To ask Her Majesty's Government whether strategic health authorities can require the merger of primary care trust commissioners if they consider that the commissioning performance of particular trusts is unsatisfactory, not serving the best interests of the local population or wasting public money; and, if so, whether such mergers would require the agreement of the Competition and Collaboration Panel. [HL4742]

In June 2008, the department published Developing the NHS Performance Regime¹, which sets out expectations of strategic health authorities (SHAs) in identifying underperformance, supporting recovery and the options for managing commissioner failure. A copy has already been placed in the Library. These options include recommending a statutory merger, which would be subject to Secretary of State approval in individual cases. Subject to published materiality thresholds², where a proposed merger involves provider services the SHA would be expected to refer the proposal to the Co-operation and Competition Panel for advice and in order to inform the approval process. The Co-operation and Competition Panel would advise on the proposed merger of provider services as to compliance with the Principles and Rules for Co-operation and Competition³, which permit mergers where demonstrated to be in patient and taxpayers' best interests. A copy has already been placed in the Library.

Notes:

¹ Developing the NHS Performance regime, Department of Health, June 2008.

² Co-operation and Competition Panel, Consultation on draft interim merger inquiry guidelines, January 2009.

³ The NHS in England: The operating framework for 2008-09 Annex D—Principles and rules for co-operation and competition.

To ask Her Majesty's Government what proportion of general practitioner practices are engaged in practice-based commissioning as envisaged by their 2005 manifesto commitment to develop such commissioning; and what proportion of primary care trust commissioning budgets in each strategic health authority area is spent on practice-based commissioning in the latest financial year for which information is available. [HL4743]

The department does not collect information on the proportion of general practitioner (GP) practices that are engaged in practice-based commissioning (PBC).

However, the department carries out a quarterly survey of around 2,000 GP practices to gauge views on PBC. The last survey results were published on 27 March 2009 and show that 92 per cent of practices are part of a PBC group.

Information on the proportion of primary care trust commissioning budgets in each strategic health authority area that are spent on practice-based commissioning is not collected nationally.

To ask Her Majesty's Government when they expect primary care trust commissioners to have all their hospital trusts operating balanced budgets without one-off payments and without historic debts, in light of the Government's funding of the National Health Service up to the end of the financial year 2010–11. [HL4746]

In the 2008-09 draft accounts five National Health Service (NHS) trusts reported an operating deficit.

Whilst the financial plans have now been agreed for 2009-10, the financial plans for 2010-11 have not yet been agreed. We are working through the 2010-11 financial plans with the strategic health authorities, with a view to minimising the number of organisations with historic debt and who are not in recurrent balance at the end of 2010-11.

We do not collect information in respect of one-off payments.