Written Answers to Questions
Thursday 26 July 2007
Defence
Aircraft Carriers
[holding answer 25 July 2007]: The Fleet relies on a layered defence approach to defeat an aerial attack. The backbone of the Fleet's ability to defend itself from air attack in the outer layer of maritime air defence will continue to be provided by destroyers. At present, this is achieved using the Type 42 Destroyers equipped with the medium range Sea Dart surface to air missile system. Type 45 Destroyers will gradually replace the Type 42 destroyers. These new ships will be armed with the Principal Anti Air Missile System, enhancing the Fleet's capability to counter the most sophisticated aircraft and anti-ship missiles in the world.
In the inner layer of Maritime Air Defence the Fleet's close range air defence capability will continue to be provided by Type 22 and Type 23 Frigates equipped with the Seawolf point defence missile system. Additional air defence capability will also come from a combination of close-in weapon (gun) systems, such as Goalkeeper and Phalanx, and decoys.
Airborne Early Warning Sea King helicopters will provide the long range detection of airborne contacts.
Ammunition
The Ministry of Defence has current research programmes relevant to enhanced blast munitions valued at approximately £10 million, spread over more than five years. These are to investigate the underlying science and are aimed at the assessment of the threat to UK armed forces, what protection is appropriate, and the advantage of incorporation of such technology into weapons.
The MOD has one programme which incorporates enhanced blast technology, the Anti-Structures Munition (ASM), as announced by my predecessor on 6 February 2006, Official Report, column 34WS, due to enter service at the end of 2009. It will enable infantry to defeat hardened structures such as buildings or bunkers, reducing casualties to our forces while minimising collateral damage. In the interim an off the shelf system has been procured until the ASM becomes available. There are currently no plans for future procurement of enhanced blast munitions.
Armed Forces: Desertion
The following table shows the number of Royal Navy personnel absent without leave in each month since January 2004 to June 2006.
2004 2005 2006 2007 January 13 23 19 12 February 14 28 14 10 March 18 16 19 9 April 11 16 12 5 May 12 22 14 6 June 23 20 13 15 July 12 15 5 — August 11 14 11 — September 17 4 13 — October 26 12 15 — November 20 18 13 — December 7 8 9 —
The following table shows absence without leave statistics by calendar year from January 2004:
Navy Army RAF 2004 185 3,030 55 2005 195 2,715 35 2006 155 2,330 10 2007 55 1,275 15 Notes: 1. Both the Navy and the Army record AWOL statistics by the number of incidences of AWOL rather than the number of people who have gone AWOL, so there may be a number people who are represented more than once in these figures. 2. Figures are rounded to the nearest five and are as at 23 July 2007. 3. Differences in figures for individual years compared to previous answers occur because personnel may have been wrongly reported as AWOL in the first instance, or conversely they may have subsequently been found to have been AWOL and the records rectified later.
Monthly breakdowns of the figures for the Army and the Royal Air Force could be provided only at disproportionate cost.
The numbers of personnel who have gone absent without leave from the services since 1 January 1997 and remain so are, as at 23 July 2007,
Navy: 30
Army: 1,175
RAF: 15
These figures are rounded to the nearest five. They are subject to daily changes as individuals return to their units.
There is no evidence to suggest that operational commitments or any other factors are causing a significant increase. There are a number of reasons why personnel may go AWOL but anecdotal evidence suggests that most incidents are caused by domestic circumstances, such as family problems, rather than any wish to avoid military service.
Armed Forces: Health Services
The generous offer by the Soldiers, Sailors, Airmen and Families Association Forces Help (SSAFA—Forces Help) to use this property in Ashtead to provide short-term accommodation for families visiting relatives who are being treated at the Defence Medical Rehabilitation Centre (DMRC), Headley Court is very welcome. DMRC staff have advised that the accommodation, with minor alterations to facilitate access, will be entirely suitable for the proposed purpose.
As I made clear on a recent visit to Headley Court, when I opened a new ward, I am most grateful for the Sailors, Soldiers, Airmen and Families Association (SSAFA) Forces Help’s offer to provide a property for the short-term accommodation of families visiting relatives being treated there.
Family visits are an integral part of the rehabilitation of injured service personnel being treated at the Defence Medical Rehabilitation Centre, Headley Court.
The staff at Headley Court welcome such visits. The unit meets appropriate travel and subsistence costs, including overnight accommodation if it is in the patient’s interests to have their family close by. In addition to local hotels, accommodation currently available to visiting families includes Pigeon House, a four-bedroom house in the Headley Court grounds, and Dale View, a converted three-bedroom service married quarter.
Armed Forces: Human Rights
The trial in question lasted some six months and the transcript comprises approximately 15,000 pages. Evidence concerning advice on the application of the Human Rights Act and the European Convention on Human Rights was given on 8 December 2006. An electronic version of the complete trial transcript of open court sessions, including that day's evidence, will be made available in the Library of the House.
Armed Forces: Mental Health Services
The requirements for uniformed consultant psychiatrists and mental health nurses on 1 April 2006 and 1 April 2007 are shown as follows:
Service consultant psychiatrists Service mental health nurses 2006 26 113 2007 28 123 Source: DMSD quarterly manning return 1 April 2006/March 2007 PPSG.
As stated in my answer of 7 March 2007, Official Report, columns 1985-88W, the armed forces no longer employ uniformed psychologists and mental health occupational therapists, but the MOD does employ civilian clinical psychologists, psychiatrists and mental health nurses. The required numbers for these grades are not held centrally. I will write to the hon. Member with these figures once they have been collated and place a copy of my letter in the Library of the House.
Armed Forces: Temporary Accommodation
The Housing Prime Contract was awarded to MoDern Housing Solutions on 14 November 2005 and was rolled out in January 2006. The number of families placed in Premier Travel Inns and other hotels since 1 January 2006 is as follows:
Premier Travel inns Other hotels 2006 9 46 Up to 30 June 2007 7 23
Hotels are provided where service families need to be away, for a short period, from their SFA while repairs are carried out.
Army: Travel
In 2006, the Army Board spent £463,010 on travel in total. Of this total, the Adjutant-General spent £3,783 and the Chief of General Staff spent £78,814.
These figures include accommodation costs for ministerial members of the Army Board, which cannot be separated from travel costs. Totals also contain travel costs incurred by the relevant Army Board Member and their supporting staff, where appropriate, but excludes spouses. Costs relating to military flights and use of official staff cars have not been included.
Atomic Weapons Establishment: Sales
As indicated by my right hon. Friend the Secretary of State for Business, Enterprise and Regulatory Reform in his written statement to the House on 16 July 2007, Official Report, column 1WS, as part of the process of the sale of British Nuclear Group's share in AWE Management Ltd (AWEML), the Government will be seeking to ensure the enduring performance of AWEML in continuing to meet the requirements of its customer, the Ministry of Defence.
Such performance covers all aspects of work at the Atomic Weapons Establishment, with particular emphasis on the protection of national security and warhead design information, which are paramount considerations. We shall be applying a strict set of criteria in order to establish the acceptability of prospective purchasers before finalising an agreed shortlist of potential bidders. All factors will be taken into account in our analysis.
Bombs
The cluster munitions of humanitarian concern are those fired in the indirect role, whereas certain sub-munition variants are direct fire weapon systems. In the direct fire role the firing crew has line of sight from the platform to the target and has a sophisticated target identification and acquisition system to aid discrimination. In seeking the balance between humanitarian concern and military necessity the UK’s definition of cluster munitions therefore excludes direct fire systems.
Departments: Legislation
The Ministry of Defence has introduced only one Bill (which became the Armed Forces Act 2006) in the last five years that contains a time limit which may be regarded as a sunset clause. The clause continues the previous practice of making the main legislation governing the armed forces subject to a requirement for annual renewal by Order in Council approved by Parliament and for renewal by Act of Parliament every five years. This accords with the procedure which Parliament has adopted for this legislation in the past.
The Department has been responsible for the introduction of two Bills in the last five years which became:
The Armed Forces Pay and Compensation Act 2004
The Armed Forces Act 2006
The 2004 Act does not contain a sunset clause.
