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Health: Wales

Lord Roberts of Llandudno asked Her Majesty's Government:

Lord Davies of Oldham: The Welsh Assembly Government provide local health boards with funding to meet the needs of the local population, and the Health Commission Wales (HCW) with funding to meet the needs of those requiring specialised care in Wales. The funding is allocated directly to these organisations to provide services based upon the principle of ensuring that patients receive the most appropriate level of care irrespective of where it is provided. Consequently, there is no specific funding allocated for patients requiring specialised treatment in hospitals in England that is not available in Wales.

Revenue is provided to local health boards (LHBs) and the HCW annually to purchase the necessary care (specialist and non-specialist) for the residents of Wales. LHBs and the HCW have contracts with both Welsh and English providers to service the needs of the population. The way in which the money is spent is no different in either country—that is, in general, services are provided by block or cost and volume contracts

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for that care. Where there are requirements outside the block or cost and volume contract, individual patient contracts are used (with English providers requiring prior authorisation from Welsh LHBs).

For instance, patients from north Wales who require cardiac surgery will have it carried out in the cardiothoracic centre in Liverpool, but it is paid for by the Health Commission Wales as part of the overall contract that the HCW has with the various providers in England.

It is important to reiterate the key principle: there is no difference in the way the money is spent, irrespective of which side of the border, Wales or England, it is delivered. It is based on patient need and the most appropriate place for that to be met.

Immigration: A8 Nationals

Lord Roberts of Llandudno asked Her Majesty's Government:

The Parliamentary Under-Secretary of State, Department for Work and Pensions (Lord McKenzie of Luton): All A8 nationals may access generic jobsearch services on exactly the same basis as other groups of employed or unemployed people as soon as they arrive in the country. Generic services include the job points located in Jobcentre Plus offices and the Jobseeker Direct telephone service. All Jobcentre Plus vacancies are also advertised on the internet.

Once they have completed 12 months' continuous employment as a registered worker, A8 nationals who remain in the labour market have the same rights to access further Jobcentre Plus services, including benefit and personal adviser support, as other EEA and UK nationals.

Modernising Scientific Careers

Earl Howe asked Her Majesty's Government:

The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): Building on recent publications, Modernising Scientific Careers is set in the context of a vision for a National Health Service that empowers patients and the public, works in partnership with staff, and has quality as the organising principle. The case for change was made in the next-stage review documents published in June 2008, High Quality Care for All and A High Quality Workforce, which set out the need to modernise healthcare careers as the NHS addresses the challenges for the future around:

the changing nature of demand for healthcare services, including the effects of demography, changing public and patient expectations, more community-based care and technological advance;

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the changing nature of the supply of healthcare services, including changes driven by improvements to technology, changes in the composition of the workforce, their desired working patterns, and improvements to productivity, which also include the drive to promote more and better self-care and better use of the workforce; andthe changing nature of professional practice and the need to develop new skills and more team working, changes in accountability, leadership and independent practice and changes in the relationships between clinician and manager.

Four key questions were at the heart of developing these proposals.

First, how will the roles played by healthcare professionals change and what will be the implications for career frameworks? This has included looking at changing roles and career structures.Secondly, how should workforce planning be carried out to deliver trainees and a workforce of the right size, structure and skill? In answering this we have had to look at our core assumptions, the roles of different organisations as well as skills and resources.Thirdly, how should education be commissioned and funded to deliver trainees and a workforce of the right size, structure and skills? This has involved a review of how we commission and fund education and training as well as the capacity and capability required.Fourthly, how should we change the infrastructure and content of education to ensure the future workforce has the right skills? We have looked at education structures, regulatory structures and changes to selection processes.

These questions were considered and addressed by four working groups made up of key stakeholders and leading thinkers. The output from these groups resulted in the commitments set out in High Quality Care for All and A High Quality Workforce. These documents also provide further reference to background evidence and research and both have already been placed in the Library.

NHS: Dental Services

Lord Colwyn asked Her Majesty's Government:

The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): Seniority payments were part of the remuneration arrangements introduced in 1990. An interim scheme was included in the 2006 statement of financial entitlements, when remuneration arrangements for general dental practitioners changed from a fee-based system to one based on annual contract values agreed between primary care trusts (PCTs) and dental providers. The interim

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scheme has run for the three years of the transition to local commissioning. Seniority payments are a direct charge against PCTs' financial allocations for primary dental services. With effect from April 2009, it is proposed there will be no new entrants to the scheme but those dentists already entitled to payments will continue to receive them. There will be no immediate savings as a result, as the change will not affect allocations to PCTs.

Official Documents

Lord Taylor of Holbeach asked Her Majesty's Government:

Lord Patel of Bradford: This must be for individual departments to determine.

Parliamentary Ombudsman

Lord Morris of Manchester asked Her Majesty's Government:

Lord Patel of Bradford: The Parliamentary Commissioner Act 1967 was last amended in July 2007, to enable the Parliamentary Ombudsman, the Health Service Ombudsman and the Local Government Ombudsman to undertake joint investigations. The Cabinet Office is in regular dialogue with the Parliamentary Ombudsman, and keeps her powers under review.

Lord Lester of Herne Hill asked Her Majesty's Government:

Lord Patel of Bradford: The noble Lord has received information from individual departments for the period from 1997 up to May 2006. Unfortunately, information from May 2006 to date is not held centrally.

Recycling: IT Equipment

Lord Taylor of Holbeach asked Her Majesty's Government:

The Financial Services Secretary to the Treasury (Lord Myners): Accounting for information technology equipment is covered by the financial reporting standard (FRS) 15 tangible fixed assets. Central government applies this standard with only minor adaptations and interpretations as detailed in the Government Financial Reporting Manual (FReM).

Under FRS 15, departments as the user of the asset are responsible for assessing fixed asset lives—ie, the period over which the asset is to be depreciated. FRS 15 also requires that the useful life of an asset should be reviewed at the end of each reporting period.

Controls over equipment in use, the replacement of that equipment and whether to recycle are decided by individual departments.

Schools: Academies

Baroness Seccombe asked Her Majesty's Government:

The Parliamentary Under-Secretary of State, Department for Children, Schools and Families (Baroness Morgan of Drefelin): Academy buildings are now procured by local authorities (LAs) either as part of their Building Schools for the Future (BSF) programme or through the Partnerships for Schools national framework. Funding

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for the building project is not usually allocated for a project until it has moved beyond the feasibility stage and is in the implementation stage. However, were a sponsor to withdraw from an academy project once funding had been allocated, the LA, Partnership for Schools and the DCSF would decide whether to proceed with the refurbishment or new build for the academy either for the benefit of the predecessor school or schools, or for use by another academy or school project.

Taxation: VAT

Lord Willoughby de Broke asked Her Majesty's Government:

The Financial Services Secretary to the Treasury (Lord Myners): The Government are generally supportive of the legislative proposal adopted by the Commission, consistent with its position of supporting the flexibility of member states to apply their own choice of VAT rates to further their domestic priorities and social objectives, provided that this does not materially affect the functioning of the internal market.

Member states are currently discussing the Commission proposal, and whether any amendments should be made before it is considered by Ministers, at official level in Council working groups. The Government will take a view on the final text when it is submitted to Ministers by the presidency.


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