £27m |
| 2001-02 | £27m |
| 2002-03 | £28m |
5.2 Primary Care Capital Investment and Facilities
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]
1. The information is shown in Table 5.2.2 below and
in chart Figures 5.2.2(a) and 5.2.2(b) below.
Table 5.2.2.
SPEND ON GMS PREMISES (ENGLAND) 1994-95 TO 2000-2001
£m
Non-Discretionary (Non Cash-Limited)
| 1994-95 | 1995-96
| 1996-97 | 1997-98
| 1998-99 | 1999-00
| 2000-01 |
| Notional Rents | 44.2 | 48.7
| 56.4 | 68.2 | 75.9
| 85.6 | 93.6 |
| Actual rent | 21.6 | 22.5
| 23.2 | 18.2 | 24.7
| 28.2 | 18.6 |
| Actual rent—*Health centres (incl Lease and Licence payments only)
| | | | 18.1
| 20.7 | 19.8 | 37.5
|
| Rates/water/sewage | 40.0 |
44.2 | 52.0 | 56.9
| 63.6 | 68.1 | 71.8
|
| *Health centre Rates/water/sewage |
| | | 7.1 |
8.1 | 7.1 | 5.7 |
Ongoing rental on vacated premises,
SFA para 55
| | | |
| 0.1 | 4.0 | 0.0
|
| Non Discretionary Premises total |
105.8 | 115.4 | 131.6
| 168.5 | 193.1 |
212.8 | 227.2 |
| Discretionary (Cash-Limited) |
| | | |
| | |
| Cost Rents & LA Economic Rents | 90.8
| 94.5 | 96.4 | 96.3
| 98.2 | 88.9 | 85.6
|
| Improvement grants | 37.2 |
41.3 | 28.8 | 20.3
| 22.2 | 16.9 | 16.9
|
| Improvement grants *(for Health centres) |
| | | 7.1
| 5.6 | 2.9 | 4.5
|
Grants to surrender leases on poor premises
under SFA para 55
| | | |
| 0.2 | 0.0 | 0.0
|
| Discretionary Premises total | 128.0
| 135.8 | 125.2 |
123.7 | 126.2 | 108.7
| 107.0 |
Notes to table
(i) Non Discretionary: non cash-limited
* Please note that from 1997-98 Actual rents was split to
additionally show introduction of Health Centre rents incurred.
* Health centre rates were created in 1997-98 to identify
costs incurred.
(ii) Discretionary: cash limited
Again with the introduction of monitoring Health centre spend
from 1997-98—Improvement Grants have been split to separately
identify Health Centre spend.
(iii) Please note that 2000-01 information is based on provisional
FIS discretionary and non-discretionary outturn.
(iv) All data is unaudited and is based on FIS(FHS)4 part
B and part C non cash limited and cash limited returns respectively.
(v) Data up to 1995-96 is based on the returns of the former
90 FHSAs up to 1996, the 100 England HAs and PCTs from 2000-01.
Data from 1996 onwards is based on HA returns.
(vi) Data on PMS premises is not collected centrally.
5.2 Primary Care Capital Investment and Facilities
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]
1. The total value of premises occupied by GPs is around
£2.35billion. This comprises £1.79billion owner-occupied
premises, £18.6million rented from the private sector and
£37.5million for NHS-owned health centres.
5.2 Primary Care Capital Investment and Facilities
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]
1. Financial data on the value of backlog repair and
maintenance for the GP estate is not held centrally. However,
from a total of around 11,000 premises, analysis of a sample of
3,912 rented (excluding health centres) and notional rented premises
showed the following:
5.2 Primary Care Capital Investment and Facilities
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]
1. The ratios for GP premises are 63 per cent owner-occupied,
21 per cent private sector owned and 16 per cent occupying NHS-owned
health centres. To date, premises built by third party developers
have mainly replaced existing premises already rented in the private
sector. It is expected therefore that the above ratios currently
remain constant.
2. The leasing of purpose built premises to GPs is still
a relatively new concept involving an increasing number of developers
with varying numbers of completed projects. A "top ten"
list of companies is not yet feasible in this maturing sector
of the GP estate. However, the Department has issued standards
of size, design, construction and lease terms that all third party
developers should give regard when building premises suitable
for modern primary care.
5.2 Primary Care Capital Investment and Facilities
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]
1. Details of the transfer of HCHS capital for HA revenue
allocations to fund primary care investment are provided at question
5.2.1. Public loans and capital receipts form part of the overall
financing of the Department of Health capital programme and are
not specifically directed at individual schemes.
5.2 Primary Care Capital Investment and Facilities
5.2.7 Could the department please provide a list of primary
care premises which have signed or are 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]
1. PFI is not currently used for the provision of primary
care premises in the NHS.
2. NHS LIFT is a new form of public-private partnership
which aims to develop new primary care facilities. Forty-two schemes
are currently being developed under the NHS LIFT initiative.
5.2 Primary Care Capital Investment and Facilities
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 10 years. [4.9c]
1. All current support takes place under existing rental
reimbursement schemes (eg notional, actual). Information on the
costs and trends is given in the answer to question 5.2.2.
2. The revenue costs and future revenue implications
of NHS LIFT schemes can be provided in future years to the Health
Select Committee when contracts have been signed under this initiative.
5.2 Primary Care Capital Investment and Facilities
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]
1. This information is not held centrally.
| 
