Select Committee on Health Memoranda


MEMORANDUM

SUBMITTED TO THE HEALTH COMMITTEE

Public Expenditure Questionnaire 2002

  Where questions are identical to those included in the 2001 PEQ, last year's question number is given in square brackets at the end of the question.

1.1 NHS medical workforce

  1.1.1   Could the Department provide information (a) on numbers of GP trainers for each of the last five years, (b) on current numbers of GP trainees, (c) on numbers completing training this year?

  1.1.2  In view of the impact of the medical workforce on future NHS costs and effectiveness, could the Department provide an age breakdown of hospital consultants and of unrestricted GP principals? Could the Department also provide estimates for the period 2003 to 2010 of the numbers of: (a) newly graduating medical school graduates; (b) registrars; (c) consultants and (d) GPs expected to reach retirement age.

1.2 Comparative health spending levels

  1.2.1  Could the Department provide estimates of how current levels of NHS spending compare with the European average, and estimates of changes assuming planned rates of growth in spending from now to 2007?

  1.2.2  Would the Department explain how it measures total health care spending, private as well as public, for its estimates of spending as a percentage of GDP? Has the definition of what is included within health care spending changed since 2000 and, if so, in what way?

1.3 Concordat activity

  1.3.1  How much NHS expenditure has there been on health care purchased from independent UK providers in each of the years 1999-2000, 2000-01 and 2001-02? Can these figures be broken down between acute and non-acute care and by specialty?

  1.3.2  How do prices paid by the NHS in 2001-02 for independently provided inpatient and day case treatment compare with NHS reference costs for the same treatments and procedures?

  1.3.3  How many NHS patients were treated in the private sector under the Concordat by doctors who also work in the NHS, and what proportion of all patients treated under the Concordat does this represent? How many were treated by the same doctor or surgical team they would have been treated by in the NHS, and what proportion of all patients treated under the Concordat does this represent?

  1.3.4  In a letter to the Committee of 9 January 2002, the Department reported briefly on a survey commissioned in September 2001, the purpose of which was to understand the volume, cost and nature of elective treatment provided to the NHS by the independent sector. Would the Department give a more detailed account of the findings of this survey, including tables where appropriate, and in particular the type of procedures making up the volume of cases commissioned, and the prices obtained by the NHS, and how these vary between different regions of the country? Does the Department intend to make the survey data available to independent researchers? When does the Department intend to re-run the survey, and when does it expect to make the results available publicly?

1.4 Buying from non-UK providers

  1.4.1  How much has the NHS spent on health care provided outside the UK, for how many patients and for what treatments, in each of the years 1999-2000, 2000-01 and 2001-02? What is the likely spending on health care outside the UK for 2002-03? If possible, distinguish between emergency (E111) care, non-emergency (E112) care and other purchases from non-UK providers.

1.5 Information for health

  1.5.1  Could the Department provide an annual breakdown of NHS expenditure on IM&T since the launch of `Information for Health' in 1999, for: IM&T infrastructure; Electronic Patient Records; clinical governance system; and staff training?

  1.5.2  Could the Department state what progress has been made on the Maternity Care Data Project? Is it on track to achieve the overall aim of having standardised and consistent recording of data relating to maternity and childbirth, for women and patients, within electronic patient record systems in all affected NHS organisations by April 2003? If this is not likely, what is the revised date for achieving this aim? What steps have the Department and the NHS Information Authority taken to achieve this aim? What resources will be made available to NHS Trusts and maternity units to upgrade their IT to record data in the ways defined, and to link their IT systems to those of other NHS systems?

2.  GENERAL EXPENDITURE ISSUES

2.1  NHS Financial Balance

  2.1.1  Based on current forecasts, what will be the likely financial performance of the NHS in 2002-03 in terms of financial balance, "deficit" organisations and performance. [1.1]

2.2  Overall Expenditure

  2.2.1  Could the Department provide an updated version of Table 2.1.1, and of the Department's commentary which accompanied it? Could it also show this data in graphical form? Could the Department provide a brief commentary, explaining what expenditure is included under each section of the table? Can the footnote to table 2.1.1 explain the measures and their applications for lines D to G? [2.1a]

