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Mr. Ivan Lewis: Following the publication of the National Audit Office report A safer place for patients: learning to improve patient safety in November 2005, the Chief Medical Officer commissioned a review of the organisational arrangements in place to support patient safety. It was explicitly aimed at addressing the issues raised in the NAO report and its concerns with the National Patient Safety Agency (NPSA), as well as looking at the national health service's approach to patient safety more widely.
The resulting report Safety first: A report for patients, clinicians and healthcare managers was published in December 2006 and is available in the Library. It makes fourteen recommendations including the following about the NPSA's core function:
The role of the NPSA should be refocused on its core objective of collecting and analysing patient safety data to
inform rapid patient safety learning, priority setting and coordinated activity across the NHS. A number of current functions, for example the development of technical solutions to improve patient safety, presently delivered by the organisation should in future be commissioned from other expert organisations with the requisite expertise
The agency will continue to have responsibility for the additional functions that it took on following the review of arms length bodies in 2005. These include work on safety aspects of hospital design, cleanliness and food; the Central Office for Research Ethics Committees the National Clinical Assessment Service and managing the contracts of the three national confidential enquiries.
Mr. Laws: To ask the Secretary of State for Health how much the NHS Bank (a) received, (b) loaned and (c) recovered in each year since it was established; and if she will make a statement on its operation. 
Andy Burnham: The NHS Bank is funded from a central allocation from the Department of Health. The contributions received and repayments made by strategic health authority (SHA) in each year since 2002 are set out as follows:
|NHS special assistance funding provided|
|Avon Gloucester and Wiltshire||Surrey and Sussex||Bedfordshire and Hertfordshire||Thames Valley||Kent and Medway||Total|
In addition to the distribution of special assistance funding, the NHS Bank also managed the brokerage of cash and capital resources between SHAs, from its inception in 2003 until 2005-06. The NHS Bank provided funding to SHAs only. The Bank does not provide repayable loans to PCTs and NHS trusts. The distribution of funding to individual organisations is the responsibility of the relevant SHA.
Any cash contributed from, or received by, an SHA under these arrangements was returnable in full in the following financial year. In addition, a one-off cash rebasing was carried out in 2003-04 that was not returnable the following year. The following table summarise all brokerage and cash rebasing that was managed through the NHS Bank.
|NHS cash brokerage|
|Brokerage received||Brokerage issued||Net position|
Andy Burnham: Strategic health authorities (SHAs) agree financial recovery plans for the individual organisations within their patch. Financial recovery plans are not agreed for the SHA itself. However, SHAs have a net target to break-even across their patch each year. Their latest performance against that target was published on 20 February in our national health service finance report for quarter three of 2006-07. Copies of this report are available in the Library.
Lynne Featherstone: To ask the Secretary of State for Health what consideration is given to the internal budgetary conditions of primary care trusts when setting the (a) amount and (b) proportion of the trust's budget represented by the trust's contribution to London-wide NHS reserves; and if she will make a statement. 
Andy Burnham: Returning the national health service to overall financial balance has been a key priority in 2006-07. Strategic health authorities (SHAs) have taken responsibility for developing and implementing financial and operational strategies to both manage and improve the financial position within their overall area. As part of this strategy, SHAs have top sliced resource allocations made to their primary care trusts (PCTs), thereby creating SHA reserves.
SHAs have agreed an appropriate level of contribution to these reserves with their PCTs thereby allowing the SHA to deliver the financial planning target for its economy. The level of any contributions is based on the financial and service circumstances of individual organisations, and is always underpinned by the principle of fairness.
We expect SHAs to maintain the integrity of the allocations system, with contributing PCTs being entitled to repayment of their contributions over a reasonable period, not usually exceeding the three-year allocation cycle. However, SHAs will be asked to ensure that PCTs with the greatest health need are repaid first.
Norman Lamb: To ask the Secretary of State for Health how many people participated in the NHS low income scheme in each of the last five years; how the scheme is promoted; how many patients it is estimated were entitled to assistance but did not receive it in the last 12 months; how much the scheme cost to operate in each of the last five years; and if she will make a statement. 
Caroline Flint: The estimated number of people who have made a national health service low income scheme claim in England and the estimated cost of operating the scheme is in the table. The number of claims has been estimated from annual samples.
|Estimated number of low income scheme HC1 claims for England (thousand)||Estimated direct cost per claim to operate the scheme (£)|
Prescription Pricing Division (PPD) of the NHS Business Services Authority
In addition the low income scheme provides income-related help to recipients of income support, income based jobseekers allowance, pension credit guarantee credit and child tax credit or working tax credit with a disability or severe disability element whose gross annual income is £15,050 or less. They do not need to make a separate HC1 claim.
The Prescription Pricing Division (PPD) of the NHS Business Services Authority operates the scheme in respect of England, Scotland and Wales and is responsible for publicising the scheme in England on behalf of the Department of Health. Information is provided in leaflet HC11Help With Health Costs which is available from Jobcentre Plus offices and NHS hospitals. Dentists, opticians, pharmacists and doctors may also provide them. PPD produces a poster for general display and, with the National Union of Students, a poster for display in higher educational establishments. In addition, PPD has commissioned a series of advertisements which are soon to appear in popular magazines.
Andy Burnham: The Department estimates that total redundancy costs arising as a result of the commissioning a patient led national health service initiative will be £325 million. These figures are difficult to estimate, and will only become firmer as new structures are put in place in strategic health authorities, primary care trusts and ambulance trusts.
The reconfiguration of primary care trusts and strategic health authorities provides an opportunity to deliver savings, both by reducing the number of organisations and through the greater sharing of functions. By 2008, this reconfiguration is expected to deliver at least £250 million savings each year for re-investment in frontline services.
Mr. Laws: To ask the Secretary of State for Health what proportion of the multi-professional education and training budget she estimates has been used by strategic health authorities to offset deficits elsewhere in the NHS economy in (a) 2005-06 and (b) 2006-07; what assessment she has made of the effect this has had on training across the NHS; and if she will make a statement. 
Ms Rosie Winterton:
In 2005-06 it is estimated that £136 million or 3.5 per cent. of the multi professional education and training budget was not spent on education and training. In some cases this was the genuine result of slippage (usually due to late allocations, under recruitment to courses and delays to projects). In other cases strategic health authorities (SHA) have sought to generate brokerage to contribute to the overall national health service financial position.
It is impossible to distinguish between these elements. Strategic health authorities delivered 1,500 less nurse and 100 allied health profession training places than planned in 2005-06.
In 2006-07, it is estimated that £340 million or 9 per cent. of the multi professional education and training budget has been used by SHA to offset deficits elsewhere in the national health service economy.
Ms Rosie Winterton: This information is not collected centrally. It is for local trusts to commission and deploy stoma care nurses in accordance with their local needs. Where agreements have been made for alternate funding of these posts, this is a local matter.
|Expenditure on Nurses for NHS trusts, health authorities, primary care trusts and strategic health authorities from 1991-92 to 2005-06|
Excludes NHS Foundation Trusts 2004-05 to 2005-06
NHS Trusts Financial Returns 1991-92 to 2005-06
Health Authorities Financial Returns 1996-97 to 2001-02
Primary Care Trusts Financial Returns 2000-01 to 2005-06
Strategic Health Authorities Financial Returns 2002-03 to 2005-06
Regional and District Health Authorities for the London postgraduate teaching hospitals Financial Returns 1991-92 to 1995-96
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