Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 200 - 207)



Mr Burnham

  200. Having now notched up two caesareans, have you any reasons why the caesarean rate is increasing so dramatically and if not are you commissioning any research into that?

  (Ms Edwards) I do not think we have the knowledge here.
  (Mr Denham) The one piece of work that is going on is the NICE advice on what is actually the optimum level and that will have to be done on the basis of the best evidence that they can assemble, that is what their job is.

  201. Have there been any corresponding decrease in problem childbirths?
  (Mr Denham) I do not think we have any research I am aware of. What we will do now that we have this raft of questions is to take them away.

  Chairman: Do any of my colleges have any further questions?

Dr Taylor

  202. I think we have let them off lightly because we have not got on to PFI. I have one question on PFI, it is really a request for further information. I gather from table 546 j that the PFI finance capital expended for 2002/2003 is expected to be 783 million. I also gather that the repayments this year total £315 million, that is obviously the unitary payment, which includes services as well as interest and capital. If you reckon in very rough figures that the figure for capital borrowed plus interest is a bit less than half of the total that does work out that one is paying something like 17 per cent of the 783. What I would like is a forecast year-by-year for the next 30 years of what we are going to be paying—315 million this year—not including the service cost, just the interest and the capital cost year-by-year for the next 30 years?

  (Mr Douglas) Excluding the services element?

  203. Yes, because the services element we would have to be paying in any case.
  (Mr Douglas) Okay.

  Dr Taylor: Thank you.

Julia Drown

  204. Can I ask a couple on PFI. In Table 5.4.5 (a) you show increases to the capital costs of PFI schemes. In Hull and East Yorks, for example, it says increased costs are due to increases in the building price index. I want to know whether it was considered to try and transfer that risk or whether those sort of risks are transferred in any of the PFI projects.

  (Mr Douglas) That has been the change from the strategic outline case so we would not have transferred the risk on that.

  205. I see, so the increase is not from when the project started?
  (Mr Douglas) No, it is not from close.

  Julia Drown: Would that be the same with the one above, Pinderfields and Pontefract, where it is changes in NHS Estates Departmental Cost Allowance—

  Chairman: Be careful on that one, Julia!

Julia Drown

  206. I am just interested.

  (Mr Douglas) I am double checking on the dates on the Pinderfields and Pontefract one. If there was a change because we had changed the specifications, it clearly would not be a risk we transferred to the private sector and a departmental cost allowance for a better patient environment would be one that we would impose on the private sector. So I would need to check the dates at which they were done. The Hull and East Yorks is specific about it being from the SOC and I would have to double check the other one, but basically the principle will be if it is a cost that we were responsible for then we would bear it; if it is a risk the private sector should have managed, they would bear it.

John Austin

  207. Can I just ask a brief question on the Race Relations Act. Although you provide evidence of the work that the Department has done to meet its requirements by 2002 to have a strategy in place, your answer on 3.11.2 seems to indicate that the Department has taken no steps to ensure that every other bit of the NHS has fulfilled its requirements. I know that responsibility passed to the strategic health authorities but did the Department not think that it had some responsibility to ensure that the NHS complied with the Act?

  (Mr McKeon) Yes, we have been assisting through a variety of means set out in the previous question in order to help compliance and we are now considering looking at a survey of new organisations because there have been a lot of new organisations in the NHS since 1 April, of which strategic health authorities only came into being formally on 9 October, so in the light of their new establishment now is the time to start thinking about complying with the Race Relations Act and ensuring that is followed through appropriately at that level and down to trusts and PCTs.

  Chairman: If there are no further questions, can I thank our witnesses for a very helpful session. You have promised to follow up on a number of points. You will be aware that we have got the Secretary of State in a fortnight. It would be helpful, for example on Sandra Gidley's question when she talked about the survey which referred to the EU states' figures, if it is possible to let us have that. We would be very grateful because that clearly will be an issue we are likely to raise with the Secretary of State. Otherwise, we are very grateful to you for your help.

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Prepared 4 December 2002