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NHS Expenditure Since 1976

Lord McColl of Dulwich asked Her Majesty's Government:

Lord Hunt of Kings Heath: The information requested is given in the table.

Gross United Kingdom National Health Service Expenditure in real terms

YearGross UK NHS Expenditure (1999-00 prices)1 Outturn in £m
1975-7626,218
1976-7726,332
1977-7825,705
1978-7926,529
1979-8027,006
1980-8129,603
1981-8230,401
1982-8330,990
1983-8431,477
1984-8532,137
1985-8632,303
1986-8733,642
1987-8835,100
1988-8936,568
1989-9036,832
1990-9138,026
1991-9240,556
1992-9343,040
1993-9444,246
1994-9546,141
1995-9646,913
1996-9747,240
1997-9848,572
1998-99(2)50,353

Notes:

1.Using the 26/06/99 GDP deflator.

2.This is an estimated outturn figure and is still subject to change.

3.For the first time, the Comprehensive Spending Review settlement provided the NHS with a three year planned expenditure programme. Gross plans for these three years in 1990-00 prices are; £52,376 million, £54,351 million and £56,230 million.

4.Due to classification changes figures are not directly comparable over the period.


Consultant Appointments: Obstetrics and Gynaecology

Lord McColl of Dulwich asked Her Majesty's Government:

    Why there was a 33 per cent. cut in the number of consultant appointments in obstetrics last year; and what was the percentage increase or decrease in consultant appointments in obstetrics for each of the previous five years.[HL3950]

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Lord Hunt of Kings Heath: Information about consultant appointments in obstetrics is not available centrally.

Lord McColl of Dulwich asked Her Majesty's Government:

    How many new obstetric and gynaecological consultant appointments will be required over the next four years; and what plans they have to increase the number of posts.[HL3951]

Lord Hunt of Kings Heath: It is for National Health Service trusts and health authorities to decide the number of consultants they require. We are, however, actively engaged in discussions with the NHS about staffing issues in obstetrics and gynaecology, given current concerns.

Junior Doctors: Out-of-Hours Pay Rates

Lord Astor of Hever asked Her Majesty's Government:

    What discussions they are having with the British Medical Association's Junior Doctors' Committee about improving the hourly rate of £4.02 paid to some junior doctors for their work at night, weekends and bank holidays.[HL4055]

Lord Hunt of Kings Heath: The independent Doctors and Dentist Review Body makes recommendations to the Government on the remuneration of doctors and dentists working in the National Health Service, including the rates of pay for out-of-hours work. The Government accepted, in full, the Review Body's recommendations for junior doctors pay in 1999.

Almost all junior doctors are contracted to work additional hours beyond their standard 40-hour week, to provide continuity of patient care and to protect their training needs outside the normal working week. Their out-of-hours pay rates reflect the expected call-out across different working patterns: 50 per cent of their standard rate for on-call working, 70 per cent for partial shift working and 100 per cent for shift working. These different percentages were never intended to be exact calculations in which each hour was rewarded individually, but rather a formula designed to produce broadly similar overall earnings and actual hours worked, irrespective of working pattern.

The basic pay of first-year newly qualified house officers, who represent about 12 per cent of all junior doctors, is about £16,700. However, their typical earnings are almost £23,400 when account is taken of their out-of-hours pay. We hope for a successful outcome to talks with the British Medical Association Junior Doctors' Committee about the junior doctors' pay system, their contract and their conditions of service.

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Consultant Appointments: Increases Since 1994

Lord Astor of Hever asked Her Majesty's Government:

    What has been the increase in the number of consultant appointments in the National Health

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    Service for each of the past five years in all specialities.[HL4056]

Lord Hunt of Kings Heath: Information on the number of consultant appointments in the National Health Service in all specialties is not collected centrally. Information on the total numbers of consultants in the National Health Service for each of the past five years is shown in the table.

