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NHS Commissioning

Mr. Andrew Smith: To ask the Secretary of State for Health (1) what steps she is taking under the reforms proposed by commissioning a patient-led NHS to provide for the employment and management of those primary care trust staff and functions which do not form part of the management and delivery of out-sourced commissioning. [18718]

(2) what guidance she plans to issue on the procedures for bidding for the provision of management and delivery of commissioning in Oxfordshire. [18719]

Mr. Byrne [holding answer 17 October 2005]: Strategic health authorities are expected to provide proposals for local commissioning arrangements to the
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Department by 15 October. A human resources framework for dealing with any subsequent organisational change will be published in due course. All proposals including staff implications will be subject to full local consultation. Once final decisions have been taken the Department will consider what guidance is needed.

NHS Deficits

Mike Penning: To ask the Secretary of State for Health what the total deficit is for all strategic health authorities, primary care trusts and other NHS trusts in England brought forward from 2004–05, broken down by (a) authority and (b) trust; and if she will make a statement. [24728]

Mr. Byrne: The national health service as a whole ended 2004–05 with an overall deficit of around £250 million, or 0.4 percent., of available resources. Information on the 2004–05 financial position of individual NHS organisations—strategic health
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authorities, primary care trusts and NHS trusts—has been placed in the Library. It is also available on the Department's website at

This information shows those NHS organisations that reported an overspend in 2004–05.

NHS Trusts (Sickness Absence)

Mike Penning: To ask the Secretary of State for Health what the rate of employee absence due to sickness at (a) Dacorum Primary Care Trust and (b) West Hertfordshire Hospital Trust has been in each year since 1997. [23024]

Ms Rosie Winterton: The table shows the sickness and absence rates for Dacorum Primary Care Trust (PCT) and West Hertfordshire Hospital Trust. The sickness and absence data goes back to 2000 and all figures between 2000 and 2004 have been included where available. There are no figures for 2000 for Dacorum PCT, which only came into being in 2001.
Sickness and absence rates for Dacorum PCT and West Hertfordshire hospitals national health service trust, 2000–04

Sickness absence rate (percentage)
Organisation name20002001200220032004
RWGWest Hertfordshire Hospitals NHS Trust4.
5GWDacorum PCT(20)

(20) The organisation did not exist in that particular year.
1. Sickness absence rate is defined as the amount of time lost through absences as a percentage of staff time available.
2. This does not cover maternity leave, carers' leave or any periods of absence agreed under family friendly/flexible working policies.
3. General practitioners and their staff are not included in the above figures. The overall England figures are estimates, as some organisations in the NHS did not provide figures for sickness absence.
NHS Health and Social Care Information Centre sickness absence surveys, 2000–2004.

PET Scanners

Mr. Todd: To ask the Secretary of State for Health how many PET scanners are operated by NHS acute trusts, broken down by location; and if she will make a statement. [24311]

Ms Rosie Winterton: There are five positron emission tomography-computed tomography (PET-CT) scanners and one PET scanner currently operated by national health service trusts.

Two PET-CT scanners are jointly owned and managed by Guy's and St. Thomas's NHS Trust and King's College London. University College London Hospital NHS Trust, the Royal Marsden NHS Foundation Trust (NHSFT), and University Hospital Birmingham NHSFT also have PET-CT scanners. The one PET scanner is at Hammersmith Hospitals NHS Trust.

On 11 October 2005, the Department published A Framework for the Development of Positron Emission Tomography (PET) Services in England". The intention of the framework is to provide guidance to commissioners and potential service providers on the development of services and to ensure that there is equitable access to scans for cancer patients across the country.

While there are a number of NHS and NHS/independent sector (IS) partnership schemes in development, it has been recognised that there is unequal access to current provision. To address this, £20 million capital funding will be made available to the NHS over two years for investment in PET-CT scanners. An additional 25,000 scans will be purchased annually over five years from the IS as part of the wider IS diagnostic procurement.


