Written Answers to Questions
Monday 16 April 2007
Health
Abortions
Information on the number of abortions performed by Marie Stopes International (MSI) in England by grounds, gestation and the woman’s place of residence is set out in the following table. The place of termination has been withheld in order to protect individuals’ confidentiality. This is in line with the Office for National Statistics’ guidance on the disclosure of abortion statistics, 2005.
Approved independent sector abortion clinics are inspected by the Healthcare Commission on an annual basis. Copies of the inspection reports can be viewed at:
www.healthcarecommission.org.uk.
The Department has received a small number of complaints during the last three years which were investigated. Under the Care Standards Act 2000, MSI is required to supply each patient with a written copy of its complaints procedure, fully investigate each complaint and maintain a detailed, written record of each complaint. MSI is also required to send the Healthcare Commission a statement every year with a summary of the complaints received.
In addition, the Healthcare Commission look at these records as part of a clinic inspection.
2003 2004 2005 Total 53,643 58,128 58,402 Grounds C 53,486 57,929 58,197 Other 157 199 205 Gestation weeks up to 9 39,315 43,924 45,490 10 to 12 8,739 8,723 7,892 13 and over 5,589 5,481 5,020 Place of Residence England 48,117 52,426 53,014 Wales 520 614 551 Scotland 85 118 94 Northern Ireland 577 640 685 Isle of Man 21 27 24 Irish Republic 3,943 3,956 3,676 France 38 17 23 Italy 42 49 56 Malta 31 53 41 Spain 25 20 18 United Arab Emirates 53 41 45 Other 191 167 175
Accident and Emergency Departments
Information is not collected centrally at the level of individual hospitals. However, information on the total number of attendances at accident and emergency (A&E) departments at East Sussex Hospitals National Health Service Trust is shown in the table.
Attendances at accident and emergency 2002-03 86,354 2003-04 90,526 2004-05 101,916 2005-06 110,558 2006-07 84,804 Note: 2006-07 data are for Q1, Q2 and Q3 only. Source: Department of Health dataset QMAE
Accidents: Fees and Charges
(2) how much the NHS Injury Cost Recovery Scheme is expected to cover each year; and if she will make a statement.
The regulations governing the operation of the national health service injury cost recovery (ICR) scheme came into force on 29 January 2007. The ICR scheme subsumes the existing road traffic accident (RTA) recovery scheme, and expands it to cover all cases where personal injury compensation is paid.
The existing RTA recovery scheme brings in more than £120 million for the NHS each year. We expect that the expanded scheme will recover a further £150 million a year once it is properly bedded down.
Acute Beds: East Sussex
The information is not available in the requested format. It is not possible to provide data for the number of beds at acute trusts by resident population or specific catchment areas. The following table contains the average daily number of acute hospital beds at East Sussex Hospitals National Health Service Trust.
Acute beds 1996-97 753 1997-98 746 1998-99 715 1999-2000 697 2000-01 698 2001-02 736 2002-03 675 2003-04 695 2004-05 697 2005-06 650 Notes: East Sussex Hospitals NHS Trust was formed via the merger of Eastbourne Hospitals NHS Trust and Hastings and Rother NHS Trust. Source: KH03
Living Wills
The Government have demonstrated the importance they attach to allowing people to make their own decisions about health care by including provisions for advance decisions to refuse treatment in the Mental Capacity Act (MCA). Such advance decisions are currently sometimes called living wills. The Government’s intention have always been to allow as much flexibility as possible for those making advance decisions and, therefore, there is no standard form for an advance decision. This makes issues around the formal registration of advance decisions complicated.
The MCA code of practice recommends that people think about whether they want their health care record to reflect that they have made an advance decision. We will consider the practicalities of how this option might be realised within the context of the new national health service care records service.
Air Ambulance Services: Drugs
Since 1 April 2002, the costs of clinical staff on air ambulances should be met by the national health service. Any decision to provide funding for drugs administered by air ambulance clinical staff would, however, be a matter for the local NHS ambulance trust.
Alcohol Abuse: Young People
Dependent on their individual circumstances, the vast majority of young people admitted to hospital are admitted following an acute episode of drunkenness. They may not have a substantial alcohol problem requiring treatment, but the hospital team treating them would assess this. Depending on their age and maturity, they may be referred to adult alcohol treatment services or to the local child and adolescent mental health services to address any counselling or mental health needs. If they are developing severe health problems as a result of their alcohol misuse, they would be assessed by the specialist hospital team best placed to treat their particular health conditions.
The Government are determined to reduce the harm caused to young people by alcohol misuse and are committed to educating young people on the very real harm it can cause. We are preventing the sale of alcohol to children by strengthening enforcement of the law on retailers and working with the industry to reduce under-age sales of alcohol—while continuing to educate young people about the harms, both physical and social, of alcohol abuse. Alcohol education is now part of the national curriculum. Updated guidance makes it clear that alcohol education should be about sensible drinking and reducing harm. This includes encouraging schools to look at the influence of the media on attitudes towards alcohol.
The Government have a high profile alcohol campaign, Know Your Limits, aimed at 18 to 24-year-old binge drinkers, warning them of the harms associated with binge drinking.
Ambulance Services: Standards
No assessment has been made. Annual national health service ambulance trust performance data for 2006-07 are due to be published this summer.
Information on how the £25 million capital incentive scheme monies have been spent is not held centrally.
Currently the clock starts for measuring response times when key information has been obtained from the caller. From April 2008, the clock will start earlier, when the call is connected to the ambulance control room. Response time standards will remain the same. The incentive scheme was designed to help ambulance trusts make the capital investments required to maintain response times from April 2008. It is therefore too early to make an assessment of the effectiveness of that expenditure.
Blood: Contamination
[holding answer 13 March 2007]: The Department has no record available relating to notification of conflicts of interest for the period in question. To look into this any further would incur disproportionate cost.
Body Mass Index
Information is not available in the format requested. The most recent data available on the mean body mass index (BMI) for adults and children in England is from the 2005 Health Survey for England (HSE).
Table 1 sets out the mean BMI for adults in England in 2005.
Percentage/number Men 26.9 Women 26.9 Bases (unweighted) Men 2,930 Women 3,409 Bases (weighted) Men 3,144 Women 3,184 1 Aged 16 and over. Source: Health Survey for England 2005: Headline figures. The Information Centre.
Table 2 sets out the mean BMI for children by age in England in 2005.
Percentage/number 0 1 2 3 4 5 6 7 8 Boys1 — — 17.2 17.3 17.1 17.6 16.8 16.9 16.9 Girls1 — — 2[17.3] 17.0 16.8 16.6 16.3 17.0 17.2 Bases (unweighted) Boys 4 25 62 56 73 76 64 85 86 Girls 14 30 38 71 88 89 76 104 71 Bases (weighted) Boys 4 25 56 49 68 72 65 92 82 Girls 14 30 31 60 77 80 67 94 71
9 10 11 12 13 14 15 Total Boys1 17.5 17.9 18.5 19.2 20.2 20.6 21.9 18.4 Girls1 18.3 18.3 20.0 19.8 21.5 21.8 23.0 18.7 Bases (unweighted) Boys 85 87 70 88 83 71 77 1,091 Girls 71 81 79 100 80 67 93 1,154 Bases (weighted) Boys 74 84 75 95 91 82 97 1,111 Girls 80 82 71 97 86 70 97 1,107 Notes: 1. Figures for children aged 0 and 1 are not given due small sample sizes. 2. The unweighted sample base for this category is below 50. Source: The Health Survey for England 2005: Headline Figures. The Information Centre.
Table 3 sets out the recent data available on the mean BMI for adults in the East of England Government office region (GOR) from HSE 2003. Data on the mean BMI for children in the East of England is unavailable. Information on the mean BMI for adults and children in Suffolk, Bedfordshire, Cambridgeshire, Essex, Hertfordshire and Norfolk is also not available.
Percentage/number Men 27.2 Women 26.9 Bases (unweighted) Men 728 Women 825 Bases (weighted) Men 755 Women 735 1 Aged 16 and over. Source: Health Survey for England 2003. Department of Health.
Breast Cancer: Greater London
(2) what estimate she has made of what the likely backlog will be when screening resumes at the North London Breast Screening Service;
(3) for what reasons the decision was taken to suspend breast cancer screening services at the North London Breast Screening Service.
I am advised that the temporary suspension was due to system process errors that were brought to light during a routine audit being carried out by the Quality Assurance Service. The audit flagged up that women were not invited for further assessments, in line with service protocols, following their mammogram. All the women affected received a normal mammogram (i.e. no abnormalities appeared on the mammogram). However, the women had mentioned other possible symptoms during their appointment and guidelines specify that further assessment should take place.
I understand that Enfield Primary Care Trust is currently working towards the completion of detailed plans to reopen the service during April. The service has been subject to an external review by the National Breast Screening Service Quality Assurance Team. The implementation of all the recommendations arising from the review continues to form a key part of the planning process. The trust will be able to confirm the precise arrangements for resuming the service after the review team has completed its work, which is expected by the end of March.
The trust with their partner primary care trusts have an evolving action plan in place for the recommencement of screening and to clear the backlog, including investigating arrangements with other potential service providers and their ability to assist with the backlog.
The unit is currently developing a full plan to facilitate the recommencement of screening services. Once this is complete the trust will be able to advise on estimates. It will also depend on whether arrangements can be put into place to screen women at other sites across London and the surrounding area. Women who have been waiting longest will be seen on a priority basis.
Approximately 3,500 women per month are normally seen by the service and it is estimated that approximately 10,000 women would have been affected by the suspension of the service.
This information is not held centrally.
Breast Cancer: Screening
Surrey Primary Care Trust is covered by the breast screening unit based at the Jarvis Centre, Guildford. According to figures from January to March 2006, the average interval between screens for women at the Jarvis Centre was 33 months, and 92 per cent. of women were screened within 36 months of their previous screen. In England the average interval between screens for the same period was 36 months, with 68 per cent. of women being screened within 36 months of their previous screen.
We take the issue of the 36-month standard between screens very seriously. That is why Professor Mike Richards, the National Cancer Director, wrote to the chief executives of all 10 strategic health authorities in England on 9 February 2007 highlighting the importance of maintaining the 36-month interval.
Burton Independent Sector Treatment Centre
As the independent inspection body for both the national health service and independent healthcare, the Healthcare Commission (HCC) is not part of the Department. Therefore, the information requested is not held centrally. However, information on the reviews of services undertaken by the HCC are available on their website at: www.healthcare commission.org.uk
All Independent Sector providers, including the Midlands Treatment Centre located in Burton, are required to achieve HCC approval before services are commenced and to meet subsequent reviews. We can confirm that the Midlands Treatment Centre did receive HCC approval for the start of services in July 2006.
(2) what operating and medical procedures Burton Independent Sector Treatment Centre undertakes; and whether these differ from those carried out in its first two years.
The Midlands National Health Service Treatment Centre, situated in Burton, opened in July 2006. The case mix at the treatment centre continues to include ENT (ears nose and throat), general surgery, gynaecology, OMFS (face/jaw), ophthalmology, pain relief, plastics, rheumatology, trauma and orthopaedics and urology.
The Department measures independent sector treatment centre contract performance on the basis of value rather than activity. This is to allow for the variations, which can occur through substitution of activity between procedures of varying value.
The Midlands Treatment Centre, located in Burton, has been able to provide additional surgical capacity in the Staffordshire area while offering patients a wider choice of provider for their treatment.
It is also believed that the facility has helped local national health service hospitals in achieving their maximum waiting time targets. As at January 2007, no patients in the Stoke on Trent, North Staffordshire and the South Staffordshire primary care trusts were waiting in excess of 26 weeks for inpatient treatment or 13 weeks for an outpatient appointment.
(2) what staff the Burton Independent Sector Treatment Centre employs; and from where they were recruited.
The Midlands National Health Service Treatment Centre, situated in Burton, provides training and supervision to its medical staff. The training includes continuing professional development, infection control, equipment and information management and technology.
Junior doctors work in the treatment centre alongside consultants as part of their training programme. The consultants remain responsible for clinical care and the training delivered as required. The agreement is that the direction and management of training of clinical trainees largely replicates current NHS training processes.
The treatment centre employs 179 staff (headcount), the majority of which were recruited from the United Kingdom.
Cancer
None. The Medical Research Council (MRC), one of the main agencies through which the Government supports medical and clinical research, is currently funding a broad portfolio of cancer research, including early stage trials and basic and underpinning research. The MRC has not received or considered any proposals to assess the effectiveness of dichloroacetate in attacking cancer cells. The Council always welcomes high quality applications for support in any aspect of biomedical research and these are judged in open competition with other demands on funding.
I have been asked to reply.
The information requested falls within the responsibility of the National Statistician, who has been asked to reply.
Letter from Karen Dunnell, dated 16 April 2007:
As National Statistician, I have been asked to reply to your recent Parliamentary Question asking how many people diagnosed with cancer there were in (a) England and Wales and (b) Gloucestershire, broken down by type of cancer in each of the last five years for which figures are available. [131171]
The latest available figures for newly diagnosed cases (incidence) of cancer in England are for the years 2004. Figures for 2000-2004 for (a) England and Wales and (b) the county of Gloucestershire are given in Table 1 below. Table 1 provides data for ‘all cancers excluding non-melanoma skin cancer’ and the four most common cancers—breast, colorectal, lung, and prostate—which accounted for more than half of new cases of malignant cancer (excluding non-melanoma skin cancer) registered in England and Wales in 2004.
2000 2001 2002 2003 2004 Males England and Wales All cancers xnmsc 122,046 124,103 123,225 123,917 126,539 Prostate 24,737 27,796 28,591 28,812 31,676 Lung 20,312 19,820 19,220 18,786 19,403 Colorectal 16,670 16,191 16,273 16,634 17,231 Gloucestershire All cancers xnmsc 1,842 2,005 1,783 1,856 2,201 Prostate 309 354 301 324 373 Lung 176 189 146 151 147 Colorectal 189 191 161 198 212 Females England and Wales All cancers xnmsc 122,127 122,877 121,542 125,134 123,883 Breast 35,978 36,493 36,670 38,901 39,308 Colorectal 14,248 13,955 13,926 13,894 14,361 Lung 12,882 12,768 12,687 13,042 13,269 Gloucestershire All cancers xnmsc 1,921 1,865 1,778 1,907 2,429 Breast 435 467 443 526 471 Colorectal 176 154 154 154 163 Lung 127 110 106 134 93 1 Cancers are coded to the International Classification of Diseases (Tenth Revision): Colorectal C18-21, Lung C33-34, Breast C50, Prostate C61, All cancers excluding non-melanoma skin cancer C00-97 xC44. Source: Office for National Statistics
Cancer: Urinary System
(2) what mechanisms she has put in place to ensure that service providers commissioned by her Department are meeting the Improving Outcomes guidance for urological cancers in relation to (a) multi-disciplinary team working and (a) access to specialist nurses.
Strategic health authorities were asked to submit action plans to demonstrate how they will implement the guidance on Improving Outcomes in urological cancers. Progress against these action plans is monitored by the Department and the Healthcare Commission. The majority of cancer networks reported at December 2006 that the guidance would be fully implemented by December 2007.
The guidance has also been translated into a series of measures for inclusion in the Manual of Cancer Services 2004. All cancer networks in England have now been peer reviewed against these measures, which include measures about urological cancer multi-disciplinary teams including urology nurse specialists. Reports of the local peer review visits for each cancer network can be found on the Cancer Quality Improvement Network System (CQuINS) database at www.cquins.nhs.uk. A national summary will also be produced and is expected to be available in the summer.
Care Homes
[holding answer 27 March 2007]: The information requested is not collected centrally.
The Commission for Social Care Inspection (CSCI), as the official regulator of social care provision, registers and inspects all care homes in England. It is important to note that care homes are not approved by CSCI. Registration with and inspection by CSCI simply signifies that a home is permitted to operate.
I am informed by the chair of CSCI that care homes are not registered as homes for older people (those aged over 65) or for younger adults (those aged 18-64). Many take in a mix of client groups. The following table shows the number of homes in England which have been regulated by CSCI against the national minimum standards (NMS) for care homes for older people and the NMS for care homes for younger adults.
Number Total number of homes 118,718 Care homes regulated against NMS for care homes for older people 10,671 Care homes regulated against NMS for care homes for younger adults 7,428 1 This total is greater than the sum of the two categories of home due to the fact that some homes (such as new homes) had not been regulated against the NMS by 1 April 2006. Source: CSCI report The State of Social Care in England2005-06. Figures at 31 March 2006
Care Homes: Fees and Charges
Following the Health Service Ombudsman’s report “NHS Funding for Long Term Care of Older and Disabled People”, the national health service has carried out retrospective reviews of over 12,000 cases where fully funded NHS care was denied, dating back to 1996. The case of Mr. Pearce’s mother was one of these retrospective reviews of her eligibility for continuing care. This retrospective review found that Mrs. Pearce was wrongly denied NHS funding for her care, and so Torbay Care Trust reimbursed care home fees for the period of time when they considered they should have been paying for her care.
The care trust will continue to take the same approach to any other retrospective reviews they have to conduct, but no national precedent has been set.
In 2004, primary care trusts (PCTs) estimated that they would pay approximately £180 million in repayment as a consequence of the retrospective reviews of cases following the Ombudsman’s report.
Torbay Care Trust used the strategic health authority’s (SHA) eligibility criteria, which have been reviewed in accordance with guidance issued by the Department since the Coughlan and Grogan judgments. In their consideration of Mrs. Pearce’s case, they used the draft decision support tool, published as part of the Department’s consultation in 2006 , to help them gather information about Mrs. Pearce’s needs. This information was then tested against the criteria already in place in the SHA.
Further clarification for PCTs about redress, in cases where it has been found that NHS funding was wrongly withheld, was contained in guidance published by the Department in response to the publication of the joint report by the Parliamentary Commissioner for Administration (Parliamentary Ombudsman) and the Health Service Ombudsman for England, Retrospective continuing care funding and redress, on 14 March 2007.
The information requested on NHS expenditure on care home and care home places is not held centrally.
Care Homes: Manpower
Regulation 18 of the Care Homes Regulations 2001, which apply to both nursing and residential homes, requires that the registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users, ensure that at all times suitably qualified, competent and experienced persons are working in the care home in such numbers as are appropriate for the health and welfare of service users.
Specific ratios are not laid down, either in the Regulations or the national minimum standards, which the regulator, the Commission for Social Care Inspection, must have regard to when inspecting care homes to establish compliance with the regulations.
Staffing ratios must be determined according to service users’ health and care needs; these may vary from home to home and from day to day. It is a provider’s obligation in law to ensure that their establishment is appropriately staffed on a day to day basis.
Carers: Peterborough
(2) what estimate she has made of the number of carers in the Peterborough City Council area for the purposes of the allocation of funding to assist with respite care are under the New Deal for Carers.
There were 670 carers who received an assessment or a review in Peterborough council during the year 2005-06, of which 200 carers received a break and or carers specific services.
In 2007-08 Peterborough city council will receive £1.959 million for carers, of which £233,000 will support the provision of emergency respite care.
During the same period Oxfordshire county council will receive £0.686 million for carers, of which £82,000 will support the provision of emergency respite care.
A table detailing the amounts each council will be allocated has been placed in the Library.
Cataracts: Surgery
The average waiting times for cataract operations in the former strategic health authorities for County Durham and Tees Valley and North and East Yorkshire and Northern Lincolnshire in 2005-06 are given in the following table.
Strategic health authority Median time waited (days) County Durham and Tees Valley 62 North and East Yorkshire and Northern Lincolnshire 75 England 69 Notes: 1. Data are for finished admission episodes, i.e. the first period of in-patient care under one consultant with one Healthcare provider. 2. Time waited is the difference between the admission and decision to admit dates. Source: Hospital Episodes Statistics (HES), The Information Centre for health and social care.
The Department does not collect data on numbers of cancelled operations for individual procedures such as cataract operations.
Bowel Cancer Screening
(2) what estimate she has made of the number of additional endoscopists required to support a fully-implemented national bowel cancer screening programme.
[holding answer 23 March 2007]: Training in endoscopy (bowel scoping) is vital to the diagnosis of bowel cancer. To prepare for the bowel cancer screening programme, we have built on the training established as part of the national health service cancer plan. A national training programme has been established, with three national and seven regional centres, to train medical staff, general practitioners, nurses and other health professionals to carry out vital procedures for diagnosing bowel cancer. The options appraisal analysis for the introduction of the bowel cancer screening programme estimated that an additional 61,274 endoscopies would be required equating to 14 additional endoscopy units staffed by four trained nurse endoscopists and 1.4 whole-time equivalent gastroenterologists. It is for cancer networks to work in partnership with strategic health authorities and postgraduate deaneries to put in place a sustainable process to assess, plan and review their workforce needs and the education and training of all staff linked to local and national priorities for cancer.
