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8 Feb 2006 : Column 1316W—continued

National Carers Grant

Anne Snelgrove: To ask the Secretary of State for Health what plans she has to maintain the National Carers Grant after 2008. [47544]

Mr. Byrne: The comprehensive spending review (CSR) 2007 will set the Government's priorities for the longer term. It will examine what has already been achieved and should identify what further steps must now be taken, by undertaking a zero-based review of baseline expenditure.

The National Carers Grant, along with other Department adult's social care specific grants, will be examined as part of the CSR 2007.

CSR 2007 will cover the period between 2008 and 2011.

NHS Chemotherapy Budget

Mr. Baron: To ask the Secretary of State for Health what the total NHS chemotherapy budget was in each of the last five years. [42474]

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Ms Rosie Winterton [holding answer 16 January 2006]: This information is not held centrally. It is for individual primary care trusts to decide and allocate funding for chemotherapy in their area.

NHS Finance

David Wright: To ask the Secretary of State for Health what the projected financial out-turn for 2005–06 is for each of the NHS trusts in the West Midlands Government Office area. [44406]

Mr. Byrne: The information requested on the financial outturn for 2005–06 for each of the national health service trusts in the West Midlands Government Office is provided in the table.

The forecast outturn position for 2005–06, as submitted by NHS organisations at the mid-year point (month six), is available in the Library. Copies of this information is also available on the Department's website at:

West Midlands government office area: NHS Trusts forecast outturn surplus/(deficit) as at month 6 2005–06

NHS Trust Name£000
Birmingham and Solihull Mental Health NHS Trust0
Birmingham Children's Hospital NHS Trust0
Birmingham Women's Health Care NHS Trust0
Burton Hospitals NHS Trust(1,200)
Coventry and Warwickshire Ambulance Service NHS Trust0
Dudley Group of Hospitals NHS Trust0
George Eliot Hospital NHS Trust(5,359)
Good Hope Hospital NHS Trust(4,500)
Hereford and Worcester Ambulance NHS Trust0
Hereford Hospitals NHS Trust0
Mid Staffordshire Gen Hospitals NHS Trust0
North Staffs Combined HC NHS Trust0
Rob Jones and A Hunt Orthopaedic NHS Trust0
Royal Orthopaedic Hospital NHS Trust0
Royal Wolverhampton Hospital NHS Trust(10,146)
Sandwell and West Birmingham Hosps NHS Trust(5,100)
Sandwell MH Social Care NHS Trust0
Shrewsbury and Telford Hospital NHS Trust(10,000)
South Staffordshire Healthcare NHS Trust0
South Warwickshire Gen Hosps NHS Trust(1,851)
Staffordshire Ambulance Service NHS Trust0
Univ Hosps Coventry and Warwickshire NHS Trust0
University Hospital of North Staffordshire Hospital NHS Trust(18,147)
Walsall Hospitals NHS Trust0
West Midlands Ambulance NHS Trust(1,100)
Worcestershire Acute Hospitals NHS Trust(3,794)
Worcestershire MH Partnership NHS Trust0

These figures exclude foundation trusts.

Mr. Lansley: To ask the Secretary of State for Health whether slipping payment on pay-as-you-earn and national insurance contributions, as mentioned in her interview with the Health Service Journal on 19 January, is a method sanctioned by her Department for controlling deficits in NHS organisations; what discussions she has had with (a) strategic health authorities and (b) other NHS organisations regarding delaying payment; what the content of these discussions was; and if she will make a statement. [45518]

Mr. Byrne: The Department's policy is that all national health service organisations should ensure that payments of pay-as-you-earn tax and national insurance contributions are made when they are due, or
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by the date agreed with the Inland Revenue. The issue has been discussed with all strategic health authorities and they have been reminded of the Department's policy. Where it has come to our attention that organisations are making specific proposals to delay payment, we have reminded them of the policy.

NHS Finance

Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 8 December 2005, Official Report, column 1575W, on NHS finance, what the end-of-year financial position of the NHS in total was in each year since 1997–98. [41958]

Mr. Byrne [holding answer 12 January 2006]: The year-end financial position of all national health service organisations, including NHS trusts, primary care trusts and strategic health authorities, is shown in the table for the period 1997–98 to 2004–05. In the year immediately before this period the deficit was £460 million.
Total Net (Deficit)/Surplus (£ million)

The 2004–05 figures include foundation trusts.

