Select Committee on Liaison First Report



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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Prepared 7 February 2002