asked Her Majesty's Government:

How many consultants are currently suspended from their duties in National Health Service hospitals; and what estimate has been made of the resulting annual cost.

My Lords, since April 2005, the National Clinical Assessment Service has collected figures on the total number of doctors and dentists suspended from duty. There were 31 consultant exclusions in England at 31 March 2007. In 2003 the National Audit Office report The Management of Suspensions of Clinical Staff established that the average cost of excluding a doctor was £188,000 per year.

My Lords, does that figure include the amount paid to consultants who have to be brought in to do the work which otherwise the suspended consultants would have carried out?

My Lords, the figures were produced by the National Audit Office in 2003, so they go back a long way. No work has been done since then. My understanding is that the figures were based on an average 47-week suspension for doctors and that the average cost of excluding a doctor was £188,000; for other clinical staff, the figure was £21,400. I assume that this was a comprehensive costing but I am happy to provide the noble Baroness with further details.

My Lords, years ago I asked a Question on this because of a consultant doctor who had gardening leave for some 13 years, and I believe that there were some instances of leave being even longer. I was told that this process would definitely not continue. What is the longest period of suspension of any of the people presently receiving pay at full rate?

My Lords, I am sure that the gardens turned out very well at the end of 13 years. Overall, there has been a huge improvement in the position of suspended doctors. The BMA used to produce figures which suggested that at any one time 500 hospital doctors were suspended, but the current figures show a huge reduction.

I do not have information on the longest suspension; indeed, in some cases, it could be regarded as confidential. However, I can assure the noble Baroness that the work of the National Clinical Assessment Service has ensured that except for a limited number of cases where the problems have proved intractable, the evidence is that it can get involved and deal with the problems much more quickly. More generally, I have asked the National Clinical Assessment Service to produce statistics that would show the length of suspensions in a way that is acceptable and gets over some of the confidentiality issues. It has not yet done that work but I will of course place the information in the Library when it is established.

My Lords, does my noble friend remember the dreadful headlines in the 1990s about consultants playing golf, costing the health service a large amount of money and not being used effectively? I remember them. The health service was virtually on its knees then. Now, we need to recognise that there are problems—

Noble Lords:

Question!

My Lords, there are problems, but we now have consultants working much harder and more effectively. Will my noble friend confirm that the effectiveness and amount of work done by consultants is infinitely better than it was in the 1990s, and will he keep making the improvements that we are seeing at the moment?

My Lords, I thought that my noble friend put that question very well indeed. I also pay tribute to the noble Baroness, Lady Gardner of Parkes, because she has raised this matter over many years. However, the establishment of the National Clinical Assessment Service has ensured that if a doctor is suspended for any length of time it must come to the attention of the NCAS, which gives very good advice to local employers. The record shows that that is working very well. It is why the number of suspended doctors has fallen so dramatically.

My Lords, does the Leader of the House agree that Questions and Answers should be short?

My Lords, I always thought that I was pithy in my Answers, but I cannot answer for those who ask the Questions.

My Lords, with reference to the Minister's earlier answer regarding the National Clinical Assessment Service, new rules were introduced in June 2005 to reduce targets on suspension rates and require resolution within 13 weeks, 19 weeks less than the previous 32-week target. It is nearly two years since that was put in place. Is it working?

My Lords, my understanding is that progress is being made but there is still some way to go before the NCAS reaches that target. However, I pay tribute to the work of the NCAS. It has been outstanding. This major problem, identified for so many years, has now largely been dealt with.

My Lords, have the Government considered the impact on costs for doctors following the proposals for remediation and rehabilitation as set out in the White Paper Trust, Assurance and Safety, which in 2003 estimated costs of £7.3 million a year? Has that figure been revised?

My Lords, as the noble Lord will know, following our announcement a few weeks ago work is being undertaken to prepare the ground to introduce those measures, and looking at the cost will be a part of that additional work. The revalidation and relicensing process, and the new approach of the General Medical Council incorporated in it, is designed for early intervention and to deal with these problems before there has to be a question of suspension or direct referral to the GMC. I very much hope that these measures will be cost effective.

My Lords, would the Minister be surprised if I said that the efficient working of the NCAS has not only reduced the number of suspensions but allowed for assessment and retraining of doctors, who then go back to work?

My Lords, I pay tribute to the noble Lord, who is the chair of the National Patient Safety Agency, in which the NCAS is now placed. My understanding is that, when the NCAS considers that it is safe and appropriate for a doctor to return to work, 70 per cent of those are able to do so. That is comparative to the best rates in the world including those in Canada and the west coast of the United States, which are regarded as best practice countries. Not only is the process being speeded up and the number of doctors suspended coming down but many more of them are getting back into work, which is excellent news.