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NATO

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

The right honourable and learned Member for North-East Fife (Sir Menzies Campbell) has replaced the honourable Member for Hereford (Paul Keetch) as a member of the United Kingdom delegation to the NATO Parliamentary Assembly.

NHS: Financial Performance

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.

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At the end of 2005-06, the NHS had a net deficit of £547 million, with 123 (33 per cent) organisations building up a total gross deficit of £1.3 billion. Today I am pleased to say that we have turned that position around completely.

Financial projections at the end of September 2007 show that the NHS is forecasting a healthy £1.8 billion surplus for 2007-08, with only 25 trusts forecasting a deficit. This is a dramatic improvement and a testament to the efforts of NHS staff over the past year and half.

This level of surplus—which is only about 2 per cent of the overall NHS budget—shows sensible financial management. The NHS should not merely be aiming to break even year to year, it should be planning for a surplus so that it can make long-term investment decisions, such as public health investments and shifting appropriate care out of hospital and closer to people’s homes.

The chief executive of the Audit Commission, Steve Bundred, said last month:

“The NHS is no longer in deficit, which is good news for patients and for taxpayers. Managing money well goes hand-in-hand with providing better patient care. Trusts that fail to manage their money well are unlikely to be doing their best for patients”. (Audit Commission, Press Notice, 23 October)

But, while this is good news in overall terms, we are not resting on our laurels. We are working with strategic health authorities to support a handful of financially challenged trusts, which need intensive effort to get out of deficit. Our aim is that all NHS organisations should be out of in-year deficit by the end of next year.

This financial turnaround and surplus have been achieved at the same time that the NHS has maintained or improved performance on key indicators of patient care. We will be publishing a report tomorrow that shows:

waiting times are down to an all-time low and the NHS is on course to deliver the 18-week target;cancer waits are down;the excellent level of A&E performance has been maintained, even during periods of extra pressure;latest data show continued progress towards halving rates of MRSA, a problem in health systems across the developed world; andearly signs of promise on Clostridium difficile, with latest quarterly figures showing a fall in numbers for the first time.

The financial improvement has not been at the expense then of patient care. In fact, the independent Healthcare Commission’s last survey of recent hospital inpatients showed 92 per cent rated their care as good, very good or excellent.

These results have been achieved, in part, by introducing a stronger, fairer and more transparent NHS financial regime, coupled with a renewed emphasis on performance management, but more importantly by NHS organisations taking action to increase productivity such as:

increasing the use of day surgery and minimally invasive techniques;

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by providing support for people with long-term conditions and reducing unnecessary emergency bed days; and,reducing the use of agency staff.

The Comprehensive Spending Review settlement gave health a very good increase of 4 per cent in real terms, but even this means that the NHS will need to plan for a slowdown on the recent unprecedented levels of investment. The surplus gives the NHS flexibility to respond to fluctuations in demand and enables organisations to commit future growth on improving services for patients.

It must be emphasised that this surplus is not being held at the centre. It remains with the NHS so that it can use it to invest in improving the quality of patient care next year and in future years.

Through the rest of this financial year, the NHS will use the surplus to accelerate improvements. For example, the strategic health authorities have between them agreed investments of £57 million in a programme of deep cleaning for hospitals to help deliver a better patient experience.

The NHS will also have the capacity to accelerate progress in the numbers of patients treated within 18 weeks of referral to a specialist. For example, £22 million has been made available in NHS South Central and is already producing more clinics, diagnostic facilities and operating theatre sessions.

In the north-west, £35 million will be made available to support a broad range of public health initiatives. A large amount of this resource will be targeted at educational programmes. And in the East Midlands, £7 million has been made available to improve GP access and premises, along with a further £5 million to reduce health inequalities.

In conclusion, NHS performance at quarter 2 shows encouraging progress being made in delivering our promises to patients and the wider public, and the forecast surplus is a reassuring sign that the NHS is restored to financial health and will enable investment in improving the quality of patient care. Tables have been placed in the Library.

Thurrock Thames Gateway Development Corporation

The Parliamentary Under-Secretary of State, Department for Communities and Local Government (Baroness Andrews): My right honourable friend the Minister for Housing and Planning (Yvette Cooper) has made the following Written Ministerial Statement.

One year ago, we published the interim plan for the Thames Gateway, Europe’s largest regeneration programme, setting out the long-term vision and objectives for the Thames Gateway. We are today publishing a delivery plan, which sets out cross-government priorities and funding progress for the next three years.

Since last year, we have seen major progress on key projects including Crossrail, the Eurostar Ebbsfleet station, the O2 complex and the Olympic Park.

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Investment over the past three years includes improving green spaces such as Rainham Marshes, and public sector improvement such as new Sure Start centres as well as economic regeneration projects. Two new universities, at Southend and Medway, are providing nearly 5,000 new higher and further education places; the Docklands Light Railway extension to Woolwich will be completed in 2009; and employment growth from 2001-05 was 9 per cent, faster than the national average.

