Asked by: Jacob Rees-Mogg (Conservative - North East Somerset)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to her oral statement of 7 February 2024 on NHS Dentistry: Recovery and Reform, Official Report column 251, if she will make an assessment of the potential merits of using her powers under the Professional Qualifications Act 2022 to increase the number of foreign dentists qualified to practice in the UK.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
My Rt hon. Friend, the Secretary of State for Health and Social Care has made an assessment of the merits of using powers under the Professional Qualifications Act 2022 (PQ Act) to increase the number of overseas-qualified dentists able to practice in the United Kingdom.
The PQ Act affirmed the Government’s commitment to protect the autonomy of regulators, including the General Dental Council, to assess overseas-gained professional qualifications and make decisions about whether individuals meet the requirements to work in a regulated profession in the UK.
The PQ Act contains a power for the Government to implement international agreements. This power was used to implement the UK’s free trade agreement with the European Economic Area and European Free Trade Association member states in 2023, meaning that UK regulators are now required to recognise comparable qualifications obtained in Iceland, Norway and Liechtenstein. Work is currently underway to use the PQ Act power to implement the UK-Swiss Recognition of Professional Qualifications Agreement by 1 January 2025.
Asked by: Jacob Rees-Mogg (Conservative - North East Somerset)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to her Oral Statement of 7 February 2024 on NHS Dentistry: Recovery and Reform, how she defines Somerset in the context of the area across which dentistry vans will be deployed.
Answered by Andrea Leadsom - Parliamentary Under-Secretary (Department of Health and Social Care)
We will deploy dental vans offering appointments to patients in targeted rural and coastal communities who have the most limited access to dentistry, including Somerset, starting later this year.
We are currently working with NHS England and the integrated care boards (ICBs), including NHS Somerset ICB, to agree the exact number of vans, and where they will be deployed. I expect to be able to provide more details on this in due course.
Asked by: Jacob Rees-Mogg (Conservative - North East Somerset)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many officials were working in his Department on (a) the date of the appointment and (b) 18 July 2023.
Answered by Will Quince
On 31 October 2022, the total number of civil servants employed within the core Department (excluding Arm’s Length Bodies) was 3,978. As of 18 July 2023, the total number of civil servants employed by the Department was 3,316.
Please note that these figures do not show the full establishment workforce of the Department in line with published figures on GOV.UK. Contingent Labour, secondments in, Fast Streamers and vacancies are not included.
Asked by: Jacob Rees-Mogg (Conservative - North East Somerset)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make an assessment of the adequacy of supply of the drug Actavis Propranolol in pharmacies in (a) North East Somerset and (b) Somerset.
Answered by Seema Kennedy
The Department is assured the supply of Actavis immediate release propranolol tablets is sufficient to meet normal demand. Actavis modified release propranolol capsules are currently unavailable. However, they are expected to be back in stock by the end of July and supplies of generic propranolol capsules are currently available from an alternative manufacturer. The Department does not have information on stock holding of propranolol at a local level.
Asked by: Jacob Rees-Mogg (Conservative - North East Somerset)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many non-UK EU-EEA citizens worked as (a) doctors, (b) registrars, (c) trainee-doctors (foundation year 1 and 2), (d) nurses, (e) health visitors, (f) midwives, (g) ambulance staff and (h) scientific/therapeutic/technical staff in (i) June 2016 and (ii) June 2017.
Answered by Philip Dunne
NHS Digital publishes workforce statistics and the requested information is available from their publications page on the NHS Digital website at the following links:
Asked by: Jacob Rees-Mogg (Conservative - North East Somerset)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the effectiveness of his Department's preparations for the UK leaving the EU with (a) an agreement on future partnership and (b) no agreement with the EU; and if he will make a statement.
Answered by Philip Dunne
The Government is committed to ensuring leaving the European Union is a success for the health and social care sector as well as the United Kingdom as a whole.
All relevant policy teams within the Department are involved with this work in relation to the health and social sector, including assessing the implications of the UK leaving the EU on their area, to help ensure the best outcome for the sector.
Every Government department, including the Department of Health, will be proceeding in the only responsible way possible: planning to deliver a smooth exit under any scenario. This includes preparing the UK for the future economic partnership we hope to negotiate with the EU as well as the very unlikely scenario in which no mutually satisfactory agreement can be reached and the UK exits without a deal.
Asked by: Jacob Rees-Mogg (Conservative - North East Somerset)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will make an estimate of the potential cost of implementing each clause of the National Health Service (Amended Duties and Powers) Bill.
Answered by Dan Poulter
We understand that the policy intentions of the National Health Service (Amended Duties and Powers) Bill (‘the Bill’) are to establish a duty on the Secretary of State to provide NHS services, to make reforms to the NHS in such a manner as to remove its susceptibility to procurement and competition laws and to reduce the level of non-NHS health income that NHS organisations can receive.
This Bill, were it to become law, would reverse a proportion of the changes made under the Health and Social Care Act 2012. The Department considers that a reasonable estimate of the cost of implementing this Bill would be in the order of at least tens of millions of pounds.
