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27 Feb 2006 : Column 438W—continued

Elderly Care Provision

Anne Main: To ask the Secretary of State for Health if she will take steps to introduce a minimum standard for food and nutrition for all nursing and residential homes for the elderly. [48355]

Mr. Byrne: Food and nutrition is extensively covered in the existing Care Homes for Older People—National Minimum Standards", a copy of which is available in the Library. The national minimum standards, which homes must meet in order to be assessed by the Commission for Social Care Inspection as complying with the Care Homes Regulations 2001, address food and nutrition from various perspectives, such as nutritional content, religious or cultural requirements, preparation and hygiene and the social value of meals and mealtimes.

Employment Checks

Paul Rowen: To ask the Secretary of State for Health (1) what steps her Department takes to ensure that all people working with (a) vulnerable adults and (b) the elderly are checked by the Criminal Records Bureau before they are employed; [51352]

(2) what steps her Department takes to ensure that private companies providing care for (a) the elderly and (b) vulnerable adults adhere to guidelines to ensure that all their employees are checked by the Criminal Records Bureau before commencing employment; [51353]

(3) what reports she has received of cases of people being employed in the care of elderly and vulnerable people who subsequently were found to have criminal
 
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records and to be unsuitable for such employment; and what steps she took following receipt of those reports. [51530]

Mr. Byrne [holding answer 14 February 2006]: All care homes, domiciliary care agencies, adult placements schemes and nurses agencies in England are regulated by the Commission for Social Care Inspection (CSCI), which is the independent regulator for social care. The CSCI is responsible for registering and inspecting the regulated social care sector in accordance with statutory regulations and national minimum standards to ensure consistency and improve the quality of life and level of protection for the most vulnerable people in society.

Regulated social care providers, including private companies, are required to conduct rigorous pre-employment checks on prospective staff including obtaining a Criminal Records Bureau disclosure. Since 26 July 2004, there has also been a requirement for prospective employees in these areas to be checked against the protection of vulnerable adults (POVA) list before starting work.

European Health Insurance Card

Mr. Lansley: To ask the Secretary of State for Health what stage has been reached in the development of the proposed NHS card referred to in section 2.21 of the NHS Improvement Plan, published on 24 June 2004; whether it is her intention that the NHS card proposed will be placed on the reverse of the European Health Insurance Card; whether she intends the NHS card to take the form of an entitlement card; what discussions she has had with interested parties about the introduction of an NHS card; what the content of these discussions was; and if she will make a statement. [46401]

Ms Rosie Winterton: Officials have discussed the potential costs and benefits of the proposed national health service card with a range of interested parties across government, taking account of developments in existing programmes such as the NHS Connecting for Health National Programme for IT and the Home Office-led ID Cards Programme. Officials also considered the links between a possible NHS card and the European Health Insurance Card. There are no current plans to introduce an NHS card, although this will be kept under review.

Financial Management (Bedfordshire and Hertfordshire)

Mrs. Dorries: To ask the Secretary of State for Health what financial savings (a) have been implemented since 2001 and (b) are proposed for the future by (i) Bedfordshire and Hertfordshire NHS strategic health authority, (ii) Bedford Hospital NHS Trust and (iii) Bedfordshire Heartlands NHS primary care trust; and if she will make a statement. [52131]

Ms Rosie Winterton: Data on savings that have been implemented by Bedford Hospital Trusts and Bedford Heartlands primary care trust (PCT) area are shown in the table.
 
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£

	Bedford Hospital National Health Service Trust	Bedfordshire Heartlands PCT
2001–02	340,000	410,000
2002–03	700,000	478,000
2003–04	800,000	600,000
2004–05	1,508,000	3,000,000
2005–06	4,424,000	5,500,000

The Department requires the strategic health authority to deliver its agreed financial plan for 2005–06.

Mrs. Dorries: To ask the Secretary of State for Health what procedures have been put in place to ensure that the financial performance of (a) Bedfordshire and Hertfordshire NHS Strategic Health Authority, (b) Bedford Hospital NHS Trust and (c) Bedfordshire Heartlands NHS Primary Care Trust is adequately monitored; and if she will make a statement. [52150]

Ms Rosie Winterton: It is the responsibility of strategic health authorities (SHAs) to deliver the agreed financial plans for their local health communities and to ensure each and every body achieves key targets including finance.

There is also a monthly reporting channel in accordance with Department standards and additional monitoring is undertaken by the SHA. This has been reinforced recently with work undertaken by PricewaterhouseCoopers and KPMG.