  2.2.2  Could the Department identify significant changes between forecast and actual outturn for 2000-01 and between the planned level of spending and forecast outturn for 2001-02, by comparing figures in Table 2.1.1 with current figures. For each programme the planned level of spending in 2001-02 and actual outturn expenditure should be shown in tabular form.[2.1b]

  2.2.3  What is the Department's assessment of each programme's performance in 2000-01 against plans for that year, and anticipated performance in 2001-02 against plans for that year and outturn in 2000-01? [2.1d]

  2.2.4  The supply estimates are now presented in a simplified form which does not disaggregate the different sources for appropriations in aid. This is now presented only in an annex to the Departmental Report (Annex D, Information formerly in Supply Estimates). For the sake of clarity, could the Department give a detailed reconciliation between table 2.1.1 and appropriations in aid for each year since 1995-96 by sub-programme and source (ie miscellaneous, charges, sales of assets, capital repayments, trust debt remuneration). [2.1e]

  2.2.5  Any commentary which the Department wishes to append would be welcome, including information about efficiency gains and a table showing changes in the Hospital and Community Health Services cost-weighted index of activity for the latest ten years for which figures are available.[2.1f]

  2.2.6  Could the Department provide a breakdown of what the additional NHS expenditure in 2001-02 as compared with 2000-01 has been spent on? The impacts on expenditure of additional staff, increased pay levels, medicines, capital and other expenditures should be distinguished where possible.

2.3  Programme Budgets

  2.3.1  Could the Department update the information on expenditure on Programme Budgets provided in Tables 2.2? [2.2]

2.4  Special Allocations

  2.4.1  Could the Department list any special allocations and likely allocations in 2002-03, and indicate any likely allocations in 2003-04? [2.5]

2.5  Expenditure on Community Care

  2.5.1  Could the Department provide a table showing, by service, net expenditure in real terms by central and local government on community care, broken down by residential and non-residential care (taking into account relevant service pay and price increases), over the most recent five year period for which such data are available? Could this data include Social Security and Housing expenditures contributing to Community Care objectives? Could it also show this data in graphical form? [2.3]

3.  NHS RESOURCES AND ACTIVITY

3.1  General

  3.1.1  Could the Department provide tables showing health authority gross expenditure on HCHS by service sector and age group for the latest year for which data are available? [4.1a]

  3.1.2  Could the Department provide a table showing gross expenditure on Family Health Services in 2000-01 and 2001-02? [4.2]

  3.1.3  Could the Department provide tables which integrate expenditure on HCHS and FHS (Table 2.2.2. and 4.2.1) thus aligning data much more closely to PCTs' span of responsibilities? Could this integrated information also be provided by Strategic Health Authority area?

  3.1.4  Could the Department give an account of the funding streams for the General Medical Services budget and provide a trend analysis? [4.3a]

3.2  Inflation

  3.2.1  Could the Department give an explanation as to the level of funding set aside for inflation in 2002-03? In particular, can it give the average pay awards to each (subjective) staff group and the inflation assumptions for non pay including capital charges? [4.4a]

  3.2.2  Could the Department provide a breakdown of the components of the health specific inflation indices for revenue spending on HCHS and Family Health Services respectively, together with capital spending on HCHS, for 1999-2000 and 2000-01, together with estimates for 2001-02? The tables for the HCHS should show separate inflation indices for Review Body staff and non-Review Body staff pay, and whatever other breakdowns of staff are available.[4.4b]

  3.2.3  Would the Department state what the increase in expenditure on the NHS has been since 1992 in cash terms, real terms (GDP deflator) and real terms (NHS deflator)? [4.4c]

  3.2.4  Would the Department provide a table showing the construction of the NHS inflation index from main sub-indices of pay and other factor costs since 1992, and comment on the assumptions underlying this construct? Would the Department provide the weights used for each sub-index, for each year? [4.4d]

3.3  Hospital and Community Health Services Allocations and Distance from Targets

  3.3.1  Could the Department provide a table showing for each health authority or primary care trust:

    (i)  allocations for resident populations for 2001-02 (cash) and 2002-03 (cash and at 2001-02 prices);

    (ii)  2002-03 Distance From Targets (DFT) in cash and percentage terms;

    (iii)  growth in percentage terms;

    (iv)  net adjustment (cash) for Primary Care Groups and Primary Care Trusts;

    (v)  net adjustment for out of area treatments;

    (vi)  inherited deficits. [4.5a]

  3.3.2  Could the Department include a commentary explaining the key factors that determined those percentage growth increases shown in the table? [4.5b]

  3.3.3  Could the Department update the Committee on recent developments in allocations of HCHS resources and provide the timetable for any planned changes? [4.5c]

  3.3.4  Could the Department provide data on expenditure covering HCHS and FHS for each SHA area together with estimates of distances from target needs based expenditure?