Based on current trends and definitions the training programme is projected to deliver the following training courses by the end of 2006-07.
2004-05 2005-06 2006-07 Total Medical endoscopists 494 249 618 1,361 Non medical endoscopists 60 61 26 147 Total 554 310 644 1,508
(2) pursuant to the answer of 23 March 2007, Official Report, column 1190W, on bowel cancer screening, what funding earmarked for the programme has been included in the Strategic Health Authority bundle for 2007-08.
[holding answer 29 March 2007]: Funding for the national health service bowel cancer screening programme is included in the strategic health authority (SHA) bundle, that incorporates a number of budgets formally managed directly by the Department.
Around £10 million was made available for wave one of the programme in 2006-07. The value of the SHA bundle for 2007-08 is £6,945.78 million, and was announced in the NHS operating framework that was published on 11 December 2006 to the NHS. £27.5 million was included in the SHA bundle for the bowel screening programme. Allocations are made direct to SHAs, and they manage the distribution of funds among the different programmes, including the bowel cancer screening programme, taking account of local circumstances.
This is an ambitious project and the Government are committed to ensuring that the necessary funding is available to ensure the full implementation of the bowel cancer screening programme.
[holding answer 29 March 2007]: We started the roll-out of the programme slightly later than originally intended. However, we took all the practical steps possible to prepare for the roll-out and to minimise the delay. All five programme hubs in England are now operational, and 15 of the eventual 90 to 100 local screening centres opened in 2006-07. These cover 49 out of 152 primary care trusts in England, covering a population of 13 million, around 26 per cent. of the English population. It is for strategic health authorities working in partnership with their primary care trusts and local stakeholders to organise and deliver services for their local populations. We expect around half of the local screening centres to be operational by March 2008, with full overage in England by December 2009.
The bowel cancer screening programme is an ambitious project, and one of the first of its kind in Europe. When fully implemented, it will screen around 2 million men and women and detect around 3,000 bowel cancers every year. We are committed to implementing this important programme.
The bowel cancer screening programme is beginning by inviting men and women aged 60 to 69 to be screened as the risk of bowel cancer increases with age, with over 80 per cent. of bowel cancers arising in people who are 60 or over.
The successful national health service pilot study also showed that men and women in their 60s were more likely to take up their invitations for screening than men and women in their 50s.
Within the programme, men and women aged 70 and over are able to self-refer for screening every two years.
When we have rolled out the programme to the whole of England, we will make an assessment of whatever next steps may be required, including looking at the age range.
Colorectal Cancer: Surgery
Information on the number of operations relating to rectal and colon cancer in the last three years for which figures are available, is shown in the following table.
Information on the cost of these operations is not available.
FCEs 2003-04 130,451 2004-05 129,357 2005-06 136,979 Notes: 1. Diagnosis (primary diagnosis): The primary diagnosis is the first of up to 14 (seven prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was in hospital. 2. Finished consultant episode (FCE): An FCE is defined as a period of admitted patient care under one consultant within one health care provider. Please note that the figures do not represent the number of patients, as a person may have more than one episode of care within the year. 3. Ungrossed data: Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed). 4. Main operation: The main operation is the first recorded operation in the HES data set and is usually the most resource intensive procedure performed during the episode. It is appropriate to use main operation when looking at admission details, e.g. time waited, but the figures for “all operations count of episodes” give a more complete count of episodes with an operation. Source: (HES) The Information Centre for health and social care.
The following ICD-10 diagnosis codes were used to look for procedures in the primary procedure field:
C18 Malignant neoplasm of colon
C18.0 Caecum
C18.1 Appendix
C18.2 Ascending colon
C18.3 Hepatic flexure
C18.4 Transverse colon
C18.5 Splenic flexure
C18.6 Descending colon
C18.7 Sigmoid colon
C18.8 Overlapping lesion of colon
C18.9 Colon, unspecified
C19 Malignant neoplasm of rectosigmoid junction
C20 Malignant neoplasm of rectum
C21 Malignant neoplasm of anus and anal canal
C21.0 Anus, unspecified
C21.1 Anal canal
C21.2 Cloacogenic zone
C21.8 Overlapping lesion of rectum, anus and anal canal
The following ICD-10 codes relate to only the rectum
C19 Malignant neoplasm of rectosigmoid junction
C20 Malignant neoplasm of rectum
C21.8 Overlapping lesion of rectum, anus and anal canal
Secondary neoplasms
C75.5 Secondary malignant neoplasm of large intestine and rectum
Insitu neoplasms
D01 Carcinoma in situ of other and unspecified digestive organs
D01.0 Colon
D01.1 Rectosigmoid junction
D01.2 Rectum
D01.3 Anus and anal canal
Community Care: Expenditure
The following two tables provide information on the gross current expenditure from councils with social services responsibilities (CSSRs) for residential care, home care and other community-based services for both adults and children in England for the years 2001-02 to 2005-06. Expenditure data on social care by primary care trusts are not centrally available.
£000 Residential care1 Home care Other community-based services 2001-02 5,393,700 1,690,900 1,593,400 2002-03 6,314,400 1,795,800 1,690,000 2003-04 6,313,900 1,982,100 1,847,500 2004-05 6,740,100 2,220,000 2,048,400 2005-06 7,042,900 2,486,400 2,258,600 Note: From 2002-03 onwards the data on adults includes clients that transferred to CSSR support on 8 April 2002 who were formerly in receipt of higher rates of income support under the DWP preserved rights (PR) scheme. Source: PSS EX1, Information Centre.
£000 Residential care Home care Other community-based services 2001-02 815,200 21,100 1,469,100 2002-03 879,400 24,500 1,690,200 2003-04 982,400 27,300 1,944,200 2004-05 1,063,900 31,200 2,190,600 2005-06 1,103,600 32,700 2,366,700
Dental Services: West Sussex
Table 1 shows information on the number of national health service dentists as at 31 March 1997 and 2004 to 2006 for the areas requested, based on the old contractual arrangements.
The latest workforce information, as at 30 June, 30 September and 31 December 2006, is based on the new contractual arrangements, introduced on 1 April 2006, and is available at primary care trust (PCT), strategic health authority (SHA) and England level. This information is provided in Table 2. To provide these data at constituency level would incur disproportionate cost. Data based on the old contractual arrangements are not directly comparable to those under the new contractual arrangements.
Information is taken from the following reports:
NHS Dental Activity and Workforce Report, England: 31 March 2006
NHS Dental Statistics for England Quarter 3, 31 December 2006.
Both reports are available in the Library.
1997 2004 2005 2006 Arundel and South Downs constituency 29 23 23 22 Adur, Arun and Worthing PCT 90 120 138 154 Crawley PCT 48 65 83 99 Horsham and Chanctonbury PCT 51 69 72 69 Mid-Sussex PCT 67 110 118 129 Western Sussex PCT 67 88 95 98 Notes: 1. Dentists consist of principals, assistants and trainees. Information on NHS dentistry in the community dental service, in hospitals and in prisons is excluded. 2. A dentist can provide as little or as much NHS treatment as he or she chooses or has agreed within the contract. In some cases an NHS dentist may be listed to carry out NHS work but may not do so for a given period. 3. Information is based on NHS dentists on PCT lists from the BSA. 4. PCT boundaries are as at 30 September 2006. 5. The PCTs listed are those that now form West Sussex PCT as a result of the 1 October 2006 PCT boundary changes. 6. Constituency boundaries may have changed over time therefore these data may not be directly comparable. Source: The Information Centre for health and social care. NHS Business Services Authority (BSA).
2006 30 June 30 September 31 December West Sussex PCT 477 478 474 Notes: 1. A performer is defined as a dentist who has been set up on the BSA payments online (POL) system by the PCT to work under an open contract during the relevant time period. 2. Data provided are a count of the individuals listed as performers on open contracts within a PCT, including orthodontists. 3. A dentist can provide as little or as much NHS treatment as he or she chooses or has agreed within the contract. In some cases an NHS dentist may be listed to carry out NHS work but may not do so for a given period. 4. Data consists of performers in general dental services (GDS), personal dental services (PDS) and trust-led dental services. 5. PCT boundaries are as at 1 October 2006. 6. The PCTs listed are those that now form West Sussex PCT as a result of the 1 October 2006 PCT boundary changes. 7. Dentists will be counted more than once if they have contracts in more than one PCT. Source: The Information Centre for health and social care. NHS Business Services Authority.
Table 1 shows information on the number of adult and child patients registered with a national health service dentist for the areas requested as at 31 March 1997 and 2004 to 2006, based on the old contractual arrangements and under the PCT boundaries as at 30 September 2006.
Under the new dental contractual arrangements, introduced on 1 April 2006, registration data are no longer collected centrally. Instead, there is a new measure on patients seen within the previous 24 months. The latest information on total numbers of patients seen within the previous 24 months is provided in table 2. Information in table 2 is under the primary care trust (PCT) boundaries as at 1 October 2006. To provide these data at constituency level would incur disproportionate cost.
Information is taken from the following reports:
NHS Dental Activity and Workforce Report, England: 31 March 2006
NHS Dental Statistics for England Quarter 3, 31 December 2006.
Both reports are available in the Library.
Table 1: General dental services (GDS) and personal dental services (PDS): Numbers of adult and child patients registered with an NHS dentist in the specified constituency and PCTs as at 31 March each year1997200420052006AdultsChildrenAdultsChildrenAdultsChildrenAdultsChildrenArundel and South Downs constituency26,3219,94217,1338,66516,3088,07616,1957,948Adur, Arun and Worthing PCT95,51729,76772,81631,74271,52931,38676,56432,367Crawley PCT25,74614,77821,87315,15520,95114,16828,53416,908Horsham and Chanctonbury PCT47,14218,63533,14116,91534,48616,95337,42917,847Mid-Sussex PCT56,44422,81048,10524,54245,74223,77947,79023,677Western Sussex PCT72,27923,18671,90027,05768,37925,85463,63924,716 Notes: 1. Child patient registrations are aged 0 to 17 and adults are aged 18 and over. 2. PCT boundaries are as at 30 September 2006. 3. The PCTs listed are those that now form West Sussex PCT as a result of the 1 October 2006 PCT boundary changes. 4. Constituency boundaries may have changed over time therefore these data may not be directly comparable. Source: The Information Centre for health and social care. NHS Business Services Authority.
30 June 2006 30 September 2006 31 December 2006 Adult Child Adult Child Adult Child West Sussex PCT 292,188 126,918 290,952 126,826 290,443 126,953 Notes: 1. PCT boundaries are as at 1 October 2006. 2. Patients have been identified by using surname, first initial, gender and date of birth. 3. The age of the patient as at the last day of the 24 month period is used to allocate between adult or child in the most recent form processed. 4. Child patient registrations are aged 0-17 and adults are aged 18 and over. Source: The Information Centre for health and social care. NHS Business Services Authority.
Departmental Contracts
Contracts for the independent sector and the purpose of each is shown in the following table. Contracts are generally for five years.
Provider Contract Capio One contract to provide Independent Sector Treatment Centre (ISTC) services Alliance Medical One contract to provide mobile MRI services Amicus Healthcare None Bupa Healthcare A provider through the Independent Sector Extended Choice Network (IS ECN)1 Mercury Health One contract to provide ISTCs services one contract for diagnostic services. Nations Healthcare Two contracts to provide ISTC services Netcare Healthcare Two contracts to provide NHS Walk In Centres with a commuter focus one contract to provide ISTC services one contract to provide mobile ophthalmic services Nuffield Hospitals A provider through the Independent Sector Extended Choice Network (IS ECN)1 Partnership Health Group Four contracts to provide ISTC services UKSH One contract to provide ISTC services 1 IS ECN providers are members of a framework and are paid on a per procedure basis and do not have five year contracts.
Financial information on individual contracts is commercially sensitive, the total value paid on all the ISTC programme contracts in 2006-07 is £216 million.
Departments: Work Permits
The Department applied for one work permit, in 2005.
The Medicines and Healthcare products Regulatory Agency, an executive agency of the Department, applied for two work permits in the last five years —one in 2003 and one in 2006.
NHS Purchasing and Supply Agency, an executive agency of the Department, applied for a total of two work permits—one applied for in 2003 and one in 2007.
Diabetes: Screening
Data are not collected on the numbers of registered people with diabetes who have access to blood testing strips.
The following table shows the number of blood glucose monitoring strips dispensed in England from 1997 to 20061.
Items 1997 1,971,463 1998 2,438,640 1999 2,857,441 2000 3,372,897 2001 3,987,930 2002 4,702,845 2003 5,077,542 2004 5,330,313 2005 5,553,611 20061 4,263,166 1 2006—figures are for the first nine months only
PCA Data
Prescription information is taken from the Prescription Cost Analysis (PCA) system, supplied by the Prescription Pricing Authority (PPA), and is based on a full analysis of all prescriptions dispensed in the community i.e. by community pharmacists and appliance contractors, dispensing doctors, and prescriptions submitted by prescribing doctors for items personally administered in England. Also included are prescriptions written in Wales, Scotland, Northern Ireland and the Isle of Man but dispensed in England. The data do not cover drugs dispensed in hospitals, including mental health trusts, or private prescriptions.
Prescription Items
Prescriptions are written on a prescription form. Each single item written on the form is counted as a prescription item. A person with diabetes may get more than one prescription item each year.
Drugs: Internet
The Medicines and Healthcare products Regulatory Agency routinely monitors medicines being offered for sale on the Internet and is concerned about the increase in the online availability of medicines, including slimming pills.
In the United Kingdom (UK), there are strict legal controls on the retail sale, supply and advertisement of medicinal products. These controls apply without distinction to medicines sold or supplied through Internet transactions and mail order.
Slimming drugs are, generally speaking, classified as prescription only medicines (POM) and are available only after a consultation with a healthcare practitioner. Products purchased from Internet sites cannot be guaranteed for their quality, safety and efficacy, nor can their effects on patients be monitored. For these reasons, the supply of POMs is strictly controlled in the UK and breaches in regulatory requirements are investigated.
Additionally, specific information relating to slimming products and other medicines considered to be at risk of counterfeiting are circulated to stakeholders in order to increase vigilance through more focused surveillance and inspections.
Mechanisms for promoting suitable medical supervision, however, are matters of professional practice and are not covered by medicines legislation.
Drugs: Licensing
[holding answer 27 March 2007]: The National Institute for Health and Clinical Excellence (NICE), published a technical appraisal on naltrexone as a treatment for relapse prevention on 24 January 2007.
The National Treatment Agency (NTA) is supporting the Department in developing an implementation strategy for the dissemination of the NICE technology appraisal on naltrexone and their other current work relating to drug treatment. This strategy will seek to ensure that complementary initiatives undertaken by NICE and the NTA are disseminated in a coherent and co-ordinated way to inform the commissioners and providers of drug treatment.
Drugs: Side Effects
(2) what assessment she has made of the merits of introducing a requirement for doctors to report adverse reactions to (a) licensed and (b) unlicensed drugs;
(3) what assessment she has made of the merits of extending the remit of the Medicines and Healthcare products Regulatory Agency in order to allow it to monitor adverse reactions to unlicensed drugs.
The Yellow Card Scheme is used to collect reports of suspected adverse drug reactions (ADRs) associated with any marketed medicinal product, including those available on prescription or purchased from a pharmacy, or a general retail outlet. The scheme encompasses unlicensed as well as licensed products, including herbal products.
The Medicines and Healthcare products Regulatory Agency (MHRA) and Commission for Human Medicines (CHM) are continually working to increase the quality and quantity of reports received via the Yellow Card Scheme.
The following table shows the number of reports received in the past three years.
Number of reports 2006 23,992 2005 22,127 2004 20,037
In 2003, an independent review of the Yellow Card Scheme strongly endorsed the value and importance of the Scheme for public health and the benefit of patients. The MHRA is currently developing a strategy in consultation with the CHM to build on these recommendations in order to further strengthen reporting to the Yellow Card Scheme.
It is recognised that voluntary spontaneous reporting systems such as the Yellow Card Scheme are associated with an unknown level of under-reporting. It has been estimated that 10 per cent. of serious ADRs and between 2 and 4 per cent. of non-serious ADRs are reported and that serious reactions are five times more likely to be reported than non-serious reactions.
The value of introducing mandatory reporting of suspected ADRs by healthcare professionals has been considered on several occasions, most recently during the independent review of the Yellow Card Scheme. Available evidence indicates that there is no clear increase in rates of reporting in countries with mandatory reporting when compared with those where reporting is voluntary. Furthermore there would be practical difficulties in enforcing mandatory reporting. The Independent Review did not recommend a mandatory system for suspected ADR reporting in the United Kingdom.
Drugs: Testing
The criminal investigation into whether GlaxoSmithKline PLC withheld from the Medicines and Healthcare products Regulatory Agency (MHRA) information from paediatric clinical trials of their drug Seroxat (the United Kingdom brand name for paroxetine) was commenced by the Enforcement and Intelligence Group of the MHRA on 1 October 2003.The investigation is ongoing.
Criminal investigations into alleged breaches of medicines regulations are the statutory responsibility of the Secretary of State and are carried out by authorised officers in the Enforcement and Intelligence Group at MHRA.
Essex Rivers Healthcare Trust
[holding answer 23 March 2007]: The information is not collected centrally in the form requested. However, the following table shows doctors in training alongside nursing, midwifery and health visiting staff figures as at 30 September 2005.
Essex Rivers Healthcare NHS Trust as at 30 September 2005 Number (headcount) All medical and dental staff 330 Of which: Doctors in training 170 All Nursing staff 1,531 Of which: Qualified nurses 1,100 Sources: The Information Centre for health and social care medical and dental workforce census. The Information Centre for health and social care non-medical workforce census.
General Practitioners: East Sussex
(2) how many GPs in (a) Eastbourne and (b) East Sussex (i) do and (ii) do not work on an out-of-office hours contract.
The information requested is not collected centrally.
General Practitioners: Standards
As part of the General Medical Services contract for 2006-07, the BMA and NHS Employers (on behalf of the Department) agreed that primary medical care contractors should be subject to the same level of efficiency improvement placed on other parts of the national health service. This remains our expectation.
Gynaecology
This information cannot be provided in the format requested.
This information is shown in the following tables.