The 2006 Act contains a time limit which may be regarded as a form of sunset clause. The clause continues the previous practice of making the main legislation governing the armed forces subject to a requirement for annual renewal by Order in Council approved by Parliament and for renewal by Act of Parliament every five years.
Departments: Recruitment
The information requested on how much the Department paid in fees to recruitment agencies for temporary workers and permanent staff in each year since 1997 is not held centrally. It could be provided only at disproportionate cost.
Departments: Sales
The total accrued disposal receipts for each year since 1997 are published in the Defence Estates annual reports and accounts, copies of which are available in the Library of the House.
Departments: Written Questions
Yes. I have placed a copy of the Department’s guidance on answering written parliamentary questions in the Library of the House.
Ex-servicemen: Mental Health Services
A process and outcome evaluation of the pilots over their two-year duration is an integral part of the project. The key measures, advised on by national clinical experts, will be the assessment and treatment regimes provided, and the patient (and carer) experience and outcomes.
The costs of running the pilot scheme are not yet available as negotiations for the funding of individual sites are still continuing between the MOD, the Department of Health and NHS trusts. The cost of rolling out the scheme nationwide will depend on the outcomes of the pilots.
The proposed service is advised on by clinical and health care experts and reflects the long established intention that veterans’ health care is primarily a matter for the NHS. Using NHS best practice and processes, veterans-sensitive evidence-based interventions will be delivered by public, private or charitable providers. These will be modified as necessary in the light of the pilot evaluation.
In addition, we have recently announced the expansion of our Medical Assessment Programme (MAP) based at St Thomas’ Hospital, London, to include assessment of veterans with mental health symptoms with operational service from 1982 (including veterans of the Falklands campaign). The clinician in charge is a recently retired service military psychiatrist, who will provide support and advice to GPs and other civilian health professionals where the individual is concerned that the service background of their condition may not have been understood within the NHS or where the health professional is seeking expertise on the assessment or treatment of a veteran’s condition.
Iraq-Kuwait Conflict: Gulf War Syndrome
It has been the Government’s policy since 1997 to be open and transparent about Gulf veterans issues, including the publication of all relevant documents. We have identified and published the lessons of the past, accepting that mistakes were made in 1990-91, particularly with regard to medical record keeping. The Government’s view is that there are no substantive issues to be addressed by a public inquiry and that, in particular, it would not help to resolve the long outstanding issue of why veterans are ill; only scientific research might do this. We have funded a substantial programme of research designed to address the key candidate causes so far put forward, but recognising that it would not be sensible to duplicate work being undertaken elsewhere.
Military Bases: Germany
Service families accommodation (SFA) and single living accommodation (SLA) in Germany is assessed by grade for charge (rather than Standard for Condition which is used in Great Britain).
On that basis, the total number of SFA and SLA by grade is as follows:
SFA SLA Grade 1 2,101 1,658 Grade 2 5,376 1,354 Grade 3 4,743 3,475 Grade 4 982 9,782 Total 13,202 16,269
Grade for charge is broken down on amenities and location. Grade for charge 1 would be accommodation that is close to all amenities. Grade 4 would be properties further away. This differs from standard for conditions, which relates to the physical condition of the property.
Navy: Drug Seizures
The physical seizure of cocaine on Royal Navy interdiction operations is conducted by personnel from relevant local law enforcement agencies embarked on Royal Naval vessels. Once retrieved, the cocaine becomes the responsibility of the relevant law enforcement agency.
Navy: Warships
[holding answer 25 July 2007]: As at 19 July 2007, the following vessels were deployed:
Destroyers:
HMS Manchester
HMS Edinburgh
HMS Southampton
HMS York
Frigates:
HMS Cornwall
HMS Kent
HMS Monmouth
HMS Portland
HMS Richmond
HMS Montrose
Attack Submarines:
The general policy is that we do not discuss submarine operations. Fleet Attack Submarines (SSN) are on patrols in various locations.
As my predecessor made clear in his letter of 6 March 2007, a copy of which is available in the Library of the House, it is not MOD policy to publish details of the readiness states of individual RN vessels or types. I am not prepared, therefore, to provide details of vessels available for short-notice deployments.
[holding answer 25 July 2007]: The Royal Navy is conducting trials and experimentation programmes to help determine optimal manning solutions, both in the short and mid to longer term, that will maximise the contribution to defence by enabling ships to remain deployed for extended periods, while minimising the impact on personnel. These programmes include swapping ship’s companies of HMS Edinburgh and HMS Exeter (Type 42 destroyers), and several Mine Counter Measure Vessels; and providing temporary relief for some personnel on the extended deployment of HMS Sutherland and HMS Monmouth (Type 23 frigates). The trials are continuing.
Peacekeeping Operations
The information requested is shown in the following table.
RAF Brize Norton RAF Lyneham 2003 53 0 2004 38 0 2005 16 14 2006 64 0 2007 (as at 20 July) 15 36 Total 186 50
In the process of answering this question, it has become apparent that some of the figures provided in response to the hon. Member’s parliamentary question of 26 March 2007, Official Report, column 1359W, were incorrect.
Unfortunately there were errors in the source documentation for the 2004, 2005 and 2007 figures for repatriations held by Headquarters Air Command. A figure for 2005 was inadvertently reflected in 2004. Also, the figures for 2006 did not include the 14 personnel who were killed in the Nimrod XV230 crash in September 2006. This was because the repatriation ceremony for these personnel was held at RAF Kinloss, but because their bodies were repatriated through, and returned to, RAF Brize Norton, with hindsight it is clear that they should have been included.
RAF Personnel Management Agency: Finance
The RAF Personnel Management Agency relinquished Government agency status at the start of financial year 2004-05. Therefore budgetary information for that agency is only available up to the financial year 2003-04.
The resource outturn for financial years 1997-98 to 2003-04 can be found in the RAF Personnel Management Agency annual report and accounts, which are available in the Library of the House.
The figures for initial resource provision and in-year variations are not held.
Territorial Army: Recruitment
(2) pursuant to the answer of 19 June 2007, Official Report, column 1769W, on reserve forces: recruitment, which Territorial Army units have a recruitment freeze; and what the (a) establishment and (b) current manning level is of each, broken down by (i) rank and (ii) appointment.
It is not possible to provide the information requested, as the details of measures limiting the strength of selected Territorial Army units have not yet been finalised. However, I can assure the hon. Member that a rigorous process involving a wide range of army stakeholders is currently assessing the likely impact of these measures and ensuring that coherence and effectiveness are maintained. I will write to the hon. Member with the results of that process once it is complete and will place a copy of my letter in the Library of the House.
Trident
In accordance with the usual practice on major procurement projects, the first full progress report on the programme to maintain the UK’s nuclear deterrent will be made after the Initial Gate for the new class of submarines, currently estimated to be in 2009. Interim reports will be provided depending on progress with the programme.
Type 45 Destroyers
[holding answer 25 July 2007]: No decision has yet been made to order the seventh and eighth Type 45 destroyers. A number of factors will be taken into account as part of the decision-making process, including affordability, value for money, and the wider context of the defence industrial strategy.
Unmanned Air Vehicles: Costs
The acquisition costs for the Watchkeeper system are expected to be around £840 million. The planned in-service date is 2011.
Innovation, Universities and Skills
Scientific Research
Public investment in R and D in 2005 was £7.4 billion. It has grown by almost 30 per cent. in real terms since 1997. The CSR07 period will see the science budget continue to rise above inflation.
Adult Education
I refer the hon. Member to the reply I gave the hon. Member for South-West Norfolk (Mr. Fraser).
Apprenticeships
In the 1996-97 academic year 70,100 apprentices started. Information on framework completions was not collected at that time. In the 2005-06 academic year, 171,300 apprentices started and 99,000 completed the full framework.
The continuing expansion of apprenticeships provision, for both young people and adults, is a priority for the Government. Currently around one third of apprentices are aged 19 to 24, and evidence from recent trials of 25+ apprenticeships suggests that they can be a useful method of learning for some people. Therefore the Learning and Skills Council (LSC) is making available £16.7 million in 2007-08 to fund 8,000 additional places for this age group.
The Government will naturally encourage and support employers, LSC and sector skills councils (SSCs) in their normal promotion practices to recruit adult apprentices to fill the 8,000 places.