3.4  Public Health

  3.4.1  Saving lives: our healthier nation set targets in 4 areas: cancer, CHD and stroke, accidents and mental health. How is the Department monitoring individual primary care trusts' progress towards the targets set in Saving lives? What assessment is being made of the effectiveness of any additional spending committed in response to these targets? What progress has been made to date? [3.1a]

  3.4.2  How many public health posts were there in English HAs in each year between 1998-2002? How many public health posts are there now in a) PCTs and b) Strategic Health Authorities?

3.5  Care of Mental Health and Learning Disability Patients

  3.5.1  Could the Department update the information given in Tables 2.4, on patients under the care of a learning disability or mental illness consultant, discharges by length of stay, ages and destination, and residential and other places available? Could the Department identify the number of individuals concerned, and hence the number of repeat discharges? [2.4a]

  3.5.2  Could the Department provide a table showing:

    (i)  number of people sectioned, by trust and by type of section?

    (ii)  number of people sectioned in proportion to HA population? If the data are not available, will the Department consider obtaining it from the HES?

    (iii)  number of people sectioned in proportion to number of admissions?

    (iv)  proportion of people who appeal against being sectioned and the outcomes of the appeals? [2.4b]

  3.5.3  Could the Department provide a table showing, over the last four years, the numbers of people with mental health problems and with learning disabilities who have been in special hospitals, prisons and regional secure units? [2.4c]

3.6  Expenditure on Prescribing

  3.6.1  Could the Department provide information on total NHS expenditure on pharmaceuticals for the past four years, including a breakdown by sector and by generic/branded drugs? Could the Department please state what data are available on pharmaceuticals in the non primary care sector, and how they are monitoring drug spending and cost pressures in the acute hospital and community sectors? [4.10a]

  3.6.2  Could the Department provide information on (i) total Family Health Services expenditure on prescribing for each year from 1992-93 to 2001-02, (ii) the average expenditure per capita, (iii) the total number of items prescribed and average number per capita, and (iv) the average cost per prescription? Any commentary which the Department would wish to append would be welcome, including an assessment of progress in meeting its stated target of restraining the growth in the drugs bill to sustainable and affordable limits. In particular, could the Department provide an update on the measures being taken to control NHS expenditure on generic drugs in primary care following the price increases in 1999-2000? [4.10b-c]

  3.6.3  Could the Department give an update on progress in getting the pharmaceutical industry to reduce drug costs by 4.5 per cent (as agreed in the PPRS)? Could the Department comment on issues such as volume, price and substitution? Has monitoring information improved since last year, and has this helped cost control?

  3.6.4  Could the Department provide estimates of the likely costs of NICE recommendations for the current financial year?

  3.6.5  Could the Department provide figures for the amount of money spent on statins per year over each of the last four years, if possible broken down by Trust and Health Authority.

3.7  Allocations to National Specialist Services

  3.7.1  What was the total allocation in 2000-01 and 2001-02 to each of the supra regional services and what is the planned allocation for 2002-03; and what significant changes have there been in the overall pattern of expenditure? [4.11]

3.8  Management and Administration Costs

  3.8.1  Could the Department provide a commentary on the progress it has made in defining management costs in PCTs, Strategic Health Authorities and NHS trusts? Could the Department update Table 4.11.1? [4.12]

  3.8.2  Could the Department provide figures for annual redundancy costs as a result of restructuring broken down by Health Authority and Trust, over the last 10 years?

