Asked by: Karin Smyth (Labour - Bristol South)
Question to the HM Treasury:
To ask the Chancellor of the Exchequer, with reference to his Department's policy paper VAT and the Public Sector: Reform to VAT Refund Rules, published on 27 August 2020, whether he plans to implement changes to the VAT regime for NHS (a) trusts and (b) foundation trusts considering establishing wholly owned subsidiary companies.
Answered by Victoria Atkins - Secretary of State for Health and Social Care
The 2020 policy paper published by HM Treasury set out the case for a Full Refund Model for public bodies currently eligible for VAT refunds under Section 41 of the VAT Act, to simplify the VAT system for public bodies and enhance public sector productivity. Please find the published paper on the GOV.UK website here: https://www.gov.uk/government/publications/vat-and-the-public-sector-reform-to-vat-refund-rules.
We are continuing to consider the practicalities of any reform and no decisions have been made on whether to proceed. We will update on next steps in due course.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many wholly owned subsidiary companies are operating within NHS England.
Answered by Will Quince
Ministers do not have a role in approving Wholly Owned Subsidiary companies created by NHS Foundation Trusts, with this role undertaken through the statutory powers and duties of NHS England. Ministers only have a role in approving subsidiaries created by NHS Trusts for income-generation purposes.
The Department is not currently assessing any plans for new NHS Trust subsidiaries created for income-generation purposes. NHS England published guidance in November 2018 setting out the regulatory review process required before NHS trusts and foundation trusts can implement plans involving subsidiaries. Since the guidance was published, 48 proposals have been reported to NHS England for classification and potential review. A number of these are still ‘live’ cases where a proposal has been reported, but has not yet been reviewed and not all proposals will have been implemented.
No discussions have taken place with NHS England on preventing NHS trusts and foundation trusts from setting up wholly owned subsidiary companies. NHS England are working to publish updated guidance, reflecting lessons learned on trust subsidiary reviews. There are no plans to publish a list of wholly owned subsidiary companies operating within England.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to increase engagement with (a) staff and (b) trade unions on the establishment of wholly owned subsidiary companies by NHS trusts and foundation trusts.
Answered by Will Quince
NHS England published guidance in November 2018 setting out the regulatory review process required before NHS trusts and foundation trusts can implement plans involving subsidiaries. As part of this review, NHS England consider engagement with staff and trade unions. NHS England routinely involve regional workforce leads in the review process where a subsidiary proposal involves changes to the workforce.
NHS England work in conjunction with trusts and trade unions, setting out good practice workforce engagement and consultation guidance for trusts considering setting up or dissolving a subsidiary.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many plans for (a) new and (b) altered wholly owned subsidiary companies in the NHS are being assessed by his Department.
Answered by Will Quince
Ministers do not have a role in approving Wholly Owned Subsidiary companies created by NHS Foundation Trusts, with this role undertaken through the statutory powers and duties of NHS England. Ministers only have a role in approving subsidiaries created by NHS Trusts for income-generation purposes.
The Department is not currently assessing any plans for new NHS Trust subsidiaries created for income-generation purposes. NHS England published guidance in November 2018 setting out the regulatory review process required before NHS trusts and foundation trusts can implement plans involving subsidiaries. Since the guidance was published, 48 proposals have been reported to NHS England for classification and potential review. A number of these are still ‘live’ cases where a proposal has been reported, but has not yet been reviewed and not all proposals will have been implemented.
No discussions have taken place with NHS England on preventing NHS trusts and foundation trusts from setting up wholly owned subsidiary companies. NHS England are working to publish updated guidance, reflecting lessons learned on trust subsidiary reviews. There are no plans to publish a list of wholly owned subsidiary companies operating within England.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to update guidance for (a) NHS trusts and (b) foundation trusts on the development of wholly owned subsidiary companies.
Answered by Will Quince
Ministers do not have a role in approving Wholly Owned Subsidiary companies created by NHS Foundation Trusts, with this role undertaken through the statutory powers and duties of NHS England. Ministers only have a role in approving subsidiaries created by NHS Trusts for income-generation purposes.
The Department is not currently assessing any plans for new NHS Trust subsidiaries created for income-generation purposes. NHS England published guidance in November 2018 setting out the regulatory review process required before NHS trusts and foundation trusts can implement plans involving subsidiaries. Since the guidance was published, 48 proposals have been reported to NHS England for classification and potential review. A number of these are still ‘live’ cases where a proposal has been reported, but has not yet been reviewed and not all proposals will have been implemented.
No discussions have taken place with NHS England on preventing NHS trusts and foundation trusts from setting up wholly owned subsidiary companies. NHS England are working to publish updated guidance, reflecting lessons learned on trust subsidiary reviews. There are no plans to publish a list of wholly owned subsidiary companies operating within England.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether he has held discussions with NHS England on preventing NHS trusts and foundation trusts from setting up wholly owned subsidiary companies.