The Government are also supporting the LSC in its new skills campaign ‘Our future. It’s in our hands’ launched on 9 July. This campaign is aimed at improving the skills of the nation and will include the promotion of adult apprenticeships.
Science and Innovation
The Government published their third annual report on the Science and Innovation Investment Framework on Monday (23 July). The report shows that over the last year there has been continued, good progress in implementing the Government’s challenging vision for science and innovation.
Apprentices: Cumbria
Figures for those participating in apprenticeships can be derived from the Learning and Skills Council’s (LSC) Individualised Learner Record (ILR). There were 440 learners on apprenticeships and 250 on advanced apprenticeships in the Westmorland and Lonsdale parliamentary constituency (based on home post code of the learner) in 2005/06. Comparable figures for 2006/07 will not be available until December 2007.
Source:
Learning and Skills Council (LSC) Work Based Learning (WBL) Individualised Learner Record (ILR).
Numbers have been rounded to the nearest 10.
Basic Skills: Training
More than 150 leading private and public sector employers from across England made the Skills Pledge at its launch on 14 June. This means that over 1.7 million employees are covered by a Skills Pledge. Since 14 June an additional 146 companies have expressed an interest in the Skills Pledge through the Train to Gain website and helpline. Brokers are currently working with these employers to take their commitment forward.
Unemployment: York
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 26 July 2007:
As National Statistician, I have been asked to reply to your Parliamentary Question asking what percentage of 16 to 19 year olds in York were registered as unemployed in January 2007. (151627)
The Office for National Statistics (ONS) compiles unemployment statistics for parliamentary constituencies from the Annual Population Survey (APS) following ILO definitions.
For the 12 months ending in December 2006, the latest available data, there were 1,000 persons aged 16 to 19, resident in the City of York constituency, who were unemployed. This estimate is 16 per cent of the resident population aged 16 to 19. The unemployment rate, which is the number of unemployed expressed as a percentage of the economically active population, in that age group, was 25 per cent.
As these estimates are for a subset of the population in small geographical areas, they are based on small sample sizes, and are therefore subject to large margins of uncertainty.
ONS also compiles statistics for local areas of people claiming Jobseeker’s Allowance (JSA). For January 2007, there were 200 persons aged 16 to 19, resident in the City of York constituency, claiming JSA. The corresponding figure for the latest available month, June 2007, is 180.
Thousand Men Women Total 12 months ending Level1 Rate2 (percentage) Level1 Rate2 (percentage) Level1 Rate2 (percentage) February 1997 22 71 22 65 44 68 February 1998 24 74 21 63 45 69 February 1999 28 81 20 65 48 73 February 2000 25 81 20 72 45 77 February 2001 27 81 24 76 51 79 February 2002 28 81 24 72 51 77 February 2003 29 83 25 72 54 77 February 2004 28 80 25 73 53 77 March 2005 29 80 26 71 55 75 March 2006 27 79 25 73 52 76 1 Persons aged 16 and over. 2 Persons of working age—males aged 16 to 64 and females aged 16 to 59. Note: Estimates are subject to sampling variability. Changes in the estimates over time should be treated with particular caution. Source: Annual local area Labour Force Survey; Annual Population Survey
Thousand Men Women Total 12 months ending Level1 Rate2 (percentage) Level1 Rate2 (percentage) Level1 Rate2 (percentage) February 1997 43 79 39 71 82 75 February 1998 43 79 34 65 77 72 February 1999 45 82 38 71 83 76 February 2000 44 81 39 71 83 76 February 2001 49 84 44 78 93 81 February 2002 49 84 43 75 93 80 February 2003 50 84 43 74 93 79 February 2004 48 82 43 77 92 79 March 2005 49 82 43 76 92 79 March 2006 48 81 45 76 93 79 1 Persons aged 16 and over. 2 Persons of working age—males aged 16 to 64 and females aged 16 to 59. Note: Estimates are subject to sampling variability. Changes in the estimates over time should be treated with particular caution. Source: Annual local area Labour Force Survey; Annual Population Survey
Thousand Men Women Total 12 months ending Level1 Rate2 (percentage) Level1 Rate2 (percentage) Level1 Rate2 (percentage) February 1997 1,163 74 988 66 2,151 70 February 1998 1,178 76 993 66 2,170 71 February 1999 1,202 77 1,010 68 2,212 73 February 2000 1,197 77 1,014 68 2,211 73 February 2001 1,208 78 1,051 70 2,259 74 February 2002 1,221 78 1,044 69 2,265 73 February 2003 1,233 78 1,047 68 2,280 73 February 2004 1,248 78 1,064 69 2,312 74 March 2005 1,252 79 1,068 69 2,320 74 March 2006 1,251 78 1,072 69 2,322 74 1 Persons aged 16 and over. 2 Persons of working age—males aged 16 to 64 and females aged 16 to 59. Note: Estimates are subject to sampling variability. Changes in the estimates over time should be treated with particular caution. Source: Annual local area Labour Force Survey; Annual Population Survey
Young People: Training
Around a third of the current total of 250,000 apprenticeships are being delivered in the public sector. We want to expand apprenticeships to meet Lord Leitch’s ambition for 500,000 apprentices in learning in the UK (400,000 in England) by 2020. I will be speaking to my ministerial colleagues about this over the coming weeks.
Prime Minister
Parliamentary Questions
I have been asked to reply.
All Ministers aim to answer all parliamentary questions as soon as possible.
Wales
Administration of Justice
Departments: Official Hospitality
The following is a breakdown of the number of receptions hosted year on year in Gwydyr House.
Receptions 2003 3 2004 3 2005 6 2006 5 2007 4
Departments: Stationery
Stationery is supplied under a general office supplies contract, and its cost within the total is not identified separately.
National Assembly for Wales (Legislative Competence) Order 2007
The proposed draft order was placed in the Vote Office and Library of the House today, 26 July 2007. Copies can also be downloaded via the Wales Office website.
House of Commons Commission
Official Report: Paper
Copies of the daily part of the Official Report are not distributed to all right hon. and hon. Members' offices, but 252 copies are distributed to the offices or other addresses of Members who have specifically requested such a distribution by completing a sessional demand form.
In all an average of 1,758 copies of the Official Report are produced daily. The total amount of paper, including run-up, waste and trimmings, used in the production of the daily part of the Official Report during a typical sitting week of four sitting days is approximately 3 tonnes. The 252 copies distributed on request to the Members' offices equate to an amount of paper of just under 450 kg.
Business, Enterprise and Regulatory Reform
Coal: Sulphur
Information about the typical sulphur content of UK coal reserves is readily available in a range of technical publications. In addition, integrated pollution prevention and control regulations require regular sampling and analysis of the sulphur content of coal being used in processes within their scope, such as electricity generation, with the amalgamated reported data being published by the Environment Agency. This is in addition to any sampling carried out by UK producers and their customers to ensure that shipments comply with contract terms.
Electricity: Energy Supply
Electrical inspectors in my Department receive reports of significant interruptions to electricity supply and investigate incidents if the circumstances are warranted. For example inspectors looked into the interruptions at Hurst, London, in October 2006 (National Grid—transformer failure); Carnaby Street, London, in July 2006 (EDF—transformer and underground cable failure); in southern Scotland in March 2006 (storm impact); at Bournemouth in November 2005 (Southern Electricity—fire affecting overhead power line); at Carlisle in January 2005 (United Utilities—substation flooded); and at Birmingham in February 2004 (Aquila now Central Networks—fire in cable tunnel).
Inspectors also look into circumstances of specific localised power failures affecting individual customers, if problems remain unresolved.
My officials also liaise closely with electricity companies on an ongoing basis to ensure arrangements are in place to handle large-scale emergency situations.
My Department maintains records of significant interruptions to electricity supply in GB.
These are reported to the Department in accordance with regulation 32 of the Electricity Safety, Quality and Continuity Regulations 2002 as amended. Electricity transmission and distribution companies are required to report incidents affecting 20 MW of demand or more for more than three minutes, or 5 MW of demand or more for more than one hour, or 5,000 customers or more for more than one hour.