3.9  Activity and waiting times

  3.9.1  Could the Department update the information given in Tables 4.13 showing activity data by region for 2000-01 and 2001-02, including: total activity, with trends; activity by Inpatient, Day-Case and Outpatient; maternity and simple access data? Could the Department provide figures for the ratio of Finished Consultant Episodes (FCEs) to hospital spells by Region for the same period? To what extent do a relatively small number of providers depart from the overall pattern? Could the Department report on the progress made by the NHS Information Authority in reviewing clinical information, including the use of the FCE as a measure of activity? [4.13]

  3.9.2  Could the Department update the data provided in table 4.14 on 10 year trends in bed availability and patient throughput for each major hospital sector and for each Region? Could information on bed occupancy (collected for the first time in 1996-97) and occupancy rates also be included? [4.14a]

  3.9.3  Could the Department provide figures for the number of delayed discharges of patients from acute settings? [4.14b] Could the Department provide an estimate of the number of bed days in 2001-02 for which Social Services Departments would have been expected to reimburse the NHS, had the proposed scheme for incentivising the release of beds been in force in that year?

  3.9.4  How many maternities were registered in each NHS region in 2000-01 and how many records in the Maternity Hospital Episode System had (i) maternity tails and, (ii) maternity tails containing data? Could the Department also update the information given in Tables 4.14.3-4.14.7? [4.15a]

  3.9.5  Could the Department provide figures on the Caesarean Section rate by Trust over the past five years, plus such figures for other maternity interventions as are available.

  3.9.6  Could the Department provide a commentary on, and show evidence of, the progress Trusts and Regions are making in improving data quality and on the steps the Department has taken to ensure improvement? [4.15b]

  3.9.7  Could the Department provide information about waiting lists, both distribution by waiting time as well as mean and median average time, on a district of residence basis and on a provider unit basis? Could the Department update Figure 14.16.1 showing changes in mean and median waiting times since March 1988? [4.16]

  3.9.8  Could the Department provide an update of Tables 4.16.4 to 4.16.8 on outpatient waiting times? [4.16b]

  3.9.9  Can the Department provide information about current levels and past trends of patients' total waiting times from first referral to a specialist to eventual inpatient or day case treatment?

  3.9.10  Could the Department provide figures on how many people were removed from waiting lists for day case treatment and for in-patient treatment (i) because of admission for treatment and (ii) for reasons other than treatment? How many people were self-deferred in each six-month period since September 1988? What rules apply to ensure consistent interpretation of these figures? Has the Department made any assessment of the extent to which people removed for reasons other than treatment in that hospital had either been admitted, died, been treated in another hospital, or no longer required treatment? [4.16c]

  3.9.11  Could the Department provide charts and figures showing how trends in emergency and waiting list, booked and planned activity have moved with waiting lists sizes since June 1991? Could the Department provide both indices and actual numbers in each case? [4.16d]

  3.9.12  Can the Department provide a comparison of total numbers of people waiting for outpatient appointments for each year for which figures are available, separately identifying trends in the average wait for an outpatient appointment? [4.16e]

  3.9.13  Can the Department estimate the number of people at each access point of the elective care system broken down to show:

    (a)  numbers of GP consultations

    (b)  numbers of referrals to specialist outpatient clinics

    (c)  numbers of attendances at specialist outpatient clinics

    (d)  numbers of placements on waiting lists (differentiated by (i) "waiting list", (ii) "booked" and (iii) "planned", and

    (e)  numbers of elective episodes of care, for each year since 1991-92 [4.16f]

  3.9.14  Would the Department provide a commentary on changes over time in numbers waiting at each stage, and the conversion rates between each stage? [4.16f]

  3.9.15  What additional mechanisms have been put in place since last year's response to deal with waiting lists? How is the success of each of these measured? What assessment have you made of the effectiveness of each? What has been the cost of each of these? [4.16g]

  3.9.16  Could the Department supply information on readmission rates to acute hospitals over the past ten years?

  3.9.17  Would the Department provide figures on the number of people on NHS waiting lists whose treatment has been paid for in the independent sector over the last 10 years? Would the Department explain how these patients are dealt with when calculating average waiting times for NHS patients? Are private patients treated in NHS hospitals included in the figures used by the Department to calculate total NHS elective activity, numbers admitted from NHS waiting lists and average NHS waiting times?

3.10  Commission for Health Improvement

  3.10.1  Would the Department provide the latest figures on the total expenditure by the Commission for Health Improvement (CHI) in each year since it was established in April 2000? Would the Department provide figures on the set-up costs of CHI in 1999-2000? Would the Department provide the latest planned expenditure figures for CHI in 2002-03 and 2003-04?

  3.10.2  Would the Department provide figures for the number of people employed each year by CHI since it was established in April 2000?