2001-02 2002-03 2003-04 Strategic health authority of treatment Dysfunctional Uterine Bleeding Menorrhagia Dysfunctional Uterine Bleeding Menorrhagia Dysfunctional Uterine Bleeding Menorrhagia Q01 Norfolk, Suffolk and Cambridgeshire HA 305 2,548 244 2,518 199 2,555 Q02 Bedfordshire and Hertfordshire HA 131 1,291 92 1,259 92 1,194 Q03 Essex HA 299 1,403 318 1,251 348 1,422 Q04 North West London HA 114 1,285 62 1,334 90 1,588 Q05 North Central London HA 166 1,569 177 1,704 181 1,463 Q06 North East London HA 140 1,863 84 1,910 90 1,839 Q07 South East London HA 59 1,401 69 1,634 80 1,459 Q08 South West London HA 84 1,173 101 1,155 90 1,254 Q09 Northumberland, Tyne and Wear HA 366 1,788 336 2,011 316 2,018 Q10 County Durham and Tees Valley HA 253 766 324 1,639 303 1,439 Q11 North and East Yorkshire and Northern Lincolnshire HA 356 2,650 353 2,508 503 2,638 Q12 West Yorkshire HA 404 3,472 428 3,276 407 3,001 Q13 Cumbria and Lancashire HA 115 1,598 231 2,428 215 2,356 Q14 Greater Manchester HA 334 1,838 359 2,806 360 2,687 Q15 Cheshire and Merseyside HA 600 3,580 588 3,367 582 3,224 Q16 Thames Valley HA 163 2,614 187 3,148 172 2,594 Q17 Hampshire and Isle of Wight HA 297 1,872 296 1,835 258 1,533 Q18 Kent and Medway HA 281 1,904 347 1,754 302 1,653 Q19 Surrey and Sussex HA 112 1,307 174 2,299 168 2,384 Q20 Avon, Gloucestershire and Wiltshire HA 239 1,489 268 2,079 228 2,164 Q21 South West Peninsula HA 141 1,919 124 1,768 84 1,638 Q22 Dorset and Somerset HA 141 1,467 129 1,399 109 1,484 Q23 South Yorkshire HA 372 1,386 391 1,564 488 1,549 Q24 Trent HA 448 2,969 414 3,055 396 2,947 Q25 Leicestershire, Northamptonshire and Rutland HA 271 1,874 246 1,654 157 2,106 Q26 Shropshire and Staffordshire HA 272 2,202 150 2,652 180 2,611 Q27 Birmingham and the Black Country HA 305 3,275 307 3,340 454 3,210 Q28 Coventry, Warwickshire, Herefordshire and Worcestershire HA 159 1,913 189 2,017 214 1,668 Y Not known 443 4,728 — — — 1—
Strategic health authority of treatment Dysfunctional Uterine Bleeding Menorrhagia Dysfunctional Uterine Bleeding Menorrhagia Q01 Norfolk, Suffolk and Cambridgeshire HA 193 2,351 171 2,492 Q02 Bedfordshire and Hertfordshire HA 60 1,290 83 1,193 Q03 Essex HA 282 1,408 235 1,422 Q04 North West London HA 49 1,473 50 1,738 Q05 North Central London HA 166 1,399 93 1,282 Q06 North East London HA 48 1,939 83 2,097 Q07 South East London HA 87 1,433 88 1,755 Q08 South West London HA 78 1,337 82 1,257 Q09 Northumberland, Tyne and Wear HA 290 1,884 193 1,926 Q10 County Durham and Tees Valley HA 248 1,460 319 1,452 Q11 North and East Yorkshire and Northern Lincolnshire HA 394 2,694 287 3,023 Q12 West Yorkshire HA 291 2,860 222 2,573 Q13 Cumbria and Lancashire HA 235 2,276 248 2,593 Q14 Greater Manchester HA 332 2,602 267 2,784 Q15 Cheshire and Merseyside HA 420 2,778 429 3,588 Q16 Thames Valley HA 165 2,408 172 2,811 Q17 Hampshire and Isle of Wight HA 279 1,513 241 1,596 Q18 Kent and Medway HA 233 1,490 334 1,776 Q19 Surrey and Sussex HA 203 2,241 235 2,509 Q20 Avon, Gloucestershire and Wiltshire HA 154 2,141 163 2,184 Q21 South West Peninsula HA 125 1,564 124 1,709 Q22 Dorset and Somerset HA 78 1,384 116 1,344 Q23 South Yorkshire HA 585 1,941 215 2,122 Q24 Trent HA 316 2,938 241 2,937 Q25 Leicestershire, Northamptonshire and Rutland HA 166 2,020 325 2,657 Q26 Shropshire and Staffordshire HA 131 2,623 79 2,207 Q27 Birmingham and the Black Country HA 280 2,923 273 3,303 Q28 Coventry, Warwickshire, Herefordshire and Worcestershire HA 217 1,730 212 1,839 Y Not known — — — — 1 Due to reasons of confidentiality, figures between 1 and 5 have been suppressed. Notes: Finished admission episodes A finished admission episode is the first period of in-patient care under one consultant within one health care provider. Please note that admissions do not represent the number of in-patients, as a person may have more than one admission within the year. Diagnosis (primary diagnosis) The primary diagnosis is the first of up to 14 (seven prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was in hospital. Selected primary diagnosis codes for Dysfunctional Uterine Bleeding* and Menorrhagia** Dysfunctional Uterine Bleeding* N93.8 Other specified abnormal uterine and vaginal bleeding Includes dysfunctional or functional uterine or vaginal bleeding NOS Menorrhagia** Menorrhagia is the term for excessive or frequent menstruation. N92.0 Excessive and frequent menstruation with regular cycle Includes Heavy periods NOS Menorrhagia NOS Polymenoirrhoea N92.2 Excessive menstruation at puberty Includes Excessive bleeding associated with onset of menstrual periods Pubertal menorrhagia Puberty bleeding N92.4 Excessive bleeding in premenopausal period Includes Menorrhagia or metrorrhagia Climacteric Menopausal Preclimacteric Premenopausal N95.0 Post menopausal bleeding Data Quality Hospital Episode Statistics (HES) are compiled from data sent by over 300 NHS trusts and primary care trusts (PCT's) in England. The Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain. Source: Hospital Episode Statistics (HES), the Information Centre for Health and Social Care.
This information cannot be provided in the format requested.
HC1 Form
The following table provides an estimate of those claiming for help with their health costs via the HC1 form (based on 2005-06 data as figures are not available for the calendar year 2005).
Those in receipt of HC2 certificates receive full help consisting of free prescriptions, sight tests, NHS dental treatment, wigs and fabric supports and travel to receive national health service treatment under the care of a consultant. The HC3 certificate provides partial help with the cost of the above, with the exception of prescriptions which are not free.
Under 25 All students including those under 25 HC1 claims 136,815 100,860 HC2 entitlements 72,731 57,213 HC3 entitlements 57,599 43,647 Source: Prescription Pricing Division of the NHS Business Services Authority
Health Professions: Foreign Workers
The Department does not collect this information centrally. The General Medical Council and the General Nursing and Midwifery Council hold the register of doctors and nurses who practise in the United Kingdom, and make decisions on investigations and erasure from their registers.
Health Services
“The NHS in England: operating framework for 2007-08” signalled the introduction of a new national health service contract for primary care trusts to use when commissioning acute secondary care services covered by payment by results (PbR), from NHS trusts, NHS foundation trusts and independent sector providers. The NHS contract for acute hospital services covers agreements between primary care trusts (PCTs) and providers for the delivery of acute hospital-based care. The contract enables patients to choose where they are referred for elective care, and hospitals will be paid by PCT commissioners according to PbR rules for the work they do.
The rules and principles relating to the operation of the contract are set out in “Guidance on the NHS Contract for Acute Hospital Services for 2007-08”. A copy of this document is available in the Library. All acute NHS trust will adopt the new contract from April 2007. The contract will be applied to NHS foundation trusts either from April 2007 or subsequently, from the earliest point at which their pre-existing contracts become invalid.
The principles of patient choice apply equally to services provided by NHS foundation trusts which remain on the previous form of contract.
A breakdown of the 90 per cent. of contacts with the health service that take place outside hospital has been estimated as follows: 26 per cent. with the family doctor service, 59 per cent. prescription items dispensed in the community and 5 per cent. other services, including district nurses and other community based staff.
Health Services: Internet
[holding answer 27 February 2007]: Financial resources and new policy developments were deciding factors regarding the contract for Best Treatments. The Department remains committed to providing patients and the public with the information they need to make informed decisions about their healthcare and social care, but needs to target resources where they will be most effective.
The Department will help people to find the excellent information that is already available rather than duplicate production. That is why we are developing information prescriptions and an information accreditation scheme. In this way, we will drive up quality of information and assure people that the information they access is reliable and relevant to them.
Health Services: North West Region
Netcare, who are the preferred bidder for the Cumbria and Lancashire Clinical Assessment, Treatment and Support (CATS) electives scheme and one of the two Greater Manchester CATS schemes, provides national health service services in the North West through the Greater Manchester Surgical Centre, part of Wave 1 of the Independent Sector Treatment Centre programme.
Health Services: Overseas Residence
(2) what the estimated revenue from UK citizens resident abroad in NHS fees was in each of the last five years for which figures are available.
In general, any United Kingdom citizen who resides abroad is treated as an overseas visitor and may be required to pay for national health service treatment under the provisions of the NHS (Charges to Overseas Visitors) Regulations 1989, as amended. Successive Governments have not required the NHS to provide statistics on the number of overseas visitors seen, treated or charged under these provisions, nor any costs involved. It is therefore not possible to provide the information requested.
Health: Irish Community
Smoking cessation campaigns are predominantly targeted at the general population of smokers, and the highest prevalence group of 25-44 year olds in lower socio-economic groups (C2DE). We develop our campaigns with appropriate messaging for this group based on insights into their smoking behaviour, with additional campaign materials developed for communities where cultural factors affect the accessibility of these messages. There has been no evidence yet suggested by research that members of the Irish community in our target audience will be less receptive to the core national campaign messages, or experience accessibility issues. Individual PCTs that have substantial Irish communities within their catchment area may run targeted public health campaigns for this group.
On healthy diet and exercise, we will be rolling out a series of initiatives linking in with partner organisations across the public sector, the food manufacturing and retail sector and with voluntary organisations to support families to live a healthy life based on a healthy diet and increased physical activity. The Healthy Living strategy is about providing support when and where it is required and in a way that people will respond to.
The most extensive survey on behaviours of minority ethnic groups ever carried out in England was published in April 2006. The Health Survey for England 2004 interviewed over 6,000 adults from black and minority ethnic communities including Irish communities. The proportion of Irish adults who met the five-a-day recommendation was 26 per cent. of Irish men and 32 per cent. of Irish women compared with 23 per cent. and 27 per cent. of the general population.
On exercise the proportion of Irish adults who reported physical activity rates at the chief medical officer's recommended level of at least 30 minutes a day, five days a week was 39 per cent. for men and 29 per cent. for women compared with the figures for the general population of 37 per cent. for men and 25 per cent. for women.
A copy of the survey is available in the Library.
Health: Regulatory Impact Assessment
The specific information requested could be obtained only at disproportionate cost.
Regulatory impact assessments (RIAs) for legislation made since health impact assessments were incorporated into the RIA framework are available in the Library and on Government Departments' websites.
Hearing Aids: Gloucestershire
The information requested is not collected centrally.
Heart Diseases: Bolton
The information requested is not held centrally.
Hepatitis
The information requested is provided in the following tables.
(a) Hepatitis A
Number of reports 1997 1,272 1998 1,058 1999 1,357 2000 1,009 2001 785 2002 1,338 2003 984 2004 649 2005 444 2006 268 Note: 2006 data are provisional, and numbers are likely to increase. Source: Health Protection Agency (HPA)
(b) Chronic Hepatitis B
Data on chronic hepatitis B are not collected.
Data are collected on laboratory reports of acute Hepatitis B. Surveillance of the incidence of acute infection is used to monitor trends, to evaluate the Hepatitis B immunisation programme and to inform the development of national and local control policies.
(c) Hepatitis C
Number of reports 1997 2,652 1998 4,098 1999 5,294 2000 4,917 2001 4,675 2002 5,590 2003 6,566 2004 7,993 2005 7,579 2006 5,842 Note: 2006 data are provision, and numbers are likely to increase Source: Health Protection Agency
(d) Hepatitis D
Data on Hepatitis D are not collected. Hepatitis D is a defective virus that replicates only in the presence of the Hepatitis B virus.
(e) Hepatitis E
Information is available from 2003 to 2006
Number of reports 2003 125 2004 150 2005 329 2006 292 Source: Health Protection Agency
(f) Hepatitis F
Hepatitis F is a hypothetical hepatitis virus. Several hepatitis F virus candidates emerged in the 1990s. Further investigations failed to confirm the existence of the virus, and it was delisted as a cause of infectious hepatitis.
(g) Hepatitis G
Data are not routinely collected on hepatitis G. Extensive worldwide investigation has failed to identify any association between the hepatitis G virus and hepatitis, and its clinical significance is unknown.
(h) Hepatitis H
There is currently no virus designated as hepatitis H.
Home Births
I have been asked to reply.
The information requested falls within the responsibility of the National Statistician, who has been asked to reply.
Letter from Karen Dunnell, dated 16 April 2007:
As National Statistician I have been asked to reply to your recent Parliamentary Question about the number and proportion of deliveries that were home births in each year since 1995. (126162)
The latest year for which we have data is 2005. The attached table shows the number and percentage of maternities that took place at home in England and Wales in each year between 1995 and 2005.
Number of maternities at home total Percentage of maternities taking place at home 1995 12,487 642,404 1.9 1996 13,460 643,862 2.1 1997 14,412 637,001 2.3 1998 13,815 629,926 2.2 1999 13,271 615,994 2.2 2000 12,803 598,580 2.1 2001 12,115 588,868 2.1 2002 12,697 590,453 2.2 2003 13,590 615,787 2.2 2004 14,506 633,728 2.3 2005 16,501 639,627 2.6 Source: Birth Statistics, Series FM1 no. 24 to 34.
Hospital Stays
[holding answer 29 March 2007]: Data on length of stay by hospital in England is published annually by the Information Centre for Health and Social Care and can be found at www.hesonline.org. The median length of stay in hospital during 2005-06 was two days. Variation will reduce as the national health service continues to make progress towards its target of 18 weeks between referral and treatment.
The Organisation for Economic Co-operation and Development (OECD) publishes annual data which shows that average length of stay in the United Kingdom compares favourably with those in many other countries. This data can be obtained from OECD.
Hospitals: Admissions
Currently the best computations of readmission rates are those released by the National Centre for Health Outcomes Development (NCHOD). They publish their data on a website at www.nchod.nhs.uk. Presently there are three years data from 2001-02 to 2003-04 at primary care trust (PCT) level. There are plans to produce an eight-year series up to 2005-06 at PCT and trust level. Other analyses could be produced only at disproportionate cost.
Hospitals: Consultants
The information is not available centrally as this is a matter for the national health service locally. Activity is agreed and monitored locally through contracts between co-ordinating commissioners and providers.
The Department published on 14 December 2006 good practice “Care and resource utilisation: ensuring appropriateness of care” that outlines some techniques that aim to ensure a more effective initial assessment, resulting in improved patient progress through the system and thereby reducing delays. The techniques are owned and agreed by clinicians, working in partnership across primary and secondary care, to deliver integrated, well-designed services. The document is available in the Library and at:
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_063265
Hospitals: Greater London
The tables show the counts and percentage of finished in-year admissions with a valid time waited from 2002-03 to 2005-06, for all London primary care trusts of responsibility.
2002-03 1 day to under 6 months 6 months to under 12 months 12 months and over Finished in-year admissions Percentage waited 1 day to under 6 months Finished in-year admissions Percentage waited 6 months to 12 months Finished in- year admissions Percentage waited more than 12 months Number of elective waiting list and booked admissions where it is not possible to calculate accurate waiting times 5A9 Barnet PCT 15,299 84.1 2,126 11.7 766 4.2 1,802 5AX Bexley PCT 13,076 82.8 1,715 10.9 998 6.3 1,148 5C1 Enfield PCT 10,117 73.5 2,119 15.4 1,533 11.1 2,555 5C4 Tower Hamlets PCT 8,798 82.9 1,283 12.1 536 5.0 125 5C6 Walthamstow, Leyton and Leytonstone PCT 5,198 68.1 1,420 18.6 1,011 13.3 221 5C7 Chingford, Wanstead and Woodford PCT 4,106 69.0 1,047 17.6 802 13.5 222 5C8 Redbridge PCT 8,615 76.5 1,463 13.0 1,179 10.5 1,139 5C9 Haringey PCT 10,273 82.2 1,555 12.4 676 5.4 1,999 5H1 Hammersmith and Fulham PCT 8,815 89.7 766 7.8 243 2.5 2,310 5HX Ealing PCT 19,752 88.5 1,701 7.6 875 3.9 5,554 SHY Hounslow PCT 7,870 83.5 1,147 12.2 403 4.3 10,094 5K5 Brent PCT 14,762 87.0 1,665 9.8 535 3.2 2,856 5K6 Harrow PCT 8,554 82.9 1,337 13.0 423 4.1 2,018 5K7 Camden PCT 10,858 88.4 1,037 8.4 388 3.2 1,160 5K8 Islington PCT 10,773 87.8 1,102 9.0 399 3.3 1,653 5K9 Croydon PCT 13,550 79.8 2,216 13.1 1,209 7.1 3,925 5LA Kensington and Chelsea PCT 6,335 88.8 652 9.1 150 2.1 1,964 5LC Westminster PCT 8,923 88.3 948 9.4 232 2.3 1,875 5LD Lambeth PCT 14,051 82.9 1,894 11.2 1,003 5.9 1,904 5LE Southwark PCT 13,231 83.4 1,690 10.6 948 6.0 1,798 5LF Lewisham PCT 15,575 81.9 2,403 12.6 1,032 5.4 2,713 5LG Wandsworth PCT 8,952 77.9 1,775 15.4 772 6.7 1,710 5M6 Richmond and Twickenham PCT 5,932 79.8 1,098 14.8 403 5.4 4,999 5M7 Sutton and Merton PCT 18,717 80.6 3,203 13.8 1,294 5.6 4,035 London PCT Total 262,132 82.6 37,362 11.8 17,810 5.6 59,779
1 day to under 6 months 6 months to under 12 months 12 months and over Finished in-year admissions Percentage waited 1 day to under 6 months Finished in-year admissions Percentage waited 6 months to 12 months Finished in- year admissions Percentage waited more than 12 months Number of elective waiting list and booked admissions where it is not possible to calculate accurate waiting times 5A9 Barnet PCT 14,901 82.6 2,727 15.1 411 2.3 1,740 5C1 Enfield PCT 10,652 75.5 2,760 19.6 701 5.0 2,815 5C4 Tower Hamlets PCT 9,020 83.6 1,619 15.0 155 1.4 251 5C9 Haringey Teaching PCT 10,639 84.5 1,650 13.1 307 2.4 2,030 5H1 Hammersmith and Fulham PCT 9,089 89.3 1,027 10.1 60 0.6 2,193 5HX Ealing PCT 19,744 88.0 2,356 10.5 340 1.5 6,068 SHY Hounslow PCT 8,346 82.3 1,668 16.5 122 1.2 9,091 5K5 Brent Teaching PCT 13,062 88.5 1,516 10.3 182 1.2 2,583 5K6 Harrow PCT 9,829 85.6 1,454 12.7 202 1.8 2,080 5K7 Camden PCT 9,928 87.1 1,269 11.1 198 1.7 1,197 5K8 Islington PCT 10,526 88.8 1,155 9.7 179 1.5 1,628 5K9 Croydon PCT 13,982 80.4 2,792 16.1 619 3.6 4,745 5LA Kensington and Chelsea PCT 6,599 89.7 682 9.3 79 1.1 1,784 5LC Westminster PCT 9,164 88.1 1,089 10.5 149 1.4 1,683 5LD Lambeth PCT 15,228 85.5 2,166 12.2 417 2.3 2,883 5LE Southwark PCT 13,261 85.5 1,957 12.6 300 1.9 2,747 5LF Lewisham PCT 10,442 85.0 1,559 12.7 281 2.3 8,896 5LG Wandsworth PCT 10,261 83.3 1,786 14.5 275 2.2 1,751 5M6 Richmond and Twickenham PCT 6,633 83.6 1,142 14.4 163 2.1 4,229 5M7 Sutton and Merton PCT 20,648 86.0 2,934 12.2 420 1.7 3,201 5NA Redbridge PCT 11,262 77.0 2,820 19.3 544 3.7 833 5NC Waltham Forest PCT 8,035 72.3 2,650 23.8 429 3.9 410 TAK Bexley Care Trust 14,468 85.8 1,872 11.1 528 3.1 2,300 London PCT total 265,719 84.2 42,650 13.5 7,061 2.2 67,138
1 day to under 6 months 6 months to under 12 months 12 months and over Finished in-year admissions Percentage waited 1 day to under 6 months Finished in-year admissions Percentage waited 6 months to 12 months Finished in- year admissions Percentage waited more than 12 months Number of elective waiting list and booked admissions where it is not possible to calculate accurate waiting times 5A9 Barnet PCT 15,478 84.0 2,715 14.7 227 1.2 1,873 5C1 Enfield PCT 10,356 77.2 2,773 20.7 280 2.1 2,337 5C4 Tower Hamlets PCT 11,871 89.8 1,238 9.4 115 0.9 336 5C9 Haringey Teaching PCT 10,026 84.3 1,685 14.2 184 1.5 1,936 5H1 Hammersmith and Fulham PCT 8,065 89.9 813 9.1 91 1.0 1,753 5HX Ealing PCT 20,004 88.9 2,172 9.7 330 1.5 5,708 SHY Hounslow PCT 12,229 90.3 1,241 9.2 73 0.5 3,491 5K5 Brent Teaching PCT 13,592 89.1 1,570 10.3 95 0.6 3,352 5K6 Harrow PCT 9,607 86.1 1,450 13.0 102 0.9 2,037 5K7 Camden PCT 9,770 88.0 1,181 10.6 157 1.4 1,221 5K8 Islington PCT 10,195 88.6 1,173 10.2 138 1.2 1,608 5K9 Croydon PCT 13,664 81.9 2,721 16.3 299 1.8 3,905 5LA Kensington and Chelsea PCT 6,466 89.6 698 9.7 55 0.8 1,749 5LC Westminster PCT 9,184 89.5 967 9.4 105 1.0 1,926 5LD Lambeth PCT 15,316 88.9 1,743 10.1 168 1.0 2,728 5LE Southwark PCT 13,496 89.3 1,485 9.8 125 0.8 2,730 5LF Lewisham PCT 7,239 89.7 740 9.2 87 1.1 11,540 5LG Wandsworth PCT 10,181 86.6 1,429 12.2 142 1.2 1,670 5M6 Richmond and Twickenham PCT 7,856 87.1 1,055 11.7 107 1.2 2,118 5M7 Sutton and Merton PCT 19,688 87.7 2,556 11.4 217 1.0 2,685 5NA Redbridge PCT 11,002 81.3 2,265 16.7 260 1.9 1,066 5NC Waltham Forest PCT 7,802 76.4 2,142 21.0 265 2.6 339 TAK Bexley Care Trust 14,898 88.7 1,654 9.8 246 1.5 2,634 London PCT total 267,985 86.6 37,466 12.1 3,868 1.3 60,742
2005-061 day to under 6 months6 months to under 12 months12 months and overFinished in-year admissionsPercentage waited 1 day to under 6 monthsFinished in-year admissionsPercentage waited 6 months to 12 monthsFinished in- year admissionsPercentage waited more than 12 monthsNumber of elective waiting list and booked admissions where it is not possible to calculate accurate waiting times5A9Barnet PCT16,57888.32,03610.81650.91,8805C1Enfield PCT10,75979.42,57619.02101.62,3945C4Tower Hamlets PCT13,27593.28686.1930.75265C9Haringey Teaching PCT10,96086.81,48311.71851.52,0205H1Hammersmith and Fulham PCT9,37790.39419.1700.71,7875HXEaling PCT20,65789.52,1679.42451.17,099SHYHounslow PCT8,69790.68198.5830.97,2855K5Brent Teaching PCT15,49889.91,6809.7700.44,0855K6Harrow PCT10,43687.21,46912.3650.52,6395K7Camden PCT10,22190.49698.61111.01,3915K8Islington PCT11,45091.79007.21311.02,3205K9Croydon PCT16,63688.71,89910.12191.24,0165LAKensington and Chelsea PCT6,51690.56298.7530.71,9685LCWestminster PCT9,01690.09019.01021.02,5945LDLambeth PCT16,44789.31,7899.71871.03,8515LESouthwark PCT14,76289.41,6019.71550.93,5615LFLewisham PCT7,73091.26798.0690.812,4095LGWandsworth PCT11,16588.81,27010.11381.12,0855M6Richmond and Twickenham PCT7,03987.590511.21041.33,5525M7Sutton and Merton PCT21,70488.32,64810.82250.93,0725NARedbridge PCT11,39387.21,50111.51731.31,477 5NCWaltham Forest PCT8,80682.61,69015.81671.6636TAKBexley Care Trust15,21491.31,2957.81520.93,570London PCT total284,33688.832,71510.23,1721.076,217 Notes:Finished in-year admissions A finished in-year admission is the first period of in-patient care under one consultant within one health care provider, excluding admissions beginning before 1 April at the start of the data year. Please note that admissions do not represent the number of in-patients, as a person may have more than one admission within the year. Ungrossed DataFigures have not been adjusted for shortfalls in data (i.e. the data are ungrossed). Time waited (days)Time waited statistics from Hospital Episode Statistics (HES) are not the same as the published waiting list statistics. HES provides counts and time waited for all patients admitted to hospital within a given period whereas the published waiting list statistics count those waiting for treatment on a specific date and how long they have been on the waiting list. Also, HES calculates the time waited as the difference between the admission and decision to admit dates. Where there is no recorded entry for decision to admit, or when decision to admit and admission date are the same this creates an invalid waiting time. Unlike published waiting list statistics, this is not adjusted for self-deferrals or periods of medical/social suspension. The time band ‘one day to under six months’ includes those who waited one to 182 days, the ‘six months to under 12 months’ includes those who waited 183 to 364 days, the ‘12 months and over’ includes those who waited 365 and over days. Primary care trust (PCT) and strategic health authority (SHA) data quality PCT and SHA data was added to historic data-years in the HES database using 2002-03 boundaries, as a one-off exercise in 2004. The quality of the data on PCT of Treatment and SHA of Treatment is poor in 1996-97,1997-98 and 1998-99, with over a third of all finished episodes having missing values in these years. Data quality of PCT of GP practice and SHA of GP practice in 1997-98 and 1998-99 is also poor, with a high proportion missing values where practices changed or ceased to exist. There is less change in completeness of the residence-based fields over time, where the majority of unknown values are due to missing postcodes on birth episodes. Users of time series analysis including these years need to be aware of these issues in their interpretation of the data. Data QualityHospital Episode Statistics (HES) are compiled from data sent by over 300 NHS trusts and primary care trusts (PCTs) in England. The Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain. Source:Hospital Episode Statistics (HES), The Information Centre for Health and Social Care.