Mrs. Dorries: To ask the Secretary of State for Health what procedures have been put in place to ensure that the financial accounts of (a) Bedfordshire and Hertfordshire NHS Strategic Health Authority, (b) Bedford Hospital NHS Trust financial accounts and (c) Bedfordshire Heartlands NHS Primary Care Trust have been regularly audited; and if she will make a statement. [52151]

Ms Rosie Winterton: All national health service bodies are directed to have their accounts audited each year by independent auditors appointed by the Audit Commission under the Audit Commission Act 1998. NHS bodies publish their accounts which must include a report by the auditor as to whether the accounts present a true and fair view of the financial position at the year end and that the income and expenditure has been applied to the purposes intended by Parliament.

All NHS bodies are required to transmit to the Department audited accounts each year including the auditor's report on the accounts. The accounts and reports are scrutinised by the Department and the National Audit Office.

Mrs. Dorries: To ask the Secretary of State for Health what the (a) budget was and (b) total spent from budget was under each financial heading for
 
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(i) the Bedfordshire and Hertfordshire NHS Strategic Health Authority, (ii) Bedford Hospital NHS Trust and (iii) Bedfordshire Heartlands NHS Primary Care Trust in each year since 2001; and if she will make a statement. [52152]

 
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Ms Rosie Winterton: Tables one, two and three detail the budgetary expenditure for Bedfordshire and Hertfordshire Strategic Health Authority (SHA), Bedford Hospital National Health Service Trust and Bedfordshire Heartlands Primary Care Trust (PCT).
Table 1: Bedfordshire and Hertfordshire SHA £000

	2002–03	2003–04	2004–05
Primary healthcare purchased	52,372	0	0
Primary care act pilots healthcare purchased	3,406	0	0
Secondary healthcare purchased	1,400	0	0
Total healthcare expenditure	57,178	0	0
Non-executive members remuneration	55	62	62
Other salaries and wages	2,613	3,632	4,832
Pension costs: pre-1995 early retirements	4,208	0	0
Supplies and services—clinical	0	0	0
Supplies and services—general	15	0	0
Establishment expenses	639	497	626
Transport and moveable plant	3	3	2
Premises and fixed plant	2,319	817	1,040
External contractors	740	380	590
Capital—depreciation	40	37	0
Capital—impairments	0	1,198	140
Capital charges interest	1,643	118	44
(Profit)/loss on disposal of fixed assets	0	0	0
Auditors remuneration—audit fee	127	172	90
Auditors remuneration—other fees	63	0	1
Unwinding of discount on provisions	0	0	0
Interest payable	23	45	0
PCT preparatory costs	0	0	0
Training (workforce development confederations)	55,771	61,964	67,205
Miscellaneous	169	760	924
Total expenditure	125,606	69,685	75,556
Revenue resource limit	66,471	67,713	74,541
Underspend against revenue resource limit	363	1,408	1,976

Table 2: Bedford Hospitals NHS Trust £000

	2001–02	2002–03	2003–04	2004–05
Services from other NHS trusts	494	486	559	1,524
Services from other NHS bodies	0	4	0	191
Services from foundation trusts	0	0	0	290
Purchase of healthcare from non-NHS bodies	0	0	628	912
Directors costs	364	394	441	616
Staff costs	53,780	58,782	65,256	74,376
Supplies and services—clinical	10,718	12,336	12,848	14,216
Supplies and services—general	1,774	1,745	1,872	2,044
Establishment	1,687	1,467	1,605	1,666
Transport	110	101	119	148
Premises	3,455	3,521	4,153	4,061
Bad debts	54	28	13	125
Depreciation and amortisation	2,324	2,410	2,809	3,880
Fixed asset impairments and reversals	0	1,646	0	0
Audit fees	159	185	205	146
Other auditors remuneration	0	0	54	0
Clinical negligence	361	938	1,061	1,851
Pre-95 early retirements	0	0	0	0
Other	2,580	3,917	2,179	958
Total expenditure	77,860	87,960	93,802	107,004
Retained surplus/(deficit) for the year	(3,149)	2,741	120	(8,480)

 
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Table 3: Bedfordshire Heartlands Primary Care Trust £000

