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NHS Commissioning
Mr. Lansley: To ask the Secretary of State for Health (1) when she intends to publish her Department’s framework for commissioning, practice-based commissioning and the national contract template for 2007-08; [84453]
(2) when she plans to publish her Department's framework for (a) the future of provider reform, (b) future workforce development and (c) the management and regulation of the healthcare system. [84457]
Ms Rosie Winterton: On Friday 14 July, my right hon. Friend the Secretary of State for Health made a written statement announcing the publication of “Health Reform in England: Update and Commissioning Framework”. This document contains a detailed commissioning framework, which includes proposals for strengthening practice based commissioning and a new model of contracting. It also provides updates on the future of provider reform, workforce development and system management and regulation. A copy of the framework is available in the Library.
A consultation document on system management and regulation will be published in the autumn and further information on workforce will be published later this year.
NHS Direct
Julia Goldsworthy: To ask the Secretary of State for Health pursuant to the Answer of 26 June 2006, Official Report, columns 231-2W, on NHS Direct, what proportion of total NHS Direct sites the proposed closure of 12 sites represents; and what proportion of the total NHS Direct workforce 573 posts represents. [81937]
Ms Rosie Winterton: NHS Direct currently has 54 sites. A number of the 12 sites proposed for closure, representing 22 per cent. of the estate, are small and do not provide suitable accommodation that meets the future needs of NHS Direct for either facilities or good support for staff through supervision.
The consultation document sets out that the organisation has 2,796 posts. The possible reduction in posts in the organisation could be around 400, representing 14 per cent. of the current posts.
Julia Goldsworthy: To ask the Secretary of State for Health (1) what assessment her Department has made of the impact of NHS Direct on front line services; and if she will make a statement; [81974]
(2) what assessment she has made of the likely impact of proposed (a) site closures and (b) staff redundancies on NHS Direct front-line services. [82035]
Ms Rosie Winterton: The proposals set out in the consultation document are designed to ensure that NHS Direct can continue to provide a high quality service to patients and can improve the value for money offered to commissioners and to taxpayers. The proposals aim to increase efficiency of NHS Direct operations, improve the patient experience, improve the working experience for staff, and make better use of specialist skills throughout the organisation. NHS Direct recognise that this is a difficult time for staff and are working to ensure that all staff have the opportunity to comment on the proposals, through formal and informal means, as well as working closely with union representatives.
NHS Employees
Mr. Hancock: To ask the Secretary of State for Health if she will make a statement on the progress of the review by her Department of the financial support available to students studying for employment in the NHS. [83683]
Ms Rosie Winterton: We have started to review the national health service bursary scheme, in particular to ensure it complies with age discrimination and eligibility legislation. We will also introduce a formal policy to pay for students absent due to maternity and childbirth to replace the current interim arrangements. A consultative meeting has taken place with the Royal College of Nursing, Unison and the British Medical Association. Further meetings are planned during the summer with student representatives and other stakeholders.
NHS Finance
Mr. Soames: To ask the Secretary of State for Health what additional net resources will be available to the NHS in 2006-07 after taking into account (a) NHS inflation and (b) the 2005-06 deficit. [58168]
Andy Burnham: There will be £6,540 million additional net resources available to the national health service in 2006-07. This represents a real terms increase of 5.8 per cent. on NHS expenditure in 2005-06. This growth takes into account the 2005-06 deficit position. The following able provides the total net NHS expenditure in each of the years.
| 2005-06 (Estimated outturn) | 2006-07 (Plan) | |
Percentage increase (real-gross domestic product deflator 29 March) |
These figures are as reported in Department Report 2006 (DR2006) Table 3.4.
Tim Farron: To ask the Secretary of State for Health what the capital underspend was for the NHS in 2005-06; and whether her Department plans to redirect the underspend to health authorities with financial deficits. [87114]
Andy Burnham: The 2005-06 provisional outturn is the most recently published data on the national health service financial position. This data shows that the provisional capital underspend in 2005-06 was £1,162 million.
Capital and revenue are managed and controlled separately by HM Treasury. The Department is voted separate budgets for both capital and revenue and does not have the power to vire funding from the capital budget to the revenue budget.