  3.10.3  Would the Department give a brief commentary on the work and achievements of CHI including the total number of clinical governance reviews, investigations and national studies that have been completed? Would the Department provide an estimate, by year if available, of:

    —  Cost per clinical governance review

    —  Cost per investigation

    —  Cost per national study

  3.10.4  Would the Department explain how it has evaluated CHI to ensure that it is delivering value for money and improvements to the quality of care in the NHS?

3.11  Race Relations (Amendment) Act 2000

  3.11.1  Would the Department explain what the additional responsibilities of NHS bodies are under the Race Relations (Amendment) Act 2000, and what steps the Department is taking to ensure that NHS bodies meet these responsibilities?

  3.11.2  Would the Department provide figures on the number of NHS bodies, by type of body, which have met the requirement under the Race Relations (Amendment) Act 2000 to publish a Race Equality Scheme by 31 May 2002?

  3.11.3  Would the Department like to provide any commentary on its own response to the Race Relations (Amendment) Act 2000?

  3.11.4  Would the Department provide figures on ethnic minority representation at board level in NHS bodies over the last five years, by health authority, NHS trust, or PCT, as appropriate? Would the Department also provide figures at Departmental and regional level?

  3.11.5  Would the Department provide figures on the numbers and proportions of ethnic minority staff employed by NHS bodies, by staff group, over the last five years, by health authority, NHS trust, or PCT as appropriate? Would the Department also provide figures at Departmental and regional level?

  3.11.6  All populations served by NHS bodies should receive equal treatment according to their needs. Would the Department explain what steps it has taken to ensure that people from minority ethnic groups receive equal treatment from NHS bodies? What evidence does the Department have to show that people from minority ethnic groups receive equal treatment from NHS bodies?

4.  PERSONAL SOCIAL SERVICES RESOURCES AND ACTIVITY

  4.1  Could the Department provide a table showing the latest figures on waiting times for receipt of care packages in each social services department?

  4.2  Could the Department provide a breakdown by PCT of time taken to issue first payments of free nursing care?

  4.3  Could the Department set out the Standard Spending Assessments (SSAs) for social services in the latest year, by local authority, and SSA sub-block, in cash, per capita, per capita of relevant population and per client? Could the Department also provide a table comparing the change in the total PSS SSA between the last two years for each local authority? [5.1]

  4.4  Could the Department describe any changes to the SSA formulae introduced in this year and provide details of any plans the Department has to review PSS SSAs further? Could the tables include sub-totals for type of authority and averages (so that individual authorities figures can be seen in context)? [5.1]

  4.5  Could the Department provide a table comparing PSS SSAs with the corresponding budget for each local authority for the latest two years for which comparable information is available? Could the Department illustrate how the total of PSS SSAs and budgeted expenditure in PSS have compared at the national level over the latest five years? Could the Department provide a commentary on any trends shown by these figures? [5.2]

  4.6  Could the Department set out in a table how the unit costs of the main social services for children and adults have changed over time? Could the Department quantify the degree of variation in these unit costs between authorities? Could the Department provide a commentary on these figures? [5.3]

  4.7  Could the Department provide a table showing for each authority the latest information on the proportion of social services for adults which are purchased from the independent sector rather than being provided directly? Could the Department supply a commentary on these figures? [5.4]

  4.8  Could the Department provide a table, by local authority, comparing the number of children fostered, with the number of children placed in community homes? [5.5]

  4.9  Could the Department provide data on the number of children involved in schemes which are specifically designed to support families? [5.5]

  4.10  Could the Department provide figures showing how the delivery of non-residential social services has changed over the last five years and comment on these trends? [5.6]

  4.11  Could the Department provide details of the specific inflation index calculated for social services, and an assessment of the financial effect of demographic pressures on social services? [5.7]

  4.12  Could the Department provide a breakdown by client group of gross expenditure for the latest available two years on the main items of social services activity? Could the Department also update Tables 5.8? [5.8]

  4.13  Could the Department provide details of any forthcoming changes to statistical information the Department collects on personal social services? [5.10]

  4.14  Could the Department provide details of any research work not reported last year that is currently being sponsored by the Department on the outcomes and effectiveness of social care? [5.11]

4.15  Fees, charges and grants

  4.15.1  Could the Department update Tables 5.12 providing separate figures on residential care for each client group? Could the Department quantify the degree of variation in domiciliary charges between authorities? Could the Department provide a commentary? [5.12]