Hospitals: Waiting Lists
The information is not available in the format requested.
Data on the time patients are waiting for cancer treatment is not collected centrally.
Information is collected on performance against the cancer waiting times standards of a maximum wait of 31 days from diagnosis to first cancer treatment and a maximum wait of 62 days from urgent referral to first cancer treatment, which were introduced for all cancer patients from December 2005. Data giving performance against these standards for the period July to September 2006 shows that patients at the City Hospitals Sunderland National Health Service Foundation Trust achieved 99.4 per cent. and 96.7 per cent. respectively.
More detailed information and historic statistics for these standards and the cancer two week wait has been placed in the Library and are available online at:
www.performance.doh.gov.uk/cancerwaits/
Cardiology waiting times at the City Hospitals Sunderland NHS Foundation Trust have been set out in the table shown.
Month Total waiting Number waiting over 13 weeks Percentage of total waiting list waiting over 13 weeks Number waiting over 26 weeks Percentage of total waiting list waiting over 26 weeks 1997 March 6 0 0 0 0 1998 March 1 0 0 0 0 1999 March 10 6 60 2 20.0 2000 March 44 4 9.1 1 2.3 2001 March 85 9 10.6 0 0 2002 March 105 12 11.4 1 1.0 2003 March 78 7 9.0 0 0 2004 March 90 2 2.2 0 0 2005 March 42 1 2.4 0 0 2006 March 184 34 18.5 0 0 2006 December 205 11 5.4 0 0 Source: Department of Health, KH07
Hull and East Yorkshire Hospitals NHS Trust: Out-patients
This information is not collected centrally.
Hull and East Yorkshire Hospitals NHS Trust: Surgery
This information is not collected centrally.
The information requested is set out in the following tables.
Heart surgery Ophthalmology surgery Knee surgery Hip replacements Urology surgery 2001-02 5,510 4,957 1,796 612 6,722 2002-03 5,864 7,633 1,794 581 7,056 2003-04 5,950 7,426 1,582 655 7,770 2004-05 6,363 7,674 1,406 ,700 7,475 2005-06 6,012 8,088 1,375 749 7,922 Notes: 1. Finished consultant episode (FCE). An FCE is defined as a period of admitted patient care under one consultant within one healthcare. 2. All operations count of mentions. These figures represent a count of all mentions of an operation in any of the 12 (4 prior to 2002-03) operation fields in the Hospital Episode Statistics (HES) data set. Therefore, if an operation is mentioned in more than one operation field during an episode, all operations are counted. 3. Main operation. The main operation is the first recorded operation in the HES data set and is usually the most resource intensive procedure performed during the episode. It is appropriate to use main operation when looking at admission details, e.g. time waited, but the figures for “all operations count of episodes” give a more complete count of episodes with an operation. 4. Secondary procedure. As well as the main operative procedure, there are up to 11 (3 prior to 2002-03) secondary operation fields in HES that show secondary or additional procedures performed on the patient during the episode of care. 5. Data quality. HES are compiled from data sent by over 300 NHS trusts and primary care trusts (PCTs) in England. The Information Centre for care and social services liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain. 6. Ungrossed data. Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed). Codes: Provider code RWA Hull and East Yorkshire Hospitals Trust Heart surgery defined by OPCS 4.2 codes KOI to K71 Ophthalmology surgery defined by OPCS 4.2 codes C01 to C86 Knee surgery defined by OPCS 4.2 codes W06.3, W40, W41, W42, W70, W78.3, W82, W85, W87 Hip replacements defined by OPCS 4.2 codes W37, W38, W39, W46, W47, W48 Urology surgery defined by OPCS 4.2 codes M01 to M83 Source: Hospital Episode Statistics (HES), The Information Centre for health and social care
The following table shows the median time waited for finished in-year admission episodes with an admission method of 11 or 12 and a main operation of heart surgery at Hull and East Yorkshire Hospitals NHS Trust for 2001-02 to 2005-06.
Median (days) Total episodes 2001-02 92 2,557 2002-03 100 2,883 2003-04 99 2,817 2004-05 88 3,347 2005-06 85 3,709 Notes: 1. Heart surgery defined by OPCS 4.2 codes KOI to K71 2. Admission methods 11 elective—from waiting list and 12 elective--booked
The following table shows the median time waited for finished in-year admission episodes within an admission method of 11 or 12 and a main operation of ophthalmology surgery at the Hull and East Yorkshire Hospitals NHS Trust for 2001-02 to 2005-06.
Median (days) Total episodes 2001-02 181 2,524 2002-03 160 3,127 2003-04 135 3,107 2004-05 74 3,207 2005-06 49 3,402 Notes: 1. Ophthalmology surgery defined by OPCS 4.2 codes C01 to C86 2. Admission methods 11 elective—from waiting list and 12 elective—booked
The following table shows the median time waited for finished in-ear admission episodes within an admission method of 11 or 12 and a main operation of knee surgery at the Hull and East Yorkshire Hospitals NHS Trust for 2001-02 to 2005-06.
Median (days) Total episodes 2001-02 142 1,076 2002-03 156 1,092 2003-04 192 1,062 2004-05 175 1,186 2005-06 155 1,198 Notes: 1. Knee surgery defined by OPCS 4.2 codes W06.3, W40, W41, W42, W70, W78.3, W82, W85, W87 2. Admission methods 11 elective—from waiting list and 12 elective—booked
The following table shows the median time waited for finished in-year admission episodes within an admission method of 11 or 12 and a main operation of hip replacement at the Hull and East Yorkshire Hospitals NHS Trust for 2001-02 to 2005-06.
Median (days) Total episodes 2001-02 133 365 2002-03 126 342 2003-04 148 396 2004-05 157 359 2005-06 163 360 Notes: 1. Hip replacements defined by OPCS 4.2 codes W37, W38, W39, W46, W47, W48 2. Admission methods 11 elective—from waiting list and 12 elective—booked
The following table shows the median time waited for finished in-year admission episodes within an admission method of 11 or 12 and a main operation of urology surgery at the Hull and East Yorkshire Hospitals NHS Trust for 2001-2002 to 2005-2006.
Median (days)Total episodes2001-02742,5352002-03233,7272003-04363,9412004-05424,1642005-06483,747 Notes:1. Urology surgery defined by OPCS 4.2 codes M01 to M832. Admission methods 11 elective—from waiting list and 12 elective—booked3. Finished in-year admissions. A finished in-year admission is the first period of inpatient care under one consultant within one health care provider, excluding admissions beginning before 1 April at the start of the data year. Please note that admissions do not represent the number of inpatients, as a person may have more than one admission within the year.4. Main operation. The main operation is the first recorded operation in the Hospital Episode Statistics (HES) data set and is usually the most resource intensive procedure performed during the episode. It is appropriate to use main operation when looking at admission details, e.g. time waited, but the figures for “all operations count of episodes” give a more complete count of episodes with an operation.5. Time waited (days). Time waited statistics from HES are not the same as the published waiting list statistics. HES provides counts and time waited for all patients admitted to hospital within a given period whereas the published waiting list statistics count those waiting for treatment on a specific date and how long they have been on the waiting list. Also, HES calculates the time waited as the difference between the admission and decision to admit dates. Unlike published waiting list statistics, this is not adjusted for self-deferrals or periods of medical/social suspension.6. Data quality. HES are compiled from data sent by over 300 NHS trusts and primary care trusts (PCTs) in England. The Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain.7. Ungrossed data. Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).Source:Hospital Episode Statistics (HES), The Information Centre for health and social care
It is not possible to provide the information in the format requested as numbers of cancelled operations are not collected by type.
However, the number of last minute cancellations for non clinical reasons for the Hull and East Yorkshire National Health Service Hospitals Trust is set out in the following table.
Number 2001-02 783 2002-03 877 2003-04 867 2004-05 1,045 2005-06 825 2006-071 429 1 Data for 2006-07 is for the first three quarters only. Source: Department of Health dataset QMC
Human-Animal Hybrid Embryos
The Government’s policy proposals following their review of the Human Fertilisation and Embryology Act 1990 were published on 14 December 2006 in the Command Paper “Review of the Human Fertilisation and Embryology Act: Proposals for revised legislation (including establishment of the Regulatory Authority for Tissue and Embryos)”. Copies are available in the Library (Cm 6989). The proposals will form the basis for a bill, to be published in draft, for pre-legislative scrutiny.
Revised legislation will clarify the extent to which the law applies to embryos combining human and animal material. We have proposed that the creation of hybrid and chimera embryos in vitro should not be allowed, in general, while at the same time recognising that there may be valuable avenues of scientific research in this area by the provision of a secondary legislative power to makes exceptions subject to licensing.
The House of Commons Science and Technology Committee is in the process of conducting an inquiry into the Government’s proposals for the regulation of hybrid and chimera embryos, and the Government will study carefully any recommendations arising.
Incontinence: Children
Paediatric continence services are assessed by local primary care trusts (PCTs), in line with standard six of the national service framework for children. This standard includes a specific section on paediatric incontinence. There is a benchmarking tool to assist PCTs to evaluate their paediatric continence services, benchmark against other PCTs, and share good practice. This is available online at:
www.cgsupport.nhs.uk/PDFs/articles/good_practice_paediatric_continence_services.pdf
We have also funded the voluntary organisation ERIC (Education and Resources for Improving Childhood Continence) to a maximum of £90,000 over the three years 2006-07 to 2008-09 for their project on the implementation of national integrated continence services.
Independent Sector
Information on expenditure on the independent sector treatment centre (ISTC) programme from central budgets is shown in the table.
ISTC programme expenditure (£ million)1Total NHS expenditure (£ million)ISTC expenditure as a percentage of total NHS spend2003-040.464,183—2004-0584.769,0790.122005-06113.775,8300.15 1 Expenditure on locally procured independent sector treatment providers is not separately identified in the annual financial returns of national health service trusts, primary care trusts and strategic health authorities.Note:The first ISTC commenced services in 2003. The above figures include central funding provided for the ISTCs, the general supplementary procurement and pathfinder contracts.NHS spend on independent healthcare providers will be determined by the choices made by patients and those who commission services locally on their behalf.
Insulin
[holding answer 26 March 2007]: I refer the hon. Member to the reply given on 21 March 2007, Official Report, column 1013W.
(2) what the evidential basis is for the assessment that analogue insulins are (a) safe, (b) effective and (c) cost-effective.
Detailed information regarding the adverse effects known or suspected to be associated with a medicine is provided in the summary of product characteristics (the product information for prescribers) and the patient information leaflet.
Generally the side effects observed are broadly similar for all types of insulins with the most commonly observed side effects being hypoglycaemia, visual disturbance and injection site reactions. Tables which summarise the current knowledge of frequencies of adverse reactions with different insulins have been placed in the Library. These provide a breakdown of the types of adverse effects and their frequencies, where known. The tables contain the information relating to animal, human and analogue insulins and are separated by the classification of the medicine into the following four groups: rapid; intermediate; long and biphasic action. It is important to note that a report of an adverse reaction does not necessarily mean that the drug caused it and a number of the adverse reactions reported by patients treated with insulin may be due to the underlying diabetes.
There is less information available on the frequency of side effects for some of the older products. Guidelines for the investigation of the safety and efficacy of new medicinal products have developed over the years and the evidence base available for older products tends to be much less than that available for newer products such as the insulin analogues.
The following aspects of the product are evaluated in detail as the evidential basis for the assessment of safety and efficacy of the analogue insulins:
Manufacturing data, including biological purity, stability and viral removal processes;
Laboratory testing of the product activity such as its binding to the relevant tissues;
Testing on animals for safety and activity;
Clinical trials in healthy volunteers and/or patient volunteers to;
Establish the mechanism of action;
Study distribution of the product within human body;
Evaluate safety in sufficient numbers of volunteers to reflect safety issues that would be usually expected in clinical practice; and
Evaluate efficacy in sufficient number of volunteers to demonstrate that the product in question would be clinically useful as intended.
If it is considered that benefit versus risk profile of the product is positive, on the basis of aforementioned evaluation, a recommendation to license the product would normally be made.
A summary of the available data on safety and effectiveness submitted in support of the licence applications for many of the insulin analogues is made publicly available in the form of a European Public Assessment Report available on the website of the European Medicines Agency (www.emea.europa.eu).
Assessing the cost-effectiveness of a treatment is the responsibility of the National Institute for Health and Clinical Excellence (NICE). The Appraisal Committee of NICE are asked to take account of the overall resources available to the national health service. Decisions on the cost-effectives of a treatment must include judgments on the implications for other patient groups.
Junior Doctors: Career Structure
The four United Kingdom Health Departments are responsible for the overall implementation of modernising medical careers. The Health Departments co-ordinate action through a United Kingdom modernising medical careers strategy group which includes members from the Academy of Medical Royal Colleges, the General Medical Council, the Postgraduate Medical Education and Training Board (PMETB) and national health service employers. Each country also has a dedicated implementation team.
The Royal Colleges are directly responsible for developing the new competency-based curricula which are approved by PMETB. The Royal Colleges also work closely with postgraduate deans over the development of person specifications for the recruitment process and the postgraduate deans themselves oversee selection into posts.
The number of training opportunities available in 2007 was based on local discussions between local NHS employers, strategic health authorities and postgraduate deans.
Maternity Services
Data derived from Hospital Episode Statistics show that for 1997 there were 213 hospital trusts providing maternity services and 192 in 2001. Most trusts have one principal hospital site with delivery facilities and the majority of deliveries are reported through that main hospital trust. Any decrease in the number of units is likely to be due to reconfiguration of national health service trusts without any decrease in the number of hospitals, wards and birthing centres offering services.
Maternity Services: Leeds
(2) what assessment she has made of the impact of proposed changes to midwifery services in Leeds on the distances midwifery staff will have to travel in the course of their duties; and what provision has been made for the effect on costs of such travel;
(3) what consultation was undertaken on proposed changes to midwifery provision in Leeds with (a) midwifery staff and (b) representatives of the Leeds Primary Care Trust.
[holding answer 22 March 2007]: The NHS Yorkshire and the Humber Strategic Health Authority reports that the proposed changes were formulated in November 2006 and consultation involving the Royal College of Midwives, human resources and local staff side commenced in December 2006. Staff have been invited to raise their concerns at one to one meetings. The head of midwifery works in close collaboration with the primary care commissioners, midwifery educationalists, and the health visiting lead, who are aware of the proposed changes and welcome the modernisation schedule for maternity services taking shape. Focus groups have also been held with women to better understand their expectations of the service.
Midwives will continue to be available to provide home visits where appropriate. The provision of home visits will be based on an assessment of risk and need.
The Leeds Teaching Hospitals National Health Service Trust may require staff to change their work base for operational reasons. Eligibility for reimbursement of excess travel does not normally apply in these circumstances under the current agenda for change terms and conditions for staff employed in the NHS.
Mental Health Services: Children
Data will be available online in April at www.camhsmapping.org.uk. The 2006 Child and Adolescent Mental Health Services Mapping report is scheduled to be published in July.
Migraine
The main agency through which the Government support medical and clinical research is the Medical Research Council (MRC). The MRC is an independent body funded by the Department of Trade and Industry via the Office of Science and Innovation.
The MRC is not currently funding research specifically relating to migraine. However, a strategic grant award to Dr. Leone Ridsdale, King’s College, London for a prospective study on diagnostic management referral and one year outcome for patients with headache in primary care has recently been completed. The aim of this study was to provide evidence about the accuracy of diagnosis, the prognosis, reasons for referral, and the economic costs for patients and society.
The Department funds research to support policy and to provide the evidence needed to underpin quality improvement and service development in the NHS and through its health technology assessment programme has supported a pragmatic, randomised trial into the use of acupuncture for migraine and headache in primary care; and is planning a randomised placebo controlled trial of propranolol and Pizotifen in preventing migraine in children.
Over 75 per cent. of the Department’s total expenditure on health research is devolved to and managed by national health service organisations. Details of individual projects, including a number concerned with migraine, are available on the national research register at:
www.dh.gov.uk/research.
Milton Keynes Primary Care Trust: Taxis
The information requested is not collected centrally. It is for the local health economy to determine how to use its allocated resources.
NHS Budget
The information is shown in the table.
Non-NHS bodies include local authorities, other statutory bodies and the independent sector.
Total cash terms (£ million) Total real terms (£ million) As a proportion of NHS expenditure (percentage) 1997-98 1,108.2 1,337.8 3.20 1998-99 1,230.4 1,448.5 3.36 1999-2000 1,301.2 1,501.5 3.24 2000-01 1,549.2 1,762.8 3.53 2001-02 1,793.0 1,993.0 3.66 2002-03 2,239.3 2,414.4 4.14 2003-04 3,315.9 3,471.9 5.26 2004-05 3,681.0 3,749.7 5.31 2005-06 4,435.1 4,435.1 5.81 Notes: 1. Figures include £15.0 million of spending in 2004-05 and £19.6 million in 2005-06 by NHS foundation trusts. 2. HM Treasury Gross Domestic Product Deflator used to provide the real terms figures with 2005-06 as the base year. 3. Figures for 2005-06 are provisional. Source: Annual financial returns for primary care trusts, strategic health authorities and NHS trusts for 1997-98 to 2005-06. Review and consolidated accounts of NHS foundation trusts 2005-06.