Electricity: Meters
My Department has had and will continue to have further discussion on its proposals for smart meters with a range of interested parties, including energy suppliers, metering manufacturers and environmental stakeholders. The Government have also indicated that they will consult on the implementation of proposals in the context of their ambition to see a roll-out of smart meters within 10 years.
Electronic Equipment: Waste Disposal
The WEEE regulations place a number of obligations on producers and retailers of Electrical and Electronic Equipment (EEE) to provide information to consumers as to how best they can dispose of their WEEE to help protect the environment. From 1 July consumers are receiving information from retailers when they buy a new item of electrical equipment on how they can do this.
A number of trade associations have been helping to raise awareness among their members. The Department has organised roadshows, seminars and mailouts as well as press and publicity in national, regional and trade publications. Further briefing events will be taking place in September across the UK for small businesses.
Energy Development Unit
(2) what the total value is of gifts and hospitality received by the Energy Development Unit from energy companies in each year since 1997.
All civil servants in the Department are required to follow the Department's guidance on the acceptance of hospitality and gifts, set out in the staff handbook.
The guidance recognises that, in the business world, hospitality is a common and well established means of maintaining working relationships and conducting business and that, in these circumstances, civil servants may accept it when the issues of propriety and possible conflicts of interest have been properly considered.
Under this guidance, a gifts and hospitality register was established in 1998, on which is registered all gifts over £10 in value and all material hospitality accepted.
The register was not set up to record the estimated value of gifts or hospitality until 2001 and the guidance does not require estimates to be entered when they may not be known or meaningful, for instance in the case of lunches or dinners. The following table shows the total of the values recorded between 2001 and 22 July 2007, and the percentage of entries where no value was given.
Year Value recorded (£) Percentage that were not given a value 2001 2,242 74 2002 1,741 65 2003 612 71 2004 1,442 51 2005 1,313 54 2006 3,403 32 20071 1,626 38 1 To 22 July
Export Controls
As the hon. Member is aware, I announced on 18 June 2007 a review of the export control legislation introduced in 2004 under the Export Control Act 2002. This includes a public consultation which seeks comments on the impact and effectiveness of the legislation and whether there is a need to change or enhance the controls.
In these circumstances I am unable to comment substantively on the potential for changes to the controls as this would risk prejudging the outcome of the review. However, the consultation document includes options for amending the Military End-Use Control, which currently applies in specified circumstances to components that are not controlled elsewhere in the legislation.
Where items that are being exported are licensable under current UK export control legislation, all known relevant factors, including whether the items are for incorporation into other equipment for re-export to a third country, are taken into account in the assessment of licence applications. When it is clear that military goods will be re-exported or that the equipment into which they are incorporated will be re-exported to a country covered by a full scope military arms embargo, the application for those items will be refused under the Consolidated EU and National Arms Export Licensing Criteria.
Respondents to the consultation will be able to provide their views, reasoning and evidence on this issue, as well as raising any other areas where they believe that the Government should consider changing the controls.
Housing: South East Region
Following the South East England regional assembly’s adoption of housing growth options in October 2004, SEEDA commissioned work to explore the needs of the region’s economy. This established that maintaining present economic growth rates would require up to 45,000 new houses per annum, and that improvements in productivity and economic activity rates could reduce this requirement to 34,800 new houses per year while maintaining overall growth rates.
On the basis of this work (which was published by SEEDA), SEEDA’s board agreed in March 2005 a response to the Regional Spatial Strategy consultation draft (published in April 2005) which made the case for a minimum average level of housing growth of 34,800 units per year 2006-26. The regional assembly adopted a proposed profile of 32,000 units per annum for 2006-11 and 36,000 units per annum for 2011-26.
Once the draft RSS was published in April 2006, SEEDA’s board reconsidered the evidence at its June 2006 meeting and reaffirmed its support for the housing growth levels given above.
On this basis, SEEDA submitted written objections to the draft RSS which were considered by the Panel of Inspectors at the Examination in Public (October 2006-March 2007).
Manufacturing Industries: Balance of Trade
The Office for National Statistics estimates that the UK trade deficit in manufactures (Standard International Trade Classification sections 5 to 8) was about £51.9 billion in 2006 on a balance of payments basis.
The Government are strongly committed to the development of a high-value modern manufacturing sector which competes effectively in global markets. We have been successful in providing a stable macro-economic framework in which business can prosper and grow and are taking action through the manufacturing strategy to enable manufacturers to move to high value-added production through the application of science and innovation and the development of world class skills.
Nuclear Power Stations
Before we make a decision on nuclear, we are committed to consulting. Our nuclear consultation was published on 23 May. The Government have a preliminary view that it would be in the public interest to give energy companies the option to consider nuclear alongside other forms of low carbon electricity generation, but have not made a decision.
The Government will consider all responses as part of the consultation and will make a decision later this year after, and in the light of, the consultation.
Renewables Obligation
Between 2002-03, when the RO was introduced, and 2005-06—the latest date for which figures are available from Ofgem—the RO was responsible for 37.9 TWh of generation from renewable sources. This amounts to a saving of 5.2 MtC.
Work by Oxera, published alongside the consultation on banding the RO on 23 May 2007, suggests that unchanged, the RO is estimated to save 90.6 MtC over its lifetime (until 2026-27).
Renewables generation assets, such as wind farms, which have been built to take advantage of the RO will continue in operation after the RO has come to an end, providing further savings beyond 2026-27.
Severn Barrage
[holding answer 24 July 2007]: There is no specific proposal at present to build a Severn barrage, so I have not had any discussions with the Royal Society for the Protection of Birds (RSPB) or any of the wildlife trusts on this issue.
However, the Sustainable Development Commission, with financial support from various parties including my Department, is undertaking a major study of tidal power in the UK. The study is looking at various options for harnessing the potential tidal energy resource that exists around the UK, including within the Severn estuary.
The study has included a programme of stakeholder and public engagement, as part of which the SDC has held discussions with the RSPB and the statutory conservation agencies. The SDC's final report is expected to be published in September and further details of the study can be seen at
www.sd-commission.org.uk/pages/tidal.html.
[holding answer 24 July 2007]: A central part of the Sustainable Development Commission's (SDC) work has been a public and stakeholder engagement programme. Although not aimed exclusively at Members for the Severn region constituencies, a stakeholder workshop held in Cardiff and an online forum on the SDC website have provided Members with the opportunity to contribute to the study.
Given that the study is now at an advanced stage and with the final report expected in September, I am doubtful about whether the SDC would find it reasonably practicable to accommodate such a request. However, Members are free to directly approach the SDC, with which any decision on whether or not to accept further representations rests.
It is worth pointing out that were any specific development proposal taken forward, significant public consultation would be required.
Shipping
I have been asked to reply.
Government reports and statistics monitor changes in the UK merchant navy and the effect of these changes on the UK economy on a regular basis. The Department for Transport’s (DfT) annual “Maritime Statistics” records the size of the UK merchant fleet.
In recent years, the UK registered fleet has not been diminishing, as the hon. Member suggests. Between December 1997 and March 2007 the number of UK registered ships increased by over a quarter to over 1,900 (of which 1,459 are merchant vessels), while their deadweight capacity increased fourfold from 3.5 million tonnes to 14 million tonnes.
The DfT has commissioned London Metropolitan University to produce an annual assessment of the number of UK merchant navy officers, ratings, and new trainees, published in “United Kingdom Seafarers Analysis”. The DfT has also commissioned two studies from Cardiff University in 1996 and 2003 on “The UK economy’s requirements for people with experience of working at sea”. In addition the Inland Revenue and the DfT produced a “Post Implementation Review of Tonnage Tax” in 2004.
Health
Abortion
The information requested is set out in the following table.
Total previous pregnancies that resulted in a live or still birth Age2 0 1 2 3 4 5 and more Total under 18 533 — — — — — 554 18 to 19 549 — — — — — 636 20 to 24 931 300 140 — — — 1,427 25 to 29 448 266 241 86 — — 1,072 30 to 34 172 190 247 114 — — 781 35 to 39 121 117 265 112 — — 686 40 and over 34 45 116 66 — — 283 Total all ages 2,788 1,009 1,025 424 133 60 5,439 1 Totals shown relate to PCTs for Mid Essex, North East Essex, South East Essex, South West Essex and West Essex. 2 Age groups are shown as published so as not to overlap ages and (for reasons of confidentiality) reveal small numbers, suppressed value or where a presented total would reveal a suppressed value.
