We can confirm that no such discussions have taken place. The Department wrote out to the finance directors of all National Health Service providers in September 2017 reminding them of their responsibilities around tax and advising that tax avoidance arrangements should not be entered into under any circumstances. We would expect all NHS providers to follow this guidance when considering any new arrangements or different ways of working. Given these safeguards which are in place around tax avoidance in the NHS, no discussions have taken place between the Department of Health and Social Care and HM Treasury.
We can confirm that no such estimate has been made. There are a number of reasons for a Trust to set up a subsidiary company, including:
- Employ staff on more flexible and in some cases more generous terms and conditions;
- Providing services for other trusts; and
- Being able to attract staff from the local employment market.