Select Committee on Health Memoranda

5.  Capital Expenditure And Investment (continued)

  5.3.7  Could the Department provide an update of Table 5.3.7, specifying the cost of the unitary fee for PFI hospitals above that negotiated in the original contract? [5.3.7]

  1.  The information requested is provided in Table 5.3.7.

Table 5.3.7

INCREASE IN UNITARY FEE

A	B	C	D	E
Trust	Unitary fee at FC £000	Revised Unitary Fee £000	% change	Reason
Norfolk and Norwich	28,401	29,238	2.9	Variations for provision of additional 144 beds; other variations including additional renal and cardiology facilities. In 2003-04 a refinancing of original deal led to a £1 million reduction to the Unitary payments for a 30 year period.
Luton and Dunstable	1,021	1,139	11.6	Provision of an additional ward
Greenwich Healthcare	18,620	19,073	2.4	Unitary payment uplifted to 2003-04 prices. Last years real terms increase due to Maintenance requirements of conference centre and IT. This year the Unitary Payment has increased for introduction of Better Hospital Food, Increased laundry volumes, increased cleaning and MRSA control, increased clinical waste volumes and portering changes.
St George's Healthcare	7,327	7,629	4.1	Last year's increase was due to an additional cardiac theatre, 12 cardiac beds, hot laboratory and additional ITU pendants reported in 2003-04. For this year an additional 126k per annum variation for ward hostess service is included.
West Middlesex University Hospital	9,700	10,500	8.2	Variations relating to new areas and charges for other areas receiving more usage than designed in the contract. In the first year of the scheme, other variable costs were incurred not identified in original unitary charge calculation.
Northumbria Healthcare	3,706	3,779	2.0	Variation to add a small residences block.
Worcestershire Acute Hospitals	19,399	22,280	14.85	Additional services extended to Newtown Site, Additional Equipment and other design and building changes required by the Trust.
University Hospitals Coventry and Warwickshire	50,211	53,926	7.40	In this first negotiation of the new Retention of Employment (ROE) model, trust accepted risk that Whitley pay rises would exceed RPI.
Hereford Hospitals	9,690	9,803	1.17	Additional services and upgrade costs required by the Trust.
South Manchester University Hospital Trust	19,754	21,697	9.84	Increased maintenance costs for the non-PFI estate. Increased number of wards and patient numbers leading to increased portering and catering requirements across the site and triggering volume payments for these services.

5.4  Capital investment in social services

  5.4.1  Could the Department update the figures provided last year on the acquisition, upgrade and sale of personal social services assets? [5.4.1]

  1.  The information requested is provided in Table 5.4.1

Table 5.4.1

LOCAL AUTHORITY PERSONAL SOCIAL SERVICES CAPITAL EXPENDITURE AND INCOME 2000-01 TO 2003-04

				£ million
	2000-01	2001-02	2002-03	2003-04 provisional
Maintenance	12.3	12.5
New acquisitions	143.7	145.5
TOTAL SPEND	156.0	158.0	199.3	263.0
Sale of buildings	49.6	64.5
Sale of equipment	12.4	5.5
TOTAL SALES	62.0	70.0	75.0	89.0
NET SPEND	94.0	88.0	124.3	174.0

1.  Figures may not sum due to rounding.

2.  From 2002-03 the breakdown between maintenance and new acquisitions and the sale of buildings and equipment is no longer available.

3.  Figures include children's services.

  5.4.2  Could the Department provide an update on PFI projects currently supported, or being considered by the Departments? [5.4.2]

  1.  The Department's criteria for supporting PFI projects remain broadly unchanged: the Department is seeking to support innovative approaches to problems associated with social exclusion. This can apply to any social services client group such as older people, people with learning disabilities and people with mental health needs. With the move of children's services to DfES, accompanied by £20m of PSS PFI funding, it is expected that DfES will provide PFI credits for children's services in future. The Department sponsors projects that are part of long term strategic service planning, that provide evidence of value for money and of flexibility.

  2.  The following PFI projects have been approved to date:

Coventry	New Homes for Older People
Dudley	Health and Social Care Centre
Ealing	Resource Centres for Older People
Enfield	Resource Centre for Older People with Cognitive Impairment
Greenwich	Neighbourhood Resource Centres for Older People
Hammersmith and Fulham	Nursing Care and Extra Care Housing for Older People
Harrow	Care Services for Older People
Harrow	Mixed Services for People with Learning Disability and Mental Health needs
Hertfordshire	Children's Homes Project
Kent	Integrated Health and Social Care Services
Kent	Integrated Health and Social Care Services
Northampton	Specialist Care Services for Older People with
	Dementia
Portsmouth	Mixed Services for People with Learning Disabilities
Richmond	Care Services for Older People
Shropshire	Community Services for people with Learning Disabilities and Older People including a Joint Service Centre
Staffordshire	Children's Small Homes
Surrey	Services for Older People
Westminster	Resource Centre for Older People

  3.  Croydon County Council's Outline Business Case for an older people's scheme is currently progressing through approvals. Schemes expected to submit soon are: Leeds (Learning Disabilities); and Sheffield (Intermediate Care).

  4.  Social Services PFI continues to increase, including for people with learning disabilities and people with mental health needs. The demand for services for older people remains the highest. Generally, much of the demand is in response to Local Authorities' long-term strategic planning and Best Value reviews of their current provision of care services for social services client groups, for example, residential and nursing care for older people. Social Services' joint working with health is well established, with some developing partnerships with other key services such as housing, where the Department of Health works with ODPM. And links are developing with NHS LIFT schemes (Local Investment Finance Trusts, for capital investment in primary care building stock), particularly in Sheffield where the PSS scheme is joint with the local LIFT.

  5.4.3  Could the Department compare actual capital spend by social services departments with the funding provided through credit approvals and capital grants? [5.5.4]

  1.  Table 5.4.3  compares total actual capital spend by social services departments with the funding provided by the Department through supported capital expenditure. The table shows that capital support provided by the Department is only one source of capital for Local Authorities. Local Authorities can fund their capital requirements in other ways, through capital receipts, joint funding, EC funding and through the Private Finance Initiative. Additional capital support is also provided by the Department for Education and Skills which took over responsibility for children's social services from 1 April 2003.

Table 5.4.3

LOCAL AUTHORITY PERSONAL SOCIAL SERVICES CAPITAL EXPENDITURE, DEPARTMENTAL SUPPORTED CAPITAL EXPENDITURE 2000-01 TO 2003-04

				£ million
	2000-01	2001-02	2002-03	2003-04 provisional
TOTAL SPEND	156.0	158.0	199.3	263.0
Capital grants	8.2	9.3	40.7	25.0
Credit approvals/supported capital expenditure (revenue)	55.7	55.7	55.7	50.2
TOTAL PROVISION	63.9	65.0	96.5	75.2

1.  Figures may not sum due to rounding

2.  Figures include children's services up to 2002-03

3.  Credit approvals were abolished on 31 March 2004

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Prepared 21 February 2005