3. System Reform
3.1.1 What has NHS expenditure on the purchase
of healthcare from non-NHS bodies been in each year since 1997-98?
Could the Department provide a detailed breakdown of these data
where available? What efforts are being made to ensure this information
is available from Foundation Trusts?(Q16)
Answer
1. Table 16a shows the overall spending
on healthcare provided by non-NHS bodies. Figures are from annual
financial returns and for 2006-07 and 2007-08 from audited PCT
summarisation schedules and should be reliable.
2. The figures show the total purchase of
healthcare from non-NHS bodies and so include nursing care spend
(for non-NHS staff). The data in the table include expenditure
on services provided by all non-NHS bodies, including local authorities
and other statutory bodies, as well as independent healthcare
providers. The figures cannot be broken down between acute and
non-acute.
3. From 2006-07, new analysis is available
showing how non-NHS spend by PCTs, which accounts for 95% of the
total, is spread across different types of provider (see Table
16b).
4. The responsibilities of NHS foundation
trusts (NHS FTs) to provide information externally are set out
in the NHS Act 2006. Under s48, the Terms of Authorisation for
NHS FTs:
— must require the trust to disclose
such information as the SofS specifies to Monitor; and
— may require the trust to disclose
other information to Monitor.
5. NHS FTs have independent status in the
NHS and are free from SofS's powers of direction. The earned autonomy
enjoyed by foundation status is a fundamental part of health reform
and it is important that this is properly protected. The Department
has worked with Monitor and others to ensure that only information
determined as necessary is collected from the NHS FT sector eg
to support policy development, standard setting, funding decisions
for the NHS etc. All data returns from NHS FTs are set out in
schedule 6 of each Authorisation in accordance with the legislation
and principles set out in guidance.
6. NHS FTs are not required to complete
information data requests that do not fit with mandatory requirements.
In this specific case, these data will be included as part of
each NHS foundation trust's annual accounts, which they must present
before Parliament each year. Monitor is also obliged to prepare
a report each year that presents an overall summary of the accounts
of NHS foundation trusts and lay this before Parliament, which
is published on the Monitor website. These show that between 2004-05
and 2006-07 the non-NHS spend by NHS foundation trusts was £15
million, £20 million and £48 million respectively. Figures
for 2007-08 are not yet available.
Table 16a
EXPENDITURE BY NHS BODIES ON THE PURCHASE
OF HEALTHCARE FROM NON-NHS BODIES
£ thousands
| Year | Health authorities/
| Primary care | NHS trusts |
Total expenditure |
| strategic health authorities
| trusts | |
|
1997-98 | 985,746
| n/a | 122,436 | 1,108,182
|
| 1998-99 | 1,108,471 | n/a
| 121,954 | 1,230,425 |
| 1999-2000 | 1,166,412 | n/a
| 134,784 | 1,301,196 |
| 2000-01 | 1,328,208 | 33,774
| 187,190 | 1,549,172 |
| 2001-02 | 1,136,793 | 409,936
| 246,238 | 1,792,967 |
| 2002-03 | 27,234 | 1,873,925
| 338,172 | 2,239,331 |
| 2003-04 | 3,329 | 2,903,763
| 408,801 | 3,315,893 |
| 2004-05 | 0 | 3,353,036
| 312,988 | 3,666,024 |
| 2005-06 | 0 | 4,096,300
| 319,231 | 4,415,531 |
| 2006-07 | 0 | 4,700,373
| 297,440 | 4,997,813 |
| 2007-08 | 0 | 5,718,197
| 295,079 | 6,013,276 |
Source:
Financial Planning and Allocations, DH.
Annual Financial Returns of Health Authorities, 1997-98 to 2001-02.
Annual Financial Returns of Strategic Health Authorities, 2002-03 to 2007-08.
Annual Financial Returns of NHS Trusts, 1997-98 to 2005-06.
Audited NHS Trust summarisation schedules 2006-07 and 2007-08.
Annual Financial Returns Primary Care Trusts, 2000-01 to 2005-06.
Audited PCT summarisation schedules 2006-07 and 2007-08.
Footnote:
1. 2004-05, 2005-06, 2006-07 and 2007-08 NHS trusts data does not include NHS foundation trusts.
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Table 16b
EXPENDITURE BY PCTs ON THE PURCHASE OF HEALTHCARE FROM
NON-NHS BODIES, 2006-07 AND 2007-08
£ million
| Spend with | 2006-07
| 2007-08 |
ISTCs | 200 |
314 |
| Other private sector providers | 1,992
| 2,602 |
| Voluntary sector | 366 |
421 |
| Local authorities | 1,487 |
1,936 |
| Other | 655 | 445
|
| Total spend by PCTs | 4,700
| 5,718 |
Source:
Financial Planning and Allocations, DH.
(Audited PCT summarisation schedules 2006-07 and 2007-08).
Footnote:
1. Figures for 2006-07 have been restated following further validation.
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