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Foreign and Commonwealth Office: DEL

The Minister of State, Foreign and Commonwealth Office (Lord Malloch-Brown): My honourable friend the Parliamentary Under-Secretary of State for Foreign and Commonwealth Affairs (Meg Munn) has made the following Written Ministerial Statement.

Subject to parliamentary approval of any necessary supplementary estimate, the Foreign and Commonwealth Office departmental expenditure limit (DEL) will be increased by £48,122,000 from £1,840,333,000 to £1,888,455,000. The administration budget will be increased by £14,000 from £870,046,000 to £870,060,000. Within the DEL change, the impact on resources and capital are as set out in the following table:

	Change £’000		New DEL £’000
	Voted	Non- voted	Voted	Non- voted	Total
Resource	30,122	-17,000	1,811,464	10,862	1,822,326
Of which:
Administration budget *	17,014	-17,000	870,060	-	870,060
Near-cash in resource DEL	30,122	-17,000	1,654,745	10,862	1,665,607
Capital **	36,000	-1,000	182,753	-	182,753
Depreciation ***	-	-	-116,624	-	-116,624
Total	66,122	-18,000	1,877,593	10,862	1,888,455

* The total of administration budget and near-cash in resource DEL figures may well be greater than total resource DEL, due to the definitions overlapping.

** Capital DEL includes items treated as resource in estimates and accounts but as capital DEL in budgets.

*** Depreciation, which forms part of resource DEL, is excluded from the total DEL since capital DEL includes capital spending and to include depreciation of those assets would lead to double counting.

The change in the resource element of the DEL arises from:

Administration

£14,000 transfer of administration budget from Cabinet Office in respect of the Privy Council Office.

Programme

take-up of £22,000,000 other current end-year flexibility for departmental restructuring;transfer of £7,000,000 other current expenditure to Home Office for the Border and Immigration Agency; transfer of £5,300,000 programme expenditure to the security and intelligence agencies to cover expansion and capability; and

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a £3,407,000 claim on the DEL reserve in respect of emergency disaster relief.

increased other current expenditure of £60,000,000, fully offset by income, for consular and visa work; andincreased other current expenditure of £2,830,000, fully offset by income, in respect of anti-narcotics work.

Capital

take-up of £35,000,000 end-year flexibility in respect of the FCO estate.

Programme

transfer of £3,000,000 from DfID in respect of conflict prevention operations in Afghanistan; and transfer of £3,000,000 programme expenditure to security and intelligence agencies to cover expansion and capability.

Government Equalities Office: DEL

The Lord President of the Council (Baroness Ashton of Upholland): My right honourable friend the Lord Privy Seal (Harriet Harman) has made the following Statement.

The Transfer of Functions (Equality) Order 2007 (No. 2914) confirms the establishment of the Government Equalities Office and details the functions that have transferred from the Secretary of State for Communities and Local Government. The transfer of functions from the Department of Communities and Local Government came into force on 12 October 2007.

Subject to parliamentary approval of the necessary supplementary estimate, the Government Equalities Office departmental expenditure limit will be set at £73,430,000 and the administration budget will be set at £3,885,000. The departmental expenditure limit includes £46,500,000 resource and £7,000,000 capital funding for the Commission for Equality and Human Rights.

Within the departmental expenditure limit, the impact on resource and capital is as set out in the following table:

Departmental expenditure limit £k
	Voted	Non-voted	Total
Resource	33,296	33,538	66,834
Of which:*
Administration	3,885	0	3,885
Near-cash	33,296	32,929	66,225
Capital **	0	7,175	7,175
Depreciation ***	0	-579	-579
Total	33,296	40,134	73,430

^*The total of administration budget and near-cash figures may be greater than total resource departmental expenditure limit, due to the definitions overlapping.

^**Capital departmental expenditure limit includes items treated as resource in estimates and accounts but treated as capital departmental expenditure limit in budgets.

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^***Depreciation, which forms part of resource departmental expenditure limit, is excluded from the total departmental expenditure limit since capital departmental expenditure limit includes capital spending and to include depreciation of those assets would lead to double counting.

Health: Independent Sector

The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): My right honourable friend the Secretary of State for Health (Alan Johnson) has made the following Written Ministerial Statement.