Total previous pregnancies that resulted in a live or still birth Age1 0 1 2 3 4 5 and more Total under 16 3,960 — — — — — 3,990 16 and 17 13,721 — — — — — 14,629 18 and 19 18,625 3,448 533 — — — 22,667 20 to 24 35,293 12,751 5,600 1,360 274 62 55,340 25 to 29 18,735 9,341 7,828 3,244 928 320 40,396 30 to 34 7,981 6,491 8,020 3,670 1,323 668 28,153 35 to 39 3,682 3,903 6,877 3,481 1,341 790 20,074 40 and over 1,174 1,504 3,066 1,693 630 421 8,488 Total all ages 103,171 38,295 31,985 13,495 4,517 2,274 193,737 1 Age groups are shown as published so as not to overlap ages and (for reasons of confidentiality) reveal small numbers, suppressed value or where a presented total would reveal a suppressed value.
The information requested is set out in the following tables.
Gestation Age 3 & 4 5 6 7 8 9 10 11 12 13 14 u20 124 1,118 4,085 6,411 7,860 5,601 4,888 3,127 2,344 1,271 1,050 20-24 254 2,156 6,715 9,659 10,351 7,337 6,138 3,763 2,770 1,502 1,157 25-29 270 2,120 5,872 7,915 7,457 5,014 3,976 2,365 1,707 935 620 30-34 199 1,536 4,424 5,536 5,039 3,420 2,671 1,637 1,160 654 408 35+ 205 1,670 4,632 5,753 5,088 3,220 2,578 1,499 1,208 763 456 Total 1,052 8,600 25,728 35,274 35,795 24,592 20,251 12,391 9,189 5,125 3,691
Age 15 16 17 18 19 20 21 22 23 24+ Total u20 810 553 483 375 357 262 213 175 168 11 41,286 20-24 891 619 516 386 324 280 207 172 121 22 55,340 25-29 513 352 311 250 180 176 125 112 98 28 40,396 30-34 369 222 194 165 104 117 113 76 66 43 28,153 35+ 341 256 203 181 146 97 96 81 57 32 28,562 Total 2,924 2,002 1,707 1,357 1,111 932 754 616 510 136 193,737 Note: Totals are grouped where there are less than 10 (0 to 9) cases, or where a presented value would reveal a total less than 10 (0 to 9) when used with data already published.
Gestation Country of residence 3 & 4 5 6 7 8 9 10 11 12 13 14 England and Wales 1,052 8,600 25,728 35,274 35,795 24,592 20,251 12,391 9,189 5,125 3,691 Scotland — — 43 57 48 19 16 — — — — Republic of Ireland — — 482 1,015 968 735 438 353 246 171 91 Other non England and Wales residents — — 186 333 348 238 182 119 86 54 68
Country of residence 15 16 17 18 19 20 21 22 23 24+ Total England and Wales 2,924 2,002 1,707 1,357 1,111 932 754 616 510 136 193,737 Scotland — — — 11 20 27 20 31 — — 362 Republic of Ireland 94 71 77 56 28 37 25 15 — — 5,042 Other non England and Wales residents 57 59 55 45 35 28 25 20 — — 2,032 Note: Totals are grouped where there are less than 10 (0 to 9) cases, or where a presented value would reveal a total less than 10 (0 to 9) when used with data already published.
Gestation Grounds 9 and under 10 11 12 13 14 15 16 17 Section 1(1 )(a) and other1 131,020 20,240 12,333 8,964 4,823 3,515 2,819 1,889 1,589 Section 1(1 )(d) 21 11 58 225 302 176 105 113 118 Total 131,041 20,251 12,391 9,189 5,125 3,691 2,924 2,002 1,707
Grounds 18 19 20 21 22 23 24+ Total Section 1(1 )(a) and other1 1,242 1,021 787 573 485 398 0 191,698 Section 1(1 )(d) 115 90 145 181 131 112 1136 2,039 Total 1,357 1,111 932 754 616 510 136 193,737 1 Abortions 24 weeks and over and carried out under sections 1(1)(b), 1(1)(c) and 1(4) of the Abortion Act are included in total 136. Note: Totals are grouped where there are less than 10 (0 to 9) cases, or where a presented value would reveal a total less than 10 (0 to 9) when used with data already published.
More detail for grounds by gestation group can be found in Table 7b of Abortion Statistics, England and Wales, 2006
Section 1(1)(a): that the pregnancy has not exceeded its twenty-fourth week and that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family.
Section 1(1)(b): that the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman.
Section 1(1)(c ): that the continuance of the pregnancy would involve risk to the life of the pregnant woman, greater than if the pregnancy were terminated.
Section 1 (1)(d): that there is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped
Section 1(4): that the termination is immediately necessary to save the life or to prevent grave permanent injury to the physical or mental health of the pregnant woman.
Gestation Marital status 3 & 4 5 6 7 8 9 10 11 12 13 14 Single 614 4,793 14,752 21,967 24,110 16,997 14,141 8,663 6,505 3,459 2,645 Married 126 1,322 3,638 5,301 4,854 3,138 2,407 1,424 1,112 754 408 Divorced, separated, widowed 39 295 782 1,025 1,003 657 551 298 236 140 102 Not known/not stated 273 2,190 6,556 6,981 5,828 3,800 3,152 2,006 1,336 772 536 Total 1,052 8,600 25,728 35,274 35,795 24,592 20,251 12,391 9,189 5,125 3,691
Marital status 15 16 17 18 19 20 21 22 23 24+ Total Single 1,931 1,355 1,127 924 750 625 504 397 349 49 126,657 Married 300 231 225 177 150 154 147 117 99 66 26,150 Divorced, separated, widowed 87 52 35 34 23 14 — 11 — — 5,403 Not known/not stated 606 364 320 222 188 139 — 91 — — 35,527 Total 2,924 2,002 1,707 1,357 1,111 932 754 616 510 136 193,737 Note: Totals are grouped where there are less than 10 (0 to 9) cases, or where a presented value would reveal a total less than 10 (0 to 9) when used with data already published.
Gestation Number of previous live or stillbirths over 24 weeks 3 & 4 5 6 7 8 9 10 11 12 13 14 0 630 4,697 13,815 18,880 19,204 13,029 10,428 6,443 4,766 2,699 1,921 1 192 1,495 4,795 6,579 6,964 4,924 4,239 2,567 1,962 1,130 833 2 162 1,549 4,571 6,128 5,989 4,071 3,295 1,960 1,415 736 556 3 or more 68 859 2,547 3,687 3,638 2,568 2,289 1,421 1,046 560 381 Total 1,052 8,600 25,728 35,274 35,795 24,592 20,251 12,391 9,189 5,125 3,691
Number of previous live or stillbirths over 24 weeks 15 16 17 18 19 20 21 22 23 24+ Total 0 1,555 1,060 915 730 641 550 445 386 313 64 103,171 1 671 431 362 298 239 186 164 122 103 39 38,295 2 390 307 232 169 118 113 89 64 52 19 31,985 3 or more 308 204 198 160 113 83 56 44 42 14 20,286 Total 2,924 2,002 1,707 1,357 1,111 932 754 616 510 136 193,737 Note: Totals are grouped where there are less than 10 (0 to 9) cases, or where a presented value would reveal a total less than 10 (0 to 9) when used with data already published.
Gestation Number of previous abortions 3 & 4 5 6 7 8 9 10 11 12 13 14 0 711 5,771 17,303 23,597 24,646 16,696 13,945 8,380 6,210 3,514 2,542 1 278 2,159 6,432 8,925 8,463 5,966 4,772 3,007 2,307 1,257 883 2 or more 63 670 1,993 2,752 2,686 1,930 1,534 1,004 672 354 266 Total 1,052 8,600 25,728 35,274 35,795 24,592 20,251 12,391 9,189 5,125 3,691
Number of previous abortions 15 16 17 18 19 20 21 22 23 24+ Total 0 1,995 1,365 1,193 961 788 657 586 471 379 123 131,833 1 709 473 396 305 252 220 124 117 — — 47,156 2 or more 220 164 118 91 71 55 44 28 — — 14,748 Total 2,924 2,002 1,707 1,357 1,111 932 754 616 510 136 193,737 Note: Totals are grouped where there are less than 10 (0 to 9) cases, or where a presented value would reveal a total less than 10 (0 to 9) when used with data already published.