Mr. Drew: To ask the Secretary of State for Health (1) what steps are being taken to ensure that the matching of job descriptions to pay bands in podiatry is consistent throughout England; [19175]

(2) what assessment she has made of the consistency of pay banding for podiatry staff, with particular reference to new posts across different primary care trusts; what assessment she has made of the effects of differences in pay banding on recruitment; and if she will make a statement. [19176]

Mr. Byrne: A full range of national profiles has been produced, covering podiatry posts from band two through to band nine.
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A national computer-aided job evaluation system has been purchased to support organisations in applying the scheme consistently throughout England and the job evaluation group, a subgroup of the NHS Staff Council, has responsibility for production of the national profiles. This group consists of representatives from both staff and management side. Job profiles are based on current jobs in the service and profiles are subject to consultation with a wider reference group prior to being agreed for publication by the executive of the NHS Staff Council. Where a post locally does not match a national profile, local evaluation will take place based on the same national health service job evaluation scheme.

Individual NHS employers ultimately are responsible for consistency checking for their organisation based on the agreed national guidance, but this is supported by both national and strategic health authority-level processes.

Premature Births

Sandra Gidley: To ask the Secretary of State for Health (1) how many babies were born prematurely in England in each year since 1997; [23824]

(2) how many babies were born at (a) under 24 weeks, (b) 24 to 28 weeks, (c) 28 to 32 weeks and (d) 32 to 37 weeks in England in each year since 1997. [23825]

Mr. Byrne: The available information is published in table 21 of the statistical bulletin NHS Maternity Statistics, England". Figures are available for the financial years 1997–98 and 2000–01 to 2003–04. Copies of the bulletins are available in the Library and on the Department's website at

Primary Care Trusts

Mr. Dismore: To ask the Secretary of State for Health (1) what assessment she has made of the impact for patient care in Barnet of (a) a potential merger of Barnet primary care trust (PCT) into a larger PCT and (b) the removal of Barnet PCT's role in providing services; and if she will make a statement; [20572]

(2) what assessment she has made of the impact on patient services of Barnet primary care trust's co-terminosity with other public sector providers including the borough council; and if she will make a statement. [20575]

Jane Kennedy: Strategic health authorities (SHAs) have recently submitted their proposals for the re-configuration of primary care trusts (PCTs), which set out how they intend to strengthen their commissioning function. These proposals will be assessed by an independent external panel drawn from and representing a wide range of stakeholder interests. The panel will determine whether the SHA proposals meet the criteria stipulated in the document, Commissioning a Patient-Led NHS", published in July 2005. If the criteria are judged to have been met, the proposals will go forward to a three month public consultation, in which the wider impact of PCT re-configuration will be considered, including issues surrounding co-terminosity with local authorities and other local partner organisations. No decisions on the reorganisation of PCTs will be taken until this process has been completed,Similarly, no decisions on the future provision of community and primary healthcare
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services will be taken until after the White Paper on community healthcare services has been published. The White Paper will be informed by the results of the Your Health, Your Care, Your Say" listening exercise, which is currently under way. Clinical services will continue to be provided by PCTs unless and until those PCTs decide otherwise. These decisions would be driven locally, following our White Paper deliberations and will only be implemented following full local public and staff consultation.

Mike Penning: To ask the Secretary of State for Health what the cumulative deficit is for the (a) Dacorum Primary Care Trust, (b) West Hertfordshire Hospital Trust and (c) Hertfordshire and Bedfordshire Strategic Health Authority; and if she will make a statement. [23286]

Ms Rosie Winterton: The cumulative breakeven position for 2004–05 for West Hertfordshire Hospital Trust is a deficit of £14.4 million.

The term cumulative deficit does not apply to strategic health authorities (SHAs) and primary care trusts (PCTs). The 2004–05 outturn of the PCT and SHA against the revenue resource limit is shown in the table.
National health service organisation2004–05 under/(over) spend
against the revenue resource limit
(£ thousand)
Bedfordshire and Hertfordshire SHA1,976
Dacorum PCT(4,840)

2004–05 summarisation schedules.