The independent sector is playing an important and increasing role within the NHS, providing high-quality treatment and choice for patients, and innovation, dynamism and contestability for existing National Health Service providers. Alongside the hard work of staff and in every organisation, the use of the independent sector is an integral part of our success in delivering dramatic falls in waiting times for patients. That is why we have taken a number of measures to make better use of the independent sector:

in the first wave of the independent sector treatment centre (ISTC) programme we established 23 fixed site ISTCs, a mobile ophthalmology service, a mobile MRI scanning service, a chlamydia screening service and six walk-in centres. This investment worth over £1.4 billion has provided nearly 800,000 elective procedures, diagnostic assessments and episodes of primary care to NHS patients and is helping to reduce waiting times in those areas. I am today providing further information on each first-wave scheme, including the contract value, volume of activity, case mix by volume and utilisation rates, and in future these data will be published annually;there has been rapid growth in patients choosing to be referred to the 129 independent sector hospitals currently registered under the extended choice scheme. The value of activity has doubled in the last month alone. From April 2008, all patients referred for an elective procedure will be able to choose to go to any hospital in England which meets NHS standards and price. This already applies for orthopaedics and from December will cover general surgery, gynaecology and cardiology; and we are procuring additional GP services through the fairness in primary care initiative from a range of providers including the independent sector, and as announced last month we will be inviting bidders for further primary care contracts as we roll out new GP-led health centres and extra GP surgeries in deprived areas. In addition, we are offering primary care trusts the opportunity to use independent sector expertise in developing their commissioning function.

As I said to the Health Select Committee in July, independent sector procurement will have to meet the local needs of patients and offer sound value for money for taxpayers. Where it meets these requirements we will increase the role of the independent sector in the provision of NHS services.

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The department has therefore undertaken a thorough revalidation of all the schemes currently being procured nationally through the ISTC programme to ensure they meet these objectives.

The director-general of the commercial directorate has advised that I proceed with the procurement of the following schemes:

PET CT North Diagnostics (additional CT scans);PET CT South Diagnostics (additional CT scans);Renal (provision of dialysis treatment);Hampshire and Isle of Wight Electives (Southampton element);Greater Manchester (B) Clinical Assessment and Treatment Services;Avon, Gloucestershire and Wiltshire Electives;Essex Electives;Hertfordshire Electives;Greater Manchester (A) Clinical Assessment and Treatment Services; andLondon North Electives.

I am pleased to announce that three of these—PET CT North, PET CT South and the Renal scheme—have been approved to move to financial close. The department will conclude decisions on the remaining schemes no later than the end of March 2008.

However, the director-general has concluded that the following schemes should not proceed as they were unlikely to provide acceptable value for money as the local NHS has successfully improved capacity to meet patients’ needs. These are:

North East Yorkshire and North Lincolnshire Referral Assessment Diagnostics and Treatment Service;North East Diagnostics;South East Diagnostics;Norfolk, Suffolk and Cambridge Electives;Cumbria and Lancashire Clinical Assessment and Treatment Service; and Hampshire and Isle of Wight Electives (Lymington element).

In addition, the director-general has advised that the contract with Care UK for the provision of diagnostic services in the West Midlands should be terminated because of an unacceptably low rate of use (5 per cent utilisation to date), and a very low prospect of the utilisation increasing which represents poor value for money to the taxpayer. In short, a significant increase in productivity by local NHS providers has substantially reduced the need for the capacity provided by this scheme with waiting times for most diagnostics reduced from more than one year to currently three weeks on average.

The reduction in the overall size of the procurement does not represent a change in policy. As I have stated before, we will continue to use the independent sector. However, as I said to the Health Select Committee, we will now move towards greater local procurement of services. This will enable primary care trusts to take procurement decisions quickly on behalf of their patients rather than waiting

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for a prolonged process run from Whitehall. We believe that this will be a more effective route for increasing the quality of the role which the independent sector is able to provide in the NHS

To support this move I am announcing today the establishment of an independent sector procurement forum as a means for independent and third sector providers to advise the department on policies and practices related to local procurement of clinical services in order to ensure a level playing field. The forum will draw on a range of expertise and experience, including Ivan Bradbury of InHealth Netcare and Sir Ian Carruthers of the South West Strategic Health Authority. The forum will be advisory and act as a channel for the market to communicate and advise the department on PCT procurement policies and practices.

We remain committed to choice, to empower patients and drive improvements in the quality of care. For choice to be truly effective, and for all providers to be able to compete fairly, it is essential that all patients are aware that they can now choose the hospital they are referred to. In the run-up to the start of free choice, we will raise public awareness of choice through, for example, NHS Choices and other means, as well as encouraging local providers to inform patients about the local choices available to them, and publishing a code of promotion to help guide them in this. To ensure fairness we will also:

publish clear competition principles and simple rules for commissioners and providers to apply consistently for all those that provide services on behalf of the NHS, including social enterprise and third sector organisations as well as the independent sector;

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