NHS Treatment Centres: Personal Records
Currently wave 1 independent sector treatment centre (ISTC) providers do not market their services to national health service patients or referrers.
Choice is a key part of health reform. Going forward, NHS providers, independent and public sector, should be providing patients with information which enables them to make an informed decision about their health care options. This will include information gathered from the treatment of NHS patients.
The marketing schedule for phase 2 ISTC contracts states that marketing brochures produced by the provider for patients of the facilities must include (among other things) patient and provider statistics consistent with those contained in the NHS choice booklets, to the extent that they are relevant to the ISTC programme. These include details of in-patient waiting times, cancelled operations, out-patient waiting times, methicillin resistant staphylococcus aureus infection rates and the results of patient satisfaction surveys.
Marketing brochures produced for Referring Health Service Bodies must include all the above, and in addition should cover complication rates and length of stay/day case rates.
The schedule also provides that marketing material should not include information relating to private health care services or products and services offered by the IS provider, or a third party, which do not relate to the services being provided under the ISTC agreement with the authority.
NHS: Complaints
(2) what plans she has to reform the NHS complaints procedure to make it easier for users of the NHS to make a complaint.
We received representation on the national health service complaints procedure in a joint letter in October 2006 from the Parliamentary and Health Service Ombudsman (PHSO) and the Local Government Ombudsman, providing feedback which welcomes our commitment to establish integrated health and social care complaints arrangements, gives their views on the principles they consider should govern the development and delivery of the new integrated approach, and summarises what they believe needs to be in place to make an effective integrated approach a reality.
The White Paper “Our health, our care, our say” published in January 2006, signals our commitment to
“develop by 2009 a comprehensive single complaints system across health and social care [that will] focus on resolving complaints locally with a more personal and comprehensive approach to handling complaints”,
in response to people’s wishes for easy and effective ways of complaining.
We intend to conduct a consultation exercise very shortly on reform of the complaints arrangements across health and social care. In so doing we will take account of the recommendations by the PHSO and Local Government Ombudsman in developing a new complaints system, which we agree should be based on the following principles:
open and easy to access—flexible about the ways people could complain and with effective information and support for people wishing to do so, and specialist advocacy as appropriate;
fair—emphasising early resolution so minimising the strain and distress for all those involved; investigation should be robust, effective and comprehensive at this stage;
responsive—providing appropriate, tailored and proportionate response and redress; having proper regard to the complainant's legitimate interests; and
providing an opportunity for learning and developing—ensuring complaints are viewed as a positive opportunity to learn from patients’ experiences and views to drive continual improvement in services.
We have accepted a recommendation of the Shipman Inquiry (Fifth Report) that there should be a statutory recognition of the importance of the proper investigation of complaints to the processes of organisational learning and of monitoring the quality of care. Additionally a fair and responsive system must address the specific needs of vulnerable people, such as those with learning difficulties, mental health problems and communication difficulties.
Throughout the consultation process we will maintain ongoing communication and feedback from key stakeholders, such as the ombudsman, the Local Government Ombudsman, the Healthcare Commission, the Commission for Social Care Inspection and Monitor, the regulator for foundation trusts. We will consult widely on the proposals across all health and social care communities, in the public and private sectors, and with patient and user representatives. As well as written responses we intend to conduct events in London and around the country to encourage thorough debate and feedback.
NHS: Finance
Cost data collected from the national health service do not distinguish between the costs of individual patients.
We are therefore unable to separately identify the number of patients whose complex needs cost £100,000 to £249,999, £250,000 to £499,999 and more than £500,000 per annum in each of the last three years.
The purpose and value of the centrally funded initiatives services and special allocations (CFISSA) funds issued with primary care trust (PCT) initial allocations are in the following table. These allocations differ from other CFISSA allocations only in that they are incorporated into PCT initial resource limits and are allocated at the start of the financial year. Other funds issued to the national health service from the CFISSA programme are made as in year allocation adjustments.
£000 Primary medical services resource limit adjustment 4,517,190 General medical services cash limited rebasing -702,554 Pension indexation: PCT contribution 1,333,343 NHS funded nursing care 584,000 Palliative care 50,000 Pensions indexation adjustment for personal medical services practice staff 33,171 Neo natal intensive care 20,709 Revascularisation 16,901 Dangerous people with serious personality disorders 12,286 Health Protection Agency 9,674 Dentistry 3,907 Health Protection Agency 2,315 Medium secure services for deaf people 1,394 Non medical education and training 870 Improving services for people with multiple sclerosis 758 Health Protection Agency 610 Pensions indexation 500 Regional directors of public health support 437 Prison healthcare 90 Defibrillator funding to PCTs 66 PRION 52 Multiple Sclerosis service improvements 42 NHS funded nursing care—short-term respite care adjustment 4 National specialist commissioning—pancreatic transplantation -2,473 Cancer registries -8,770 National specialist commissioning—children and adolescent mental health services -12,109 Old long stay -44,934 Total 5,817,479
Tables are available in the Library providing:
(a) listings of all allocations by budget title and value to National Health Service organisations from 1997-98 to 2005-06;
(b) total expenditure of the centrally funded, initiatives services and special allocations (CFISSA) programme from 1997-98 to 2005-06;
(c) special allocations issued with initial allocations from 1997-98 to 2005-06; and
(d) special allocations and associated budgets issued to NHS organisations as additional allocations (and which are included in the tables described in (a) and (b) above).
Full year 2006-07 information and anticipated expenditure in 2007-08 on centrally funded initiatives services and special allocations is not yet available. This information will be contained within the 2006-07 Departmental Report that has an estimated publishing date of May 2007.
The reversals set out in the written ministerial statement of 28 March 2007, Official Report, columns 96-98WS, are for income deductions applied to NHS trusts in 2006-07 as a result of deficits incurred during 2005-06. No such income deduction was made to Maidstone and Tunbridge Wells NHS Trust as the trust’s financial position reported in the 2005-06 final accounts was a surplus of £112,000.
Under the new rules, NHS trusts that had income deductions made in years prior to 2006-07 will be able to agree a disregard for these deductions in the calculation of their statutory breakeven duty. This means that they will no longer have to generate a surplus to recover any part of their cumulative deficit that arose solely from the application of resource accounting and budgeting (RAB) income deductions.
Maidstone and Tunbridge Wells NHS Trust will therefore need to agree with its auditors the impact on its breakeven duty of any RAB income deductions applied in 2005-06 and earlier years. The breakeven note would then be adjusted to exclude these in the 2006-07 final accounts.
The NHS Plan (2000) introduced national health service local improvement finance trusts (LIFT) as a way of supporting the delivery of more investment in primary care premises. LIFT is providing modern integrated super surgeries, often in the heart of deprived communities. As of 31 March 2007, it has delivered 115 new buildings open to patients with another 74 under construction, supported by over £1.2 billion of investment. The NAO report on LIFT, Innovation in the NHS, noted that LIFT is well designed and offered advantages over other forms of procurement.
Information is not held centrally to allow for an assessment on the effectiveness of the buildings commissioning period for each scheme. It is for PCTs to manage the commissioning of their new facilities.
Information is not held centrally to allow for an assessment of effectiveness of the financing of each individual scheme. However, as part of the business case approval for each scheme financing terms are assessed, with the support of expert financial advice. The Department is also assembling benchmarking data to support this analysis in current and future LIFTs.
The Department as part of its Better Healthcare Buildings policy initiative is working closely with the commission for architecture and the built environment who have undertaken a detailed design quality survey of a representational cross section of primary care buildings procured under the LIFT initiative. They are preparing findings, which the Department will learn from and implement policy aimed at continually raising the standards of LIFT buildings.
Individual national health service accounts must, by statute, be published locally on or before 30 September 2007. The Department expects that this date will be met or bettered by all NHS bodies.
The Department plans to submit draft summarised accounts that consolidate NHS bodies' accounts to the National Audit Office for review by 20 August 2007. The date of publication is a matter for the Comptroller and Auditor General and depends on the date of completion of the audit process.
NHS: ICT
The information is in the table.
Patient administration systems (PAS) implemented in: Deployments to date Additional deployments planned to be completed by 23 April 2007 Acute Trusts 19 4 Primary Care Trusts 94 5 Primary Care Trusts (PAS with additional clinical functionality) 89 0 Mental Health Trusts 17 0 Total 219 9
The national health service is in the process of moving from being an organisation with fragmented or incomplete systems, with physical processing and storage of records on paper, to a position where national systems are fully integrated, record keeping is digital, and patients have unprecedented access to their personal health records. PAS systems that are compliant with other applications delivered through the national programme for information technology are a key element of this process.
The national programme is providing essential services to support patient care and the smooth running of the NHS, without which it could already not properly function. Thousands of national and local systems have already been successfully deployed on time, including widespread coverage of community PAS where none existed previously. Almost two thirds of hospitals now have digital X-rays and scans, and at the heart of the programme is the NHS care records service which will in due course provide a lifelong electronic personal health record for NHS patients in England.
NHS: Procurement
The agreement with DHL requires NHS Supply Chain to comply with government policies on request. NHS Supply Chain is already committed to liaise closely with the Centre for Evidence-based Purchasing either directly or through the NHS Purchasing and Supply Agency.
NHS Supply Chain has no current plans to release guidance on best practise for the composition of specialised clinical assessment groups.
The Department has mechanisms in place to monitor the overall performance of NHS Supply Chain.
The establishment of clinical councils, to help determine what products the national health service requires, will enable clinicians or other trust representatives to raise any failing in trust's access to medical technologies for their patients.
There is a process whereby issues can be escalated to the NHS BSA (Supply Chain Management Division), and ultimately a joint board chaired by the Department's Commercial Director General.
The contract with NHS Supply Chain will measure savings based on the reduction to buy price for the national health service.
NHS: Publications
The total cost was £2,905. This was a web-only publication and therefore no printing or distribution costs. No Braille, audio or large-print versions have been produced.
Northern Lincolnshire and Goole Hospitals NHS Trust: Maternity Services
The information requested is shown in the table. Beds data is collected annually and 2006-07 figures will not be available until August 2007.
Number of beds 2003-04 102 2004-05 108 2005-06 115 Source: Department of Health dataset KH03.
Nurses: Pay
[holding answer 5 March 2007]: The starting pay for a newly qualified nurse at 2006-07 prices in each of the last 20 years is set out in the following table.
Starting pay cash1,2 Starting pay real terms3 1987-88 7,300 13,955 1988-89 8,025 14,341 1989-90 8,565 14,285 1990-91 9,335 14,436 1991-92 10,230 14,908 1992-93 10,820 15,276 1993-94 10,980 15,108 1994-95 11,320 15,344 1995-964 11,605 15,266 1996-97 11,895 15,138 1997-98 12,385 15,316 1998-99 12,855 15,504 1999-00 14,400 17,023 2000-01 14,890 17,358 2001-02 15,445 17,587 2002-03 16,005 17,678 2003-04 16,525 17,725 2004-055 18,114 18,909 2005-06 18,698 19,155 2006-07 19,166 19,166 1 Starting pay for a newly qualified nurse is normally the minimum of the grade applicable to basic grade qualified nurses. 2 The grades applicable to basic grade qualified nurses in the years set out in the table are as follows:- 1977-78 to 1987-88 Staff Nurse 1988-89 to 2003-04 D Grade 2004-05 to 2006-07 Agenda for Change Band 5 Figures given are for the minimum of these grades in the year in question, including any staged increases. 3 Real terms in 2006-07 prices. 4 The starting pay given for 1995-96 is the rate for non-trust staff. 5 The starting pay given for 2004-05 is the minimum of the Agenda for Change Band 5 scale at the effective date of implementation of Agenda for Change on 1 October 2004.
Obesity: Surgery
The figures are shown in the table.
NHS Hospitals, England Method of Admission 11 Elective - from waiting list and 12 Elective—booked Gastric Bypass Surgery defined by OPCS4.2 Codes: G01.2, G01.3, G27.1, G27.2, G27.3, G27.4, G27.5, G27.8, G27.9, G28.1, G28.2, G28.3, G28.8, G28.9, G31.1, G31.2, G31.3, G31.4, G31.8, G31.9, G31.0, G32.1, G32.2, G32.3, G32.8, G32.9, G32.0, G33.1, G33.2, G33.3, G33.8, G33.9, G33.0 Provider code Provider description Median waiting time (days) Total episodes RA2 Royal Surrey County Hospital NHS Trust 13 8 RA3 Weston Area Health NHS Trust — — RA7 United Bristol Healthcare NHS Trust 14 25 RA9 South Devon Health Care NHS Trust — — RAE Bradford Teaching Hospitals NHS Foundation Trust 11 18 RAJ Southend Hospital NHS Trust — — RAL Royal Free Hampstead NHS Trust 13 9 RAX Kingston Hospital NHS Trust — — RBA Taunton and Somerset NHS Trust 86 36 RBD West Dorset General Hospitals NHS Trust — — RBK Walsall Hospitals NHS Trust 132 25 RBL Wirral Hospital NHS Trust 5 18 RBN St. Helens and Knowsley Hospitals NHS Trust 15 8 RBQ The Cardiothoracic Centre—Liverpool NHS Trust — — RBS Royal Liverpool Children’s NHS Trust — — RBT The Mid Cheshire Hospitals NHS Trust — — RC1 Bedford Hospital NHS Trust — — RC3 Ealing Hospital NHS Trust — — RC9 Luton and Dunstable Hospital NHS Trust 85 17 RCB York Hospitals NHS Trust 264 44 RCC Scarborough and North East Yorkshire Health Care NHS Trust — — RCD Harrogate and District NHS Foundation Trust — — RCF Airedale NHS Trust — — RCS Nottingham City Hospital NHS Trust 10 33 RCX The Queen Elizabeth Hospital King’s Lynn NHS Trust — — RD1 Royal United Hospital Bath NHS Trust 18 7 RD3 Poole Hospital NHS Trust — — RD7 Heatherwood and Wexham Park Hospitals NHS Trust 17 6 RDD Basildon and Thurrock University Hospitals NHS Foundation Trust 19 11 RDE Essex Rivers Healthcare NHS Trust — — RDU Frimley Park Hospital NHS Foundation Trust 16 14 RDZ Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust — — REF Royal Cornwall Hospitals NHS Trust 25 11 REM Aintree Hospitals NHS Trust 34 14 RF4 Barking, Havering and Redbridge Hospitals NHS Trust 26 11 RFF Barnsley District General Hospital NHS Foundation Trust 13 6 RFK Queen’s Medical Centre, Nottingham University Hospitals NHS Trust — — RFR The Rotherham NHS Foundation Trust — — RFS Chesterfield Royal Hospital NHS Foundation Trust 6 8 RG2 Queen Elizabeth Hospital NHS Trust 15 6 RG3-X Bromley Hospitals NHS Trust 15 6 RGC Whipps Cross University Hospital NHS Trust 24 6 RGN Peterborough and Stamford Hospitals NHS Foundation Trust 28 14 RGP James Paget Healthcare NHS Trust — — RGQ Ipswich Hospital NHS Trust 25 20 RGT Cambridge University Hospitals NHS Foundation Trust 11 18 RGZ Queen Mary’s Sidcup NHS Trust — — RH8 Royal Devon and Exeter NHS Foundation Trust 19 15 RHM Southampton University Hospitals NHS Trust 17 17 RHQ Sheffield Teaching Hospitals NHS Foundation Trust 214 129 RHU Portsmouth Hospitals NHS Trust 12 21 RHW Royal Berkshire and Battle Hospitals NHS Trust — — RJ1 Guy’s and St. Thomas’ NHS Foundation Trust 19 40 RJ2 The Lewisham Hospital NHS Trust — — RJ5 St. Mary’s NHS Trust 10 11 RJ7 St. George’s Healthcare NHS Trust 160 39 RJC South Warwickshire General Hospitals NHS Trust — — RJD-X Mid Staffordshire General Hospitals NHS Trust — — RJE University Hospital of North Staffordshire NHS Trust 14 25 RJF Burton Hospitals NHS Trust — — RJL-X Northern Lincolnshire and Goole Hospitals NHS Trust 11 9 RJN East Cheshire NHS Trust — — RJR Countess of Chester Hospital NHS Foundation Trust — — RJZ King’s College Hospital NHS Trust 236 29 RK5 Sherwood Forest Hospitals NHS Trust — — RK9 Plymouth Hospitals NHS Trust 13 20 RKB University Hospitals Coventry and Warwickshire NHS Trust 14 24 RKE The Whittington Hospital NHS Trust — — RL4 The Royal Wolverhampton Hospitals NHS Trust 15 8 RLN City Hospitals Sunderland NHS Foundation Trust — — RLQ Hereford Hospitals NHS Trust 13 6 RM1 Norfolk and Norwich University Hospital NHS Trust 13 11 RM2 South Manchester University Hospitals NHS Trust 19 9 RM3 Salford Royal Hospitals NHS Trust 12 11 RMC Bolton Hospitals NHS Trust — — RMP Tameside and Glossop Acute Services NHS Trust 9 11 RN1-X Winchester and Eastleigh Healthcare NHS Trust — — RN3 Swindon and Marlborough NHS Trust — — RN5-X North Hampshire Hospitals NHS Trust — — RN7 Dartford and Gravesham NHS Trust — — RNA Dudley Group of Hospitals NHS Trust 13 9 RNJ Barts and The London NHS Trust 6 29 RNL North Cumbria Acute Hospitals NHS Trust 5 13 RNQ Kettering General Hospital NHS Trust — — RNS Northampton General Hospital NHS Trust 23 8 RNZ Salisbury Health Care NHS Trust 39 6 RP4 Great Ormond Street Hospital for Children NHS Trust — — RP5 Doncaster and Bassetlaw Hospitals NHS Foundation Trust 9 12 RPL Worthing and Southlands Hospitals NHS Trust — — RPR Royal West Sussex NHS Trust — — RPY The Royal Marsden NHS Foundation Trust 14 26 RQ3 Birmingham Children’s Hospital NHS Trust — — RQ6 Royal Liverpool and Broadgreen University Hospitals NHS Trust 4 27 RQ8 Mid Essex Hospital Services NHS Trust 11 10 RQM Chelsea and Westminster Healthcare NHS Trust 161 10 RQN Hammersmith Hospitals NHS Trust 8 23 RQW The Princess Alexandra Hospital NHS Trust — — RQX Homerton University Hospital NHS Foundation Trust 72 21 RR1 Heart of England NHS Foundation Trust 7 19 RR2 Isle of Wight Healthcare NHS Trust — — RR7 Gateshead Health NHS Foundation Trust — — RR8 Leeds Teaching Hospitals NHS Trust 116 77 RRF Wrightington, Wigan and Leigh NHS Trust 9 6 RRK University Hospital Birmingham NHS Foundation Trust 14 47 RRV University College London Hospitals NHS Foundation Trust 13 24 RT3 Royal Brompton and Harefield NHS Trust — — RTD The Newcastle-upon-Tyne Hospitals NHS Trust 6 52 RTE Gloucestershire Hospitals NHS Foundation Trust 14 10 RTF Northumbria Health Care NHS Trust — — RTG Derby Hospitals NHS Foundation Trust 15 15 RTH Oxford Radcliffe Hospitals NHS Trust 13 20 RTK Ashford and St. Peter’s Hospitals NHS Trust — — RTP Surrey and Sussex Healthcare NHS Trust — — RTR South Tees Hospitals NHS Trust 16 19 RTX University Hospitals of Morecambe Bay NHS Trust 10 9 RV8 North West London Hospitals NHS Trust 12 11 RVJ North Bristol NHS Trust — — RVL Barnet and Chase Farm Hospitals NHS Trust 9 8 RW East Kent Hospitals NHS Trust 14 7 RVW North Tees and Hartlepool NHS Trust 13 8 RVY Southport and Ormskirk Hospital NHS Trust — — RW3 Central Manchester and Manchester Children’s University Hospitals NHS Trust 23 10 RW6 Pennine Acute Hospitals NHS Trust 10 28 RWA Hull and East Yorkshire Hospitals NHS Trust 181 103 RWD United Lincolnshire Hospitals NHS Trust 24 18 RWE University Hospitals of Leicester NHS Trust 29 64 RWF Maidstone and Tunbridge Wells NHS Trust 40 10 RWG West Hertfordshire Hospitals NHS Trust 19 12 RWH East and North Hertfordshire NHS Trust — — RWJ Stockport NHS Foundation Trust 16 8 RWP-X Worcestershire Acute Hospitals NHS Trust 14 11 RWW North Cheshire Hospitals NHS Trust 28 9 RWY Calderdale and Huddersfield NHS Trust 22 9 RXC East Sussex Hospitals NHS Trust — — RXF-X Mid Yorkshire Hospitals NHS Trust 10 22 RXH Brighton and Sussex University Hospitals NHS Trust 27 10 RXL Blackpool, Fylde and Wyre Hospitals NHS Trust 20 11 RXN Lancashire Teaching Hospitals NHS Foundation Trust 0 7 RXP County Durham and Darlington Acute Hospitals NHS Trust — — RXQ Buckinghamshire Hospitals NHS Trust 14 7 RXR East Lancashire Hospitals NHS Trust 9 16 RXW Shrewsbury and Telford Hospital NHS Trust 14 12 Finished admission episodes A finished admission episode is the first period of in-patient care under one consultant within one health care provider. Please note that admissions do not represent the number of in-patients, as a person may have more than one admission within the year. Main Operation The main operation is the first recorded operation in the HES data set and is usually the most resource intensive procedure performed during the episode. It is appropriate to use main operation when looking at admission details, e.g. time waited, but the figures for "all operations count of episodes" give a more complete count of episodes with an operation. Time Waited (days) Time waited statistics from Hospital Episode Statistics (HES) are not the same as the published waiting list statistics. HES provides counts and time waited for all patients admitted to hospital within a given period whereas the published waiting list statistics count those waiting for treatment on a specific date and how long they have been on the waiting list. Also, HES calculates the time waited as the difference between the admission and decision to admit dates. Unlike published waiting list statistics, this is not adjusted for self-deferrals or periods of medical/social suspension. Data Quality Hospital Episode Statistics (HES) are compiled from data sent by over 300 NHS trusts and primary care trusts (PCTs) in England. The Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain. Ungrossed Data Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed). Low Numbers Due to reasons of confidentiality, episodes figures between 1 and 5 and their corresponding waiting times have been suppressed and replaced with “—”. Source: Hospital Episode Statistics (HES), The Information Centre for Health & Social Care.