The plan published today provides a framework for making the best use of public investment, local ownership, big project expertise and private sector entrepreneurship. It sets out a proposed spending programme for 2008-11 which includes £500 million from the Department for Communities and Local Government for regeneration and £100 million for local transport improvements within a total government investment commitment of more than £9 billion.

The cross-government plan identifies three important themes for change in the Gateway: a strong economy, improvements in the quality of life for local communities and the development of the Gateway as an eco-region.

Within these, key to the success of the region are (1) economic transformation in four key areas: Canary Wharf, London Gateway, Ebbsfleet Valley, and the Olympic Park with Stratford City; (2) supporting the 10 largest developments for new homes; (3) the Thames Gateway Parklands; and (4) investing in a skilled workforce.

In terms of local communities, we have given priority in our spending allocations to six priority locations: Stratford, the Lower Lea and the Royal Docks; London Riverside; Greenwich Peninsula and Woolwich; Thurrock; Kent Thameside; and Medway. There are also five urban renewal areas receiving support: Barking; Basildon; Erith; Sittingbourne and Swale; and Southend.

The plan sets out the route to make the most of the economic potential of the Gateway, encourage new investment and jobs, and boost the skills of local people to take up new opportunities. This plan outlines:

an increase in the number of new jobs we expect in the Gateway to 225,000 by 2016;a £200 million strategic economic investment fund to support priority projects from the RDAs’ Thames Gateway economic development investment plan, that the RDAs estimate will lever in an additional £75 million and is on top of their baseline annual investment;a pan-Gateway skills plan developed by the Learning and Skills Councils to invest £1.6 billion in teaching and learning, and £850 million in new building for further education;the building and opening of new and extended further and higher education campuses in Grays and Basildon, Swale and Medway, creating around 9,000 places;

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commitment to a recommended approach to the biggest remaining constraint to development in the Thames Gateway, J30 of the M25 (the junction with the A13) with an announcement in 2008; and an allocation of £100 million from the community infrastructure fund to invest in 13 local transport schemes.

On top of economic investment, we are committed to improving the quality of life for all residents in the Gateway as a critical part of regeneration—building more affordable houses, investing in thriving town centres, public places and spaces, growing and improving public services, and supporting community cohesion. In this plan:

we prioritise funding from the Thames Gateway programme to secure housing programmes in the 10 locations where extra homes are most urgently needed. These 10 programmes are expected to deliver nearly 110,000 homes by 2016, the majority of our target figure;we set out the Housing Corporation intention to invest more than £800 million in around 15,000 affordable homes by 2011;we confirm that the Department for Communities and Local Government will ask the Commission for Architecture and the Built Environment (CABE) to do a further housing audit in the Gateway in 2010 to measure progress in improving design quality;we include planned spending of more than £600 million in this CSR period as part of a longer term £1.4 billion programme on new hospital provision serving the Gateway;we include planned investment of £1.2 billion on new or substantially refurbished schools in Gateway authorities, as well as £278 million allocated to support Sure Start centres in Gateway authorities, including 90 new ones; and we announce the appointment of Sir Terry Farrell as design champion for the Thames Gateway Parklands, a new programme to celebrate and enhance the individual character of the Gateway backed by a £35 million allocation of Thames Gateway funding to invest in improving the natural and urban environment.

The plan also outlines the challenges for the Gateway in both increasing economic growth, development and prosperity and tackling climate change. The Thames Gateway can lead the way with environmental jobs, greater use of renewables and new technologies, and environmental improvements

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to existing homes and building. This plan takes the first steps to promote higher standards for cutting carbon emissions, water conservation, reducing waste, and protecting people against flood risk. The plan outlines:

that the Department for Communities and Local Government will invite proposals for a new eco-quarter in the Gateway, similar to the plans for eco-towns but this time—for the first time—within an existing urban area;a continuing commitment to 80 per cent of new homes being built on brownfield land;£2 million available to promoters and developers to fund eco-risk assessments of the top 10 housing programmes, to ensure they will design in climate change mitigation, flood risk management, energy and water efficiency from the start;planned investment of £15 million in a community-focused programme to retrofit existing homes with energy-saving measures that will reduce emissions by up to 60 per cent;an allocation of £1.5 million from the Thames Gateway fund to work with the Energy Savings Trust to establish the first of the new national energy service centres to deliver the green homes services across the Gateway;a follow-up to our “water neutrality” feasibility study, investigating costs and possible delivery mechanisms;work on the costs and possible delivery mechanisms for a zero construction waste target across the Gateway; andinvestment by the RDAs in an international institute for sustainability.

The Government will ensure that public funds invested in the Gateway are subject to rigorous appraisal to secure value for money and, wherever possible, be used to attract additional private funding to maximise the benefit for Thames Gateway communities. The levels of funding set out in this delivery plan are therefore indicative and subject to final confirmation as individual projects come forward for appraisal.

The role of government across the Gateway is to ensure that key infrastructure is provided to promote improvement and growth and to provide the conditions that enable investor confidence to flourish. We need the market to respond to the new opportunities on offer. The ultimate measure of success will be when that investor confidence is assured and places in the Gateway take on a new and self-sustaining identity.

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