DEPARTMENT OF HEALTH DEPARTMENT Department of Health DEPARTMENTAL REPORT REPORT DEPARTMENTAL The Government’s Expenditure Plans 2001-2002 to 2003-2004 and Main Estimates 2001-2002 Published by The Stationery Office Limited and available from: 2001 The Publications Centre (mail, telephone and fax orders only) PO Box 29, Norwich NR3 1GN General enquiries 0870 600 55 22 Order through the Parliamentary Hotline Lo-call 0845 7 02 34 74 Fax orders 0870 600 55 33 E-mail [email protected] Internet http://www.ukstale.com The Stationery Office Bookshops 123 Kingsway, London WC2B 6PQ 020 7242 6393 Fax 020 7242 6394 68-69 Bull Street, Birmingham B4 6AD The Stationery Office 0121 236 9696 Fax 0121 236 9699 33 Wine Street, Bristol BS1 2BQ 0117 926 4306 Fax 0117 929 4515 9-21 Princess Street, Manchester M60 8AS 0161 834 7201 Fax 0161 833 0634 16 Arthur Street, Belfast BT1 4GD 028 9023 8451 Fax 028 9023 5401 The Stationery Office Oriel Bookshop 18-19 High Street, Cardiff CF1 2BZ 029 2039 5548 Fax 029 2039 4347 71 Lothian Road, Edinburgh EH3 9AZ 0870 606 5566 Fax 0870 606 5588 The Parliamentary Bookshop 12 Bridge Street, Parliament Square London SW1A 2JX Telephone orders 020 7219 3890 General enquiries 020 7219 3890 Fax orders 020 7219 3866 Departmental Report Accredited Agents (see Yellow Pages) The Health and Personal and through good booksellers Social Services Programmes This is part of a series of departmental reports (Cm 5102 to 5123) accompanied by the document Public Expenditure: Statistical Analysis, 2000–2001 (Cm 5101), which present the Government’s expenditure plans for 2001–2002 to 2003–2004. The complete series is also available as a set at a discounted price. © Crown Copyright 2001 The text in this document may be reproduced free of charge in any format or media without requiring specific permission. This is subject to the material not being used in a derogatory manner or in a misleading context. The source of the material must be acknowledged as Crown copyright and the title of the document must be included when being reproduced as part of another publication or service. Any enquiries relating to the copyright in this document should be addressed to Printed in the UK for The Stationery Office Limited on behalf of the HMSO, The Copyright Unit, St Clements House, 2-16 Colegate, Norwich NR3 1BQ. Controller of Her Majesty’s Stationery Office Fax: 01603 723000 or e-mail: [email protected]. Dd 5069864 3/01 1374 TJ003902 This is part of a series of departmental reports (Cm 5102 to 5123) accompanied by the document Public Expenditure: Statistical Analysis, 2000–2001 (Cm 5101), which present the Government’s expenditure plans for 2001–2002 to 2003–2004. The complete series is also available as a set at a discounted price. © Crown Copyright 2001 The text in this document may be reproduced free of charge in any format or media without requiring specific permission. This is subject to the material not being used in a derogatory manner or in a misleading context. The source of the material must be acknowledged as Crown copyright and the title of the document must be included when being reproduced as part of another publication or service. Any enquiries relating to the copyright in this document should be addressed to Printed in the UK for The Stationery Office Limited on behalf of the HMSO, The Copyright Unit, St Clements House, 2-16 Colegate, Norwich NR3 1BQ. Controller of Her Majesty’s Stationery Office Fax: 01603 723000 or e-mail: [email protected]. Dd 5069864 3/01 1374 TJ003902 The Government’s Expenditure Plans 2001-2002 to 2003-2004 and Main Estimates 2001-2002 Department of Health DEPARTMENTAL REPORT Presented to Parliament by the Secretary of State for Health and the Chief Secretary to the Treasury by Command of Her Majesty March 2001 Cm 5103 £18.50 Contents Page Foreword by the Secretary Of State 1 Ministerial Responsibilities 3 Structure of the Department of Health 5 Chapter 1: Introduction 7 Chapter 2: Delivering Better Public Services – Progress 9 Chapter 3: Expenditure Plans 21 Chapter 4: Investment 33 Chapter 5: The NHS Plan – a Plan for Investment, A Plan for Reform 39 Chapter 6: Breakdown of Spending Programme 45 Chapter 7: Activity, Performance and Efficiency 53 Chapter 8: Managing the Department of Health 71 List of Annexes 75 Bibliography 115 List of Figures 119 Glossary 121 Full Contents List 125 The purpose of this report is to present to Parliament and the Public a clear and informative account of the expenditure and activities of the Department of Health. This report and those of 1998, 1999 and 2000 are available on the Internet at http://www.doh.gov.uk/dohreport/ The Department of Health also has a Public Enquiry Office which deals with general queries, 0207 210 4850. Foreword by the Secretary of State It gives me great pleasure to present the