Out-patients: Eastbourne
The information requested is not collected centrally.
Patients: Surveys
The 2006-07 general practitioner patient survey was launched in January 2007. The final date for the return of patient questionnaires was 5 April. The total cost will depend upon the survey results which will be made available when the questionnaires are returned and analysed. It is not therefore possible to give a final figure for the total cost until this is complete. The budgeted cost, however, for administration of the survey in 2006-07 is £11 million.
Pharmacy
(2) whether she has received any representations on the operation of Pfizer's new distribution model for pharmaceuticals;
(3) whether she has met (a) Pfizer and (b) UniChem to discuss the operation of their pharmaceutical distribution network;
(4) what assessment she has made of the extent to which the operation of Pfizer's new distribution model for pharmaceuticals meets the guarantees provided to her Department in October 2006.
Ministers have had no meetings with representatives of Pfizer, UniChem, pharmacists or the pharmaceutical wholesale industry, since the launch of Pfizer's new distribution arrangements on 5 March, to discuss these new arrangements.
Since the launch of the new arrangements, the Department has received eight written representations, as of 2 April, not including the four questions asked by the hon. Member. Officials in the Department continue to monitor the operation of the new system.
Pregnancy
This information is not available in the format requested. However, data derived from Hospital Episode Statistics (HES) shows the age at which it is most common for women to give birth for the first time over the past five years. This is shown in the table as follows.
1 April to 31 March: Age in years 2001-02 30 2002-03 30 2003-04 29 2004-05 30 2005-06 30
Primary Care Trusts: Per Capita Costs
2007-08 revenue allocations were announced in February 2005 for 303 primary care trusts (PCTs). The following table shows allocations per head of population for 152 PCTs following the reduction in their number on 1 October 2006.
PCT 2007-08 allocation per head (£) Islington PCT 1,956 Tower Hamlets PCT 1,843 Southwark PCT 1,825 City and Hackney Teaching PCT 1,818 Knowsley PCT 1,816 Lambeth PCT 1,812 Liverpool PCT 1,788 Lewisham PCT 1,743 Camden PCT 1,727 Manchester PCT 1,723 Salford PCT 1,717 Newham PCT 1,714 South Tyneside PCT 1,639 Blackpool PCT 1,636 Brent Teaching PCT 1,632 Sunderland Teaching PCT 1,632 Gateshead PCT 1,629 Middlesbrough PCT 1,626 Hammersmith and Fulham PCT 1,626 Newcastle PCT 1,615 Redcar and Cleveland PCT 1,601 Hartlepool PCT 1,600 Wirral PCT 1,595 Haringey Teaching PCT 1,595 Halton and St. Helens PCT 1,586 Heart of Birmingham Teaching PCT 1,586 Barking and Dagenham PCT 1,581 County Durham PCT 1,575 Hastings and Rother PCT 1,571 Westminster PCT 1,564 Stoke On Trent PCT 1,559 Greenwich Teaching PCT 1,558 Sefton PCT 1,556 Sandwell PCT 1,554 Wandsworth PCT 1,538 Barnsley PCT 1,537 Heywood, Middleton and Rochdale PCT 1,536 Waltham Forest PCT 1,531 Walsall Teaching PCT 1,526 Ealing PCT 1,516 Blackburn with Darwen PCT 1,514 Sheffield PCT 1,512 Hull PCT 1,511 Wolverhampton City PCT 1,511 Oldham PCT 1,511 Birmingham East and North PCT 1,509 Darlington PCT 1,508 Tameside and Glossop PCT 1,504 Doncaster PCT 1,499 North Tyneside PCT 1,497 Peterborough PCT 1,494 East Lancashire PCT 1,490 South Birmingham PCT 1,489 Nottingham City PCT 1,483 Ashton, Leigh and Wigan PCT 1,483 Rotherham PCT 1,480 Hounslow PCT 1,477 Coventry Teaching PCT 1,466 Torbay Care Trust 1,464 Wakefield District PCT 1,464 Bolton PCT 1,457 Brighton and Hove City PCT 1,449 Bradford and Airedale PCT 1,444 Great Yarmouth and Waveney PCT 1,441 Isle of Wight NHS PCT 1,440 Enfield PCT 1,432 Leeds PCT 1,422 North East Lincolnshire PCT 1,417 Leicester City PCT 1,416 Calderdale PCT 1,415 Kensington and Chelsea PCT 1,407 North Lancashire PCT 1,406 Trafford PCT 1,405 Bournemouth and Poole PCT 1,405 Northumberland Care Trust 1,404 Plymouth Teaching PCT 1,402 Eastern and Coastal Kent PCT 1,401 Bristol PCT 1,398 East Sussex Downs and Weald PCT 1,396 Harrow PCT 1,396 Cumbria PCT 1,389 Redbridge PCT 1,384 Havering PCT 1,384 Portsmouth City Teaching PCT 1,382 Central Lancashire PCT 1,374 Barnet PCT 1,374 North East Essex PCT 1,373 North Staffordshire PCT 1,365 Kirklees PCT 1,364 Western Cheshire PCT 1,363 Bury PCT 1,362 Croydon PCT 1,359 Luton PCT 1,359 Hillingdon PCT 1,358 Stockport PCT 1,356 Southampton City PCT 1,353 Dudley PCT 1,349 Bassetlaw PCT 1,348 Sutton and Merton PCT 1,347 North Tees PCT 1,344 Cornwall and Isles of Scilly PCT 1,339 Warrington PCT 1,339 Bexley Care Trust 1,339 South West Essex PCT 1,337 North Lincolnshire PCT 1,337 West Sussex PCT 1,336 Derbyshire County PCT 1,336 South East Essex PCT 1,334 Nottinghamshire County PCT 1,329 Derby City PCT 1,327 Dorset PCT 1,319 Devon PCT 1,318 West Essex PCT 1,315 Bromley PCT 1,306 Lincolnshire PCT 1,302 Solihull Care Trust 1,297 Norfolk PCT 1,295 Swindon PCT 1,288 North Somerset PCT 1,288 Telford and Wrekin PCT 1,282 Central and Eastern Cheshire PCT 1,282 Kingston PCT 1,280 Somerset PCT 1,276 Herefordshire PCT 1,274 Richmond and Twickenham PCT 1,273 Northamptonshire PCT 1,269 Shropshire County PCT 1,268 Gloucestershire PCT 1,261 Surrey PCT 1,258 West Hertfordshire PCT 1,257 Medway PCT 1,254 East Riding Of Yorkshire PCT 1,248 Berkshire East PCT 1,243 Warwickshire PCT 1,241 Worcestershire PCT 1,239 West Kent PCT 1,239 North Yorkshire and York PCT 1,238 South Staffordshire PCT 1,234 Bath and North East Somerset PCT 1,230 Suffolk PCT 1,227 East and North Hertfordshire PCT 1,220 Hampshire PCT 1,212 Milton Keynes PCT 1,201 Wiltshire PCT 1,194 Bedfordshire PCT 1,185 Oxfordshire PCT 1,171 Buckinghamshire PCT 1,168 Cambridgeshire PCT 1,160 Berkshire West PCT 1,155 Mid Essex PCT 1,150 South Gloucestershire PCT 1,143 Leicestershire County and Rutland PCT 1,140 England average 1,388
Primary Care Trusts: Planning
(2) which primary care trusts are (a) reviewing and (b) consulting on the provision of (i) acute services, (ii) accident and emergency provision and (iii) maternity provision in their areas.
Any proposals for the reconfiguration of services are a matter for the national health service locally.
There is a well established and well understood process for managing formal public consultations on proposals for major service change so that the public and other stakeholders can help to inform the local debate.
Primary Care Trusts: Prisons
[holding answer 27 March 2007]: The information requested is shown in the table. The list does not include private prisons, for which primary care trusts do not have responsibility for commissioning health care.
Primary care trust (PCT) Prison establishments for which the PCT has responsibility for commissioning healthcare Ashton, Leigh and Wigan PCT HMP Hindley HMP Risley Bassetlaw PCT HMP Ramby Bedfordshire PCT HMP Bedford Berkshire West PCT HMP Reading Bristol PCT HMP Bristol Buckinghamshire PCT HMP Aylesbury HMP Grendon/Spring Hill Cambridgeshire PCT HMP Littlehey HMP Whitemoor Central and Eastern Cheshire PCT HMP Styal Central Lancashire PCT HMP Garth HMP Preston HMP Wymott County Durham PCT HMP Deerbolt HMP Durham HMP Frankland HMP Low Newton Cumbria PCT HMP Haverigg Derbyshire County PCT HMP Foston Hall HMP Sudbury Devon PCT HMP Channings Wood HMP Dartmoor HMP Exeter Doncaster PCT HMP Lindholme HMP Moorland Dorset PCT HMP Dorchester HMP Guys Marsh HMP Portland HMP The Verne HMP Weare East Riding of Yorkshire PCT HMP Everthorpe HMP Full Sutton East Sussex Downs and Weald PCT HMP Lewes Eastern and Coastal Kent PCT HMP Canterbury HMP Elmley HMP Stanford Hill HMP Swaleside Gloucestershire PCT HMP Gloucester HMP Eastwood Park HMP Leyhill Great Yarmouth and Waveney PCT HMP Blundeston Greenwich PCT HMP Belmarsh Hammersmith and Fulham PCT HMP Wormwood Scrubs Hampshire PCT HMP Winchester Heart of Birmingham Teaching PCT HMP Birmingham Heywood, Middleton and Rochdale PCT HMP Buckley Hall Hounslow PCT HMP Feltham Hull PCT HMP Hull Isle of Wight NHS PCT HMP Albany HMP Camp Hill HMP Parkhurst Islington PCT HMP Holloway HMP Pentonville Lambeth PCT HMP Brixton Leeds PCT HMP Leeds HMP Wealstun HMP Wetherby Leicestershire County and Rutland PCT HMP Ashwell HMP Gartree HMP Glen Parva HMP Stocken HMP Leicester Lincolnshire PCT HMP Lincoln HMP Morton Hall HMP North Sea Camp Liverpool PCT HMP Liverpool Manchester PCT HMP Manchester Medway PCT HMP Cookham Wood HMP Rochester Mid Essex PCT HMP Chelmsford Milton Keynes PCT HMP Woodhill Norfolk PCT HMP Norwich HMP Wayland North Lancashire PCT HMP Kirkham HMP Lancaster Farms HMP Lancaster Castle North Staffordshire PCT HMP Werrington North Tees PCT HMP Holme House HMP Kirklevington Grange North Yorkshire and York PCT HMP Askham Grange HMP Northallerton Northamptonshire PCT HMP Onley HMP Wellingborough Northumberland Care Trust HMP Acklington HMP Castington Nottingham City PCT HMP Nottingham Nottinghamshire County PCT HMP Whatton Oxfordshire PCT HMP Bullingdon HMP Huntercombe Portsmouth City PCT HMP Kingston Richmond and Twickenham PCT HMP Latchmere House Shropshire County PCT HMP Shrewsbury HMP Stoke Heath Somerset PCT HMP Shepton Mallet South East Essex PCT HMP Bullwood Hall South Staffordshire PCT HMP Drake Hall HMP Brinsford HMP Featherstone HMP Stafford HMP Swinfen Hall Suffolk PCT HMP Edmunds Hill HMP Warren Hill HMP Hollesley Bay HMP Highpoint South Surrey PCT HMP Coldingley HMP Downview HMP High Down HMP Send Wakefield District PCT HMP New Hall HMP Wakefield Wandsworth PCT HMP Wandsworth Warrington PCT HMP Thorn Cross West Hertfordshire PCT HMP The Mount West Kent PCT HMP Blantyre House HMP East Sutton Park HMP Maidstone West Sussex PCT HMP Ford Wiltshire PCT HMP Erlestoke Worcestershire PCT HMP Blakenhurst HMP Brockhill HMP Hewell Grange HMP Long Lartin
Private Sector Treatment
The local national health service remains confident that the Bodmin NHS Treatment Centre will reach full utilisation in the near future.
The Department measures independent sector treatment centre contract performance on the basis of value rather than activity. This is to allow for the variations, which can occur through substitution of activity between procedures of varying value.
Public Health Observatories
The Department does not collect this data. However, our understanding from the Public Health Observatories (PHOs) is that they frequently input into local and regional health impact assessments (HIAs) as well as leading on them.
All PHOs are involved in HIA support and training activity to varying degrees.
PHOs utilise the HIA expertise that exists across their network in order to manage the provision of HIA training and support for local/regional colleagues. Through their network, PHOs are able to offer programmes around the country which contribute to educating colleagues about HIA at a variety of levels.
Quality Health Ltd.
The Department is not aware of any direct communications it has had with Quality Health Limited since 2001.
The Department has not paid anything to Quality Health Ltd. since 2001. The information requested in respect of the national health service is not held by the Department.
Russells Hall Hospital
The decision for the Department to meet the additional costs at Russells Hall Hospital arose out of a one off settlement of a contractual dispute between the trust and its private sector partner. To date the Department has not directly met cost increases at any other private finance initiative project.
Scottish Expenditure
The information requested could be provided only at disproportionate cost.
Smoking: Licensed Premises
(2) what guidance she has issued on specifications and design of smoking shelters in public houses and clubs;
(3) what plans there are to provide advisory material for publicans and landlords on implementation of the forthcoming smoking ban in public places;
(4) what guidance she has issued on the specifications and design of no smoking signs in public places.
The Department is providing a range of information and support to businesses to help them be ready for the implementation of smokefree legislation on 1 July 2007.
On 23 March 2007, the Department published the guide ‘Everything you need to prepare for the new smokefree law on 1 July 2007’ with comprehensive information on smokefree legislation for businesses. The guide will be included within a pack to be posted to all employing and trading businesses in England during April and is available to download on the Smokefree England website at:
www.smokefreeengland.co.uk
The guidance includes full details of the minimum requirements for signage. The guidance packs that businesses will receive will also include no-smoking signs and other support materials.
Smokefree legislation will apply to premises that are enclosed and substantially enclosed, which is explained in the guidance. The Department cannot provide specific guidance on the design or construction of smoking shelters.
Businesses can also contact their local council for information and advice on getting ready for the implementation of smokefree legislation.
A copy of the guidance is available in the Library.
The Government have not made an assessment of the likely effect on the numbers of people who smoke of banning the sale of tobacco in pubs and clubs.
Smoking: Public Places
The Health Act 2006 will prohibit smoking in enclosed and substantially enclosed workplaces and public places. Within the Act, smoking refers to smoking tobacco or anything which contains tobacco, or smoking any other substance. The smokefree provisions within the Health Act will therefore apply to the use of waterpipes such as shisha and hookah.
Smoking of waterpipes was addressed in the regulatory impact assessment for smokefree legislation, the Department’s consultation on proposed smokefree regulations and was debated during the passage of the Health Bill through Parliament.
Representations on the health effects of smoking of waterpipes have referred to World Health Organisation (WHO) advice that using a waterpipe to smoke tobacco poses a serious potential health hazard to smokers and others exposed to the smoke emitted. The WHO advice states that second-hand smoke from waterpipes is a mixture of tobacco smoke in addition to smoke from the fuel, and therefore poses a serious health risk for non-smokers and recommends that waterpipes should be prohibited in public places consistent with bans on cigarette and other forms of tobacco smoking (World Health Organisation (2005) “Waterpipe Tobacco Smoke: Health effects, research needs and recommended actions by regulators.” WHO, Geneva).
In February 2007, the American Lung Association published advice titled “An emerging deadly trend: waterpipe tobacco use” which cited evidence that waterpipe use may increase exposure to carcinogens because smokers use a waterpipe over a much longer period of time, often 40 to 45 minutes, rather than the five to 10 minutes it takes to smoke a cigarette. Due to the longer, more sustained period of inhalation and exposure, a waterpipe smoker may inhale as much smoke as consuming 100 or more cigarettes during a single session. The American Lung Association report concluded that existing evidence on waterpipe smoking shows that it carries many of the same health risks and has been linked to many of the same diseases caused by cigarette smoking.
Copies of documents referred to are available in the Library.
Smoking: Television
The Department has not commissioned any surveys on this area. However, we are committed in the 2004 Choosing Health White Paper to pressing the responsible bodies to reduce the depiction of smoking in television and films. As a result, the British Board of Film Classification has revised its guidance to take account of portrayal of smoking in its classification of films. Following pressure from the Department, the Ofcom TV broadcasting guidelines have been tightened up to discourage the portrayal of smoking before the 9.00 pm watershed in a glamorous or positive way, unless editorially necessary. In line with the smokefree law coming into force in July 2007, no smoking will be allowed in this year's Big Brother house.
Soft Drinks
I have been asked to reply.
The Government do not collect specific data on the consumption of fizzy drinks.
However, according to the Expenditure and Food Survey England, household residents purchased an average of 65 litres of ready-to-drink soft drinks per person in the year from April 2004 to March 2005. This figure includes still and fizzy soft drinks, including fruit juice drinks, but excludes pure fruit juices and smoothies.
Surgery: Eastbourne
The following table details the number of last minute operations cancelled for non-medical reasons at East Sussex Hospitals National Health Service Trust from 2002-03 to 2006-07.
Number of last minute cancellations for non clinical reasons 2002-03 302 2003-04 375 2004-05 632 2005-06 491 2006-07 93 Note: Data for 2006-07 are for quarter 1 to quarter 3 only. Source: Department of Health dataset QMCO
Surgery: Eastern Region
The following table shows the count of procedures for finished consultant episodes carried out in the Hull and East Yorkshire Hospitals National Health Service Trust for 2001-02 to 2005-06. Total costs of operations performed by NHS trusts are not held centrally.
Total number of procedures2001-200283,7702002-200394,9542003-2004102,9002004-2005104,1682005-2006109,316 Notes: OPCS 4.2 codes A01 to X59Finished Consultant Episode (FCE) An FCE is defined as a period of admitted patient care under one consultant within one healthcare provider. All operations count of mentions These figures represent a count of all mentions of an operation in any of the 12 (4 prior to 2002-03) operation fields in the HES data set. Therefore, if an operation is mentioned in more than one operation field during an episode, all operations are counted. Main operation The main operation is the first recorded operation in the HES data set and is usually the most resource intensive procedure performed during the episode. It is appropriate to use main operation when looking at admission details, for example time waited, but the figures for all operations count of episodes give a more complete count of episodes with an operation. Secondary procedure As well as the main operative procedure, there are up to 11 (3 prior to 2002-03) secondary operation fields in Hospital Episode Statistics (HES) that show secondary or additional procedures performed on the patient during this episode of care. Data quality Hospital Episode Statistics (HES) are compiled from data sent by over 300 NHS Trusts and Primary Care Trusts (PCTs) in England. The Information Centre for health and social care liaises closely with these organisation to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data view HES processes. While this brings about improvement over time, some shortcomings remain. Ungrossed data Figures have not been adjusted for shortfalls in data (for example the data are ungrossed). Source: Hospital Episode Statistics (HES), The Information Centre for health and social care.
Three Rivers Primary Care Trust: Wheelchairs
The Department does not collect information on waiting times for assessments for electrically-powered wheelchairs.
