§ 53. Mr. Simon Coombs
To ask the Secretary of State for Health whether there are any experiments being undertaken to assess how the proposed National Health Service reforms would work.
§ Mr. Kenneth Clarke
The Health Service is undertaking a wide range of projects designed to inform the implementation of the Government's proposals to improve services.
§ Mrs. Virginia Bottomley
We are making good progress in putting into action the changes outlined in the White Paper "Working for Patients". We are confident that the NHS will be ready to implement the basic elements of the new and better systems of matching growth and resources with expansion of patient services by April 1991, once Parliament approves the necessary legislation. By 1990—91 the total expenditure on the implementation of the Government's proposals to improve the Health Service will exceed £300 million.
We have issued detailed guidance on many subjects, including the education and training of non-medical staff. Guidance on the principles of the new contracting system was issued in September, and further guidance on additional aspects of the contracting system will be issued shortly.
We have recently published a GP fundholder programme, which gives more details about the operation of a GP practice fund.
A new working paper, the 11th in the series, has been published, called, "Framework for Information Systems: Overview". This working paper covers two documents issued for consultation, looking at the way ahead for information and information technology and concentrating on action in preparation for April 1991.
We have launched a project to support district health authorities in detailed work in developing the key role 667W which DHAs will have under the new system of identifying and obtaining the best pattern of services which will most effectively meet all the health needs of the population they serve.
We have received over 180 expressions of interest from potential NHS hospital trusts. Seventy-nine of them are proceeding towards being the first wave of applicants for trust status within the NHS in April 1991. Subject to progress in Parliament, we expect many more to be ready for later waves of applicants in future years.
We have made £2 million available for implementation of medical audit this financial year, and a further £26 million has been allocated to hospital and community health services for the development of medical audit in 1990–91. A £4.5 million scheme has been launched to develop information technology skills. Demonstration projects, aimed at improving the quality of care and services to patients, have been announced for five outpatient departments. The principles of general management are being introduced into the family practitioner committee system.
Good progress is also being made in relation to medical education and research. As my right hon. and learned Friend the Secretary of State explained in a speech on 10 July 1989, since sent to all hospital doctors, we intend to take powers to ensure, for instance, the continuation of high standards of undergraduate, postgraduate and continuing education and research in all NHS hospitals.
We will also ensure that postgraduate training posts are provided in NHS hospital trusts in accordance with the national objectives set out in "Achieving a Balance". Medical education and research will be further enhanced by the proposed increase in the service increment for training (SIFT) to meet 100 per cent. of the median excess costs of teaching hospitals. This will be distributed by regions in consultation with universities.
The National Health Service and Community Care Bill is now before the House.