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It now appears likely that a WTO ministerial on the DDA will be convened later in December. The discussion is likely to focus on the EU position and tactics ahead of the proposed ministerial. The Government expect partners to express a range of views on the likely
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outcome and success of the negotiations, reiterating in this context domestic concerns. Achieving agreement in the DDA remains the Government’s top trade priority and our objective at the GAERC will be to ensure Partners’ continued support for the European Commission, so that it can negotiate the best possible outcome for the EU.

Western Balkans

Discussion is likely to focus on Kosovo, and in particular deployment of the EU’s rule of law mission, EULEX. Kosovo has made clear its agreement to EULEX deployment while, following last week’s presidential statement in the UN Security Council, Serbia has also announced that it would support it. The Government believe EULEX should rapidly become operational throughout Kosovo.

Ministers are also likely to discuss Serbia’s progress towards the EU. The Government believes that Serbia has in recent months significantly improved its co-operation with the International Criminal Tribunal for the former Yugoslavia (ICTY) in The Hague. While we would be happy for the EU to recognise that improvement—for example by allowing the entry into force of the “Interim Agreement”—we believe that Serbia will need to demonstrate full co-operation with ICTY before its stabilisation and association agreement with the EU can be ratified.

Middle East

The Council will discuss the renewed EU action strategy for peace in the Middle East, recognising the need for a comprehensive regional approach utilising the Arab peace initiative. Ministers will reaffirm the EU’s commitment to focus on supporting Israeli-Palestinian negotiations and assisting Palestinian state building efforts.

We expect Council conclusions to: condemn all violence; urge a halt to new settlement activities; and call for an urgent improvement in the Gaza humanitarian situation, the release of Gilad Shalit and an increase in the numbers of Palestinian prisoners released.

The Council will confirm that the Middle East Peace Process is a top priority for the EU and will remain so into 2009, and urge the next US Administration to participate in early engagement on this issue.

Democratic Republic of Congo (DRC)

Discussion is likely to focus on progress towards a political resolution of the conflict in eastern DRC. Ministers will consider how the EU can support the efforts of former President Obasanjo, the UN Secretary-General’s Special Envoy to the region. They are also likely to discuss ways of alleviating the very serious humanitarian consequences of recent fighting. As the CNDP militia—rebels loyal to Laurent Nkunda— retreats from positions it has captured recently, it is vital that humanitarian aid can reliably reach the people who need it. This requires appropriate military capacity and Ministers are likely to consider what role the EU can play in the augmentation of the UN Mission in the DRC (MONUC).


We expect conclusions to condemn the ongoing failure to reach an equitable power-sharing agreement in Zimbabwe. We anticipate that the Council will express serious concern at the deepening humanitarian crisis
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and the rising incidents of cholera in Zimbabwe. The EU will reaffirm its commitment to the alleviation of suffering through the provision of aid.


We expect conclusions to welcome Pakistan’s return to democracy and commitment to step up measures to counter terrorism and extremism. We also expect Ministers to commit to further developing EU political dialogue in a number of areas including: trade and development; intercultural exchange; non-proliferation; human rights; counter-terrorism; and radicalisation and education. The Council will discuss how best to intensify political dialogue in line with EU commitments to enhance engagement with Pakistan. The Council will also acknowledge Pakistan’s request to initiate the process for an EU-Pakistan Free Trade Agreement and will commit to examining all the options aimed at enhancing trade relations.

European Security and Defence Policy (ESDP)

Ministers will consider efforts to improve the capabilities of the EU Member States; teaching partnerships with organisations such as NATO and UN; and ongoing EU operations, including the operation to improve maritime security off the coast of Somalia, which will be commanded by a British Rear Admiral from the UK’s multinational headquarters at Northwood. Ministers will also agree statements on increasing co-operation between the European Defence Agency (EDA) and the Organisation for Joint Armament Cooperation (OCCAR); a voluntary scheme for the exchange of young military officers; civilian and military capabilities; and on international security. The Government welcome this opportunity to underline the importance we attach to further improving the EU’s ability to stabilise countries emerging from conflict.

We also expect Ministers to approve a review by high representative Solana of the implementation of the European Security Strategy. The document is intended to complement—not replace—the 2003 Strategy which was the EU’s first high level security strategy. The review text focuses mainly on what has been achieved and what has changed. It highlights new threats to stability since 2003: climate change, energy security, globalisation, proliferation, cyber security, piracy. The Government can welcome the broad direction of the document and its key policy conclusions—greater coherence, engagement with the neighbourhood and capabilities.


