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The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): Strategic health authorities (SHAs) are looking at options for those National Health Service trusts which will not be able to make an application for foundation trust status by 31 December 2010. Options may include mergers and reconfigurations to create viable organisations able to achieve foundation status. The aim is that all National Health Service hospitals should ultimately offer services to the foundation trust standard. SHAs have been asked to present options by the end of 2009.
To ask Her Majesty's Government whether strategic health authorities can require the merger of primary care trust commissioners if they consider that the commissioning performance of particular trusts is unsatisfactory, not serving the best interests of the local population or wasting public money; and, if so, whether such mergers would require the agreement of the Competition and Collaboration Panel. [HL4742]
The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): In June 2008, the department published Developing the NHS Performance Regime1, which sets out expectations of strategic health authorities (SHAs) in identifying underperformance, supporting recovery and the options for managing commissioner failure. A copy has already been placed in the Library. These options include recommending a statutory merger, which would be subject to Secretary of State approval in individual cases. Subject to published materiality thresholds2, where a proposed merger involves provider services the SHA would be expected to refer the proposal to the Co-operation and Competition Panel for advice and in order to inform the approval process. The Co-operation and Competition Panel would advise on the proposed merger of provider services as to compliance with the Principles and Rules for Co-operation and Competition3, which permit mergers where demonstrated to be in patient and taxpayers' best interests. A copy has already been placed in the Library.
To ask Her Majesty's Government what proportion of general practitioner practices are engaged in practice-based commissioning as envisaged by their 2005 manifesto commitment to develop such commissioning; and what proportion of primary care trust commissioning budgets in each strategic health authority area is spent on practice-based commissioning in the latest financial year for which information is available. [HL4743]
However, the department carries out a quarterly survey of around 2,000 GP practices to gauge views on PBC. The last survey results were published on 27 March 2009 and show that 92 per cent of practices are part of a PBC group.
To ask Her Majesty's Government when they expect primary care trust commissioners to have all their hospital trusts operating balanced budgets without one-off payments and without historic debts, in light of the Government's funding of the National Health Service up to the end of the financial year 2010-11. [HL4746]
Whilst the financial plans have now been agreed for 2009-10, the financial plans for 2010-11 have not yet been agreed. We are working through the 2010-11 financial plans with the strategic health authorities, with a view to minimising the number of organisations with historic debt and who are not in recurrent balance at the end of 2010-11.
To ask Her Majesty's Government what measures of performance are available to the public to assess the efficiency and effectiveness of primary care trust community services, particularly those providing district nursing and health visitors similar to those provided for acute hospitals. [HL4649]
To ask Her Majesty's Government what are the primary care trusts that are regarded by strategic health authorities as having "business ready" autonomous provider organisations; and when they envisage the remainder will achieve this status. [HL4650]
To ask Her Majesty's Government whether they plan to require primary care trusts to subject new "business ready" autonomous provider organisations to a process of open competition to improve efficiency, effectiveness and value for money. [HL4651]
The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): In January 2009, the department published Transforming Community Services: enabling new patterns of provision1,
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Strategic health authorities (SHAs) are responsible for overseeing this process, at local level, and for agreeing development plans to ensure all PCTs provider arms have moved into a contractual relationship with the PCT commissioning function by October 2010. Data on the progress of individual PCTs towards achievement of these aims are not currently held centrally.
Under the principles and rules for co-operation and competition in the National Health Service2 (NHS), it is for individual PCTs to decide and agree with their respective SHA which services should be subject to direct competition, the extent of such competition, and how this should be secured (having regard to these principles and rules).
Also, on 24 June 2009, we launched the Transforming Community Services Quality Framework: Guidance for Community Services3, which sets the direction for implementing the quality framework within community services. We have identified an initial set of 76 potential indicators to describe quality community services and we are now seeking views on these. The intention is that these indicators, once validated, will be published by the NHS Information Centre as part of the indicators for quality improvement and will be made more accessible to the public through publishing relevant indicators on NHS Choices.
To ask Her Majesty's Government what plans they have to introduce changes to the acute hospital tariff to discourage patients being inappropriately placed in acute hospital beds, as identified by the NHS Chief Executive on page 40 of his 2008-09 annual report. [HL4666]
The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): The development of the national tariff continues to be guided by the desire to incentivise the provision of high quality care in the most appropriate setting.
In 2010-11 we intend, for the first time, to set a small number of tariffs based on clinical best practice rather than average costs. The outcomes of this work will inform future thinking on the approach to tariff-setting for admitted patient care, and in particular how this mechanism can be used to recognise best practice patient pathways and further incentivise the provision of care in the most appropriate setting.
The Financial Services Secretary to the Treasury (Lord Myners): Since 2002 HM Treasury has regularly published long-term projections of expenditure on state pensions and public sector pensions. The latest projections were published in March 2008 in the Long-Term Public Finance Report, a copy of which has been deposited in the Library of the House. The next Long-Term Public Finance Report will be published in 2009.
To ask Her Majesty's Government further to the Written Answer by Baroness Royall of Blaisdon on 23 June (WA 272-3) concerning the team appointed to renew the equity monitoring procedures of the Northern Ireland Prison Service, why, although the names of the members were listed in a public document, they will not provide the names. [HL4565]
Baroness Royall of Blaisdon: The roles of the review team members, not their names, were listed in the public document. As previously stated, it is not normal
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The Parliamentary Under-Secretary of State, Department for Children, Schools and Families (Baroness Morgan of Drefelin): Information on the costs of educating children with special educational needs (SEN) broken down by age is not collected centrally.
To ask Her Majesty's Government whether all appropriate persons have been identified by the Environment Agency Wales in relation to pollution at Brofiscin Quarry; and when remedial action is expected to take place. [HL4564]
The Parliamentary Under-Secretary of State, Department for Environment, Food and Rural Affairs (Lord Davies of Oldham): The Environment Agency has not yet formally concluded its "appropriate person" determination in respect of Brofiscin Quarry.
Encouraging voluntary remediation is an important objective of the contaminated land regime and the Environment Agency is continuing to explore opportunities for such an approach. The remedial options appraisal outlines the remedial assessment actions required. These actions began in autumn 2008 and are planned to take place over a three-year period.
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