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27 Feb 2006 : Column 477W—continued


Mr. Lansley: To ask the Secretary of State for Health how many operations have been undertaken in primary care settings in each year since 1997. [48842]

Jane Kennedy: Table 3.5.6 in the statistical supplement of the Chief Executive's report to the NHS" (December 2005) sets out the number of national health service-funded operative procedures in different settings. Due to definitional issues, data prior to 2003–04 are not comparable.

The supplement is available on the Department's website at:

Tim Loughton: To ask the Secretary of State for Health which trusts are restricting the number of operations they carry out until the 2006–07 financial year. [51940]

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Jane Kennedy: This information is not centrally collected by the Department. However, at the end of 2005, the maximum waiting time for first outpatient appointment with a consultant fell to 13 weeks and the maximum waiting time for inpatient treatment fell to six months. The national health service remains committed to these targets.

Ostomy Care

Mr. Sheerman: To ask the Secretary of State for Health what representations she has received on the consultation Arrangements for the Provision of Dressings, Incontinence Appliances, Stoma Appliances, Chemical Reagents and Other Appliances to Primary and Secondary Care. [45054]

Jane Kennedy: I refer the hon. Member to the reply I gave on 13 February 2006, Official Report, columns 1795–96W, to the hon. Member for South Derbyshire (Mr. Todd)

Parliamentary Questions

Mr. Clappison: To ask the Secretary of State for Health when she plans to reply to the question of 17 January 2006 (44309) from the hon. Member for Hertsmere regarding colon cancer screening. [52254]

Ms Rosie Winterton: A reply was given to the hon. Member on 15 February 2006, Official Report, column 2110W.

Patient-led Frameworks

Mr. Meacher: To ask the Secretary of State for Health under the health reform in England proposals, who will have overall responsibility for the patient in the patient-led framework; whether primary care trusts will have a (a) superintending and (b) funding role for (i) general practice and (ii) hospitals. [49627]

Mr. Byrne: General practitioners (GPs) will continue to have primary clinical responsibility for their patients. They will continue to provide clinical care and referrals where appropriate.

The Department will continue to make allocations to primary care trusts (PCTs) through the unified allocation. PCTs will then be responsible for commissioning or providing services to meet local healthcare needs.

PCTs will commission primary care services under primary medical services and general medical services contractual agreements. They will work closely with, and support, GPs and primary care professionals through practice based commissioning to commission hospital and other healthcare services.

There will be clear contractual arrangements between PCTs and healthcare providers, including hospitals, which will enable PCTs to effectively performance manage the services provided.

Payment by Results

Mr. Meacher: To ask the Secretary of State for Health under the health reform in England proposals for the system of payment by results, whether the tariff to enable the system will take account of
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(a) differences in costs dependent on the location of the hospital, (b) the change in prognosis for the patient before and after treatment achieved by the hospital, (c) differing responses of patients to treatment and (d) variations in duration of stay in hospital of different types of patient. [49625]

Mr. Byrne: Under payment by results, the tariff is adjusted by a market forces factor which takes account of unavoidable differences in the cost of providing services across the country.

The tariff is based on average costs as reported by national health service organisations and as such will reflect the full case mix of patients, whatever their prognosis on admission. Although there is no specific adjustment for the patient's prognosis after treatment, there is provision in guidance for a price to be agreed locally for emergency readmissions.

The tariff takes account of differing responses to treatment, and variations in duration of stay, by providing adjustments for long and short stays in hospital. A long stay outlier payment will operate after a patient's length of stay exceeds a pre determined period in hospital, dependant on the relevant healthcare resource group (HRG), at a per diem rate specific to that particular HRG. A short stay emergency payment system is in use for certain HRGs that have a national mean non-elective spell duration of five days or more. A reduced short stay tariff is paid where the stay is zero to one day.

Mr. Meacher: To ask the Secretary of State for Health under the health reform in England proposals for a tariff to be used to enable the system of payment by results, what (a) advice and (b) expertise will be provided to hospitals to enable them to assess future income against current and projected expenditure on (i) infrastructure, (ii) staff costs and (iii) service costs; where responsibility will lie for the provision of such guidance; what advice has been prepared for hospitals admitting fewer patients than budgeted for; and what measures will be available in the (A) short and (B) long-term to help hospitals that exceed the tariff rate to cover the resulting deficit. [49628]

Mr. Byrne: As part of the roll-out of the whole health community diagnostic project to national health service acute trusts, an assessment will be made of the financial robustness and viability of all acute trusts that have not yet applied to become NHS Foundation Trusts (NHSFTs). This will encompass their wider health economies, as well as looking at other authorisation requirements and will give trusts a clear indication of any areas of improvement before they embark upon the NHSFTs application process.

As a measure to help hospitals whose current costs exceed the tariff rate, payment by results is being implemented over a four-year transition period. Provider income will be managed from local prices to national tariff in incremental steps.

Year-on-year baseline income changes are capped at two per cent. for individual providers during the four-year transition period, that is until 2008–09, to help ensure stability.
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Pension Liabilities

Mr. Philip Hammond: To ask the Secretary of State for Health if she will estimate the net present value of accrued pension liabilities in respect of (a) present and (b) former employees of her Department and its predecessors. [52112]

Mr. Byrne: The Principal Civil Service Pension Scheme is an unfunded multi-employer defined benefit scheme and individual departments' pension liabilities are not available. The Cabinet Office: civil superannuation resource accounts for 2004–05 showed that the total pension liability at 31 March 2005 was £84.1 billion. The value of pension liabilities was assessed as follows:

As a result of a change in the discount rate used for calculating pension liabilities with effect from 1 April 2005, the total pension liability at 1 April 2005 increased by £10.6 billion to £94.7 billion.

Employer contributions for the Principal Civil Service Pension Scheme, to the nearest thousand, are as follows:

Projected costs for 2005–06 are £13,500,000.

Pharmacy Services

Steve Webb: To ask the Secretary of State for Health if she will estimate the number of pharmacists who (a) do not provide pharmacy services on Saturdays and (b) provide restricted services on Saturdays. [51907]

Jane Kennedy: The information requested is not held centrally.

However, the Department does collect information on the number of pharmacies receiving payment for extended weekday opening, which until 3 March 2005, included hours of service before 9 a.m. and after 5.30 p.m. Monday to Saturday. In 2004–05 there were 1,524 such pharmacies in England and Wales. Other pharmacies may open voluntarily.

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