NHS Life Check
Mr. Lansley: To ask the Secretary of State for Health pursuant to her oral statement of 30 January 2006, Official Report, column 22, on health and social care services, what progress she has made in developing an NHS life check. [84641]
Caroline Flint: We have made good progress developing the national health service life check. Following a very successful stakeholder workshop there will initially be NHS life checks for three key life stages: early years, adolescence, and mid-life.
We have established a small project delivery team and are currently setting up a steering group of key stakeholders. A review of existing online self-assessment tools has also been completed, which will inform the development of the NHS life check assessment tools. The Department has applied to the Patent Office for the NHS life check trademark.
NHS Litigation Authority
Mr. Lansley: To ask the Secretary of State for Health pursuant to the written statement of 11 June 2006, Official Report, column 64WS, on the NHS Litigation Authority, for what reasons the NHS Litigation Authority achieved an underspend of £205 million in 2005-06; and whether she expects the change in the discount rate in 2005-06 to lead to additional costs for the Authority in future years. [86211]
Ms Rosie Winterton: The NHS Litigation Authority (NHSLA) forecasts in advance the likely claims expenditure and number of new claims reported to the schemes, neither of which is controlled by the NHSLA. The major impacting factor on the NHSLA’s resource limit is the level of claims reported to the schemes. In 2005-06 fewer claims were made than forecast, meaning fewer new provisions and therefore an underspend in resource terms. As a consequence, NHSLA actuarial advisors reviewed the incurred but not reported provisions which led to a reduction in the resource requirement in year.
The additional costs to the NHSLA, which result from the change in the discount rate for provisions, have been taken into account in setting the departmental expenditure limit for the Department for 2006-07 and future years and in setting the budgets for the NHSLA.
NHS Staff Redundancies
Mr. Dismore: To ask the Secretary of State for Health how many staff (a) have been and (b) were expected to be made redundant (i) voluntarily and (ii) compulsorily at (A) Barnet primary care trust, (B) Barnet Chase Farm trust, (C) Royal Free trust and (D) Northwick Park; and if she will make a statement. [84351]
Ms Rosie Winterton: This information is not collected centrally.
NHS Supply Chain Excellence Programme
Dr. Desmond Turner: To ask the Secretary of State for Health what mechanisms are in place to allow health trusts to consider long-term cost effectiveness when making purchasing decisions following the introduction of the supply chain excellence programme. [86402]
Andy Burnham: The supply chain excellence programme approach to procurement is to blend national health service clinical expertise with best in-class procurement methodology. This methodology includes a review of whole-life costs, where appropriate, of the goods and services the NHS uses.
This approach to strategic sourcing is being embedded across the NHS in order to ensure best value to the taxpayer and quality of care for patients. NHS trusts have a duty of care to deliver both of these objectives.
Dr. Desmond Turner: To ask the Secretary of State for Health what assessment she has made of the potential impact of the NHS supply chain excellence programme on the uptake and use of medical technology in the NHS. [86403]
Andy Burnham: It is expected that the supply chain excellence programme will have a positive impact on the uptake and use of medical technology in the national health service.
Increasingly there is a more strategic approach to procurement of goods and services, and to markets, across the service. A strategic approach that will ensure that the NHS is getting best value for money from the significant amount it spends on goods and services, including medical technology.
If best value for money is achieved there will be more resources to spend on patient care and as a result there will be a need for more medical technology to support that care.
In securing best value, mechanisms are in place to ensure that procurement takes account of clinical choice which in itself will help to ensure uptake.
NHS Trusts (Financial Management)
Anne Main: To ask the Secretary of State for Health if she will introduce financial management training for chief executives of NHS trusts which are in financial deficit. [86377]
Andy Burnham: All NHS chief executives, as accountable officers, need the skills and experience to ensure proper financial controls are in place and that all resources are well managed. This is assessed as part of the appointment process.
Where chief executives of NHS trusts are in financial deficit, the strategic health authority agrees what action is needed to bring finances back under control including an assessment of senior leadership skills.
There are no plans to introduce mandatory financial management training for any chief executives. However, sound financial management is a critical issue and a comprehensive capability-building programme is being developed for finance directors throughout the NHS, and it is anticipated that a number of chief executives may wish to participate.
