APPENDIX H
HEALTH COMMITTEE
Memorandum to the Liaison Committee
1. The Committee first met on 18 July 2001. We
agreed to maintain the practice of our predecessor Committee in
interspersing short inquiries (1-3 evidence sessions) with more
substantial ones.
2. We also agreed to maintain the practice of
conducting an annual review of Department of Health (DoH) expenditure.
A detailed questionnaire was sent DoH on expenditure on health
and personal social services 2000-2001. The Department returned
a memorandum, which formed the basis of oral evidence from DoH
officials and the Secretary of State. We propose to review the
methodology of the expenditure questionnaire next year, to achieve
more focus whilst at the same time maintaining consistency of
data with previous surveys.
3. We agreed that our first major inquiry should
be into The Role of the Private Sector in the NHS, focusing
specifically on:
- · The NHS Concordat with the Private
and Voluntary Sectors,
- · The Private Finance Initiative and
- · Public Private Partnerships
4. We deliberately chose wide-ranging terms of
reference since we were anxious to give ourselves the flexibility
to cover fast-changing events. Such an analysis has been amply
borne out. Since we launched our inquiry the Secretary of State
has announced:
- · plans to double expenditure in the
current year on activity purchased from the private sector under
the Concordat;
- · plans to send NHS patients abroad
for treatment;
- · an agreement with BUPA hospitals to
run a surgical centre solely for NHS patients.
5. Inevitably much of the early interest in our
inquiry centred on the controversial topic of the Private Finance
Initiative. This is a highly contentious areas and much of the
oral evidence we have received represents polarized strands of
opinion. In order to get some feel for the impact of the PFI in
an acute hospital, we visited two of the first eight completed
schemes: North Durham Healthcare NHS Trust, and the Cumberland
Infirmary.
6. We broke with recent tradition in the Health
Committee by taking formal oral evidence from various parties
at the Cumberland Infirmary. We wanted to focus on an individual
PFI project to establish how the scheme impacted on the local
health economy and to gauge the reactions of clinical and non-clinical
staff, management and the consortium.
7. Benefits certainly accrued from this procedure,
not least in that it allows us to draw on the evidence in formulating
our report. At the same time we believe that at least as much
was gained from informal contacts at meetings before and
after the evidence session, in tours of the facilities and in
discussions with staff and patients. So we aim to continue the
tradition of our predecessor Committee of tapping into grass roots
opinion wherever possible.
8. Our inquiry into The Role of the Private
Sector in the NHS is drawing to a close. The Committee has
already determined its next two inquiries. First we will conduct
a short inquiry into the work of The National Institute for
Clinical Excellence (NICE). This inquiry arises out of concerns
that the decision-making processes of NICE are not always perceived
to be transparent and independent. The inquiry will also seek
to establish how effectively NICE has achieved its objectives
in delivering the goals initially envisaged for it in A First
Class Service in terms of providing clear and credible guidance,
ending confusion in prescribing and promoting clinically and cost
effective interventions.
9. Our next major inquiry will be into Delayed
Discharges, where we will have the opportunity to examine
more general issues relating to hospital capacity, alternatives
to admission and problems in intermediate care, home care and
other social service interventions.
17 January 2002
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