Answered by Will Quince
Ministers do not have a role in approving Wholly Owned Subsidiary companies created by NHS Foundation Trusts, with this role undertaken through the statutory powers and duties of NHS England. Ministers only have a role in approving subsidiaries created by NHS Trusts for income-generation purposes.
The Department is not currently assessing any plans for new NHS Trust subsidiaries created for income-generation purposes. NHS England published guidance in November 2018 setting out the regulatory review process required before NHS trusts and foundation trusts can implement plans involving subsidiaries. Since the guidance was published, 48 proposals have been reported to NHS England for classification and potential review. A number of these are still ‘live’ cases where a proposal has been reported, but has not yet been reviewed and not all proposals will have been implemented.
No discussions have taken place with NHS England on preventing NHS trusts and foundation trusts from setting up wholly owned subsidiary companies. NHS England are working to publish updated guidance, reflecting lessons learned on trust subsidiary reviews. There are no plans to publish a list of wholly owned subsidiary companies operating within England.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will publish a list of wholly owned subsidiary companies operating within NHS England.
Answered by Will Quince
Ministers do not have a role in approving Wholly Owned Subsidiary companies created by NHS Foundation Trusts, with this role undertaken through the statutory powers and duties of NHS England. Ministers only have a role in approving subsidiaries created by NHS Trusts for income-generation purposes.
The Department is not currently assessing any plans for new NHS Trust subsidiaries created for income-generation purposes. NHS England published guidance in November 2018 setting out the regulatory review process required before NHS trusts and foundation trusts can implement plans involving subsidiaries. Since the guidance was published, 48 proposals have been reported to NHS England for classification and potential review. A number of these are still ‘live’ cases where a proposal has been reported, but has not yet been reviewed and not all proposals will have been implemented.
No discussions have taken place with NHS England on preventing NHS trusts and foundation trusts from setting up wholly owned subsidiary companies. NHS England are working to publish updated guidance, reflecting lessons learned on trust subsidiary reviews. There are no plans to publish a list of wholly owned subsidiary companies operating within England.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the impact of the establishment of wholly-owned subsidiary companies by (a) NHS trusts and (b) foundation trusts on the morale of NHS staff.
Answered by Will Quince
There has been no assessment made of the potential impact of the establishment of wholly owned subsidiary companies by NHS trusts or foundation trusts on morale or workforce retention. NHS England published guidance in 2018 setting out the regulatory review process required before NHS trusts and foundation trusts can implement plans involving subsidiaries. As part of this review, NHS England consider engagement with staff and trade unions. NHS England routinely involve regional workforce leads in the review process where a subsidiary proposal involves changes to the workforce. NHS England work in conjunction with trusts and trade unions, setting out good practice workforce engagement and consultation guidance for trusts considering setting up or dissolving a subsidiary.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential impact of the establishment of wholly owned subsidiary companies by (a) NHS trusts and (b) foundation trusts on workforce retention.
Answered by Will Quince
There has been no assessment made of the potential impact of the establishment of wholly owned subsidiary companies by NHS trusts or foundation trusts on morale or workforce retention. NHS England published guidance in 2018 setting out the regulatory review process required before NHS trusts and foundation trusts can implement plans involving subsidiaries. As part of this review, NHS England consider engagement with staff and trade unions. NHS England routinely involve regional workforce leads in the review process where a subsidiary proposal involves changes to the workforce. NHS England work in conjunction with trusts and trade unions, setting out good practice workforce engagement and consultation guidance for trusts considering setting up or dissolving a subsidiary.
Asked by: Justin Madders (Labour - Ellesmere Port and Neston)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent discussions officials in his Department have had with representatives of NHS Improvement on the proposals for a review of the guidance covering transactions involving the creation of subsidiaries or material changes to existing subsidiaries.
Answered by Edward Argar - Minister of State (Ministry of Justice)
The National Health Service has had a long-standing ability to create subsidiary companies under the National Health Service Act 2006. NHS foundation trusts can establish subsidiaries with approval undertaken through the statutory powers and duties of NHS England and NHS Improvement. NHS trusts may only establish subsidiaries with approval of the Secretary of State. The review of proposals under the existing Addendum to the transactions guidance for trusts forming or changing a subsidiary involving the creation of subsidiaries and material changes, including those that are considered significant to existing subsidiaries, has been paused to allow both NHS England and NHS Improvement and the sector to focus on supporting the recovery of services
NHS England and NHS Improvement made a small number of exemptions to this principle, where there were exceptional circumstances. Over the last 12 months, NHS trusts and foundation trusts have reported four proposals to create new subsidiaries and six proposals to make material changes to existing subsidiaries. Updated guidance is due to be published later in 2021/22.
There have been a number of recent discussions involving Departmental officials and NHS England and NHS Improvement on the proposals for a review of the guidance covering the creation of subsidiaries or material changes to existing subsidiaries.