  4.15.2  Could these figures be listed by LA, including any differential rates?

  4.15.3  Could the Department provide an analysis, to include chart, tables and commentary, of (i) the recent national trend in the percentage of gross expenditure on residential accommodation for older people recouped through fees and charges and (ii) the recent national trend in the percentage of gross expenditure on home care/home help for all client groups recouped through fees and charges? [5.12]

  4.15.4  Could the Department provide an analysis, to include chart, tables and commentary, of (i) the local authority variations in the latest year in the percentage of gross expenditure on residential accommodation for older people recouped through fees and charges and (ii) the local authority variations in the latest year in the percentage of gross expenditure on home care/home help for all client groups recouped through fees and charges? [5.12]

  4.15.5  Could the Department supplement this with a breakdown of proportion of patients on each social services rate (eg £35, £70, £105) per PCT?

  4.15.6  Could the Department provide details of the volume of specific or special grants made available, by the Department, to social services departments for the years 1997-98 to 2002-03? Could the Department provide a full explanation of any changes, introduced this year, to the volume, the purpose or the monitoring arrangements for any of the grants? [5.13]

5.  CAPITAL EXPENDITURE AND INVESTMENT

5.1  General

  5.1.1  Could the Department provide a table showing planned capital spending from 2001-02 to 2003-04? [4.1b]

5.2  Primary care capital investment and facilities

  5.2.1  Could the Department provide an account of capital allocations for primary care investment and the sources of funding (both HCHS capital and revenue and Family Health Services budgets) over the last eight years for England and by health authority? Can they reconcile the General Medical Services budgets against the HCHS and Family Health Services budgets? [4.3b]

  5.2.2  Could the Department provide a trend analysis of the costs of the rental reimbursement schemes (in graphic form) by category (eg notional, actual etc) and an explanation for any changes? [4.3c]

  5.2.3  Could the Department provide an account of the total value of the asset base in primary care by category of owner, eg HA, LA, GP, private provider? [4.3d]

  5.2.4  Could the Department provide an account of estimates of backlog in repairs and maintenance for primary care nationally and by health authority? [4.3e]

  5.2.5  Could the Department provide baseline data on the changing ownership of primary care premises and provide details of the top ten new provider companies? [4.3g]

  5.2.6  Could the Department please provide data on all grants, public loans and capital receipts used to fund or finance primary care facilities on an annual basis since 1997? [4.9a]

  5.2.7  Could the Department please provide a list of primary care premises which have signed or in the process of signing up for the use of PFI, together with their total capital cost, the length of contract, the annual unitary charge and availability fee and FM fee. Where projects are bundled with non-NHS facilities, could they also provide details of the other income streams eg from commercial and retail, local authority? [4.9b]

  5.2.8  Could the Department please provide a full account of the revenue implications of using private finance for all primary care schemes annually for the next ten years? [4.9c]

  5.2.9  Could the Department provide data on practice premise size (single handed, 1-4, 4-8, 8-12, 12 plus and average list size) by ownership category? [4.3h]

5.3  Hospital and Community Health Services capital prioritisation

  5.3.1  Could the Department list the criteria used by the Capital Prioritisation Advisory Group in its assessment of which projects to prioritise for major investment? Which schemes were assessed last year, and which were prioritised for investment? Of these, which have been allocated public and private funding? Could the Department give examples of schemes which have been turned down, and explain why? [4.7]

5.4  Long Term Capital Projects and PFI

  5.4.1  Could the Department provide a table showing all publicly funded capital projects with a total cost above £10 million which are under construction during 2002-03? Could this also show the original and current estimated completion dates along with a percentage figure for any additional time overrun/saving? Likewise, the original total cost and current estimated out-turn cost should be provided along with a percentage cost performance figure.[4.8a]

  5.4.2  Could the Department provide a commentary on cases where there are significant discrepancies between original estimates of completion dates and/or expenditures and current estimates? [4.8a]

  5.4.3  Could the Department provide details of PFI projects with a capital value of £10 million or over approved since 1992, including their current status? [4.8b]

  5.4.4  Could the Department provide tables showing the planned and actual annual contribution to capital from PFI, and the forecast level of investment generated by schemes over £10m plus an aggregate of those below £10m, since 1997-98? What revenue or transitional support is being given to support the scheme? Could the Department provide further details of locally agreed arrangements to provide revenue or transitional support to schemes? [4.8c]

