HC Deb 01 February 1990 vol 166 cc323-4W
Mr. Michael

To ask the Secretary of State for Wales (1) against what criteria he intends to advise health authorities in Wales to judge the advisability of contracting a particular service to a hospital outside the authority's own area;

(2) how he intends to assess the impact on journeys for patients and their families of any decisions by a health authority in Wales to contract particular services to a hospital outside that authority's own area;

(3) whether he will instruct health authorities in Wales to assess the likely impact on travel for patients and their families of contracting any service to a hospital outside the health authority's own area and to weigh that assessment in the balance with other relevant criteria before letting any contract.

Mr. Grist

It will be the responsibility of district health authorities to secure an adequate range, quality and depth of services for their local populations through appropriate contractual arrangements. The document "Contracts for Health Services: Operations Principles", which was circulated to the National Health Service in Wales on 20

Payments of Distinction Awards to Consultants1
Health Authority 1984–85

£

1985–86

£

1986–87

£

1987–88

£

1988–89

£

Clwyd 151,435 169,892 176,187 166,838 328,862
East Dyfed 85,265 113,465 93,683 87,044 94,720
Gwent 193,194 216,255 257,142 321,938 343,278
Gwynedd 58,123 70,186 95,904 115,189 113,659
Mid Glamorgan 111,784 86,101 121,133 127,622 164,590
Pembrokeshire 26,317 30,106 30,559 51,174 54,734
Powys 4,489 9,780 10,700 5,717 12,364
South Glamorgan 1,146,812 1,360,037 1,621,917 1,814,516 1,906,649
West Glamorgan 197,253 217,700 210,540 8,752 253,742
Wales 1,974,672 2,273,522 2,617,765 2,698,790 3,272,598
Allocations to Health Authorities for Consultant Distinction Awards
Health Authority 1988–89 1989–9023 1990–9123
£ million £ million £ million
Clwyd 0.599 0.348 0.231
East Dyfed 0.142 0.127 0.138
Gwent 0.418 0.382 0.412
Gwynedd 0.281 0.216 0.231
Mid Glamorgan 0.344 0.168 0.181
Pembrokeshire 0095 0.065 0.069
Powys 0.014 0.006 0.007
South Glamorgan 2.092 2.108 2.277
West Glamorgan 0.522 0.320 0343
Total all Health 4.507 3.740 3.889

October 1989, stated that, in determining the content of the contracts they seek to let, district health authorities will need to reconcile need for service, quality of access to service, and value for money in the mode of provision. As now, the majority of services will be provided in local hospitals. However, referrals already take place to hospitals in other districts and health authorities will therefore wish to make some contracts for such referrals.

In considering these contracts, authorities will carefully consult general practitioners to establish anticipated patterns of referral and will take into account the impact of travelling on patients and their families. We should emphasise that in all cases the object will be to secure the patterns of referral preferred by referrers themselves and that no patients will be forced to travel against their will for treatment. The arrangements made by health authorities to secure services for their populations will be subject to scrutiny in the annual reviews of performance chaired by director, National Health Service (Wales).