The costing does not reflect the opportunity costs, organisational restructuring and associated staff and redundancy costs that may need to be accommodated. Significant costs could also arise from implementation costs, including legal costs. There are also likely to be significant costs associated with the transitional changes required to give effect to the Bill’s provisions. For example, Clause 5 gives the Secretary of State power to direct clinical commissioning groups and the NHS Commissioning Board. Such a power materially changes the character of these organisations, which have been established to exist outside of a traditional NHS ‘hierarchy’ and to minimise the risk of political micro-management.
Competition and procurement legislation
A key policy aim of the Bill – and particularly clauses 6, 9 and 11 is to attempt to remove the susceptibility of the NHS to existing competition and procurement legislation. To achieve this aim the system would have to change significantly.
As well as the above changes, we believe that the Department would need to set aside significant levels of contingency budgets in order to allow for the extra costs associated with legal challenges to NHS procurements.
Direct costs would be incurred from; Part 1, clause 2 (new section 2c), subsections (2) - (7)) and clause 6 (new section 9 subsections (18) - (21) and Part 3 clause 12 of this Bill attributed to the Secretary of State for Health being required to:
- Fulfil an amended role in relation to mergers between NHS Trust / Foundation Trust;
- provide guidance on cooperation and social solidarity;
- seek advice from relevant parties and issue directions;
- adjudicate on any complaints they consider appropriate; and,
- deal with any NHS Contract references to arbitration under Section 3.
The Health and Social Care Act 2012 made changes to Monitor’s functions and the Secretary of State’s powers of direction over commissioners. This Bill proposes to make similar changes, albeit opposite to the 2012 Act under Parts 1, 2 and 3 for changes to Monitor’s and the Competition and Market Authority’s (CMA) functions and to reintroduce Secretary of State’s powers of direction over commissioners.
Parts 1, 2 and 3 of this Bill will incur new costs. To fulfil these new Duties, advice would be required from experts from an organisation similar in scale to what is currently spent on competition in Monitor. This function (other than mergers) could be delegated to Monitor, or within the Department, but some redundancy costs could be expected for those not wishing to transfer, or from winding down the function in Monitor if it returned to the Department. For 2013/14 this cost was £1,588,554[1] which included 30 staff. At least this level of cost would be directly incurred in addition to what is currently spent as a result of Part 3, clause 12; Part 1, clause 2, (new section 2c, subsections (2) - (7) and Part 2 clause 6 (new section 9, subsections (18) - (21).
In particular the functions set out in Part 3, clause 12 are currently undertaken by the CMA. Therefore, a similar function would be required to be established to support the Secretary of State in making decisions, as the CMA is likely to retain its existing staff to work on other market investigations. This is because the CMA has a legal duty to refer a merger for an in-depth investigation where:
(a) a relevant merger situation has been created or arrangements are in progress or in contemplation which, if carried into effect, will result in the creation of a relevant merger situation, and
(b) the creation of that situation has resulted, or may be expected to result, in a substantial lessening of competition within any market or markets for goods or services in the UK.
The Secretary of State would potentially issue guidance on the role of competition and choice, and would have a role in the adjudication of complaints in these matters. At the moment, this role is undertaken by Monitor. This would require a resource in the scale of the Competition and Cooperation Panel that undertook this role prior to the Health and Social Care Act 2012, indicative figures for which are set out above.
Clause 7, (new section 43, subsections 1-6) and clause 8 of the Bill would provide the Secretary of State with the power of direction over the level of NHS Foundation Trust and NHS Trust non-health service patient income.
Private patient income cap
We note that the Bill does not define the level of non-health service patient income which NHS trusts could collect, but note that the Shadow Secretary of State said during the Second Reading of the Bill that (Official Report, 21 November 2014, column 574):
“It reduces the private patient income cap back down to single figures”
Reducing the private income cap to 9% would mean that the following NHS organisations experience a shortfall totalling £50 million as of 2013/14:
PRIVATE PATIENT INCOME | Shortfall in income through loss of funding if the Bill became law | |||
2012-13 | 2013-14 | 2012-13 | 2013-14 | |
% | % | £000's | £000's | |
The Royal Marsden NHS Foundation Trust | 18.6% | 20.1% | 30,893 | 37,499 |
Moorfields Eye Hospital NHS Foundation Trust | 12.2% | 12.3% | 5,004 | 5,686 |
Great Ormond Street Hospital for Children NHS Foundation Trust | 11.1% | 10.1% | 7,829 | 4,602 |
Royal Brompton and Harefield NHS Foundation Trust | 9.1% | 9.9% | 273 | 3,009 |
Total Shortfall | 43,999 | 50,796 | ||
[1] Monitor’s competition functions were established by the Health and Social Care Act 2012. In the transition year 2012-13 Monitor hosted the Cooperation and Competition Panel at a cost of £1,068,099. The cost for 2013-14 also included hosting the Cooperation and Competition Panel.