8. What steps he is taking to improve the sustainability of NHS trusts. (110322)

We are working directly with all NHS trusts to enable them to achieve foundation trust status—for the great majority, by April 2014. Achieving foundation trust status means that NHS trusts have achieved high and sustainable levels of clinical quality and financial governance.

It is possible that North Yorkshire and York primary care trust will this year declare a deficit based on inherited debt from the merger of PCTs several years ago. I am concerned that the new clinical commissioning groups might have to pick up that deficit. Will my right hon. Friend look at all the options to ensure that clinical commissioning groups can be given the best possible start by having a clear balance sheet?

No primary care trust should plan for a deficit in 2012-13. Primary care trusts carrying legacy debt into 2012-13 must clear it in accordance with the 2012-13 NHS operating framework. As at the end of 2011-12, the primary care trust my hon. Friend mentions had legacy debt that has been managed and absorbed locally by the strategic health authority. As at the end of 2011-12, the PCT is not forecasting any legacy debt.

No-shows and people failing to keep appointments in out-patient departments are costing Brighton and Sussex University Hospitals NHS Trust nearly £6 million a year. Does my right hon. Friend agree that this is extremely selfish, and would he propose sanctions on those who fail to show up for their appointments?

I am grateful to my right hon. Friend. I have no proposals for sanctions, but I commend to him and his trust the many mechanisms that are available, which they may know about, such as sending text messages to mobile phones. I have seen them in practice, and they do stimulate patients to attend their appointments and so reduce what has been an unacceptable level of non-attendance.