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NHS Direct

Dr. Fox: To ask the Secretary of State for Health what the cost has been of NHS Direct. [127379]

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Ms Rosie Winterton: Since March 1998, NHS Direct sites have been funded from a top-sliced central budget. The total costs of the service since 1998–99 are given in the table.

	Total cost (£ million)
1998–99	14
1999–2000	55
2000–01	90.1
2001–02	109.7
2002–03	124

Tim Loughton: To ask the Secretary of State for Health what the cost is per call to NHS Direct. [127556]

Ms Rosie Winterton: The average cost of a call to NHS Direct is currently about £18.00, although this is expected to fall further in the future as call volumes rise. The National Audit Office has found that half of callers are directed to forms of care they would not have chosen and that this tends to be care of a lower level and cost of intervention. More than half of NHS Direct costs are saved in this way.

Tim Loughton: To ask the Secretary of State for Health how many qualified nurses work for NHS Direct, broken down by grade. [127557]

Ms Rosie Winterton: There are approximately 1,100 whole-time equivalent nurses working for NHS Direct. Specific information about NHS Direct nurses broken down by grade is not collected centrally.

Tim Loughton: To ask the Secretary of State for Health how many calls were made to NHS Direct in each year since it was set up. [127568]

Ms Rosie Winterton: The table shows how many calls have been made to NHS Direct since its launch in March 1998.

Financial year	Total calls handled	Cumulative total calls
1998–99	110,000	110,000
1999–2000	1,650,000	1,760,000
2000–01	3,420,000	5,180,000
2001–02	5,213,062	10,393,062
2002–03	6,318,844	16,711,906
2003-July 2004	1,653,344	18,365,250

Tim Loughton: To ask the Secretary of State for Health how many different callers have used NHS Direct in each year since it was set up. [127569]

Ms Rosie Winterton: NHS Direct has handled over 18 million calls since the service was launched in March 1998, and NHS Direct Online has had over 8 million visitors. Specific information is not available on how many different callers have used NHS Direct each year since the service was set up.

Chris Grayling: To ask the Secretary of State for Health how many (a) nurses and (b) managers are employed by NHS Direct. [127637]

Ms Rosie Winterton: Currently all NHS Direct members of staff are employed by their host organisation trust. NHS Direct employs approximately 1,100 whole-time equivalent nurses across the 22 NHS

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Direct sites. Specific information about the number of managers employed by NHS Direct is not collected centrally.

Chris Grayling: To ask the Secretary of State for Health what the budgeted cost of NHS Direct in financial year 2003–04 is. [127638]

Ms Rosie Winterton: The total budgeted cost for the NHS Direct telephone service, NHS Direct Online, and other related services for the financial year 2003–04 is £124 million.

Chris Grayling: To ask the Secretary of State for Health from how many sites NHS Direct operates; and how many staff are employed at each site. [127639]

Ms Rosie Winterton: Specific information on how many staff are employed at each of the 22 NHS Direct sites is not collected centrally. The following table outlines the number of nurses and call handlers based at each site.

	Staff in post FTE
Sites	Nurses	Call handlers	Total FTE
1. Anglia	38.63	15.22	53.85
2. Avon	47.53	29.43	76.96
3. Bedfordshire and Hertfordshire	47.80	23.17	70.97
4. East Midlands	70.80	36.21	107.01
5. Essex	50.03	24.95	74.98
6. Hampshire	56.31	15.60	71.91
7. Kent, Surrey and Sussex	64.83	28.70	93.53
8. Manchester	87.35	41.40	128.75
9. Midlandshires	55.26	33.72	88.98
10. North and Central London	22.68	12.94	35.62
11. North East	56.76	28.00	84.76
12. North East London	23.20	16.70	39.90
13. North West Coast	76.51	18.48	94.99
14. South East London	36.58	23.39	59.97
15. South West London	25.60	12.60	38.20
16. South Yorkshire	39.63	26.80	66.43
17. TENYAS	34.70	13.10	47.80
18. Thames Valley	46.50	15.20	61.70
19. West County	59.27	29.80	89.07
20. West London	38.70	22.60	61.30
21. West Midlands	50.47	24.96	75.43
22. West Yorkshire	52.93	24.45	77.38
Total	1,082.07	517.42	1,599.49