eleventh annual report of the Department of Health. In the past, the debate about health and social care focused on resources, or the lack of them. Not any more. The March 2000 budget set out the largest level of sustained real terms growth over any four year period in NHS history. Since then, the NHS has received a further £120 million from the Treasury Capital Modernisation Fund (TCMF) for investment in coronary heart disease – £50 million in 2000-2001 and £70 million in 2001-2002. In the budget of 7th March 2001, the Chancellor announced further resources for the NHS in England: on average an extra £275 million per year for the next three years. This means that the annual average real terms increase in NHS expenditure is now 6.6 per cent (compared to the 6.3 per cent announced in the 2000 budget). During the period 1999-2000 to 2003-2004, government expenditure on the NHS will have risen by over 50 per cent to £57 billion (over 37 per cent in real terms). Now the questions about funding have been answered it is time to concentrate on the real issue – delivering better health, and faster, fairer more convenient services. Reforming the way the health service works, so that in future, the patient is at the centre of everything we do. In July 2000, after extensive consultation, we published the NHS Plan – a ten year programme for reform. The Plan sets out exactly how we will deliver a health service fit for the 21st century. How we are investing in 7,000 extra beds over the next few years and 100 new hospital schemes over the next decade. And investing in nearly 10,000 more consultants and GPs, 20,000 more nurses and 6,500 other health professionals over the next four years. Increasing capacity is vital, but on its own it is not enough. We also have to change the way the NHS works, to make the most effective use of these extra resources. We have to drive up standards, so that everyone can expect the same high quality of care. And we have to release the full potential of NHS staff, who have been instrumental in drawing up the Plan, and who are among the most effective advocates for change. That is why the NHS Plan introduces a new Modernisation Agency to spread best practice, and a National Performance Fund worth £500 million by 2003-04, to raise standards across the NHS. In future there will be a system of inspection and accountability for all parts of the NHS. The best performers will be given greater autonomy to use their share of the performance fund, and those who need more time will receive assistance from the Modernisation Agency. Nurses and other health professionals will be given the bigger roles that their qualifications and expertise deserve. We are cutting waiting times for treatment, expanding cancer screening programmes, and giving patients greater choice and new protection, for example against delays caused by cancelled operations. In future we want to see closer working between health and social services. We will support this with an extra £900 million investment in intermediate care by 2003-04, and new Care Trusts, combining health and social services. And we want to provide dignity, security and independence in old age including higher standards of care for older people and a new Care Direct Service. Taken together, these and the other changes outlined in the NHS Plan represent an unprecedented opportunity to transform not just the quantity of care available, but also the quality. The standards we have set are challenging, but we are confident they can be delivered, because the Plan will be implemented in the same inclusive way it was drawn up – with the active involvement of NHS staff, patients’ representatives, and other experts. As I write this foreword, the legislation required to enable many of the Plan’s key reforms is going through Parliament. The last year has proved that there is universal support within the NHS for our overall aim: to reshape the NHS from the patient’s point of view. This Departmental report is an early account of some of the progress we are making. Rt Hon Alan Milburn MP Secretary of State for Health 1 Introduction 2 Ministerial Responsibilities Secretary of State: The Right Honourable Alan Milburn MP Overall responsibility for the work of the Department of Health; Individual responsibility for NHS finance; NHS resource allocation; NHS central budgets; Performance monitoring; Management costs & NHS efficiency; PFI & NHS capital; NHS Estates; Strategic communications; sponsorship including health exports. Minister of State for Health, MS (H): John Denham MP Responsibility for: NHS strategy and planning; Waiting lists and times; Clinical quality inc NICE, CHI; Primary Care; Human resources in the NHS; NHS pay and conditions; Medical training and education; Medical workforce planning; Regional NHS casework for London.