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The below Parliamentary question was asked by Roger Godsiff on 2016-01-21.

To ask the Secretary of State for Health, whether NHS bodies which carry out surgery to repair work performed by outsourcing companies are able to claim back the costs of carrying out that work.

George Freeman

Whether or not National Health Service bodies are able to claim back the costs depends on a number of circumstances. For instance:

– A clinical commissioning group (CCG) may have placed a contract for elective surgery with an independent sector provider. A patient treated in this provider’s hospital may experience complications and require further treatment, which has to be arranged under the CCG’s separate contract with the local NHS trust or foundation trust (FT) (perhaps because it has the facilities to carry out more specialist treatment); or

– An NHS trust or FT may sub-contract surgical procedures to an independent sector provider. Again, a patient treated at the sub-contractor’s hospital may experience complications and require further treatment, which has to be carried out by the NHS Trust or FT (again, because it has the facilities to carry out more specialist treatment).

The terms of such subcontracts are not nationally prescribed, but it would be usual for such a sub-contract to require the sub-contractor to indemnify the NHS provider for the cost it incurs as a result of negligent or inadequate treatment on the part of the sub-contractor.

However, it is important to be clear that complications after surgery are not necessarily associated with negligence. It is normal for patients experiencing complications to be referred to the hospital which can provide the best care. In these circumstances, each NHS provider will normally be paid by the relevant NHS commissioner for the specific service it has provided to the patient.

In the first example, the NHS trust or FT will be paid in full by its local CCG for the further treatment it has provided, at the normal national prices laid down in the National Tariff Payment System. Normally, the CCG would also have paid for the initial treatment provided by the independent sector provider, but if there is evidence of breach of contract or negligence, the CCG would be entitled to be indemnified for the additional costs of further treatment.

In the second example, the NHS provider is responsible to the commissioner both for the treatment it has carried out itself and under sub-contract by the independent sector provider. It will therefore be paid by its CCG at National Tariff prices for all the operations that have been undertaken at both hospitals – though, again, this would be subject to the potential for the CCG to withhold payment to in a clear case of negligence or breach of contractual requirements. Payment between the NHS provider and its sub-contractor would be a matter for those parties to agree locally between themselves, as a part of their sub-contract.

The below Parliamentary question was asked by Roger Godsiff on 2016-01-21.

To ask the Secretary of State for Health, how much compensation the NHS has paid to patients who were injured by healthcare carried out by private contractors in each of the last five years.

Ben Gummer

The Department does not hold this information centrally; the answer has been supplied by the National Health Service Litigation Authority (NHS LA).

The table below shows all payments made on claims against private providers as at 31 December 2015 (open and closed claims) for payment years 2010/11 to 2014/15.

Year of Payment	Damages £	Defence Costs £	Claimant Costs £	Total Paid £
2010/11 2011/12 2012/13 2013/14 2014/15	3,213,372 4,143,937 8,132,597 8,522,797 8,905,057	378,903 621,887 807,120 868,765 1,096,935	1,251,698 1,989,256 3,312,219 4,172,732 4,504,967	4,843,973 6,755,080 12,251,935 13,564,293 14,506,960
Total	32,917,760	3,773,610	15,230,871	51,922,241

Source: NHSLA

Date: January 2016

Prior to that date indemnity cover was provided by the referring National Health Service body. Since 1 April 2013 independent providers have been directly eligible for membership of the clinical negligence scheme for trusts. The figures in the table represent all private provider claims for each of the last five years.

The below Parliamentary question was asked by Roger Godsiff on 2016-01-21.

To ask the Secretary of State for Health, whether there is any requirement for NHS bodies which outsource health services to ensure that companies with which they contract are fully insured.

George Freeman

Clinical commissioning groups and NHS England, when commissioning foundation trusts, NHS trusts and others to deliver non-primary care clinical services, must do so using the NHS Standard Contract published each year by NHS England.

The NHS Standard Contract requires the provider of clinical services to “put in place and maintain appropriate indemnity arrangements in respect of:

– employers’ liability;

– clinical negligence;

– public liability; and

– professional negligence.

The below Parliamentary question was asked by Roger Godsiff on 2016-01-21.

To ask the Secretary of State for Health, whether private outsourcing companies which take on NHS contracts and obtain insurance by paying into the NHS insurance scheme are required to contribute (a) full or (b) a partial cost of that cover.

Ben Gummer

The NHS Litigation Authority is responsible for administering all National Health Service risk pooling schemes. Since April 2013, independent sector providers of healthcare have been able to obtain indemnity cover under the Clinical Negligence Scheme for Trusts (CNST). All CNST members are required to pay their actuarially assessed costs for each year that they are a member of the scheme.

The below Parliamentary question was asked by Roger Godsiff on 2016-01-21.

To ask the Secretary of State for Health, what estimate his Department has made of the cost to the NHS of (a) fixing eye operations contracted out by Musgrove Park Hospital which had a high failure rate and (b) paying compensation for eye injuries sustained as a result of operations outsourced by Musgrove Park Hospital.

Ben Gummer

The Department does not hold the information requested; a response has been supplied by the National Health Service Litigation Authority.

To date 10 claims have been received in relation to this initiative. Two claims have been paid at a total cost of £87,250 inclusive of legal costs. The remaining eight claims are outstanding and it would not be appropriate to reveal financial information at this stage.