Steve Webb: To ask the Secretary of State for Health pursuant to her written statement of 1 December 2005, Official Report, column 37WS, on NHS finance data, if she will place in the Library a copy of the latest in-year financial forecasts for each NHS trust, primary care trust and strategic health authority for 2005–06. [46859]

Mr. Byrne [holding answer 30 January 2006]: The forecast outturn position for 2005–06, as submitted by national health service organisations (strategic health authorities, primary care trusts and NHS trusts) at the mid-year point (month six), is available in the Library and is also available on the Department's website at:

Mr. Ancram: To ask the Secretary of State for Health (1) what the current overall national financial deficit of the NHS is; what the deficit is of each (a) strategic health authority and (b) primary care trust which has one; and what percentage of debt is (i) historical and (ii) recurring in each case; [42690]

(2) what account she has taken of the unexpected costs incurred by primary care trusts in implementing the Government's required changes to GP contracts and out of hour services in assessing the overall national NHS deficit; and if she will make a statement; [42698]

(3) what guidance she has issued to primary care trusts in the priority they should give to (a) repayment of debt and (b) delivery of services; [42699]
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(4) what assessment she has made of the effects of (a) short-term financial pressures on primary care trusts (PCTs) and (b) Government requirements on PCTs to address financial deficits on (i) patients and (ii) healthcare services; and if she will make a statement; [42700]

(5) to what timescale a primary care trust in a financially balanced recurrent expenditure position but with an accrued historic budget deficit is required to repay that historic element. [42723]

Jane Kennedy: The net deficit for 2004–05 across the national health service was £256 million, which includes the financial outturn of NHS Foundation Trusts (NHSFTs). The forecast outturn position for 2005–06, as submitted by NHS organisations at the mid-year point, is a net deficit of around £620 million, excluding NHSFTs. The 2004–05 financial position and the 2005–06 forecast month six position for NHS organisations, excluding foundation trusts is available on the Department's website at: /PublicationsPolicyAndGuidance/PublicationsPolicyAnd GuidanceArticle/fs/en?CONTENT_ID=4119175&chk= JuzTDZ.

Overspending and underspending by NHS bodies is carried into the following year, as part of the carry forward regime. This is operated by the Department at strategic health authority level (SHA), and SHAs have the authority to determine how the regime operates for organisations within their health economy. For this reason we do not know how much of the carry forward was applied to individual organisations, so it is not possible to distinguish between historical and recurring deficits for primary care trusts (PCTs) and SHAs. For the purposes of comparison, the turnover and financial position for all SHAs and PCTs for each of the last two years, 2003–04 and 2004–05 has been placed in the Library.

All NHS Trusts and PCTs should break even every year. Where an organisation has a historic deficit, the SHA can provide financial support to the organisations to allow them more time to break even whilst the recovery plan is implemented. SHAs have the responsibility for ensuring the organisations across its area are in financial balance every year, so to provide planned support to one organisation requires 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.

All NHS organisations have minimum standards of quality they must deliver, including targets for maximum waiting times. These are dramatically better than the standards of the NHS in the past and there can be no trade-off between these quality standards and removing deficits. All areas of the country have seen dramatic improvements in care, and all areas of the country will continue to see improvements. Going further in a specific hospital cannot be achieved if it is
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unaffordable. This would, in effect, be one part of the NHS spending the money of another part of the NHS to deliver a better service, which is unfair on the other parts of the country.

The Department allocated PCTs £4.5 billion through primary medical services (PMEDS) funding arrangements in 2005–06, contributing towards the implementation of new general medical services (GMS) contract arrangements including out of hours and quality outcome framework (QOF) services for both GMS and personal medical services.

The latest available data, which are still being validated, is for 2004–05. This data indicates that PCTs are having to manage overspends on allocations around the quality outcome framework (£200 million) and out of hours (£100 million). This has been offset by lower than expecting growth in other areas, such as hospital elective activity and prescribing expenditure.

The NHS has received record increases in funding, and the majority of PCTs are delivering improved services as well as living within their budget. Where organisations are failing to do this it is due to poor management, so there is no need to sacrifice the delivery of the required standards and targets to deliver financial balance.

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