Select Committee on Health Written Evidence

Supplementary letter from Lord Warner, Minister of State, Department of Health (CP 01B)

  At the fourth evidence session by the Health Committee into NHS charges attended by Rosie Winterton MP and Jane Kennedy MP, you made enquiries about a new dermatology clinic being run by Harrogate and District NHS Foundation Trust (NHSFT) and asked for Ministers' views on the treatments being offered.

  I am sure you will appreciate that due to their independent status within the NHS and the different accountability framework within which they operate, Ministers are no longer in a position to assess, validate and provide information relating to operational management in NHSFTs in the same way we would for NHS Trusts. The most common approach is to refer questions relating to the day to day activities of NHSFTS to the relevant Chair for answer. In this particular case, I have been informed by the Chair of Harrogate and District NHSFT that its dermatology clinic has been set up to fill a gap in service provision for its community. The clinic offers a range of cosmetic dermatology treatments which are not ordinarily available to NHS patients as a result of a loclly agreed cosmetic exclusion policy at PCT level eg removal of benign moles, warts and skin blemishes, and injections to reduce excess sweating. While the Department of Health does not call upon the NHS to operate a cosmetic exclusion policy, I am informed that such a policy has been in place locally at Harrogate and District Trust since 2003.

  NHSFTs do not have powers to impose charges for any NHS services, however, legislation permits NHSFTs to impose charges for other services in certain limited circumstances and provided specific conditions are met. As Jane Kennedy highlighted during the evidence session, NHSFTs are also specifically prevented in law from expanding private patient clinical activity faster than their expansion of clinical activity for NHS patients. Moreover, as public benefit corporations, any operating financial surpluses made by NHSFTs need to be reinvested to promote their public benefit mandate. NHSFTs are also overseen by Monitor, the Inepdnent Regulator of NHS Foundation Trusts, for compliance with their terms of authorisation.

  NHSFTs are at the forefront of our programme of change and we share their enthusiasm to promote innovation and enterprise and are committed to their continuing development. While NHSFTs are free to set up new ventures (including entering into joint ventures) without Ministerial consent, these initiatives must be consistent with their public benefit purpose and terms of authorisation.

  Further details about the clinic may be obtained by writing to the Chair of Harrogate and District NHSFT.

  I trust you find this helpful.

Lord Warner

Department of Health

4 April 2006

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