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SHAs and PCTs may hold commercial bank accounts but in practice the large majority of cash balances of all SHAs and PCTs will be in Government bank accounts. In addition, SHAs and PCTs are discouraged from holding commercial bank accounts by applying a charge to any average cleared balance over £25,000.
National health service trusts are able to hold commercial bank accounts but these are limited by legislation and in practice the large majority of balances for NHS trusts will be held in Government bank accounts.
NHS foundation trusts are autonomous organisations, free from central Government control. As high performing organisations, NHS foundation trusts have wide discretion to invest money. The boards of NHS foundation trusts are responsible for ensuring that surplus cash is invested in accordance with their duty to safeguard and properly account for the use of public money. Monitor, the independent regulator, has issued best practice guidance on how NHS foundation trusts should mange their cash. This guidance reflects prudent practice, and is designed to promote fiscal responsibility and prudent investments that do not compromise effective, efficient and economic delivery of services.
|Proportion of the increase in the NHS expenditure on pay|
|Total NHS expenditure||Total pay bill|
1. Total expenditure is calculated as the sum of revenue and capital expenditure net of non-trust depreciation and impairments. This is in line with HMT guidance.
2. Total pay bill comprises all NHS staff in England only and excludes agency; includes estimates for foundation trusts.
3. Pay bill figures are taken from final NHS financial returns for 2006-07.
4. The forecasts of pay for 2007-08 are consistent with those supplied as part of the written evidence to pay review bodies.
Mike Penning: To ask the Secretary of State for Health if he will break down the NHS Settlement for 2007-08 as allocated to centrally-funded initiatives by main budget heading; and if he will make a statement. 
Norman Lamb: To ask the Secretary of State for Health whether the budgets of NHS organisations have been top-sliced in 2008-09; whether the top-sliced amounts held by the strategic health authorities at the end of 2007-08 have been returned to the organisations; and if he will make a statement. 
Mr. Bradshaw: The 2008-09 national health service (NHS) operating framework confirms that strategic health authorities (SHAs) may agree arrangements with the primary care trusts (PCTs) in their area which allow the voluntary transfer and lodgement of revenue resources with the SHA, provided that such transfer is within the limit of the overall SHA planned surplus. The Department does not expect SHAs to require an involuntary top slice of PCT revenue allocations.
Audited NHS accounts for 2007-08 report the net value of the top-sliced revenue resources transferred to, and paid back, by SHAs during the year, and the balance remaining with SHAs at the year-end. This information has already been placed in the Library.
Mike Penning: To ask the Secretary of State for Health how many litigation cases were brought against his Department for clinical negligence in the latest period for which figures are available; and how much was paid out as a result. 
Of the 4,593 cases formally claimed in 2007-08, as of 30 September 2008, 2,262 have been settled, with £18,217,815 being paid out in damages, £2,272,334 in defence legal costs and £7,878,866 in claimant legal costs. The NHS Litigation Authority, which handles clinical negligence cases on behalf of member organisations, provided this information. The data do not include claims made against self-employed contractors in primary care.
Ann Keen: NHS care workers are paid according to the Agenda for Change (AfC) system. The AfC pay system covers all directly employed NHS staff except doctors and dentists pay review body groups and very senior managers. A three-year pay deal for AfC staff is in place which provides a headline pay uplift of 2.75 per cent. for 2008-09among the best increases in the public sector this year. The deal will be worth 2.54 per cent. in 2009-10 and 2.5 per cent. in 2010-11. These increases are in addition to year-on-year incremental increases for the vast majority of AfC staff.
Ann Keen: The Department has worked with key stakeholders such as NHS Employers, Skills for Health and trade unions to develop education and career frameworks and to ensure effective use of the Joint Investment Fund that will provide up to £100 million per year of extra investment. This will be backed up by a doubling in investment in apprenticeships in the NHS.
Ann Keen: The Government expect that all staff possess the level of skills required to deliver high quality health care, irrespective of whether they are employed directly by the NHS or they have been contracted to deliver that service. This applies to clinical and non-clinical staff alike.
Mr. Lansley: To ask the Secretary of State for Health (1) if he will place in the Library a copy of each item of guidance his Department has issued to the NHS in the last 12 months on the modern matrons programme; 
Ann Keen: Information about the number of modern matrons is collected centrally. This shows that there were 5,538 modern matrons in post on 6 June. No further information is collected centrally and no guidance has been issued in the last 12 months.