Chris Grayling: To ask the Secretary of State for Health what percentage of calls to NHS Direct result in (a) no further action being taken by the caller, (b) the caller being advised to contact their GP, (c) the caller being advised to attend an accident and emergency department and (d) an ambulance being summoned to the caller's location. [127642]

Ms Rosie Winterton: 45 per cent. of calls to NHS Direct result in no onward referral to another service, 35 per cent. of callers are advised to contact their general practitioner, 7 per cent. of callers are advised to attend an accident and emergency department, and 3 per cent. of callers required an ambulance dispatching to the caller's location.

Source:

NHS direct data April 2003-June 2003.

Chris Grayling: To ask the Secretary of State for Health how many people are employed by NHS Direct, broken down by (a) grade and (b) salary. [127636]

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Ms Rosie Winterton: Currently, all NHS Direct members of staff are employed by their host organisation trust. Specific information about the number of people employed by NHS Direct, broken down by grade and salary is not collected centrally. Approximately 3,000 members of staff are employed by NHS Direct.

NHS Fraud/Inefficiency

Mr. Burns: To ask the Secretary of State for Health what measures his Department is taking to reduce the levels of (a) financial waste, (b) fraud and (c) inefficiency in the NHS; and what progress has been made over the last 12 months. [127492]

Mr. Hutton: The Department of Health monitors and manages the performance of the national health service in the delivery of the key targets set out in the NHS Plan. In addition, the NHS is subject to external independent audit by the Audit Commission and the National Audit Office. They publish a number of studies each year on the value for money of aspects of the NHS. The Department of Health considers each of these reports, and implements their recommendations where appropriate.

The Counter Fraud Service, now Counter Fraud and Security Management Service (CFSMS), was formed in September 1998, with a remit to tackle fraud and corruption within the NHS. It established a risk measurement programme to carry out an exhaustive examination of valid samples of cases in each area of NHS spending and to produce statistically robust estimates of fraud accurate to plus or minus 1 per cent. of losses. These exercises are among the first of such exercises to be undertaken anywhere in the public or private sectors.

The first measurement exercise concentrated on patient fraud. To deter and prevent patient evasion of NHS charges and to increase the anti-fraud culture, point of dispensing and point of treatment checks were introduced. These checks require patients to provide proof of exemption to charges. The measurement exercises have already demonstrated a reduction in fraudulently claimed exemption to these charges from approximately £170 million to £109.17 million per year, a reduction of 36 per cent. since 1998.

Over 1,400 cases of potential fraud have been detected and investigated. This has resulted in 160 successful criminal prosecutions with 98 per cent. success rate, 215 civil and disciplinary sanctions have been applied and over £14 million recovered. Additionally, over £31 million of fraud has been identified and stopped.

As action takes place to counter fraud in the NHS the measurement process will be repeated to demonstrate what progress has been made to reduce fraud to an absolute minimum.

In addition, governance arrangements have been improved to ensure the necessary standards of accountability, probity and openness through the introduction in 1999 of the Controls Assurance Standards.

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NHS Finance

Dr. Fox: To ask the Secretary of State for Health if he will make a statement on the balance of income and expenditure of health authorities and the NHS trusts in England for the financial year ending 31 March. [127354]

Mr. Hutton: The audited information in respect of the 2002–03 financial position of all national health service organisations will be published in their individual annual accounts and will be available locally in September and centrally in the autumn.

Dr. Fox: To ask the Secretary of State for Health whether he is planning to meet the chairmen of NHS trusts to discuss administrative costs. [127360]

Mr. Hutton: My right hon. Friend will meet chairs of national health service trusts on 9 September; a wide range of issues will be discussed.

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