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14 Oct 2008 : Column 1162W—continued
Community Care: Disabled
Mr. Harper: To ask the Secretary of State for Health pursuant to the Answer of 7 July, Official Report, column 1137, on disabled people (budgets), what the publication date will be for the evaluation report of the Individual Budgets pilots. [227064]
Mr. Bradshaw: The evaluation report of the Individual Budgets pilots will be published shortly.
Departmental Telephone Services
Colin Challen: To ask the Secretary of State for Health what agencies or units for which his Department is responsible require the public to make telephone calls to them on numbers which charge more than the national call rate; and how much income each such agency has derived from such charges in each of the last three years. [225746]
Mr. Bradshaw [holding answer 9 October 2008]: The Department's Executive agencies, the Medicines and Healthcare products Regulatory Agency and the NHS Purchasing and Supply Agency have no 0845 or 0870 numbers for use by the public.
The Department has 24 arms length bodies, including the Executive agencies, and a number of national programmes e.g. NHS Employers. Local national health service organisations and general practitioner practices may have their own telephone numbers for the public. Information about telephone services for the public provided by these bodies is not held centrally and cannot be provided except at disproportionate cost.
Departmental Written Questions
Mr. Harper: To ask the Secretary of State for Health how many and what proportion of written questions for answer on a named day his Department has answered on the due date in the current session of Parliament to date. [226896]
Mr. Bradshaw: As of 9 October 2008, the Department had answered 830 of 1,205 named day written parliamentary questions on the due date, in the current parliamentary session. This represents 68.9 per cent. answered on time.
Foetal Alcohol Syndrome
Bob Russell: To ask the Secretary of State for Health (1) what recent research he has undertaken into foetal alcohol syndrome; and if he will make a statement; [225636]
(2) how many babies were born with foetal alcohol syndrome in each of the last 10 years for which figures are available; and if he will make a statement. [225637]
Dawn Primarolo: In May 2005 the Department's Policy Research programme commissioned a systematic review, by the National Perinatal Epidemiology Unit (NPEU), of national and international evidence on the effects of alcohol on the developing fetus and child. The review was published on the NPEU website in May 2006 and copies have been placed in the Library.
Due to difficulties in ascertaining the mother's alcohol intake during pregnancy, babies born with foetal alcohol syndrome (FAS) can often be misdiagnosed with a more general learning disability. It is therefore not possible to provide accurate figures on the number of babies born with FAS.
Health Education: Greater London
Tom Brake: To ask the Secretary of State for Health how many (a) health promotion centres and (b) health promotion resource centres (i) opened and (ii) closed in each London borough in each of the last five years; and how many (A) health promotion centres and (B) health promotion resource centres there were in each borough at the latest date for which figures are available. [224970]
Mr. Bradshaw: The information requested is not held centrally.
Health: Private Finance Initiative
Sarah Teather: To ask the Secretary of State for Health what assessment he has made of the likely effect of the economic situation on the delivery of private finance initiative health projects; and if he will make a statement. [226566]
Mr. Bradshaw: Once a NHS body has signed a private finance initiative (PFI) contract, the financial terms of the loan raised by the private sector consortium counterparty are set and fixed. The overall cost of the project to the NHS will not change (unless the NHS wants to make a change to its own requirements). PFI contracts deal comprehensively with the possibility of early termination due to contractor default, including through insolvency, in order to protect the public interest.
Hospital Wards: Gender
Mr. Crausby: To ask the Secretary of State for Health what progress has been made in phasing out mixed sex wards in NHS hospitals in (a) Bolton and (b) England. [222622]
Ann Keen: The Department continues to engage strategic health authorities about their plans to deliver a reduction in mixed sex accommodation, thus keeping levels to an absolute minimum, and where possible eliminating it.
Our guidance to the NHS has always required single sex accommodation rather than single sex wards, (the latter being where a group of patients are treated by the same team, who have the necessary specialist skills). Even within a mixed ward, good single sex accommodation can be achieved by using single rooms or single sex bays and toilet facilities.
Local plans have been made in the context of the 2008-09 Operating Framework for the NHS in England, which requires primary care trusts (PCTs) to review the current situation in all trusts and agree, publish and implement stretching local plans for improvement in delivering single sex accommodation, with identified timescales and monitoring mechanisms. The framework specifically requires that patient survey results, where available, be used as the monitoring mechanism. Plans in Bolton reflect the national approach to reducing levels of mixed sex accommodation as set out above, and more detail of such action is available from North West Strategic Health Authority.
Hospitals: Finance
Mr. Jim Cunningham: To ask the Secretary of State for Health what recent steps the Government have taken to assist hospitals with financial management. [224982]
Mr. Bradshaw: The continued development of an effective financial performance framework remains a key priority for the Department. In recent years there have been several initiatives aimed at delivering improvements in financial management in the national health service.
As part of this new financial performance framework the Department introduced a new working capital loans system in 2006-07. Instead of relying on brokerage as a source of funding or planned support, national health service trusts’ working capital requirements must now be financed by loans agreed with the Department and recorded in individual accounts. National health service trusts now have to address financial problems head-on and take steps to ensure that they live within their means. Deficits remain where they occur, and are transparent in the trust's annual accounts.
The Department has also committed to publishing the financial position of every national health service organisation on a quarterly basis, which has increased the local accountability of national health service organisations due to a greater level scrutiny over their financial performance. As a result this has ensured that all organisations put sufficient focus on their financial performance and that there is greater involvement in meeting the financial objectives from non-finance professionals including clinicians and operational staff.