Ann Keen: The Organ Donation Taskforce is currently considering its findings on the potential impact on organ donation rates of introducing an opt out system of consent. It will shortly submit its report to UK Health Ministers for consideration after which the report will be published.
Ann Keen: Local health commissioners work with local hospitals, ambulance trusts and critical care networks to assess, commission and monitor the arrangements for transferring critically ill patients. We would expect that transfers follow relevant guidance from professional organisations, in particular the Intensive Care Society.
Mr. Lansley: To ask the Secretary of State for Health (1) from what date prescription charges will be abolished for all patients with long-term conditions; how much he expects this measure to cost; and how many patients per annum he expects to benefit from it; 
Ann Keen: The expected cost of exempting cancer patients in England from prescription charges is around £20 million a year. This will be funded from within our existing Comprehensive Spending Review settlement.
Mr. Drew: To ask the Secretary of State for Health whether patients with long-term diseases will be eligible for free prescriptions under his recently announced proposals to extend eligibility for such prescriptions. 
As announced by my right hon. Friend the Secretary of State in his written ministerial statement to the House on 8 October 2008, Official Report, column 17ws), we have asked Professor Ian Gilmore to lead a review of prescription charges on how to implement our plans to phase in free prescriptions for those people
in England with long term conditions effectively. The Government estimate that a further five million people will be exempted from paying prescription charges at a cost of between £250-£350 million a year depending on the actual numbers of such patients and the timetable for implementing these changes.
Mr. Lansley: To ask the Secretary of State for Health what the evidential basis is for his Departments assertion that there is likely to be a £6 billion funding gap in social care in 20 years time. 
Alistair Burt: To ask the Secretary of State for Health what progress he is making in devising an independent complaints procedure for those who arrange and finance their own social care and who are currently excluded from other statutory complaints procedures. 
Phil Hope: We will be seeking to legislate as soon as parliamentary time allows. In the meantime departmental officials are working with the local government ombudsman on the details of the proposed new arrangements whereby the ombudsman is given the power to handle complaints by people who fund or arrange their own adult social care services.
Mike Penning: To ask the Secretary of State for Health what proportion of hospitals participate in the Trauma Audit and Research Network; and what steps he plans to take to increase the number of hospitals participating. 
Ann Keen: The Trauma and Audit Research Network (TARN) is an independent organisation that is not funded directly by the Department, and as such the Department does not collect data on participation rates. TARN publishes a wide range of information about their work on their website, www.tarn.ac.uk. Further information can be obtained from TARN via:
Professor Tim Coats (Chairman)
Clinical Sciences Building
Eccles Old Road
(T) 0161 206 5952
Ann Keen: We are unable to supply the information requested as the definition of trauma is too wide to accurately supply data. Medically trauma can refer to any serious or critical bodily injury, wound or shock. In psychiatric terms a trauma may refer to an experience that is emotionally painful, distressing or shocking which often results in lasting mental and physical effects.
Ann Keen: The information is not available as requested. Data on the count of hospital admissions to Leeds Teaching Hospitals NHS Trust, which includes the Wharfedale Hospital, from 2003-04 to 2006-07 is shown in the following table.
| Notes: Finished admission episodes: A finished admission episode is the first period of inpatient care under one consultant within one health care provider. Finished admission episodes are counted against the year in which the admission episode finishes. Please note that admissions do not represent the number of inpatients, as a person may have more than one admission within the year. Data quality: HES are compiled from data sent by more than 300 NHS trusts and primary care trusts in England. Data is also received from a number of independent sector organisations for activity commissioned by the NHS in England. The NHS Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain. Assessing growth through time: HES figures are available from 1989-90 onwards. During the years that these records have been collected by the NHS there have been on-going improvements in quality and coverage. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series. Some of the increase in figures for later years (particularly 2006-07 onwards) may be due to the improvement in the coverage of independent sector activity. Changes in NHS practice also need to be borne in mind when analysing time series. For example, a number of procedures may now be undertaken in outpatient settings and may no longer be accounted for in the HES data. This may account for any reductions in activity over time. Source: Hospital Episode Statistics (HES), The Information Centre for health and social care: NHS Hospitals England and activity performed in the Independent Sector in England commissioned by English NHS.|
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