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Dawn Primarolo: I refer the hon. Member to the oral statement made by the Secretary of State for Health on 4 November 2008, Official Report, column 131.

Mr. Lansley: To ask the Secretary of State for Health what estimate he has made of the average number of treatments involving the off-label usage of a drug (a) provided and (b) denied to patients in the latest period for which information is available; what steps his Department plans to take to assist primary care trusts to make decisions on funding off-label usage of drugs; whether his Department plans to discuss with (i) the National Institute for Health and Clinical Excellence and (ii) the Medicines and Healthcare products Regulatory Agency the funding of off-label usage of drugs; what timetable he has set for implementing Recommendation 4 of “Improving access to medicines for NHS patients”; and if he will make a statement. [237080]

Dawn Primarolo: We have made no estimate of the annual number of such treatments and we have no plans to discuss the funding of such treatments with either the National Institute for Health and Clinical Excellence or the Medicines and Healthcare products Regulatory Agency.

The NHS chief executive wrote to strategic health authority chief executives on 4 November 2008 to ask them to review, by April 2009, the way in which PCTs in their area collaborate to support effective decision-making on funding treatments. A copy of the letter has been placed in the Library. Strategic health authorities are now taking this piece of work forward in their areas.

Mr. Lansley: To ask the Secretary of State for Health what timetable he has set for implementing Recommendation 11 of “Improving access to medicines for NHS patients”; which organisations his Department plans to commission to conduct the recommended audit; whether he plans to publish the results; whether he plans to repeat the audit; and if he will make a statement. [237082]

Mr. Bradshaw: My right hon. Friend the Secretary of State has asked Professor Mike Richards to lead the implementation of recommendation 11 of his report, “Improving access to medicines on the NHS”, and Professor Richards is currently considering the best approach to this piece of work. A copy of this report has already been placed in the Library.

Mr. Lansley: To ask the Secretary of State for Health with reference to Appendix 1 of “Improving access to medicines for NHS patients”; for what reasons his Department did not request that all primary care trusts respond to his Department’s survey on the use of exceptional funding procedures; which primary care trusts provided (a) full and (b) partial responses; what assessment he has made of the reasons for six primary care trusts providing partial responses; and if he will make a statement. [237083]

Mr. Bradshaw: My right hon. Friend the Secretary of State deliberately set a challenging time scale for the review in order to minimise the period of uncertainty for patients, while still allowing Professor Richards enough time to consider these difficult issues properly.


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In light of the need to gather evidence as quickly as possible, primary care trusts (PCTs) were given a tighter deadline for responding to this survey than is normal, and the deadline for responding was over the summer period. This meant that some PCTs were unable to respond. However, Professor Richards was confident that the data collected from the 80 PCTS who did respond fully were representative of the picture across the country. For example, the results of the Department of Health survey are consistent with a survey conducted by the Rarer Cancers Forum, the results of which are set out in chapter 2 of Professor Richards’ report, “Improving access to medicines for NHS patients”. A copy of the report has already been placed in the Library.

Mr. Lansley: To ask the Secretary of State for Health with reference to Appendix 1 of Improving access to medicines for NHS patients; which (a) cancer and (b) non-cancer treatments were applied for through exceptional circumstances requests in 2008; and how many exceptional circumstances requests were (a) made and (b) approved for each treatment. [237084]

Mr. Bradshaw: This information is not held centrally. The survey of primary care trusts conducted by the Department to inform Professor Richards’ review did not ask for details of specific treatments requested for exceptional funding in order to keep the administrative burden on the national health service to a minimum. Appendix 1 of the report, “Improving access to medicines for NHS patients” (a copy of which has already been placed in the Library), sets out the data held by the Department as a result of this survey.

NHS: Information and Communications Technology

Mr. Stephen O'Brien: To ask the Secretary of State for Health what (a) hardware and (b) software has been deployed to trusts under the National Programme for IT, broken down by trust; and how much the equipment in each deployment cost. [233290]

Mr. Bradshaw: Comprehensive detailed information on the hardware and software deployed to each trust, broken down by individual trust, could be obtained only at disproportionate cost. Of total payments made to local service providers to 30 September 2008, the sum of one-off payments, representing deployments, and recorded as capital in the Department's accounts, amounts to £758 million.