	2001–02	2002–03	2003–04	2004–05
Goods and services from other PCTs	46,778	58,130	65,145	43,832
Goods and services from other NHS bodies	104,652	74,314	77,624	113,641
Goods and services from foundation trusts	0	0	0	11,051
Purchase of healthcare from non-NHS bodies	0	0	11,907	16,131
Social care from independent providers	0	0	0	0
Expenditure on drugs action teams	0	759	1,160	1,322
Non-general medical service (CMS) services from general practitioners	1,055	870	2,002	0
Personal medical services (PMS) and personal dental services (PDS) pilots	1,669	5,111	12,036	1,653
PCT board members costs	427	201	236	247
PCT executive non-officer members costs	0	165	192	151
Staff costs	10,834	13,523	15,205	17,943
Prescribing costs	24,542	28,020	30,616	32,739
CMS discretionary	4,917	3,592	3,469	0
CMS non-discretionary	0	4,089	9,380	0
G/PMS, alternative providers of medical services and PCT medical services	0	0	0	29,308
Pharmaceutical services	0	419	1,253	916
Local pharmaceutical services pilots	0	0	0	0
General dental services	0	80	183	334
General ophthalmic services	0	505	1,033	1,159
Supplies and services—clinical	1,354	1,397	2,128	2,597
Supplies and services—general	717	1,224	316	317
Establishment	1,152	1,360	1,709	1,809
Transport	68	8	8	4
Premises	99	242	820	1,129
Bad debts	0	6	7	0
Depreciation and amortisation	202	253	325	381
Fixed asset impairments and reversals	0	0	0	0
(Profit)/loss on disposal of fixed assets	0	0	1	0
Cost of capital charge	(616)	(194)	(158)	(309)
Audit fees	11	105	158	150
Other auditors remuneration	188	0	3	32
Clinical negligence costs	0	64	14	17
NHS trust impairments	0	2,665	0	0
Other finance costs—unwinding of discount	0	(23)	14	14
Other	9,876	14,847	918	782
Total expenditure	207,925	211,732	237,704	277,350
Revenue resource limit	152,826	175,146	193,348	222,156
Under/(over)spend against revenue resource limit	250	(526)	(3,008)	(14,536)

Notes:
1. SHAs were established in 2002–03 therefore only three years' data is available. Four years' data has been provided for the NHS trust and for the primary care trust. 2004–05 is the latest year for which we have audited data.
2. The Department does not set budgets for NHS bodies. SHAs and PCTs are notified of their revenue resource limit each year and their performance against the resource limit is provided in tables one and three. NHS trusts receive income for the provision of services and the performance measure is the surplus or deficit as shown in table two.
3. Not all expenditure lines were collected each year. A zero may mean there was no relevant expenditure or that the particular item was not collected.
4. Revenue resource limits do not include non-discretionary expenditure.
Source:
Audited summarisation schedules of the strategic health authority, primary care trust and NHS trust as appropriate.

Mrs. Dorries: To ask the Secretary of State for Health (1) whether a financial and management specialist team has previously been sent to (a) the Bedfordshire and Hertfordshire NHS Strategic Health Authority, (b) Bedford Hospital NHS Trust and (c) Bedfordshire Heartlands NHS Primary Care Trust; and if she will make a statement; [52154]

(2) whether there are plans for a financial and management specialist team to conduct future discussions with the (a) Bedfordshire and Hertfordshire NHS Strategic Health Authority, (b) Bedford Hospital NHS Trust and (c) Bedfordshire Heartlands NHS Primary Care Trust; and if she will make a statement; [52155]

(3) whether the (a) Bedfordshire and Hertfordshire NHS Strategic Health Authority, (b) Bedford Hospital NHS Trust and (c) Bedfordshire Heartlands NHS Primary Care Trust have been subject to (i) a
 
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baseline financial assessment exercise and (ii) an assessment of financial management; and if she will make a statement. [52156]

Ms Rosie Winterton: The turnaround teams were announced by the Secretary of State in a written ministerial statement on 1 December 2005, Official Report, column 37WS. The teams will comprise of experts with a mix of commercial and national health service turnaround skills.

The first stage of this is a baseline assessment, the aim of which is to ensure there is an agreed understanding of the local financial problem and that actions are in hand to address this. Bedford Hospital NHS Trust and Bedfordshire Heartlands NHS Primary Care Trust were included in the first phase of this assessment. The director of finance, of the Department, published the results of this assessment in a report on 25 January 2006. Both the organisations were assessed as needing to maintain their focus to achieve financial turnaround.
 
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Bedfordshire and Hertfordshire Strategic Health Authority (SHA) were not subject to this baseline assessment. The Department has appointed a turnaround director to work with the SHAs in the East of England to co-ordinate the turnaround initiatives of individual organisations, with the objective of delivering both short-term improvement and a comprehensive turnaround plan.

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