  5.4.5  Could the Department provide a table showing the increases to the capital cost of schemes since the last expenditure questionnaire and provide a commentary on changes of more than 10 per cent? In addition, could the Department provide the initial costs of PFI schemes at outline business case (baseline year) for those schemes reported in last year's questionnaire and comment on increases? [4.8d]

  5.4.6  Could the Department provide data on the revenue consequences of schemes which have reached financial close and represent long term contractual commitment over the next 25 years? Could the Department provide an update of the Departmental Report table showing the source and applications of HCHS capital, giving the outturn position for 2000-01? [4.8e]

  5.4.7  For major projects (currently defined as those greater than £25m in value), could the Department please provide a comparison between the PFI price and the publicly financed option. The publicly financed comparator's costings should be broken down as follows :

    —  Basic construction contract, broken down between pre-implementation and post implementation costs;

    —  The value of risk adjustment, again broken down between pre-implementation and post implementation costs, in both pounds and percentage terms, and

    —  The final total real full life cost of both options. [4.8f]

  5.4.8  Where adjustments have been made to the PFI costs (to bring prices to a like for like basis), these should be broken down on the same basis as the publicly funded option.[4.8f]

  5.4.9  Could the Department also provide a brief commentary on any apparent differences between the reported schemes.[4.8f]

  5.4.10  Could the Department specify to us the cost of raising finance for a PFI hospital as compared to that of a conventionally financed hospital (for which we would expect the NHS would be able to borrow at a lower rate than the private sector) both before and after adjustment for risk?

  5.4.11  Could the Department update the information given in Table 4.8g on donated capital additions by region only? [4.8g]

  5.4.12  Could the Department list, by scheme, how much has been spent on developing business cases for a sample of schemes worth over £1 million, identifying which schemes are publicly financed and which financed through the PFI? Where schemes have reached completion, could the estimated development costs be compared with actual costs? [4.8h]

  5.4.13  Could the Department detail for every NHS trust with a hospital development, whether publicly or privately financed, worth over £25 m (i) the number of NHS beds—general and acute—currently provided by the trust and (ii) the number of NHS beds—general and acute—to be provided when the development is completed? [4.8i]

  5.4.14  For each PFI scheme could the Department provide the estimates of the unitary fee and split between the availability and facilities management fee at outline business case (baseline year) and the actual cost of the unitary fee split as above on signing off the FBC? Could the Department comment on how any increases were funded? [4.8j]

  5.4.15  For each PFI scheme signed or given approval in principle, could the Department provide income and capital charges of Trusts which make up each PFI scheme prior to signing and income, availability fee and capital charges on retained estate for each scheme having signed, or estimates for those schemes which have not yet signed? [4.8k]

  5.4.16  What sums of money have been raised by PFI consortia from selling off NHS assets such as medical equipment and furniture that were handed over to them when they took over responsibility for hospital buildings and equipment? Were these sums taken into account during negotiation of the contract, and in the costings of options presented in the Full Business Cases so far approved for major PFI schemes?

  5.4.17  Could the Department provide information on capital costs in the current year of PFI schemes which are actually completed such as the Norfolk and Norwich Hospital and the Worcestershire Royal Hospital, on a basis that allows comparison with capital costs in non-PFI hospitals. We would also like any preliminary information on bed numbers actually in use in these schemes and revenue costs per bed.

5.5  Capital investment in social services

  5.5.1  Could the Department update the figures provided last year on the acquisition, upgrade and sale of personal social services assets? [5.9a]

  5.5.2  Could the Department comment on the outcome for personal social services of the Capital Challenge Pilot Fund scheme? [5.9b]

  5.5.3  Could the Department provide an update on PFI projects currently supported, or being considered by the Departments, and state its criteria for supporting such projects? [5.9c]

  5.5.4  Could the Department compare actual capital spend by social services departments with the funding provided through credit approvals and capital grants? [5.9d]

  5.5.5  How many social services departments have retained social services assets but changed their use? What have been the net gains and losses to different socials services sectors?



 
previous page contents next page

House of Commons home page Parliament home page House of Lords home page search page enquiries index

© Parliamentary copyright 2003
Prepared 17 February 2003