Purchaser NHS NHS Agency Private Total Gestation Number Percentage Number Percentage Number Percentage Number Percentage 3 & 4 73 7 440 42 539 51 1,052 100 5 1,285 15 4,193 49 3,122 36 8,600 100 6 6,194 24 12,759 50 6,775 26 25,728 100 7 10,153 29 18,715 53 6,406 18 35,274 100 8 16,173 45 16,124 45 3,498 10 35,795 100 9 12,493 51 10,394 42 1,705 7 24,592 100 10 11,535 57 7,625 38 1,091 5 20,251 100 11 6,722 54 4,999 40 670 5 12,391 100 12 4,425 48 4,214 46 550 6 9,189 100 13 2,004 39 2,786 54 335 7 5,125 100 14 1,246 34 2,273 62 172 5 3,691 100 15 786 27 1,897 65 241 8 2,924 100 16 569 28 1,264 63 169 8 2,002 100 17 409 24 1,160 68 138 8 1,707 100 18 276 20 953 70 128 9 1,357 100 19 17 16 837 75 99 9 1,111 100 20 182 20 660 71 90 0 932 100 21 212 28 490 65 52 7 754 100 22 152 25 383 62 81 3 616 100 23 128 25 328 64 54 11 510 100 24+ 136 100 0 0 136 100 Total 75,328 39 92494 48 25,915 13 193,737 100 Note: Percentages are rounded and may not add up to 100.
Abortion: Children
(2) how many women in (a) Essex Strategic Health Authority and (b) England and Wales had an abortion in 2006 who had already had (i) six and (ii) seven previous abortions.
Numbers of abortions to women age under 18 who have had a third or fourth abortion are not available for release for confidentiality reasons. This is because either the totals are less than 10 (between zero and nine cases) or because a presented total would reveal the value of a suppressed total already published. This is in line with the Office for National Statistics’ guidance on the disclosure of abortion statistics (2005).
Numbers of women resident in the Essex Primary Care Trusts of Mid Essex, North East Essex, South East Essex, South West Essex and West Essex who had an abortion in 2006 who already had (i) six and (ii) seven previous abortions are also not available for release for the same reasons stated above. The numbers for England and Wales are published in Table 4b of the Statistical Bulletin “Abortion Statistics, England and Wales: 2006”, copies of which are available in the Library.
Abortion: Private Sector
The Healthcare Commission had three new applications from independent-sector places to register for the termination of pregnancy between July 2006 and the end of June 2007. The applications have yet to be determined and therefore remain commercial in confidence.
Admissions: Heart Diseases
The information requested has been placed in the Library.
Alcohol Harm Reduction Strategy
As the ministerial reshuffle occurred shortly after publication of the strategy and the recess is now imminent, no ministerial meetings with alcohol stakeholders have taken place since the strategy was published. However, early meetings are being sought by industry organisations, and Ministers would expect to meet them, as well as non-governmental organisations such as Alcohol Concern and senior medical representatives.
Alcoholic Drinks: Females
The Department is not aware of any assessment or evidence on the potential impact of smoke-free pubs on levels of binge drinking by women.
Alcoholic Drinks: Health Services
As part of the ongoing development of the Quality and Outcomes Framework (QOF), indicators and clinical areas will be reviewed in the light of the clinical evidence base. The Expert Panel which advises the QOF negotiations looks at new areas for clinical intervention by practices, in the context of value for money and the benefits to patients.
Alcoholic Drinks: Misuse
The ministerial group on alcohol harm reduction, which is chaired jointly by myself and the Under-Secretary of State for the Home Department, my hon. Friend the Member for Gedling (Mr. Coaker), continue to monitor and manage the delivery of the priority actions and outcomes that are set out in ‘Safe. Sensible. Social. The next steps in the National Alcohol Strategy’.
Information on progress against the priority actions that are detailed in ‘Safe. Sensible. Social.’, and links to statistical data assessing reductions in alcohol harm or changes in public awareness will be published regularly on a new Government website, the details of which will be announced in the near future.
Ambulance Services
Emergency 999 calls made to ambulance control centres are prioritised so that each can be responded to according to clinical need and receive a level of care appropriate to the patient(s) condition. In order to do this national health service ambulance trusts within England use a process of call categorisation.
Call categorisation means that the caller is asked a series of questions about the patient. From the responses provided, the call is allocated a code (determinant). This provides a description of the caller’s injury/illness and the severity of that problem. Software products are used to help call handlers triage and categorise calls, and the code allocated will depend on the software product used.
Each determinant has been allocated a response level, by the Department, based on independent expert advice, according to the perceived severity of the determinant description. There are three response levels:
category A applies to a call where there appears to be an immediate threat to life.
category B identifies cases that appear to be serious in nature and require urgent assessment.
category C identifies cases that appear to be neither immediately serious or life-threatening.
Lists of codes for each software product, grouped by response level, are produced annually and are published on the Department of Health’s website. Copies have been placed in the Library.
Ambulance Services: Manpower
The number of paramedics (headcount) working in the specified organisations as at 30 September each year for the period 2002 to 2006 is shown in the table.
Specified organisation 2002 2003 2004 2005 2006 Cumbria Ambulance Service National Health Service Trust 121 144 148 146 1— Greater Manchester Ambulance Service NHS Trust 334 358 381 387 1— Lancashire Ambulance Service NHS Trust 166 198 210 232 1— Mersey Regional Ambulance Service NHS Trust 281 337 298 416 1— North West Ambulance Service NHS Trust 1— 1— 1— 1— 1,175 Total of specified organisations 902 1,037 1,037 1,181 1,175 1 Not applicable. Source: Information Centre for health and social care non-medical workforce census.
Workforce planning is a matter for individual trusts to undertake, working with their commissioners and strategic health authorities. Plans need to be, and are, regularly reviewed as circumstances change. North West Ambulance Service NHS Trust has recently provided information to the Department on projected numbers for paramedics. I understand that the trust intends to have 1,347 whole-time equivalents in employment as paramedics in 2007-08, 1,361 in 2008-09 and 1,375 in 2009-10.
In 2006, numbers of ambulance staff were collected under new, more detailed occupation codes. This included the introduction of a code for emergency care practitioners and the North West Ambulance Service NHS Trust recorded 39 ECPs in 2006.
More accurate validation processes in 2006 have resulted in the identification and removal of 9,858 duplicate non-medical staff records out of the total workforce figure of 1.3 million in 2006. Earlier years’ figures could not be accurately validated in this way and so will be slightly inflated. The level of inflation in earlier years’ figures is estimated to be less than 1 per cent. of total across all non-medical staff groups for headcount figures (and negligible for full-time equivalents). This should be taken into consideration by those analysing trends over time.
Anaemia: Medical Treatments
(2) what guidance his Department provides to clinicians managing cancer-related anaemia on the account to be taken of (a) the Chief Medical Officer's advice to conserve blood stocks and (b) the National Institute for Health and Clinical Excellence’s cost-effectiveness advice on the use of erythropoietins.
We have made no such assessment. The National Institute for Health and Clinical Excellence (NICE) has not yet issued final guidance to the NHS on the clinical and cost effectiveness of erythropoietins in the management of cancer treatment-induced anaemia. NICE issued an appraisal consultation document on 29 June and its Appraisal Committee will consider the responses received. NICE expects to issue final guidance later this year.
Arthritis: Young People
Children living with juvenile arthritis are able to access a range of treatment options depending on the severity of their condition. Drugs that health professionals are able to prescribe include analgesics, non-steroidal anti-inflammatory drugs, disease-modifying drugs, corticosteroids, and anti-tumour necrosis inhibitors. Surgery and joint replacement are also available for those severely affected.
Asthma: Greater London
Information on the number of cases of adult and childhood asthma is not collected centrally.
