Letter from the Parliamentary Clerk, Department
of Health, to the Clerk of the Committee
HEALTH SELECT COMMITTEE PUBLIC EXPENDITURE
INQUIRY 2003 FOLLOW-UP INFORMATION (PE 2)
Further to the Health Select Committee hearing
on 16 October the Department agreed to provide the Committee with
additional information.
This letter sets out the Department's response
to the requests below. For ease I have laid out the requests for
additional information that were raised by the committee followed
by a paper with the response to each of these.
The Committee requested the following additional
information:
1. To clarify for the Committee whether or
not PCTs have PALS, the total number of PALS as well as the amount
of money per PALS scheme?
2. What is the average length (and number)
of suspension for doctors who are suspended over six months?
3. When exactly is the Government's comparison
between private and NHS costs for surgical procedures going to
be published?
Is any information available on the number
of NHS patients who are treated in the private sector by the same
consultants who would otherwise have treated them in the NHS?
4. Can the Department provide figures for
projected redundancy costs associated with the reorganisation
of CHI, NCSC and any other relevant bodies to CHAI?
Can the Committee have more detailed information
about the circumstances under which the outgoing Chief Executive
of North Bristol NHS Trust was paid £78,000?
5. The Committee would welcome a note detailing
the new structures surrounding the reforms of PSS.
The responses to these requests are contained
in the paper attached.
Please let me know if I can be of any further
assistance.
28 October 2003
1. PATIENT ADVICE
AND LIAISON
SERVICE (PALS)
To clarify for the Committee whether or not PCTs
have PALS, the total number of PALS as well as the amount of money
per PALS scheme?
Numbers
The Department of Health set the overall direction
for the NHS in England to establish a Patient Advice and Liaison
Service (PALS) in every NHS trust and PCT by April 2002, together
with national standards for the delivery of a high quality service.
Strategic Health Authorities (SHAs) hold the NHS trusts and PCTs
to account for the service they deliver and how they deliver it.
In February 2003, SHAs reported to the Department
that 98% of NHS trusts and PCTs had active PALS in operation.
This meant that, of the then 575 trusts, 560 could provide patients
with PALS support. A list of NHS Trusts and PCTs with PALS is
on the Department's website, which is regularly reviewed.
To assist the Committee, SHAs have now established
that, of the 15 NHS trusts and PCTs that did not have an active
PALS at the time of the last report, 14 now have PALS in place.
The remaining trust currently provides a limited service. This
is expected to be fully operational by the end of December 2003
and the SHA is discussing with trust management how they can ensure
full coverage in the interim.
NHS trusts and PCTs have set up PALS in ways
that they consider best meet the needs of their local communities.
For example, some have established their own individual service,
while others have collaborated to provide the service across one
or more trusts. The Department is in the process of commissioning
a national evaluation of PALS, which will report its initial findings
in 2004.
We understand that Dr Taylor drew his figure
of 270 PALS from the Health Select Committee House of Commons
briefing which inaccurately stated PALS were available in 98%
of NHS Trusts. This should have read 98% of trusts (ie NHS Trusts
and Primary Care Trusts).
Costs
NHS trusts and PCTs are responsible for establishing
and funding PALS.
£10 million new money was made available
for PALS from April 2001. The money was managed centrally in 2001
to fund the Pathfinder, or early implementor PALS.
Main stream implementation was from April 2002
when the £10 million was added to the baseline allocation
for distribution via HAs/PCTs with the expectation that additional
funding would provided locally.
We do not gather data on the amount trusts allocate
to PALS, but estimate PALS funding to be in the region of £23-24
million for 2002-03.
2. SUSPENDED
DOCTORS
What is the average length (and number) of suspension
for doctors who are suspended over six months?
The average length of suspension in Q2 report
of 2003 is 18.8 months.
There are currently 26 hospital doctors and
community dentists suspended for more than six months.
3. CONCORDAT
When exactly is the Government's comparison between
private and NHS costs for surgical procedures going to be published?
We have collected, for the first time this year,
data from NHS organisations relating to activity sub-contracted
to and/or commissioned from non-NHS providers. This data is scheduled
to be released during November, subject to ministerial approval,
in aggregated format only.
