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, how many reviews of transactions involving (a) the creation of subsidiaries and (b) material changes to existing subsidiaries are being undertaken by NHS Improvement where the proposal is considered to be material as at 29 June 2021.
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.
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, how many reviews of transactions involving (a) the creation of subsidiaries and (b) material changes to existing subsidiaries are being undertaken by NHS Improvement where the proposal is considered to be significant as at 29 June 2021.
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.
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 the timetable is for publication of the review by NHS Improvement of the approach to considering 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.
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, how many NHS Trusts and Foundation Trusts have engaged with NHS Improvement on transactions involving (a) the creation of subsidiaries and (b) material changes to existing subsidiaries in the last 12 months.
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.
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, pursuant to the Answer of 2 December 2020 to Question 120891 on NHS Trusts: Subsidiary Companies, what criteria he will use to measure the benefits to patients of the subsidiary transaction.
Answered by Edward Argar - Minister of State (Ministry of Justice)
The measurement of patient benefits in proposals by trusts for forming or changing a subsidiary under NHS England and NHS Improvement’s addendum to transaction guidance is through trust board certification and a review process.
As part of the review, the trust board should clearly demonstrate why the formation of trust subsidiaries is the best option for patients, the trust and the local health economy. Plans require the support of key stakeholders in the local health economy, including those from patients to gain their perspective on perceived benefits of any 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, pursuant to the Answer of 30 September 2020 to Question 97629, what assessment he has made of the benefits to patients of NHS trusts managing their estates and property through a wholly owned subsidiary company.
Answered by Edward Argar - Minister of State (Ministry of Justice)
Current NHS England and NHS Improvement guidance on the creation of Wholly Owned Subsidiaries considers the specific aims of the business case for National Health Service trusts managing their estates and property through a wholly owned subsidiary company.
Trusts are asked to certify that they have considered a detailed options appraisal before deciding that the proposed subsidiary transaction aligns with wider system plans and is at least financially neutral for the wider system. Trusts must also demonstrate that the proposed transaction delivers benefits for patients and for the trust and that the subsidiary is the best vehicle to deliver these benefits.
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 effect on NHS Property Services of NHS Trusts setting up wholly owned subsidiary companies to manage their estates and property.
Answered by Edward Argar - Minister of State (Ministry of Justice)
National Health Service trusts and foundation trusts occupy about a third of NHS Property Services’ estate as tenants. The Company provides facilities management and other estates services to these properties; the trusts provide elements of these services to NHS Property Services themselves in many cases and these may be delivered through Wholly Owned Subsidiary Companies in areas where these have been established. It is for individual NHS trusts to decide on the best contracting model for the delivery of these services.
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 pause proposals for NHS trusts to (a) form or (b) make changes to subsidiary companies until after the Government has concluded its assessment of its proposals to reform VAT refund rules.
Answered by Edward Argar - Minister of State (Ministry of Justice)
The Health and Social Care Act 2012 established a level playing-field in which any qualified provider can provide National Health Service-funded services to encourage greater diversity of supply and improve patient choice. As such, it is vital that all providers, be they NHS or private sector, operate within existing VAT legislation as applicable to their particular entity.
Initial responses to the HM Treasury consultation on changes to S41 of the 1994 VAT Act are due by 19 November 2020. There are no plans to pause proposals for NHS trusts to form or make changes to subsidiary companies.
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 the periodic review of NHS Property Services Limited referred to by Sir Chris Wormald in oral evidence to the Public Accounts Committee on 9 September 2020 will include an assessment of the effect of the recent trend by NHS trusts to set up wholly owned subsidiary companies to manage their estates and property.
Answered by Edward Argar - Minister of State (Ministry of Justice)
Sir Chris Wormald gave his oral evidence to the Public Accounts Committee on their hearing into NHS Property Services Ltd (NHSPS) on 9 September 2019 following the publication of an NAO report into NHSPS in June 2019.
The scope of the review of NHS Property Services Limited is an update of the strategic context and justification for the company delivery model; a review of the Company’s operational and financial performance; and both with reference to changes to the role and function of the Department since the formation of the company in 2013.
The review has been completed and the findings were published on 24 September 2020 and is available at the following link:
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, pursuant to the oral contribution of the Minister for Health of 9 January 2020, Official Report, Column 727, what evidence has been provided to his Department in relation to plans to review section 41 VAT rules.
Answered by Edward Argar - Minister of State (Ministry of Justice)
At the current date, no such evidence has been received as this has not yet been requested. The Government is currently working on the section 41 VAT policy paper and this, along with a corresponding ‘call for evidence’ will be published in due course.