Autism: Greater London
The information requested is not held centrally. It is for primary care trusts to decide what services to provide for their local communities.
Blood Transfusions: Cancer
It is estimated that at least 25 per cent. of red cells are given to patients with cancer. Not all of these units are given for direct treatment of cancer. Figures for the actual number of transfusions are not collected, but in 2006-07 the National Blood Service issued 1,864,271 units of red blood cells.
These figures are based on provisional results from the Epidemiology and Survival of Transfusion Recipients study, a National Blood Service study of patients transfused in England in 2001-02. The study is in the final stages and will be submitted for publication soon. However, it is based on data collected five years ago so it is likely that changes in blood use have occurred since then.
Breast Cancer: Screening
The National Institute for Health and Clinical Excellence (NICE) published a clinical guideline on familial breast cancer in May 2004, partially updated in October 2006.
The clinical guideline relates to the classification and care of women at risk of familial breast cancer in primary, secondary and tertiary care. The guideline recommends that women at moderate familial risk of breast cancer or greater should receive annual mammography or magnetic resonance imaging surveillance.
NICE clinical guidelines are covered by the Department’s developmental standards, standards which the national health service is expected to achieve over time. The Healthcare Commission has responsibility for assessing progress towards achieving these standards.
As part of the development of the new Cancer Reform Strategy, we are examining the feasibility of bringing the management of surveillance of women at moderate familial risk of breast cancer or greater into the NHS breast screening programme.
Cancer: Anaemia
The Department has made no estimate of the economic cost of working days lost due to cancer-related anaemia and fatigue.
Cancer: Drugs
The following table shows the date on which each specific indication was authorised (information current at 24 July 2007).
Condition and Drugs Date of authorisation for specific indication Drug substance Notes Aggressive non-Hodgkin's lymphoma—rituximab (MabThera) Specific indication is not licensed Rituximab MabThera is licensed for the treatment of patients with CD20 positive diffuse large B cell non-Hodgkin's lymphoma. Breast cancer—docetaxel (Taxotere) 28 August 2000 Docetaxel First line treatment for advanced or metastatic breast cancer Breast cancer—paclitaxel (Taxol) 27 March 2000 Paclitaxel Breast cancer bevacizumab (Avastin) 27 March 2007 Bevacizumab Breast cancer (advanced or metastatic)—lapatinib (Tyverb) Drug substance not licensed Lapatinib Breast cancer (advanced)—tratuzumab (Herceptin) 28 August 2000 Tratuzumab Breast cancer (advanced)—vinorelbine (Navelbine) 10 May 1996 Vinorelbine Breast cancer (early)—anastrozole (Arimidex) 29 October 2002 Anastrozole Breast cancer (early)—docetaxel (Taxotere) Specific indication is not licensed Docetaxel Current licence is for advanced or metastatic breast cancer Breast cancer (early)—exemastane (Aromasin) 26 August 2005 Exemastane Breast cancer (early)—letrozole (Femara) 9 September 2004 Letrozole Breast cancer (early)—paclitaxel (Taxol) Specific indication is not licensed Paclitaxel Current licence is for advanced or metastatic breast cancer Breast cancer (early)—trastuzumab (Herceptin) 22 May 2006 Trastuzumab Breast cancer (locally advanced)—capecitabine (Xeloda) 21 March 2002 Capecitabine Chronic lymphocytic leukaemia—fludarabine (Fludara) 11 August 1994 Fludarabine Chronic myeloid leukaemia—imatinib (Glivec) 7 November 2001 Imatinib Colon cancer (adjuvant)—capecitabine (Xeloda) 30 March 2005 Capecitabine Colon cancer (adjuvant)—irinotecan (Campto) Specific indication is not licensed Irinotecan Not licensed for adjuvant treatment Colon cancer (adjuvant)—oxaliplatin (Eloxatin) 18 October 2004 Oxaliplatin Colorectal cancer (advanced)==irinotecan (Campto) 14 July 1999 Irinotecan Colorectal cancer (advanced)—oxaliplatin (Eloxatin) 23 August 1999 Oxaliplatin Colorectal cancer (advanced)—ralitrexed (Tomudex) 11 August 1995 Ralitrexed Colorectal cancer (metastatic)—capecitabine (Xeloda) 2 February 2001 Capecitabine Colorectal cancer (metastatic)—tegafur + uracil (Uftoral) 5 January 2001 Tagafur + uracil Follicular lymphoma—rituximab (MabThera) 2 June 1998 Rituximab Gastro-intestinal stromal tumours (GIST)—imatinib (Glivec) 7 November 2001 Imatinib Glioblastoma multiforme (recurrent)—carmustine (Gliadel) 28 September 2000 Carmustine Glioma (newly diagnosed and high-grade)—carmustine (Gliadel) 14 December 2004 Carmustine Glioma (newly diagnosed and high-grade)—temozolomide (Temodal) 21 April 2005 Temozolomide Head & neck cancer—cetuximab (Erbitux) 29 March 2006 Cetuximab Lung cancer (non small cell)—bevacizumab (Avastin) Specific indication is not licensed Bevacizumab Not licensed for lung cancers of any type Lung cancer (non small cell)—erlotinib (Tarceva) 19 September 2005 Erlotinib Lung cancer (non small cell)—gefitinib (Iressa) Not licensed Gefitinib Drug substance not licensed Lung cancer (non small cell)—pemetrexed (Alimta) 20 September 2004 Pemetrexed Lung cancer (non-small cell)—paclitaxel (Taxol) 18 November 1998 Paclitaxel Lung cancer (non-small cell) docetaxel (Taxotere) 20 January 2000 Docetaxel Lung cancer (non-small cell) gemcitabine (Gemzar) 26 April 2000 Gemcitabine Lung cancer (non-small cell) vinorelbine (Navelbine) 10 May 1996 Vinorelbine Mesothelioma pemetrexed (Alimta) 20 September 2004 Pemetrexed Metastatic breast cancer—gemcitabine (Gemzar) 25 November 2004 Gemcitabine Metastatic colorectal cancer—bevacizumab (Avastin) 12 January 2005 Bevacizumab Metastatic colorectal cancer—cetuximab (Erbitux) 24 June 2004 Cetuximab Non-Hodgkin's Lymphoma—rituximab (MabThera) 21 March 2002 Rituximab Ovarian cancer—paclitaxel (Taxol) 11 October 1996 (for first line treatment of advanced ovarian cancer) Paclitaxel Original licence was for second-line treatment only Ovarian cancer—pegylated liposomal doxorubicin (Caelyx) 24 October 2000 Doxorubicin Ovarian cancer (advanced)— topotecan (Hycamtin) 12 November 1996 Topotecan Pancreatic cancer gemcitabine (Gemzar) 30 October 1996 Gemcitabine Pancreatic cancer—Rubetican Not licensed Rubetican Drug substance not licensed Prostate cancer Atrasentan Not licensed Atrasentan Drug substance not licensed Prostate cancer—docetaxel (Taxotere) 6 February 2004 Docetaxel Recurrent malignant glioma—temozolomide (Temodal) 20 January 1999 Temozolomide Relapsed multiple myeloma—bortezomib (Velcade) 26 April 2004 Bortezomib Renal cell carcinoma—bevacizumab (Avastin) Specific indication is not licensed Bevacizumab Substance not licensed for renal cancers Renal cell carcinoma—sorafenib tosylate (Nexavar) 29 July 2004 Sorafenib tosylate Renal cell carcinoma—sunitinib (Sutent) 11 January 2007 Sunitinib
Cardiovascular System: Screening
Recent publications by the Scottish Intercollegiate Guidelines Network and by the QResearch group, the latter in the British Medical Journal, have outlined new approaches to cardiovascular risk assessment. These publications offer significant contribution to the debate that will now take place as a result of the National Institute for Health and Clinical Excellence’s recent publication of draft clinical guidelines on lipid modification, which covers cardiovascular risk assessment. The Department is monitoring this debate with interest.
(2) what steps he is taking to ensure that the guidance on vascular risk assessment being prepared by his Department will be implemented successfully at primary care level.
The Department has made no commitment to publish guidance on vascular risk assessment. There has been no delay in the publication of such guidance.