The NHS Institute for Innovation and Improvement and Monitor are co-commissioning the commercially focused development programme for NHS finance directors. The first wave will commence in November this year, with a service wide roll out from spring 2007. This programme is expected to be pivotal in delivering transformational change in NHS financial management performance.
NICE
Justine Greening: To ask the Secretary of State for Health when the cost per quality-adjusted life-year used by the National Institute for Health and Clinical Excellence (NICE) in assessing cost effectiveness was originally established; whether she plans to have NICE raise it in line with price inflation; and if she will make a statement. [87746]
Andy Burnham: The cost per quality-adjusted-life-year calculation is one of the factors that informs the National Institute for Health and Clinical Excellence (NICE) when reaching a decision on the clinical and cost effectiveness of health technologies. NICE does not have a set limit. NICE'S approach to appraising clinical and cost-effectiveness is set out in its methods guide published in April 2004 and available on its website at:
www.nice.org.uk
Dr. Desmond Turner: To ask the Secretary of State for Health what mechanisms are in place to ensure that the guidance resulting from National Institute for Health and Clinical Excellence technology appraisals is implemented across the whole NHS within three months; and if she will make a statement. [86404]
Andy
Burnham: Strategic health authorities manage the national
health service locally on behalf of the Secretary of State. They hold
all local NHS organisations (apart from NHS foundation trusts) to
account for performance and make sure national priorities—for
example, National Institute for Health
and Clinical Excellence (NICE) guidance—are integrated into local
health service
plans.
Technology appraisals from NICE are reflected in core standard C5 of “Standards for Better Health” published by the Department in July 2004.
The Healthcare Commission started assessing NHS bodies’ performance against the core standards in April 2005, and the first ratings based on this assessment will be published later this year.
Non-medical Professional Regulation
Mr. Lansley: To ask the Secretary of State for Health when she expects to publish the review of non-medical professional regulation being undertaken by her Department’s Director of Workforce. [85784]
Andy Burnham: The Department published its review of non-medical regulation on 14 July, at the same time as the Chief Medical Officer published his review of medical regulation. A joint public consultation has been launched on the recommendations, which closes on 10 November 2006. Copies of the consultation document, both reports and other related documents are available in the Library.
Non-practising Doctors
Mr. Gordon Prentice: To ask the Secretary of State for Health what estimate she has made of the number of non-practising medically qualified doctors in the UK. [85524]
Ms Rosie Winterton: This information is not collected centrally.
Nut Allergies
Mr. Hoyle: To ask the Secretary of State for Health what measures are being taken to ensure that all food labels clearly indicate whether foods contain nuts. [84264]
Caroline
Flint: The provisions of Directive 2003/89/EC require
that, as from 25 November 2005, a
specified list of allergenic foods, including nuts and peanuts, have to
be clearly declared on the label whenever they are used in all
pre-packed food, including alcoholic
drinks.
However, the directive does not cover allergenic foods that may be present unintentionally as a result of allergen cross-contamination at some point during the manufacture or transportation of the food. Therefore, the Food Standards Agency has produced voluntary best practice guidance on allergen management and advisory labelling. This guidance was published on Monday 10 July.
Osteopathy
Mr. Hancock: To ask the Secretary of State for Health if she will introduce proposals to change the practice of osteopaths determining the profession’s own standards (a) of training, (b) of practice and (c) for access to the statutory register. [80389]
Andy Burnham: I refer the hon. Member to the reply given 16 June 2006, Official Report, column 1565W.
PFI Schemes
Mr. Davey: To ask the Secretary of State for Health how much has been spent by her Department on private finance initiative schemes in the last nine years; and how many of those schemes have been completed on time. [85415]
Andy Burnham: Information on completed private finance initiative projects which have opened late is not routinely collected centrally. To provide such information for each of the past nine years would incur disproportionate costs.
A key aspect of the private finance initiative (PFI) is the transfer of risk. PFI incentivises the consortium to complete construction on schedule because the consortium does not begin to receive payments until the asset is ready for use and the service is being delivered.
The following tables show all PFI schemes which have reached financial close and are operational to date:
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