The term cumulative deficit" does not apply to SHAs or PCTs. Therefore, there is no cumulative deficit position available for SHAs and PCTs. Therefore, the 2004–05 outturn of the SHA and the PCT against the revenue resource limit for 2004–05 has been given.

If a SHA or PCT reports a deficit position in one year, that deficit is recovered by deducting it from the resources available to it in the subsequent year. Therefore, its current performance represents its cumulative position.

If, on the other hand, a NHS trust reports a deficit, it has its income reduced in the following year. In addition to this, it has a statutory duty to make good that deficit by reporting a surplus to offset it within the following two years, or four years by exception. It is the net deficit incurred during these years that is defined as the cumulative deficit for NHS trusts.

The financial position of the NHS as a whole ended 2004–05 with an overall deficit of around £250 million. This has to be seen in relation to the overall NHS spending; it represents only around 0.4 per cent. of resources. This and the latest available data on the 2004–05 financial position for all NHS organisations—SHAs, PCTs and NHS trusts—was put in the public domain on 19 September. It was based on the 2004–05 summarisation schedules that were released to the Financial Times and made available on the Department's website.
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It is the responsibility of SHAs to deliver both overall financial balance for their local health communities and to ensure each and every body achieves financial balance. However, there is a degree of flexibility in how this is managed at a local level. In circumstances where a surplus cannot be generated in the following year, SHAs can agree a recovery plan which phases the recovery of deficits over a number of years. This would require other NHS organisations within the health economy to underspend over the same period. Any such arrangements would have to be subject to the agreement of local providers, commissioners and the managing SHA.
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Mr. Jenkins: To ask the Secretary of State for Health how much was spent on (a) administration and (b) management costs by each primary care trust in the West Midlands area, expressed (i) as a percentage of their total budget and (ii) as the cost per head of population in the areas they cover, in the last year for which figures are available. [22624]

Ms Rosie Winterton: The information requested for 2004–05, the latest available year, is shown in the table.
Administration and management costs for primary care trusts in the West Midlands area, 2004–05

Primary care trust (PCT) nameManagement costs
(£ thousands)
Management costs as a percentage of net operating costsManagement costs per weighted head of population (£)
Burntwood, Lichfield and Tamworth3,6392.528.16
Cannock Chase2,1851.718.83
Coventry Teaching7,1311.821.20
Dudley Beacon and Castle2,6762.324.10
Dudley South4,2102.022.59
East Staffordshire2,3491.921.73
Eastern Birmingham6,1922.122.21
Heart of Birmingham Teaching6,3541.818.81
North Birmingham3,1411.619.04
North Stoke4,1352.428.67
North Warwickshire5,1772.928.45
Oldbury and Smethwick2,3871.920.09
Redditch and Bromsgrove2,8471.818.11
Rowley Regis and Tipton2,0662.022.45
Shropshire County5,3901.821.41
South Birmingham4,4601.012.63
South Stoke3,0041.920.96
South Warwickshire4,6931.920.98
South Western Staffordshire2,3241.315.54
South Worcestershire3,7701.313.29
Staffordshire Moorlands2,0381.721.11
Telford and Wrekin3,4382.223.04
Walsall Teaching6,3622.122.83
Wednesbury and West Bromwich2,7142.020.37
Wolverhampton City5,5862.020.76
Wyre Forest2,2572.120.35

1. Administration costs are not identified separately, so all information given relates to management costs only.
2. Total budget' has been interpreted as net operating costs for PCTs.
3. 'West Midlands area' has been interpreted as the area covered by the Shropshire and Staffordshire, Birmingham and Black Country and West Midlands South strategic health authorities.
1. Audited summarisation schedules of the named PCTs.
2. Weighted population figures for the PCTs.

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