Is any information available on the number of
NHS patients who are treated in the private sector by the same
consultants who would otherwise have treated them in the NHS?
No, there is no mechanism for collecting this
information centrally.
4. REDUNDANCY
COSTS
Can the Department provide figures for projected
redundancy costs associated with the reorganisation of CHI, NCSC
and any other relevant bodies to CHAI?
CHAI have not yet finalised their organisational
structure and as such no decision has been made on their final
staffing needs.
Can the Committee have more detailed information
about the circumstances under which the outgoing Chief Executive
of North Bristol NHS Trust was paid £78,000?
Severance Payments made to Mr Tony Woolgar
During December 2002, agreement between the
Trust and the Chief Executive, Mr Tony Woolgar was reached in
respect of the mutual decision that Mr Woolgar would resign from
his employment.
A payment was made to Mr Woolgar upon his resignation,
the total value of which was £70,961 (gross), the net value
of this to Mr Woolgar following deductions for tax/national insurance
etc was £54,576.60.
This payment was made in accordance with Mr
Woolgar's contract of employment and reflected the length of notice
required to terminate the contract, ie six months. The payment
was made having taken into account legal advice received by the
Trust, and reflected an agreement by Mr Woolgar not to pursue
any claims against the Trust at Employment Tribunal relating to
his employment . This payment was considered by the Remuneration
Committee in line with its Terms of Reference, and was approved
in December of last year.
The reference to £78,000 is taken to refer
to the amount disclosed in the Trust's annual report which took
into account other benefits in kind which Mr Woolgar had received
during the 2002-03 financial year, but which were not directly
related to the severance payment.
Within this amount therefore are considerations
in respect of a lease car (£2,243) and relocation expenses
(£6,808).
5. PERSONAL SOCIAL
SERVICES
The Committee would welcome a note detailing the
new structures surrounding the reforms of PSS
The Department of Health's change programme
is at the forefront of reform in Government, aiming to deliver
improving public services. It is doing this by re-focusing its
role on leadership to an integrated health and social care system.
The Department will do less direct work on performance management,
with other bodies taking on these key roles.
The Department will instead concentrate on:
— Setting overall direction and leading
transformation of the NHS and social care system.
— Setting national standards to enhance
quality.
— Holding the system to account.
— Securing resources and making major
investment decisions to ensure that the NHS and social care have
the capacity to deliver.
— Better understanding the whole health
and social care system, and ensuring our policies reflect this.
— Enabling wider choice and encouraging
a more diverse range of suppliers.
— Improving our service to Ministers.
— Working with key partners to ensure
quality of services.
— Applying the resources we have in
the Department flexibly to ensure that hot spots are properly
managed and dealt with.
— Improving programme and project management
and the rigour with which we develop policy and ensure delivery.
— Taking joined-up government action
on health improvement and inequalities.
Three Groups replaced the former 14 directorates
in July. Each group is integrating their responsibility for health
and social care to ensure the Department develops a whole systems
approach to its work and relationships with stakeholders.
To drive this whole systems approach a number
of key recommendations are being adopted from the change proposals.
These are:
— The Department will appoint a new
National Director of Social Care. Based in the Strategy Directorate,
the director will be responsible for strengthening relationships
with local government and social care and ensuring whole systems
thinking is embedded in policy thinking.
— Including non-executives on the Department's
Management Board from local government, and the private sector.
This would bring in experience of whole system working and recognise
the key role of local government in whole systems delivery.
— Board to Board meetings with other
key delivery departments, such as the Office of the Deputy Prime
Minister. Bringing together shared agendas and exploiting the
opportunities for joint working across the wider whole system.
— In the new Workforce directorate,
part of the Delivery Group, health and social care responsibilities
are integrated in one business unit, where flexible working on
portfolios will be prevalent.
— Proposals to group stakeholders in
managed networks to be piloted. These would establish new high
level capability to handle relationships in order to provide a
clear strategic lead to the whole system, with networks across
health and social care. For example a network such as Standard
Setting would include Social Care Institute of Excellence and
National Institute of Clinical Excellence.
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