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Elective Surgery

Dr. Richard Taylor: To ask the Secretary of State for Health what mechanisms are in place to ensure that expenditure on elective surgery on NHS patients in the private sector is minimised, and the use of NHS services is optimised. [91502]

Mr. Hutton: Health Service Circular 2000/007, "Securing Service Delivery: Commissioning Freedoms of Primary Care Trusts", issued in April 2002, made clear that primary care trusts should feel free to commission care from wherever they can obtain the best

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services for patients. Commissioning decisions should be judged against the twin tests of high clinical standards and good value for money.

Ethical Banking

Mr. Gardiner: To ask the Secretary of State for Health what contracts have been concluded as a result of the Government's commitment to support ethical banking. [89920]

Mr. Lammy: The Government believe it is important for consumers to have choice in financial products, including the availability of 'ethical' products. However, it would not be appropriate for the Government to exclusively support the development of one specific group of financial service providers. It is for individual consumers to decide the attributes they most value from their financial services and for financial services firms to be transparent about their use of funds and investments.

External Consultants

Mr. Bercow: To ask the Secretary of State for Health what the total cost to his Department was of the use of external consultants in 2002. [90507]

Mr. Lammy: Expenditure by the Department (excluding Agencies) on external consultants in 2002 was £6,800,521.

Fitness

Tim Loughton: To ask the Secretary of State for Health what local action to tackle obesity and increase physical activity entails, as mentioned in his Department's press release of 12 December 2002, Improving the Nation's Health: Government to produce food and action plan. [89354]

Ms Blears: Local action to tackle obesity and increase physical activity is being taken forward as part of the national service framework for coronary heart disease (NSF CHD) and the NHS Plan.

Standard One of the NSF CHD required all national health service bodies to have agreed and be contributing to the delivery of a local programme of effective policies on increasing physical activity and reducing overweight and obesity, and have quantified data on the programme. Examples of local action to tackle obesity and increase physical activity include initiatives in the primary care setting such as weight management clinics, exercise referral schemes, workplace interventions, and school based projects on diet and exercise which are being taken forward through the healthy schools programme.

Together with Sport England and the Countryside Agency, the Department is developing a £2.6 million programme of local exercise action pilots to investigate effective approaches to increasing physical activity, the results of which will inform and lead action on exercise across the NHS.

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Foundation Trusts

Dr. Fox: To ask the Secretary of State for Health whether the financial duties for NHS foundation trusts will include the requirement to achieve a rate of return on assets. [87817]

Mr. Hutton: The financial duties of National Health Service foundation trusts will be set out in forthcoming legislation.

Helen Jones: To ask the Secretary of State for Health what method he will adopt to test whether local people support the establishment of a foundation trust; who will be consulted; and whether local people will be able to reject the establishment of such a trust. [91361]

Mr. Hutton: It is up to applicants for national health service foundation trust status to decide how best to consult local stakeholders ("A Guide to NHS Foundation Trusts" paragraph 7.11). Second-stage applicants will need to provide evidence that both the NHS trust board and key stakeholders—for example primary care trusts, staff, partner organisations and local people—have been consulted and support the application and the strategic vision. Each application will be assessed individually based on the evidence provided ("A Guide to NHS Foundation Trusts" paragraph 7.12).

Helen Jones: To ask the Secretary of State for Health which key shareholders he plans to consult on proposals to establish a foundation trust; by what means such consultations will be conducted; and whether organisations will be required to consult their staff before replying. [91362]

Mr. Hutton: The process for assessing national health service foundation trust applications is described in paragraph 7.12 of "A Guide to NHS Foundation Trusts". The assessment will take account of evidence provided in support of the application as set out in paragraphs 7.9–7.11 of "A Guide to NHS Foundation Trusts". In this evidence, applicants will need to show that their key local stakeholders have been consulted and support the application and strategic vision.

Helen Jones: To ask the Secretary of State for Health which representatives of partner organisations will be eligible to become members of foundation trusts; how the number of representatives from each partner organisation will be determined; and whether it will be a requirement of membership that representatives of partner organisations live in the area served by the trust. [91363]

Mr. Hutton: It will be up to individual applicants to develop proposals on the size and composition of the Board of Governors to suit local circumstances, subject to demonstrating that the proposals meet the minimum requirements as set out in "A Guide to NHS Foundation Trusts" (paragraphs 2.17–2.18).

General Practitioners

Tim Loughton: To ask the Secretary of State for Health how many general practitioner vacancies there were in each primary care trust in the last two years. [83289]

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Mr. Hutton: The information requested was not collected at primary care trust level in the last two years.

Mr. Rosindell: To ask the Secretary of State for Health what his target is for the number of general practitioners per head of population. [90297]

Mr. Hutton: The NHS Plan implemented a commitment to increase the overall number of general practitioners (GPs) by 2000 in England between 1999 and 2004. Based on the latest available statistics, the number of whole-time equivalent GPs per 100,000 weighted population is 54.5. To meet the national target entails an increase to an average 55.7 GPs per 100,000 weighted population.

We want to see GP numbers expand further. Guidance to primary care trusts (PCTs) set out three parameters within which all PCTs should be aiming to recruit additional GPs during 2003–04:

those PCTs which are below the existing average 53.2 should aim to recruit sufficient GPs to raise their GP numbers by at least 6 per cent., or to at least 55.7,with the aim of achieving at least the lesser of these aims;


those PCTs which are more than the existing average of 53.2, but below the projected average of 55.7, should aim to recruit up to 6 per cent. more GPs. In some appropriate circumstances—and where it is possible—PCTs may exceed this; and


those PCTs at or above the projected average of 55.7 should aim to recruit up to 3 per cent. more GPs. In some appropriate circumstances—and where it is possible—PCTs may exceed this.

Health and Social Services (Rural Provision)

Miss McIntosh: To ask the Secretary of State for Health what measures he is taking to ensure the delivery of (a) health care and (b) social services in sparsely populated rural areas, in particular pockets of rural deprivation; and what resources he is making available for this. [87708]

Mr. Hutton: Resources to both local National Health Service bodies and local authorities take account of variations in local circumstances, while leaving these bodies to decide the best distribution of services in response to those circumstances. A number of recent initiatives in funding allocations have recognised the need to take account of remoteness.

The NHS revenue allocations for 2003–04, 2004–05 and 2005–06 announced on 11 December were made using a new formula. The new formula provides a better measure of health need in all areas. In calculating health need in rural areas, it takes account of the effects of access, transport and poverty.

The NHS confederation is currently negotiating a new general medical services (GMS) contract with the general practitioners committee of the British Medical Association. The two sides have commissioned York University to develop a GMS allocation formula that will take account of the costs and pressures of delivering high-quality primary care in different areas, including those associated with rurality and remoteness. The current timetable envisages that this work will be completed early in the New Year, when general practitioners will be balloted on the detailed and costed framework.

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For social services funding, we will be increasing the sparsity factor in the older people's social services funding formula from 2002–03 onwards, in response to new evidence on travel effects in the provision of domiciliary care commissioned by the county councils network.

Improving access to services, especially in rural and other areas which are currently under-served, was identified as a priority in the cross-cutting spending review on health inequalities. The review also recognised that there are pockets of deprivation right across the country and that health inequalities will need to be tackled in all these areas if the national health inequalities targets are to be met. The results of the review are being fed into a cross-government delivery plan on action to tackle health inequalities and meet the targets. The delivery plan will be published in the New Year.

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