Funding for all national health service wheelchair services comes out of revenue funding to primary care trusts (PCTs). This funding is not ring-fenced and it is for each PCT to assess local need and allocate funds accordingly.
Information about funding for the provision of electrically-powered wheelchairs and the number of people aged over 18 years in the area covered by the PCT who have been allocated an electrically-powered indoor/outdoor wheelchair, are not held centrally.
Transplant Surgery
(2) what regulations govern the use of combined human and pig (a) organs and (b) cells for research purposes; and if she will make a statement.
To date there have been no human transplant procedures in the United Kingdom using pig organs.
European Union (EU) legislation on medicinal products (Commission Directive 2003/63/EU) and the Clinical Trials Regulations (2004) make specific provision for such transplantation proposals. In December 2006, the Department issued guidance which covers all aspects of animal to human transplant procedures, which reflect international recommendations. The guidance is available in the Library and from the Departments website:
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_063075
In addition, the use of animals in such research, or as sources for clinical animal to human transplantation requires appropriate authorisation under the terms of the Animal (Scientific Procedures) Act 1986, which is the responsibility of the Home Office.
The Human Fertilisation and Embryology Act 1990 prohibits mixing live human gametes with the live gametes of any animal, except in certain circumstances for testing the fertility or normality of human sperm. The Government have undertaken a wide-ranging review of the law on assisted reproduction and embryology and expects shortly to publish draft legislation for pre-legislative scrutiny.
West Sussex Primary Care Trust: Finance
All national health service organisations are currently in the process of finalising their financial plans for 2007-08.
The information requested is not collected centrally.
Wheelchairs: Waiting Lists
(2) To ask the Secretary of State for Health what funding was provided by each strategic health authority for the provision of electric-powered wheelchairs in each of the last five years.
Information about waiting times and funding for provision of electric-powered wheelchairs is not held centrally.
Funding for national health service wheelchair services comes from revenue funding to primary care trusts (PCTs). It is for each PCT to assess local need and allocate funds accordingly, as funding is not ring fenced.
Worcestershire Acute Hospitals NHS Trust: Ophthalmology
The information requested is not available centrally.
Treasury
Alcoholic Drinks
Available statistics are based on the clearances of alcohol products when they are released for consumption in the UK and become liable to duty. Figures on total alcohol clearances and alcohol clearances per adult can be found in the HM Revenue and Customs ‘Alcohol Factsheet’ section 2, tables 2.1 and 2.3, which are available from the HM Revenue and Customs website address at:
http://www.uktradeinfo.com/index.cfm?task=factAlcohol
Alcoholic Drinks: Misuse
The information requested falls within the responsibility of the National Statistician who has been asked to reply.
Letter from Karen Dunnell, dated 16 April 2007:
As National Statistician, I have been asked to reply to your recent question asking in respect of how many deaths in (a) Kibble Valley and (b) Lancashire alcohol was cited as the primary cause in each of the last five years. (130736)
The attached table provides the number of deaths with an alcohol-related underlying cause in (a) Ribble Valley local authority district and (b) Lancashire county, from 2001 to 2005 (the latest year available).
So that comparison over time is for a consistent area, deaths in the current Blackpool and Blackburn with Darwen unitary authorities, which were part of the former County of Lancashire, have not been included for any year.
Deaths (persons) Ribble Valley Lancashire 2001 5 179 2002 4 162 2003 5 171 2004 8 178 2005 8 198 1 Cause of death was defined using the International Classification of Diseases, Tenth Revision (ICD-10). The specific causes of death categorised as alcohol-related, and their corresponding ICD-10 codes, are shown in the following box. 2 Based on local authority boundaries as of 2007. 3 Figures are for deaths registered in each calendar year.
Cause of death ICD-10 code(s) Mental and behavioural disorders due to use of alcohol F10 Degeneration of nervous system due to alcohol G31.2 Alcoholic polyneuropathy G62.1 Alcoholic cardiomyopathy I42.6 Alcoholic gastritis K29.2 Alcoholic liver disease K70 Chronic hepatitis, not elsewhere classified K73 Fibrosis and cirrhosis of liver (excl. Biliary cirrhosis) K74 (excl. K74.3-K74.5) Alcohol induced chronic pancreatitis K86.0 Accidental poisoning by and exposure to alcohol X45 Intentional self-poisoning by and exposure to alcohol X65 Poisoning by and exposure to alcohol, undetermined intent Y15
The information requested falls within the responsibility of the National Statistician who has been asked to reply.
Letter from Karen Dunnell, dated 16 April 2007:
As National Statistician, I have been asked to reply to your recent question asking in how many deaths in (a) Eastbourne and (b) East Sussex alcohol was cited as the primary cause in each of the last 10 years. (130962)
The attached table provides the number of deaths with an alcohol-related underlying cause in (a) Eastbourne local authority and (b) East Sussex county, from 1996 to 2005 (the latest year available).
So that comparison over time is for a consistent area, deaths in the current Brighton and Hove unitary authority, which was part of the former County of East Sussex, have not been included for any year.
Deaths (persons) Eastbourne East Sussex 1996 10 40 1997 7 42 1998 10 38 1999 9 36 2000 10 45 2001 17 65 2002 12 55 2003 13 57 2004 18 67 2005 22 61 1 Cause of death was defined using the International Classification of Diseases, Ninth Revision (ICD-9) for the years 1996 to 2000, and Tenth Revision (ICD-10) for 2001 onwards. The specific causes of death categorised as alcohol-related, and their corresponding ICD-9 and ICD-10 codes, are shown in the boxes below. The introduction of ICD-10 in 2001 means that the numbers of deaths from this cause before 2001 are not completely comparable with later years. 2 Based on local authority boundaries as of 2007. 3 Figures are for deaths registered in each calendar year.
Cause of death ICD-9 code(s) Alcoholic psychoses 291 Alcohol dependence syndrome 303 Non-dependent abuse of alcohol 305.0 Alcoholic cardiomyopathy 425.5 Alcoholic fatty liver 571.0 Acute alcoholic hepatitis 571.1 Alcoholic cirrhosis of liver 571.2 Alcoholic liver damage, unspecified 571.3 Chronic hepatitis 571.4 Cirrhosis of liver without mention of alcohol 571.5 Other chronic non-alcoholic liver disease 571.8 Unspecified chronic liver disease without mention of alcohol 571.9 Accidental poisoning by alcohol E860
Cause of death ICD-10 code(s) Mental and behavioural disorders due to use of alcohol F10 Degeneration of nervous system due to alcohol G31.2 Alcoholic polyneuropathy G62.1 Alcoholic cardiomyopathy I42.6 Alcoholic gastritis K29.2 Alcoholic liver disease K70 Chronic hepatitis, not elsewhere classified K73 Fibrosis and cirrhosis of liver (excluding Biliary cirrhosis) K741 Alcohol induced chronic pancreatitis K86.0 Accidental poisoning by and exposure to alcohol X45 Intentional self-poisoning by and exposure to alcohol X65 Poisoning by and exposure to alcohol, undetermined intent Y15 1 Excluding K74.3-K74.5.
Assets
Supervision of reattribution of inherited estate is the responsibility of the Financial Services Authority (FSA). FSA rules require the appointment of a policyholder advocate either nominated or approved by the FSA. The purpose of the policyholder advocate is to ensure that there will be an independent figure representing policyholders' interests to the firm. The precise role of the policyholder advocate depends on the nature of the firm and its proposed reattribution, but the FSA expects the proposed policyholder advocate to be free from any conflicts of interest which may be detrimental to the interests of the policyholders they represent. Typically, the policyholder advocate will negotiate with the firm on behalf of the with-profits policyholders and advise policyholders on issues such as the allocation of benefits and eligibility. He will also prepare a report on these issues. The FSA expects shareholders to meet a reasonable proportion of the policyholder advocate's costs, for the arrangement to be fair, and for the policyholder advocate to confirm that he is satisfied with it. If no agreement on reattribution is reached, the FSA expects all costs to be met by the party which initiated the process (typically the shareholders). The precise basis on which assets are reattributed will depend on the nature of the firm and the proposed reattribution and is a matter for negotiation between the firm and the policyholder advocate. If the firm decides to make an offer to policyholders which does not have the support of the policyholder advocate, it must tell policyholders why it is doing so. Policyholders may then decide individually whether or not to accept the offer, taking into account the recommendation of the policyholder advocate.
(2) if he will introduce rules preventing the reattribution of orphan assets on any basis other than that which would apply to their distribution; and if he will make a statement.
I refer the hon. Gentleman to the answer I gave him on 29 November 2006, Official Report, column 729W.
A policyholder is liable to tax on any distribution of the inherited estate to him as a bonus in the same way as he is liable on any other gain from a life insurance policy. A shareholder is liable to tax on any distribution of the inherited estate in the same way as on any other dividend or distribution by the company to its shareholders.
Assets: Kazakhstan
I have been asked to reply.
According to the Kazakh constitution, the president is not permitted to hold any other paid positions nor to carry out entrepreneurial activities. The Kazakh Law "On Fighting Corruption" also requires each state executive to submit annual declarations of income received and property owned within and outside the Republic of Kazakhstan. Other members of the presidential family are entitled to perform entrepreneurial activities and own assets. However, the Law on Parliament stipulates that no deputy of Parliament may be employed in any other paid position and conduct entrepreneurial activity. We look to the Kazakh Government to apply these regulations effectively, but are not privy to the sort of information that would enable us to make an informed assessment.
Budgets
Internal guidance on security procedures for the Budget is by its nature confidential and it would be inappropriate for it to be made public.
Cannabis: Death
(2) how many deaths have been attributed to cannabis-induced psychosis in the last five years.
The information requested falls within the responsibility of the National Statistician, who has been asked to reply.
Letter from Colin Mowl, dated 16 April 2007:
The National Statistician has been asked to reply to your recent questions asking how many people under the age of 25 years committed suicide due to cannabis-induced psychosis in 2006 and how many deaths have been attributed to cannabis-induced psychosis in the last five years. I am replying in her absence. (131201, 131202)
The most recent year for which figures are available is 2005. In England and Wales there were no suicides1 in that year where psychosis due to the use of cannabinoids2 was mentioned on the death certificate.
In the period 2001-2005 there was one death with an underlying cause of psychotic disorder due to the use of cannabinoids.2
1 In routine statistics, ONS defines suicides as deaths from both intentional self-harm and ‘injury or poisoning of undetermined intent’. It is likely that most of these latter deaths are cases where the harm is self-inflicted but there 'was insufficient evidence to prove that the deceased deliberately intended to kill themselves.
The cause of death for intentional self-harm was defined using the International Classification of Diseases, Tenth Revision (ICD-10) codes X60-X84, and the cause of death for injury or poisoning of undetermined intent was defined using the International Classification of Diseases, Tenth Revision (ICD-10) codes Y10-Y34 excluding Y33.9 where the Coroner's verdict was pending.
2 Selected using ICD-10 code F12.5.
Capital Gains Tax
Estimates of the numbers, disposal value and gains made on assets disposed of in financial year 2003-04 by type of asset, including residential property, are available in National Statistics table 14.4 on the HM Revenue and Customs website at:
http://www.hmrc.gov.uk/stats/capital_gains/menu.htm
Estimates of the revenue impact of charging capital gains tax on residential property owned by non-domiciled and non-resident individuals are not available.
Child Benefit
The cost of increasing the eldest child rate of child benefit to £20 per week from 6 April 2010, beyond statutory uprating in line with RPI, is £95 million in 2010-11. The increase to £20 per week will provide support to all families in line with the principle of progressive universalism. It is estimated that it would reduce child poverty by up to 10,000 in 2010.
Construction Industry Scheme
(2) how many temporary Construction Industry Scheme 4 cards were issued in (a) 2004, (b) 2005 and (c) 2006; and how many such cards are in circulation.
I refer my hon. Friend to the answer I gave him on 20 March 2007, Official Report, column 767W, for the number of temporary Construction Industry Scheme 4 cards issued in 2004-05 and 2005-06. The available data for 2006-07 now show that the number of temporary Construction Industry Scheme 4 cards issued in this year is 76.0001.
Temporary cards are issued for 12 months where a validated national insurance number cannot be supplied immediately and automatically expire after 12 months. Of the temporary cards 2006-07, 75,000 are currently valid and eligible for use.
Temporary construction industry scheme 4 cards ceased to be used when the new Construction Industry Scheme was introduced on 6 April this year.
1 Data for 2006-07 are incomplete.
Departmental Staff
In 2005-06 the Department spent £863,833 on temporary workers.
The number of temporary workers contracted by the Treasury is not recorded centrally, and the costs for 1997-98 are not available due to a change in finance system.
This information could therefore be provided only at disproportionate cost.
Departments: Smith Institute
(2) what security costs will be reimbursed to his Department by the Smith Institute.
[holding answer 26 February 2007]: Since 1997, 67 separate charities have used number 11 of which the Smith Institute is one. A list of these charities is included on the Treasury website.
The Smith Institute asked in 1997 to use the facility for seminars on a once a month basis and sometimes, when they are conducting a series of seminars, on a more regular basis. As previously reported, the Smith Institute held 27 seminars in the last 12 months. Any charities who use or want to use 11 Downing street can apply for more extended access if this is their wish and subject to availability.
Every external organisation who uses number 11 does so on the same basis: the organisers of events at number 11 meet all additional costs associated with holding the event.
Departments: Internet
The Treasury has registered no websites in the last 12 twelve months.
Departments: Press
The Treasury’s expenditure in January 2007 on newspapers was £1,000 and expenditure on periodicals, including trade, accountancy and economics journals, was £5,000. The combined total represents a reduction of £2,000 or 25 per cent. on the cost of expenditure on newspapers and periodicals compared to the last monthly total published on 7 November 2006, Official Report, column 1022W.
Departments: Pressure Groups
Treasury Ministers and officials have meetings with a wide variety of organisations in the public and private sectors as part of the process of policy development and delivery. As was the case with previous Administrations, it is not the Government's practice to provide details of all such meetings.
Departments: Public Expenditure
The decision to introduce ID cards was taken by Cabinet in November 2003. The Home Office has delegated authority to commit resources up to certain defined limits. The total cost of the ID cards scheme will exceed these limits and so the delivery will require Treasury approval. Approval will be sought at an appropriate stage in the project planning process.
The announcement by the Home Secretary of plans to increase prison capacity by 8,000 places was made with the prior agreement of HM Treasury. The individual projects that will deliver the new places will need to receive HM Treasury approval where they exceed the relevant limits. Approval is sought on a project-by-project basis at an appropriate stage in the project planning process.
Departments: Visits Abroad
My wife accompanies me on official visits overseas as appropriate. The costs of such visits are included in the total cost of Ministers’ visits overseas which is published on an annual basis. From 2006-07, the number of such visits will be included in the annual list. Copies of previous lists are available in the Library of the House.
Duty Free Allowances
On 28 November 2006, European Finance Ministers agreed to raise the tax-free allowance for people returning from outside the EU by air and sea to €430 (£290). This doubles the current allowance for all UK travellers returning from third countries. The Government will lay the necessary order to bring the higher allowance into force at the earliest opportunity after parallel EU legislation to increase Customs Duty allowances is adopted. This is expected to be later this year.
Economic and Monetary Union
The Government's policy on membership of the single currency was set out by the Chancellor in his statement to the House of Commons in October 1997, and again in the Chancellor's statement on the five tests assessment in June 2003. The determining factor underpinning any Government decision on membership of the single currency is the national economic interest and whether the economic case for joining is clear and unambiguous.
The Chancellor announced in Budget 2007 that, “the Government does not propose a euro assessment to be initiated at the time of this budget”. The Treasury will again review the situation at Budget time next year as required by the Chancellor's June 2003 statement.
Energy: Conservation
I have been asked to reply.
DEFRA funds the Energy Saving Trust which works to increase demand for energy efficiency through raising awareness and providing advice and support for action by householders. In addition, the Energy Efficiency Commitment has placed an obligation on energy suppliers to promote improvements in household energy efficiency.
Since its launch in June 2000, the Warm Front Scheme has assisted over 1.2 million households in fuel poverty in England, mainly through energy efficiency measures, including loft and cavity wall insulation.
Fuel poverty is a devolved matter and, in Wales, the Home Energy Efficiency Scheme (HEES) funds insulation and heating measures in order to reduce fuel bills and improve domestic energy efficiency.
Support is available for the purchases of low energy light bulbs under the Government’s Energy Efficiency Commitment, which will have provided 40 million bulbs to consumers by 2008, and through the Warm Front Scheme for vulnerable households.
Our existing European agreements prevent us from reducing the VAT rate on low energy light bulbs. However, to encourage the purchase of such bulbs and to reduce their upfront cost, the Chancellor has written to European Finance Ministers and the European Commission to recommend the introduction of a reduced VAT rate for energy efficient products.
Engineering and Physical Sciences Research Council: Finance
The allocation of end-year flexibility to specific research councils is a decision for the Secretary of State for the DTI.
European Community
Number 11 Downing street is used as a venue for Government meetings, official meetings, meetings with external stakeholders and events by charities. As was the case with the previous administration, it is not the Government's practice to disclose lists of individuals.
European Union: Citizenship
I have been asked to reply.
The Europe for Citizens programme began on 1 January 2007. Therefore, no measures were funded in the last 12 months.
Excise Duties: Alcoholic Drinks
The total duty receipts by type of alcohols products (cider, beer, wine and spirits) can be found in the HM Revenue and Customs ‘Beer & Cider Bulletin’, ‘Wine of Fresh Grapes or Made Wine Bulletin’ and ‘Spirits Bulletin’, which are available from the HM Revenue and Customs website addresses at:
http://www.uktradeinfo.co.uk/index.cfm?task=bullbeer
http://www.uktradeinfo.co.uk/index.cfm?task=bullfreshgrape
http://www.uktradeinfo.co.uk/index.cfm?task=bullmadewine
http://www.uktradeinfo.co.uk/index.cfm?task=bullspirits
HM Revenue and Customs only collects total duty receipts for alcohol products and does not split the receipts into still or sparkling alcohol products.
Excise Duties: Motor Vehicles
The Government believe that it is important that all cars registered from March 2001 are treated consistently on a carbon dioxide emissions basis under vehicle excise duty.
Vehicle excise duty for cars was reformed in 2001 and is now based on graduated CO2 emissions bands, which give a clear signal to motorists to choose less polluting vehicles. The structure of vehicle excise duty means that vehicles in the same class or of a similar size are in different bands—for example, there are various models of four wheel drive vehicles not in bands F and G. This enables people to choose less polluting vehicles but keep the same type of vehicle.
Vehicle excise duty for cars was reformed in 2001 and is now based on graduated carbon dioxide emissions bands, which give a clear signal to motorists to choose less polluting vehicles.
Budget 2007 announced rates for the next three years including increases in band G in 2007-08 and for 2008-09 followed by a freeze for 2009-10, along with a reduction in the band B rate for low carbon cars in 2007-08 which will be frozen for the subsequent two years. Band G rates will apply to all cars with emissions above 225 grams CO2 per kilometre registered from 23 March 2006 onwards.
Budget 2007 changes to vehicle excise duty apply across the UK and across manufacturers, sharpening the environmental signal to all UK motorists to purchase more fuel efficient vehicles. The sharpening of environmental signals will help deliver a 0.1-0.17 MtC reduction in CO2 emissions by 2020.
Agricultural vehicles are exempt from payment of vehicle excise duty benefiting 283,000 vehicles in 2005.
Financial Ombudsman Service
The role of the independent assessor to the Financial Ombudsman Service is not set out in the Financial Services and Markets Act 2000.
Following consultation, the board of (the Financial Ombudsman Service set up the post in 2001, under terms designed to secure the independence of the person appointed.
Under his terms of reference, the independent assessor can consider complaints about the Financial Ombudsman Service's procedures and the behaviour of its staff. Disagreements about the merit of decisions are specifically excluded from his jurisdiction. The independent assessor is authorised to make findings and recommendations for redress in cases where he believes it is justified.
Each year, the independent assessor writes an annual report, which is contained with the Financial Ombudsman Service's annual review. In it, he details the number and nature of the cases referred to him and the outcome of his investigations.
Following a national advertisement and open selection process, Sir Edward Osmotherly was appointed to the post of independent assessor in December 2001. The present incumbent, Michael Barnes CBE, succeeded him in April 2002.
Financial Services: EC Law
The Commission has asked all member states to confirm when they will complete transposition of the two MiFID directives and this information is available at
http://ec.europa.eu/internal_market/securities/isd/mifid_implementation_en_htm.
According to the responses provided so far to the Commission on the above website, as of November 2004 the UK, Ireland and Rumania had reported that they had fully transposed both MiFID directives. Lithuania reported it had transposed the level 1 MiFID directive. And by the end of the summer, the majority of countries plan to have completed transposition.
