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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.

NHS: Primary Care Trust Finances


Asked by Lord Warner

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.

Asked by Lord Warner

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Lord Darzi of Denham: The department does not collect information on the proportion of general practitioner (GP) practices that are engaged in practice-based commissioning (PBC).

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.

Information on the proportion of primary care trust commissioning budgets in each strategic health authority area that are spent on practice-based commissioning is not collected nationally.

Asked by Lord Warner

Lord Darzi of Denham: In the 2008-09 draft accounts five National Health Service (NHS) trusts reported an operating deficit.

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.

We do not collect information in respect of one-off payments.

NHS: Primary Care Trusts


Asked by Lord Warner

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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which describes our expectations of primary care trusts (PCTs) in achieving internal separation of commissioner and provider functions.

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).

We currently have no plan to depart from policy to require that PCTs subject their provider arm to a process of open competition.

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.

NHS: Tariffs


Asked by Lord Warner

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.

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Offender Management: Budgets


Asked by Lord Ramsbotham

The Parliamentary Under-Secretary of State, Ministry of Justice (Lord Bach): The operating budget for each Director of Offender Management region in England and Wales is:

East Midlands






North East


North West


South East


South West




West Midlands






Asked by The Earl of Dundee

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.

Prisons: Northern Ireland


Asked by Lord Laird

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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practice to publish the names of the prison service personnel unless this information is already in the public domain.

Schools: Special Educational Needs


Asked by Lord Bradley

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.

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Waste Management: Brofiscin Quarry


Asked by The Countess of Mar

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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