In order to assist national health service organisations, since 2007-08 the Department has issued Payment by Results tariffs and the Operating Framework earlier than was the case in previous years. This has given the national health service more time to prepare their financial plans, and as a result these financial plans have proven to be more robust with less variation between the plan, the in year forecasting and the final outturn.
In addition, the Department collects both year-to-date, and forecast information, on balance sheet, income and expenditure, and cash flow. Key indicators of financial performance are collected on a monthly basis and with strategic health authorities required to work with national health service organisations to provide explanations of any significant variations. In addition the Department also recognises the value of the Audit Commission's independent Auditor's Local Evaluations scores and is heavily involved in the performance management of organisations that do not meet minimum standards.
This increased local ownership, scrutiny, and clinical engagement within the finance function in the NHS has resulted in fewer national health service organisations recording deficits in their annual accounts. In 2005-06, prior to the introduction of this more transparent financial regime, 33 per cent. national health service organisations recorded a deficit in their annual accounts compared to only 3 per cent. of organisations recording a deficit in their 2007-08 annual accounts.
Mr. Jim Cunningham: To ask the Secretary of State for Health what recent steps the Government has taken to assist hospitals to reduce debt. [224983]
Mr. Bradshaw: The Department introduced a new working capital loans system in 2006-07. Instead of relying on brokerage as a source of funding or planned support, trust working capital requirements must now be financed by loans agreed with the Department and recorded in individual accounts. Organisations now have to address financial problems head-on and take steps to ensure that they live within their means. Deficits remain where they occur, and are transparent in final accounts at the year-end.
National health service trusts who traditionally relied on planned support are now able to focus on the areas that were causing them to overspend and look for ways to address them. Working with the strategic health authorities (SHAs), NHS trusts agree a financial plan at the beginning of the financial year that delivers a surplus, which is at least sufficient to meet any loan repayments the trust has, and thus reducing their overall debt.
As a result of introducing the new loans system, there were 17 NHS trusts where the financial challenges are such that the Department either could not give a loan because the trust could not afford to meet the repayments,
or where a loan was agreed, but the amount could only be repaid over a very extended time scale. Instead these trusts were advanced money as a short-term measure to cover their running costs while a rigorous review was conducted on their finances.
In the 2007-08 quarter 4 edition of “The Quarter”, the Department announced that 10 of the original 17 trusts were no longer classified as financially challenged. This was a result of the trusts working extremely hard in conjunction with their SHAs and primary care trusts to improve their underlying financial position. As a result, they are now trading in balance and are able to produce sufficient surpluses going forward to operate as a sustainable organisation, both financially and in the provision of health care. All 10 of these organisations will have repaid their debt within five years.
This increased local ownership, scrutiny, and clinical engagement within the finance function in the NHS has resulted in fewer national health service organisations recording deficits in their annual accounts. In 2005-06, prior to the introduction of this more transparent financial regime, 33 per cent. national health service organisations recorded a deficit in their annual accounts compared to only 3 per cent. of organisations recording a deficit in their 2007-08 annual accounts.
Industrial Diseases
Mr. Stewart Jackson: To ask the Secretary of State for Health what the estimated cost was of treating chronic obstructive pulmonary disease in each primary care trust in England in the last period for which figures are available; and if he will make a statement. [226107]
Ann Keen: The total expenditure for all obstructive airways disease is just over £537 million for 2006-07 (excluding drug costs). The figure for solely chronic obstructive pulmonary disease is not available centrally.
Mr. Stewart Jackson: To ask the Secretary of State for Health what the evidential basis is of the estimate that 15 per cent. of patients with chronic obstructive pulmonary disease will also have asthma, as stated in the Quality and Outcomes Framework guidance for the GMS contract for 2008-09; and if he will make a statement. [226108]
Ann Keen: Information is not held centrally on the number of people diagnosed with both chronic obstructive pulmonary disease (COPD) and asthma in each primary care trust in England.
The Quality and Outcomes Framework Expert Panel estimate that 15 per cent. of patients with COPD also have asthma on the basis of the following evidence:
asthma exists in up to 10 per cent. of the population and so at least that proportion of COPD patients will have asthma(1);
asthma is a risk factor for developing COPD so the rate is likely to be higher; and
unpublished data gathered by the panel based on complete practice review suggests that about 15 per cent. of patients with COPD also have asthma.
(1) Epidemiology work suffers from variable definition but Pearson M, Ayres JG, Sarno M, Massey D, Price D. Diagnosis of airway obstruction in primary care in the UK: the CADRE (COPD and Asthma Diagnostic/management Reassessment) programme International Journal of COPD 2006; 1: 435-443 found that 21 per cent. of patients with COPD were classified as having asthma as well after nurse completed spirometry and GP review and Bednarek M, Maciejewski J, Wozniak M, Kuca P, Zielinski J. Prevalence, severity and underdiagnosis of COPD in the primary care setting. Thorax. 2008 May;63(5):402-7 found 28 patients out of 155 meeting UK definition of COPD i.e. 18 per cent. and finally a review of COPD by Barnes P Mechanisms in COPD Chest 2000; 117:10s-14s states a overlap of 10 per cent.
Industrial Diseases: Health Services
Mr. Stewart Jackson: To ask the Secretary of State for Health what the waiting time for pulmonary rehabilitation was in each primary care trust in England in the latest period for which figures are available; and if he will make a statement. [226109]
Ann Keen: This information is not available centrally.
Maternity Services
Harry Cohen: To ask the Secretary of State for Health what the 100 largest settled claims awarded under the Clinical Negligence Scheme for Trusts have been; how much was paid in each case; and which claims arose from maternity care. [225891]
Mr. Bradshaw: The information requested is in the following table:
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