Mr. Stephen O'Brien: To ask the Secretary of State for Health what the unitary cost for each (a) small, (b) medium and (c) large trust under the National Programme for IT is; and what payments local service providers have (i) received and (ii) are owed for deployments in respect of each trust, broken down by size of trust. [233292]

Mr. Bradshaw: The value of local service provider contracts under the national programme for information technology, and entitlement to payment under the contracts, is based on the provision of systems and services that will meet the agreed requirements set out in the contracts. The sums concerned are linked to the type and mix of systems and services deployed at each site as well as the
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size of the trust receiving the deployment. It is therefore not possible to ascribe a single ‘unitary cost’ to national health service trusts according to whether they are small, medium or large.

Payments are not ‘owed’ to local service providers. Payments are made following local confirmation of successful deployment by the trust, when a one-off payment is made. A recurring service charge is paid monthly thereafter.

Of total payments made to 30 September 2008, the sum of one-off payments, representing deployments, amounts to £758 million.

Mr. Stephen O'Brien: To ask the Secretary of State for Health what deployment (a) in total and (b) of Cerner BT has made at (i) the Homerton Hospital NHS Trust and (ii) the Newham University Hospital NHS Trust; and what payment BT has received for the deployments. [233294]

Mr. Bradshaw: Under its national programme for information technology (NPfIT) local service provider (LSP) contract, BT assumed responsibilities for the services already contracted for between Cerner and the Homerton University Hospital NHS Foundation Trust and the Newham University Hospital Trust. Under the contract £5 million has been paid to BT in respect of each of the trusts to take over service management responsibility for the deployed Cerner Millennium systems.

Details of other deployments at the trusts and payments to BT are shown in the following table.

System Payment (£)

Newham

ESAP

(1)

MOM

(2)

PSC

(3)

PACS(4)

1,199,411

Homerton

ESAP

(1)

MOM

(2)

PSC

(3)

PACS(4)

1,018,271

1 ESAP (electronic single assessment process): deployment testing has not been completed for either trust, and no payment has yet been made.
(2 )MOM (map of medicine): a single deployment charge of £6,975,275 was paid in July 2007 to cover all London NHS organisations rather than as unit cost per organisation.
(3 )PSC (pharmacy stock control): this is an additional service commissioned and paid for directly by the trusts and not via NPfIT.
(4 )PACS : picture archiving and communications system

Mr. Stephen O'Brien: To ask the Secretary of State for Health how much Connecting for Health paid for the deployment of PACS, broken down by trust. [233296]

Mr. Bradshaw: The deployment costs of picture archiving and communications systems (PACS) provided under national programme for information technology contracts were paid locally by national health service trusts. The Department's expenditure on PACS has been primarily on central development costs and the cost of central data stores.


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Mr. Stephen O'Brien: To ask the Secretary of State for Health what mechanism (a) Connecting for Health and (b) the London Programme for IT use for (i) price deployments and (ii) transfer payment to the local service provider. [233298]

Mr. Bradshaw: The value of local service provider contracts under the national programme for information technology, and entitlement to payment under the contracts, is based on the provision of systems and services that will meet the agreed requirements set out in the contracts. The sums concerned are not directly linked to the cost of hardware, software or other supplier costs.

The price payable for deployment of each of the elements of the contracted services is set by agreement with suppliers relative to other elements of the services and to the benefit of that element to the national health service. A one-off payment is made following confirmation of successful deployment by the trust, and then a recurring service charge is paid monthly thereafter.

Funds are transferred via the bankers’ automated clearing system following receipt of invoices from the local service provider.

Mr. Stephen O'Brien: To ask the Secretary of State for Health what percentage of the funds for each of Connecting for Health's contracts is allocated to (a) design, development and testing and (b) final deployment. [233301]

Mr. Bradshaw: Payment to prime contractors for systems and services deployed under national programme for information technology contracts is only made after 45 days of live running, and on the basis that no significant operational problems have been experienced. There is no entitlement to payment for completion of the design, development and testing phases.