Primary Care Trust Revenue Allocations/NHS Operating Framework

The Secretary of State for Health (Alan Johnson): The national health service has benefited from successive generous spending settlements, as investment in the NHS has trebled since 1997. This investment has funded the record increases in staff, hospitals and medical advances we have seen in recent years.

We have also seen strong financial management across the NHS over the last few years, which has turned a deficit into a healthy surplus. The NHS has exceeded its Gershon efficiency targets, delivering £7.88 billion savings
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over the last four years. We expect the NHS to continue to deliver at this level, and to bring forward further proposals to drive additional efficiencies throughout their operations. We can be confident, therefore, that in the tighter economic climate ahead, the NHS is on a firm financial footing and will be well equipped to meet the efficiency challenges of the coming years.

I am pleased to announce today the next round of revenue allocations to primary care trusts (PCTs) for 2009-10 and 2010-11. PCTs will receive an average increase of 5.5 per cent. in both years, a total increase in funding of £8.6 billion, bringing the total allocations to PCTs over two years to £164 billion.

This means that by 2010-11 PCTs will receive, on average, £1,612 per person. The comparable figure in 1996-97 was £426 per head. We are putting a greater proportion of the resources available into local communities and closer to patients, with more than 80 per cent. of the NHS revenue budget allocated directly to PCTs.

I will be writing this week to every hon. Member in England detailing their relevant PCT’s allocations for the two years. I also have included with this statement a table of the 2009-10 and 2010-11 PCT revenue allocations.

The allocations that I am announcing today are based on a new, more technically robust formula that has been recommended by the independent Advisory Committee on Resource Allocation (ACRA). This improves on the previous formula by:

It includes a health inequalities formula that continues to target resources to the places with the biggest health problems.

I have placed in the Library ACRA’s report and recommendations on the funding formula to make it fairer.

Alongside these revenue allocations, David Nicholson, the NHS chief executive, is publishing this week the NHS operating framework for 2009-10, which sets out the priorities for next year.

This year’s operating framework sets out how we will support the health service to deliver the vision in Lord Darzi’s “High Quality Care for All” to put quality at the heart of everything the NHS does.

To ensure that we continue to empower and support the local NHS, we need to plot a stable and consistent path. Therefore, the five key priorities for the NHS are consistent with last year:

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Alongside the national priorities, PCTs will set their own local priorities built on evidence about local needs. They will need to work in step with local government through local area agreements that focus on improving health and well-being as well as better healthcare.

To deliver that agenda of improving services for patients in this challenging economic climate, we need to redouble our efforts to improve efficiency in the public sector and to get best value for taxpayers’ money.

In this context, high quality care is not a luxury but a necessity. Prioritising the most effective treatments, reducing errors and waste and keeping people healthy and independent for as long as possible are all things that contribute not only to the quality of care, but also to a more efficient and productive health service. High quality and value for money are not competing alternatives; they are one and the same thing.

We will accelerate our commitment to implement the vision of quality as the organising principle for the NHS set out in “High Quality Care for All”. As Lord Darzi said in his interim report last year: “Effective care matters of course because patients should get the best outcomes. The evidence also shows that the most effective treatment is very often the most efficient treatment”.

For example, through the great efforts of the NHS to tackle healthcare associated infections in recent years, we estimate the NHS has already saved over £75 million in reduced bed days and drug costs, while improving outcomes for patients. These savings will rise as we continue to drive down infection rates. Better care equals better value

Recent efforts have underlined the potential for further efficiency gains. As the NHS develops its plans in 2009, it will build on the work of the cross-Government operational efficiency programme and Department of Health’s own public value programme.

Already we have estimated there are substantial savings that can be delivered through driving up the quality of care, reducing waste and better commissioning and procurement, including, through better use of shared business services, improvements in the way the NHS estate is used, driving up quality through the world class commissioning programme, and changes to the tariff.

Over the course of the next year, the NHS will plan, bottom-up and in detail, how these productivity opportunities will be realised in 2010-11 and in future years. We want the NHS to bring forward the best package of measures appropriate to each locality.

Of course, a renewed drive for efficiency will be challenging, but even after making an allowance for improved efficiency, with 5.5 per cent. allocations in both of the next two years and prudent drawdown of £800 million of the NHS surplus over the same period, we are confident that the NHS can still secure the continuous improvement in care that patients, public and staff rightly demand.

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