§ Mr. CousinsTo ask the Secretary of State for Health on what basis £7,054,000 was deducted from the 1990–91 allocation to the Northern health region; if he will place 357W copies of the information that supports the deduction in the Library; and to which other English National Health Service regions sums equivalent to that amount were given.
§ Mr. Freeman[holding answer 30 January 1990]: From 1990–91, regional health authorities' allocations reflect the amount of money available for services for their resident populations. From that allocation they must pay for services used by their residents in other regions: they will also receive income for providing services to residents of other regions. For 1990–91, these payments will be made through central adjustments to cash limits. For Northern RHA this means a net deduction of £7,054,000. This is the sum of Northern RHA's net flows with all the other English regions. The amounts in question were agreed between the regions concerned.
The information on cross-boundary flows to support these adjustments will be included in the 1990–91 cash limits exposition booklet, which will be issued shortly. A copy will be placed in the Library as requested.
Subject to legislation, cross-boundary flows, like other health services, will in future be paid for by contracts between a patient's district health authority or general practitioner and the place of treatment.
§ Mr CousinsTo ask the Secretary of State for Health whether the £1,361,000 credited to the Northern health region in respect of cross-boundary flows from Scotland and Wales was deducted from National Health Service spending in Scotland and Wales; and where he proposes to record all such deductions or contributions in the public accounts.
§ Mr. Freeman[holding answer 30 January 1990]: Historically, there have not been transfers of funds across borders in respect of flows of patients between the home countries. In 1990–91, the Northern regional health authority will be compensated for treating patients from Scotland and Wales by means of a sum top-sliced from English Health Service revenue funds. Subject to legislation, contracting for health services will be introduced from the financial year 1991–92; from that stage Scottish health boards and Welsh district health authorities will be able to place contracts with English hospitals and English authorities will have similar freedom to place cross-border contracts. The treatment in the statutory accounts of funds crossing national borders under the terms of such contracts has yet to be decided.