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Number of Hospital Medical Consultants at 30 September each year
United Kingdom Numbers(headcount)

19941995199619971998
Consultants21,13022,64023,68024,89025,890

Notes:

Figures rounded to the nearest ten

Source:

Department of Health Hospital and Community Health Services Medical and Dental Workforce Census

Department of Health and Social Services Northern Ireland


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Consultant Posts

Lord Astor of Hever asked Her Majesty's Government:

    How many fully trained specialist hospital doctors are waiting for consultant posts; and how many consultant vacancies there have been in each of the past five years in all these specialities.[HL4057]

Lord Hunt of Kings Heath: On 1 April 1999, in England and Wales there were 117 fully trained specialist hospital doctors in obstetrics and gynaecology waiting for consultant appointments. Information for other specialities is not collected centrally. Information about consultant vacancies in England is being collected and will be published in due course. Copies will be placed in the Library.

Smoking-related Illnesses: Costs to the NHS

Lord Stoddart of Swindon asked Her Majesty's Government:

    Further to the Written Answer by the Baroness Hayman on 22 July (WA 115) concerning the costs to the National Health Service of smoking-related illness, how the estimates of such costs were arrived at.[HL4028]

Lord Hunt of Kings Heath: The £1.7 billion figure is based on 1991 estimates of smoking attributable mortality. The £1.4 billion estimate of smoking-related costs is based on calculations from the 1994 General Household Survey (GHS), uprated for the under-reporting of health service use by the GHS.

New Variant CJD: Deaths

The Duke of Buccleuch and Queensberry asked Her Majesty's Government:

    How many deaths from new variant CJD in the past decade are known to result from eating beef.[HL4026]

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Lord Hunt of Kings Heath: Although there is convincing scientific evidence that the agent which causes variant Creutzfeldt-Jakob disease (vCJD) in humans is the same as that which causes Bovine Spongiform Encephalopathy (BSE) in cattle, research so far has been unable to confirm how those who have died of vCJD contracted the disease. The department publishes, on a monthly basis, figures for the number of deaths of definite and probable cases of CJD of all types in the United Kingdom.

The first deaths from vCJD occurred in 1995, and the total number of deaths of definite and probable cases of vCJD in the UK is now 42. One case has also been confirmed in France.

NHS Trusts: Private Finance Initiative Schemes

Lord Clement-Jones asked Her Majesty's Government:

    What have been the outcomes of a public sector financing comparator for each private finance initiative hospital scheme authorised to date, showing in particular in each case--

    (a) the difference in cost of capital over 30 years and 60 years;

    (b) the percentage discount used to arrive at net present values;

    (c) the risk adjustment made to reflect the risk transfer;

    (d) the actual quantified elements comprising that risk transfer under the contracts entered into by the relevant private contractor;

    (e) the staffing requirements compared to the hospitals they replace;

    (f) the assumed patient throughput; and

    (g) whether any of the schemes assume retention of the proceeds of asset sales by the private contractor.[HL3938]

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Lord Hunt of Kings Heath: The information requested is contained in the final business cases for private finance initiative (PFI) schemes which National Health Service trusts are required to make publicly available following their approval. The business cases for approved PFI schemes with a capital value of £10 million or greater are available in the Library. Business cases for approved PFI schemes with a capital value below £10 million will be made available to the Library on request to the NHS trust concerned.

Audiology Services: Performance Management

Earl Howe asked Her Majesty's Government:

    What is their policy on gathering performance data on routine audiology and hearing aid services; and whether they have any plans to enhance the information collected for performance management. [HL4007]

Lord Hunt of Kings Heath: Information on the number of ear, nose and throat (ENT) out-patient attendances, broken down by clinical specialty, is contained in Out-patients and Ward Attenders, England a copy of which is available in the Library.

Information on the number of ENT day case and ordinary admissions by clinical specialty is contained in Ordinary and Day Case Admissions for England, a copy of which is available in the Library.

The Department of Health collects data on waiting times by specialty for first out-patient appointments following general practitioner written referral, including audiological medicine and ENT services.

Also, information on the hospital episode statistics database for the latest complete year (1997-98) contains approximately 11 million records detailing individual episodes within National Health Service trusts in England. It covers all specialties, including ENT and audiological medicine, and includes private patients treated in NHS hospitals. Information is recorded on the number of finished consultant episodes (FCE). An FCE represents a completed period of in-patient treatment under the care of individual hospital consultant.

There are currently no plans to change the information collected for performance management.


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