Financial Services: Regulation
The provision of financial advice is regulated under the terms of the Financial Services and Markets Act 2000 (Regulated Activities) Order 2001. Regulatory principles and detailed rules are made and enforced by the Financial Services Authority. These principles and rules require advisers to take a number of steps to ensure they provide suitable advice and treat their customers fairly. Where consumers have a complaint against a financial adviser which cannot be resolved through the adviser's own complaints process, they have access to the Financial Ombudsman service.
Government Departments: Fees and Charges
Government charging policy applies to all services provided by public bodies such as departments, agencies and NDPBs. Charges for statutory services to the public are normally set to recover the full administrative costs of the service (full cost recovery), unless legislation explicitly provides otherwise. The same principle applies where public bodies provide services to one another.
Where public bodies provide discretionary services to the public, often into competitive markets, the policy is that charges should reflect the market price, in the interests of fair competition.
The main exception is charges for information. Government policy is that certain information services should be provided free of charge or at substantially reduced cost.
Heads of State
No. 10 issues press conference transcripts following meetings with Heads of State. In addition to meeting the Prime Minister some Heads of State have on occasion also met with the Chancellor.
Income: Distribution
Estimates for the wealth Gini coefficient from 1979-2003 are published in Table 13.5 on the HMRC website at
http://www.hmrc.gov.uk/stats/personal_wealth/table13 5_pdf.
Figures for subsequent years are not yet available.
I refer the hon. Member to the DWP publication "Households Below Average Income" and the ONS publication "The Effects of Taxes and Benefits on Household Income, 2004-05".
Inheritance Tax
94 per cent. of estates do not pay inheritance tax. For estates that did pay tax, the average amount of inheritance tax paid is shown in the following table, rounded to the nearest £1,000.
£000 1996-97 90 1997-98 95 1998-99 97 1999-2000 104 2000-01 107 2001-02 110 2002-03 98 2003-04 87 2004-05 91 2005-06 100
Inheritance Tax: Northern Ireland
The inheritance tax nil-rate band increases each year by reference to the retail prices index unless Parliament decides otherwise.
However, the Chancellor announced in Budget 2007 increases in the nil-rate band in excess of the expected retail prices index for each year through to 2010-11 when it will reach £350,000.
Insurance: Pensioners
I refer the hon. Member to the answer I gave him on 28 November 2006, Official Report, column 599W. The Government do not prescribe the terms and conditions that insurance companies may set when offering insurance, nor do they intervene in the commercial decisions of insurers.
The Government's Discrimination Law Review is currently considering whether there is a case for prohibiting age discrimination in the provision of goods, facilities and services, including insurance. The Government now expect to publish a Green Paper in May of this year.
Loans: Students
HM Revenue and Customs transfers student loan repayments remitted by employers each month, along with pay as you earn (PAYE) tax and national insurance contributions (NIC) deducted from employees' earnings, to the Bank of England overnight following the date of receipt. No sums are retained or transferred to the Student Loans Company (SLC) at any stage.
Any student loan repayments received by HM Revenue and Customs (HMRC) are transferred overnight to the Treasury's consolidated account with the Bank of England. On a quarterly basis money is then transferred to the Department for Education and Skills.
HMRC does not retain any student loan repayments money nor does it earn any interest on it.
Local Authority Business Growth Incentives Scheme
In the three years to 2007-08 local authorities will receive about £1 billion through LABGI as the Government have previously announced. The Government have abolished the ceiling in LABGI. Due to Judicial Reviews brought by Corby and Slough authorities, this year the Government have retained the 70 per cent. scaling factor for payments to protect the important incentive this scheme creates for authorities both in this year and next year.
Members: Correspondence
Both letters were transferred to the Department for International Development on 3 January and the hon. Member was informed on that day.
Ministerial Residences
As was the case with previous administrations, it is not the Government’s practice to provide lists of people who have visited or stayed at the flat above number 10 Downing street.
Ministers: Travel
Several factors, including security, are taken into account when determining the most appropriate mode of transport on official business.
National Insurance Contributions
(2) pursuant to the answer of 19 February 2007, Official Report, column 485W, on voluntary national insurance contributions, how many people have applied for refunds in voluntary national insurance contributions paid since 25 May 2006.
It is not possible to estimate the number of people who will apply for refunds as this depends on their personal circumstances. The number of people that have applied for refunds of voluntary contributions paid since 25 May 2006 is around 160.
No. 11 Downing Street: Meetings
(2) which functions were held at number 11 Downing street in November 2006.
Number 11 Downing street is used as a venue for Government meetings, official meetings, meetings with external stakeholders and events by charities. This is fully in accordance with the ministerial code and long standing conventions governing the use of Downing street as operated by this and previous Governments.
A list of the charities that have used number 11 Downing street since 1997 is set out on the Treasury website.
Official Hospitality
Number 11 Downing street is used as a venue for Government meetings, official meetings, meetings with external stakeholders and events by charities. As was the case with previous administrations, it is not the Government’s practice to disclose lists of individuals who have visited No. 11.
Olympic Games: Greater London
I refer the hon. Gentleman to the statement made to the House by the Secretary of State for Culture, Media and Sport on 15 March, Official Report, columns 450-466. This is a matter for consideration in the 2007 Comprehensive Spending Review.
Pay: Public Sector
In reserved areas it is for Government Departments to determine pay settlements within the framework of the Government's pay policy. The Government's pay policy promotes pay settlements which reflect local labour market conditions. In devolved areas it is for the Welsh Assembly government to determine pay settlements.
Pay: Wales
In reserved areas it is for Government Departments to determine pay settlements within the framework of the Government's pay policy. The Government's pay policy promotes pay settlements which reflect local labour market conditions. In devolved areas it is for the Welsh Assembly government to determine pay settlements.
Public Bodies: Accountancy
As set out in paragraph 6.59 of the 2007 Financial Statement and Budget Report, the annual financial statements of Government Departments and other entities in the public sector are currently prepared using accounting polices based on UK generally accepted accounting practice. From financial year 2008-09, the annual financial statements of Government Departments and other entities in the public sector, will be prepared using international financial reporting standards, adapted as necessary for the public sector. There is as yet no EU-adopted IFRS standard setting out how the public-sector elements of PFI projects should be reported. It is too early to say what an IFRS standard, once introduced, will mean on a deal-by-deal basis for each PFI contract.
Public Expenditure
The process for the allocation of funding to Government Departments is set out in ‘Public planning and control in the UK—a brief introduction’, which is available on the HMT Treasury website.
Public Sector: Fees and Charges
Any assessment of how public services are funded must consider the impact on efficiency and equity of different funding models as well as any wider effects. Guidance on charging for Government services and products where co-payment is deemed appropriate is set out in The Fees and Charges Guide.
Revenue and Customs
The data requested is not available.
Revenue and Customs: Buildings
The cost of operating and maintaining the HM Revenue and Customs buildings and offices at Castle Meadow site in Nottingham from April 2006 to March 2007 are as shown in the following table.
Budget Heading Cost (net of VAT) PFI Unitary Charge 5,403,368 Business Rates 1,264,360 Utilities 371,501 Total 7,039,229
The PFI unitary charge is for the provision (by Mapeley) of the serviced accommodation at this address, this includes the facility management, maintenance and property costs for this site.
Revenue and Customs: Huddersfield
The hon. Member will be aware that HMRC has a commitment to retain face to face services at or close by the current location. In the event that they vacate the current office, HMRC will have several criteria for the new building, one of which will be that there is good customer access.
The following table shows the number of staff employed by HMRC and, previous to its formation in 2005, by its constituent former Departments (the Inland Revenue and HM Customs and Excise) at offices in Huddersfield during this period.
Headcount 1 April 1997 138 1 April 1998 128 1 April 1999 131 1 April 2000 135 1 April 2001 138 1 April 2002 131 1 April 2003 127 1 April 2004 131 1 April 2005 131 1 April 2006 120 1 March 2007 107
In the last 18 months HMRC have made changes to the way their inquiry centres operate to improve the face to face service offered and its efficiency.
HMRC have an effective quality assurance system. Regular assurance checks are carried out by higher grade officers, checking that the processes and approach to customers are nationally consistent. In addition, managers discuss work issues with their staff on a weekly basis and carry out quarterly quality checks on the work of each member of their staff.
Revenue and Customs: Telephone Services
(2) what the average waiting time was before a telephone call by a member of the public to the national helpline of HM Revenue and Customs was answered by a member of staff in the last period for which figures are available;
(3) what targets have been set for the management of HM Revenue and Customs for the improved handling of telephone calls to the national helpline by members of the public; and if he will make a statement;
(4) how many telephone calls to the national helpline for HM Revenue and Customs were answered in 2005-06; and how many have been answered in 2006-07;
(5) how many full-time equivalent staff are employed to deal directly with telephone calls to HM Revenue and Customs' national helpline;
(6) how many customers are held in a telephone queue for the national helpline of HM Revenue and Customs before further calls are automatically terminated;
(7) how many telephone calls to the national helpline of HM Revenue and Customs were automatically terminated during 2005-06; how many have been so terminated in 2006-07; and if he will make a statement.
The data is not available in the format requested.
Road Transport
The review will focus on road transport fuels and technologies. The Government’s objective is to ensure that aviation is included within the EU emissions trading scheme as soon as possible, but in addition the Government will continue to explore areas where support may be appropriate in the development of alternative aviation fuels.
Sick Leave
The information requested falls within the responsibility of the National Statistician who has been asked to reply.
Letter from Colin Mowl, dated 16 April 2007:
The National Statistician has been asked to reply to your Parliamentary Question about people of working age who were off work for more than six months through sickness or disability in 1997 and 2006. I am replying in her absence. (130848)
Historically, the Labour Force Survey (LFS) collects information about people who were absent from work because of sickness or injury in the week before their interview. The answers to this question give no indication of the overall length of their sickness absence.
More recently, the LFS has been extended to ask whether respondents had been off work for illnesses caused or aggravated by work. This data however excludes non- work related sicknesses or disabilities that did not originate from the workplace. It also excludes those off work for over a year.
As a result, the information necessary to answer the question is not available from the LFS.
Sir Ronald Cohen
No. 11 Downing Street is used as a venue for government meetings, official meetings, meetings with external stakeholders and events by charities. As was the case with the previous administration, it is not the Government's practice to disclose lists of individuals.
Small Businesses: Grants
I have been asked to reply.
The Government are not progressing any proposal for the establishment of a small business development bank.
Stamp Duty Land Tax
The purchase of UK commercial property by offshore companies attracts stamp duty land tax. No estimate is available of the subsequent reduction in yield from transactions of shares in those companies instead of the underlying property.
Taxation: Companies
The changes announced on 2 March 2007 target the continued use of sideways loss relief for tax avoidance and should have no significant effect on genuine investment.
Taxation: Self-assessment
The total number of £100 late filing penalties issued, cancelled and appeals received against throughout the last three years are as detailed in the following table. HMRC does not have information on how many appeals were allowed, the percentage of these penalties collected or how many were not collected due to death or tax being under £100.
Penalties issued Penalties cancelled Penalty appeals received 2003-04 1,640,267 215,851 157,001 2004-05 1,715,775 233,731 139,878 2005-06 1,658,883 190,407 142,993
Unemployment
The information requested falls within the responsibility of the National Statistician who has been asked to reply.
Letter from Karen Dunnell, dated 16 April 2007:
As National Statistician, I have been asked to reply to your recent parliamentary question asking how many children in (a) Hartlepool constituency, (b) the Tees Valley sub-regions, (c) the North East region and (d) the UK live in a family in which neither parent works. (130909)
The attached table gives the number of children in families where no parent is working. The numbers in the table include children of lone parents who are not in employment as well as children of couples in which neither partner is in employment.
Estimates are taken from the Labour Force Survey (LFS). As with any sample survey, estimates from the LFS are subject to a margin of uncertainty.
Thousand United Kingdom 2,055 North East 95 Tees Valley sub-regions 28 Hartlepool constituency 3 1 Children refers to children under 16. 2 Estimates exclude families with unknown economic activity status. Source:Labour Force Survey
Unemployment: East Sussex
The information requested falls within the responsibility of the National Statistician who has been asked to reply.
Letter from Karen Dunnell, dated 16 April 2007:
As National Statistician, I have been asked to reply to your Parliamentary Question about how many economically inactive people of working age there were in (a) Eastbourne and (b) East Sussex in age groups (i) 18 to 24, (ii) 25 to 50 and (iii) 50 years old or more in each year since 19911 (130963)
The Office for National Statistics (ONS) compiles statistics of inactivity from the annual local area Labour Force Survey (LFS) and the Annual Population Survey (APS) following International Labour Organisation definitions.
Table 1, attached, shows the number of economically inactive persons, aged 16 to 24, 25 to 49, 50 to retirement age and for all persons of working age, resident in the Eastbourne constituency, from the annual local area LFS for the 12-month periods ending in February from 1997 to 2004 and from the APS for the 12-month periods ending in March from 2005 to 2006. These numbers are also expressed as a percentage of the relevant population. Table 2 shows similar information for East Sussex.
As these estimates are for a subset of the population in a small geographical area, they are based on very small sample sizes, and are therefore subject to large margins of uncertainty. In this case, the sample sizes are not sufficient to give an accurate estimate of even the direction of the change over the period.
All estimates refer to the current administrative East Sussex area.
Thousand 16 to 24 25 to 49 50 to retirement age1 All persons of working age2 12 months ending Level Rate (%) Level Rate (%) Level Rate (%) Level Rate (%) February 1997 3 31 3 11 3 33 10 19 February 1998 2 24 5 16 4 42 11 22 February 1999 2 18 6 19 2 19 10 19 February 2000 3— 3— 5 17 2 21 8 17 February 2001 2 29 4 11 5 47 11 21 February 2002 1 12 4 14 5 39 11 21 February 2003 3 28 5 15 3 25 11 20 February 2004 2 21 7 20 3 21 11 20 March 2005 2 21 5 17 4 26 11 20 March 2006 3 21 4 14 4 29 11 19 1 Males aged 50 to 64 and females aged 50 to 59. 2 Males aged 16 to 64 and females aged 16 to 59. 3 Sample size too small to provide estimates. Notes:1. Estimates are subject to sampling variability. 2. Changes in the estimates over time should be treated with caution. Source: Annual local area Labour Force Survey; Annual Population Survey.
Thousand 16 to 24 25 to 49 50 to retirement age1 All persons of working age2 12 months ending Level Rate (%) Level Rate (%) Level Rate (%) Level Rate (%) February 1997 11 26 20 13 19 29 50 19 February 1998 9 24 22 15 21 30 53 21 February 1999 6 14 22 15 22 31 50 19 February 2000 8 18 21 14 15 22 44 16 February 2001 11 26 16 11 18 24 46 17 February 2002 10 23 22 14 21 27 53 19 February 2003 11 24 22 15 21 26 54 20 February 2004 8 18 25 16 20 25 53 19 March 2005 10 23 21 14 23 27 54 19 March 2006 10 23 25 16 22 26 57 20
USA
All ministerial visits are conducted in accordance with the “Ministerial Code” and “Travel by Ministers”. Since 1999, the Government have published on an annual basis, a list of overseas travel by Cabinet Ministers costing in excess of £500 and the total cost of all ministerial travel. Information for 2006-07 will be published as soon as possible after the end of the financial year.
Valuation and Lands Agency: ICT
I have been asked to reply.
The current estimated fixed asset value of the database is £3,560,853.
Valuation Office Agency
A copy of the Valuation Office Agency’s documents (a) and (b) have been placed in the Library.
(2) pursuant to the answers of 26 January 2007, Official Report, column 2134W, and of 30 November 2006, Official Report, column 845W, on the Valuation Office Agency, what the (a) purpose and (b) destination in each country was of each foreign visit.
I refer the hon. member to the answer given on 26 January 2007, Official Report, column 2134W, which sets out the foreign trips made in 2006. These visits were undertaken when the VOA was invited to share their expertise in the field of property valuation, as speakers or delegates at international conferences or providing advice to overseas Government valuation agencies.
No Gateway Reviews are currently under way in relation to projects of the Valuation Office Agency. The last review undertaken for a project was in October 2005.
Valuation Office Agency: Travel
The Valuation Office Agency's travel; policy is set out in Section 7 of the Guide to Working in the Valuation Office Agency. The relevant section is enclosed:
All staff should normally use standard (or economy) class travel for:
all rail journeys
all air journeys of less than 90 minutes (each way)
all ferry (or equivalent) travel
However, you may travel first class if:
you are Band 2 or above, or
you have reserved rights to travel first class (and you have completed the appropriate declaration), and
the travel is for business) purposes (i.e. not for investitures, royal garden parties etc)
Nevertheless, even if you are entitled to first class travel, you should still use standard class) if you are undertaking a rail journey of short duration (i.e. of up to ground one hour for a single journey, or around two hours for a return journey). And you are also recommended to consider standard class for longer 'commuter type' travel, even when the journey time may exceed the durations mentioned above.
All staff may travel first class on an APEX ticket provided this is cheaper than the full standard class fare (and no standard class APEX tickets are available). Exceptionally, and subject to approval by your line manager before the journey takes place, you may also travel first class if:
you have special needs that require you to travel first class
there is a business need for you to travel with a colleague who may travel first class.
Valuation: Housing
District valuers are appointed by the Commissioners for Revenue and Customs under the Housing Act 1985 to deal with right to buy determinations and this is therefore known as statutory work. All statutory work is given equal priority. Deployment of district valuer staff on non-statutory work will reflect availability within normal fluctuations in demand.
Valuation: Lancashire
Within the time frame 1 September 2005 and 1 February 2006, the numbers of determinations made by the District Valuer under section 128 of the Housing Act 1985 in each district of Lancashire is a follows:
Number Burnley 7 Chorley 7 Fylde 0 Hyndburn 11 Lancaster 3 Pendle 7 Preston 10 Ribble Valley 1 Rossendale 7 South Ribble 3 West Lancashire 9 Wyre 0
The total number of determinations in Lancashire is 65, of which one was in Ribble Valley.
VAT: Fraud
(2) whether extra resources have been transferred to Missing Trader Intra-Community fraud investigations in order to complete the checks within the appointed time limits.
In response to the rapid increase in: Missing Trader Intra-Community Fraud activity in late 2005 and early 2006, HM Revenue and Customs are actively checking a greater number of claims. Each case of verification is treated on its own merits and, given the extremely complex and highly sophisticated nature of the fraud, involving numerous cross-border transactions within and beyond the European Union as well as checks into a wide range of matters involving companies, their directors, financing and, of course, transactions and associations with other parties, the time taken to reach a decision is that required to fully establish the veracity of the claim. The setting of arbitrary time limits to complete investigations would be counterproductive to establishing the correctness of the transaction chains involved. The UK courts have, to date, supported HMRC’s policy.
HMRC recognises the importance of VAT repayments to legitimate businesses and have deployed an additional 700 staff to ensure that verification of these claims can be; carried out as effectively and efficiently as possible. Also if at any time during the verification they identify that part or the entire claim is unconnected to MTIC fraud and is otherwise valid, they will make prompt repayment of the amount.
Treasury Ministers and officials receive representations, on numerous subjects from a wide range of organisations and individuals in the public and private sectors as part of the process of policy development and delivery. As was the case with previous Administrations, it is not the Government’s practice to provide details of all such representations.
Welfare Tax Credits: Overpayments
It is HMRC's policy to suspend the recovery of overpayments while a dispute is being considered.
Widowed People: Taxation
The child and working tax credits are part of the tax system and tax credit entitlement is therefore generally based on all income of a tax year which is taken into account for income tax purposes. This includes taxable social security benefits such as widowed parent's allowance. Income which is exempt from income tax is disregarded for tax credits. In particular, maintenance received from a former spouse is disregarded to help lone parents in these circumstances to find and keep work and to encourage the payment of maintenance by the former spouse.
However, the widowed parent's allowance, together with some other income, already benefits from a £300 annual disregard which reduces the amount of such income which is taken into account for tax credit purposes.
Working Tax Credit
The working tax credit provides financial support on top of earnings for households with low incomes, making sure that work pays. It was introduced to tackle poor work incentives and persistent poverty among working people, and to respond to family circumstances, targeting resources on those most in need.
The working tax credit recognises the difficulties that those with children face in combining work with family responsibilities and the difficulties that workers with a disability may face. Workers with neither children nor a disability, aged 25 or over, are entitled to the working tax credit provided they work at least 30 hours a week. Eligibility begins at this point because it is those aged 25 or over who are most likely to face poorer incentives to work or suffer persistent poverty in work.
Working Tax Credit: Dundee
(2) how many people in Dundee West (a) are eligible for and (b) claim the child tax credit;
(3) how many people in Dundee West claim the working tax credit.
I refer my hon. Friend to the answers given to the hon. Member for Stroud (Mr. Drew) on 29 March 2007, Official Report, column 1753W.