Mr. Stephen O'Brien: To ask the Secretary of State for Health to what extent the payments to suppliers under Connecting for Health contracts are tied to completion of work commissioned. [233772]

Mr. Bradshaw: Payments to suppliers under the national programme for information technology contracts are tied to successful delivery and acceptance of an agreed service. Payments may also be made for the provision of the infrastructure to support the services being delivered and, in line with Treasury rules, to aid with suppliers' capital costs in return for a reduction in the future payment for successful delivery. In that case there is no overall increase in the cost of the services.

Peter Bottomley: To ask the Secretary of State for Health (1) which (a) Ministers and (b) heads of NHS IT have been responsible for the Cerner systems; over what periods each such person was responsible for the systems; and what meetings (i) have been held and (ii) are planned between the responsible Ministers or heads of NHS IT and hospital trusts on the systems; [235165]

(2) which part of the NHS has responsibility for funding additional costs arising from the introduction and running of NHS IT Cerner systems in hospital trusts. [235166]


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Mr. Bradshaw: Under the national programme for information technology (NPfIT) it is the responsibility of the local service providers (LSPs) to manage the delivery of systems and services to the contracted timetables and for the management of their sub-contractors and suppliers, of which Cerner is one. The Department assesses progress against plans and manages the relationship and commercial arrangements with suppliers to ensure that national health service requirements are being met.

Ministerial responsibility for NPfIT over the period has been as follows:

Day-to-day responsibility for NPfIT currently lies with Martin Bellamy as director of programme and system delivery accountable to Ministers for the strategic direction of the programme and for management of the contracts between the Department and LSPs. Mr. Bellamy took up his post in September 2008. Prior to his appointment, responsibility lay with Gordon Hextall, chief operating officer, from January 2008, following the departure of the then director general of NHS IT, Richard Granger. Mr. Granger was appointed, at the inception of the national programme, in October 2002.


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No meetings have to date been held, or are currently planned, between Ministers and trust officials specifically relating to the systems. Responsibility for deployments, including planning and timetabling, lies with the relevant NHS bodies, who agree the deployments with suppliers in line with the suppliers’ capacity and their local circumstances. There have been and will continue to be numerous meetings between trusts and heads of IT, including visits to trusts as a matter of routine business.

The local NHS service implementation and running costs of NPfIT systems and services are paid by the NHS bodies which receive and benefit from them, out of normal NHS allocations.

NHS: Manpower

Mr. Jenkins: To ask the Secretary of State for Health how many NHS (a) nurses and (b) doctors were employed by the South Staffordshire primary care trust in each year since 1997. [237331]

Ann Keen: The information is not collected in the format requested.

The number of hospital and community health services (HCHS) medical and dental staff and nurses employed by South Staffordshire primary care trust (PCT) is shown in the following table. The information is not available prior to 2002.

HCHS: medical and dental staff and nurses( 1) within South Staffordshire PCT( 2)
Number (headcount)
As at 30 September each year
2002 2003 2004 2005 2006 2007

HCHS Medical and Dental staff

7

24

34

39

39

33

HCHS Nurses

669

724

857

947

1,093

1,042

(1) General practitioners (GP) and GP practice nurses have been excluded from the figures, as they are not directly employed by the PCT.
(2) South Staffordshire PCT was formed in October 2006 from a complete merger of Burntwood, Lichfield and Tamworth PCT, East Staffordshire PCT, Cannock Chase PCT and South Western Staffordshire PCT. Figures prior to 2006 are an aggregate of these predecessor organisations.
Note:
Data Quality:
Work force statistics are compiled from data sent by more than 300 national health service (NHS) trusts and PCTs in England. The 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. Processing methods and procedures are continually being updated to improve data quality. Where this happens, any impact on figures already published will be assessed but unless this is significant at national level they will not be changed. Where there is impact only at detailed or local level, this will be footnoted in relevant analyses.
Sources:
The Information Centre for health and social care Medical and Dental Workforce Census.
The Information Centre for health and social care General and Personal Medical Services Statistics.

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