The Department’s Vascular Programme Board has been giving careful consideration to the potential benefits of a more integrated approach to vascular risk assessment and management. This is a complex area, which requires further study particularly in the light of the National Institute for Health and Clinical Excellence’s recently published draft guidance on lipid modification, which covers cardiovascular risk assessment.
Chiropody: Training
Within the overall resources allocated, it is a matter for each strategic health authority (SHA) to determine its own priorities including how much is spent on pre-registration training commissions for podiatrists. Under the current service level agreement with SHAs each SHA is expected to provide for investment in training commissions based on long-term work force need and local financial plans.
Chronically Sick People
Specialist nurses provide a valuable additional resource in the treatment and management of many long-term conditions. They can help people to manage their condition to maintain stability, improve quality of life and prevent frequent admission to hospital and reduce length of stay
The Government remain committed to the continued development of such roles, and to ensuring that there are enough specialist nurses and other health care professionals to provide high quality services for all client groups.
The responsibility for specific staffing numbers and skill mix rests with the local national health service. We have given local NHS organisations the freedom to decide how best to use their resources, in consultation with local stakeholders, as they know the health needs of their local communities best.
CJD: Blood
I refer the hon. Member to the answer given to the hon. Member for Kettering (Mr. Hollobone), 14 June 2007, Official Report, column 1298W.
No estimates have been made of the likely number of variant Creutzfeldt-Jakob disease (vCJD) cases arising from blood transfusion over the next two years. However the Spongiform Encephalopathy Advisory Committee (SEAC) did issue a position statement on Transmissible Spongiform Encephalopathy infectivity in blood in 2006. A copy of the statement can be found on the SEAC website at
www.seac.gov.uk/statements
The United Kingdom blood services are independently evaluating the efficacy of the prion reduction filters that are currently available and which meet the qualifying criteria laid down by the Advisory Committee on the Microbiological Safety of Blood, Tissues and Organs for Transplantation.
There have been three cases of Variant Creutzfeldt-Jakob disease (vCJD) in the United Kingdom arising from blood transfusions from donors who subsequently died of vCJD. All three patients have died. A fourth patient who received a transfusion from a donor who subsequently died was also found to have abnormal prion protein in the spleen and a lymph node after dying of an unrelated illness.
Colorectal Cancer: Screening
The information requested is not held centrally. This is a matter for the Chief Executive of the NHS Direct Trust.
Community First Responder Groups: North West Region
This information is not collected centrally by the Department. This would be a matter for the chair of the North West Ambulance Service.
Community Nurses: Abuse
The information requested is not collected in the format requested.
In April 2003 the NHS Security Management Service (NHS SMS) was created and assumed responsibility for the issue of tackling violence against NHS staff. Since its creation, the NHS SMS has collected data on the number of reported physical assaults against national health service staff in England for the reporting periods 2004-05 and 2005-06, broken down by NHS trust. This data has been placed in the Library.
Both the Department and the NHS SMS take the security of community nurses very seriously. The NHS SMS is in continual contact with a wide range of stakeholders representing and involved in the work of community nursing.
“Not Alone: A guide for the better protection of lone workers in the NHS” was issued by the NHS SMS in March 2005.
Compulsorily Detained Mental Patients
Information about the number of patients detained in England under the Mental Health Act 1983 by type of section in national health service hospitals and independent hospitals registered to detain people under the Mental Health Act 1983 between 1997 and 2006 has been obtained from the Information Centre for health and social care. This information is shown in the following table.
Information about the age of patients detained under the Mental Health Act 1983 is not held centrally.
Number of admissions 1996-97 1997-98 1998-99 1999-2000 2000-01 2001-02 2002-03 2003-04R 2004-05 2005-06 Total formal admissionsl 1,297 1,451 1,842 1,968 1,816 2,193 1,806 1,829 2,029 1,934 From informal to formal— total 399 486 583 555 410 524 503 426 400 321 informal to 5(2) and 5(4) 232 291 346 308 251 283 273 292 274 194 informal to 2 83 90 109 139 96 140 116 65 48 45 informal to 3 84 105 128 108 63 101 114 69 78 82 Formal admissions into hospital (excl. place of safety detentions) 898 965 1,259 1,413 1,406 1,669 1,303 1,403 1,629 1,613 Part II patients—total 773 866 1,045 1,233 1,208 1,439 1,056 1,119 1,220 1,301 2 322 389 454 545 491 573 423 460 483 582 3 412 457 561 669 705 846 621 652 732 712 4 38 20 30 19 12 20 12 7 5 7 Court and prison disposals—total 122 93 205 173 185 217 244 279 405 302 35 7 7 8 7 14 11 10 11 15 16 36 2 1 2 — 3 4 2 3 3 1 37(4)2 22 25 52 39 — — — — — — 37 (with S41 restrictions) 30 17 73 51 48 74 65 46 88 92 37 (without S41 restrictions) — — — — 56 61 66 62 99 93 45A 5 7 17 21 — — — — — — 47 (with S49 restrictions) — — — 3 8 12 38 48 71 31 47 (without S49 restrictions) 9 26 31 33 10 5 7 15 21 9 48 (with S49 restrictions) 1 5 6 4 34 36 31 73 64 33 48 (without S49 restrictions) — — — — 1 — — 6 12 — Other sections—38, 44, 46 46 5 16 15 11 14 25 15 31 27 Previous legislation (Fifth Schedule) and other Acts 3 6 9 7 13 13 3 5 4 10 1 From 1995-96 transfers between providers without a change in legal status are not included. Changes from informal to formal status while in hospital area also included. 2 From 1995-96, these admissions are counted under the appropriate section at the point was formally admitted to hospital. R Revised from bulletin published in December 2004. Source: KH15, K037 and KP90
Number of admissions 1995-96 1996-97 1997-98 1998-99 1999-2000 2000-01 2001-02 2002-03 2003-04R 2004-05 2005-06 Total formal admissionsl 40,965 39,943 42,578 45,063 44,731 44,765 44,652 43,558 42,623 43,296 43,942 From informal to formal— total 16,326 17,116 18,128 19,413 19,444 19,539 20,112 18,458 17,818 18,173 18,202 informal to 5(2) 8,927 9,238 9,701 10,244 10,091 10,081 10,254 9,534 8,894 8,232 7,637 informal to 5(4) 1,315 1,505 1,616 1,706 1,773 1,932 1,948 1,909 1,779 1,839 1,673 informal to 2 2,429 2,266 2,344 2,483 2,655 2,628 2,525 2,299 2,481 3,003 3,425 informal to 3 3,655 4,107 4,467 4,980 4,925 4,898 5,385 4,716 4,664 5,099 5,467 Formal admissions into hospital (excl. place of safety detentions) 24,639 22,827 24,450 25,650 25,287 25,226 24,540 25,100 24,805 25,123 25,740 Under Mental Health Act 1983: Part II patients—total 22,570 21,045 22,659 23,980 23,807 23,890 23,211 23,812 23,468 23,834 24,317 2 12,292 11,084 12,225 13,200 12,940 13,152 13,027 13,623 13,650 14,327 14,683 3 8,915 8,479 8,854 9,091 9,030 8,955 8,149 8,386 8,235 8,236 8,435 4 1,363 1,482 1,580 1,689 1,837 1,783 2,035 1,803 1,583 1,271 1,199 Court and prison disposals—total 1,836 1,751 1,762 1,655 1,468 1,293 1,279 1,254 1,322 1,259 1,362 35 271 261 262 253 191 134 126 141 130 103 116 36 21 31 24 21 18 15 21 21 11 9 16 37(4)2 — — — — — — — — — — — 37 (with S41 restrictions) 287 255 241 253 243 211 191 177 189 190 230 37 (without S41 restrictions) 504 447 391 376 338 310 264 286 257 250 229 45A — — — — 2 — 1 3 2 — 1 47 (with S49 restrictions) 211 203 209 219 190 176 173 182 204 228 242 47 (without S49 restrictions) 29 22 31 11 17 21 36 32 51 51 47 48 (with S49 restrictions) 341 333 403 374 320 262 313 266 276 282 328 48 (without S49 restrictions) 51 41 26 24 21 14 13 13 25 8 14 Other sections—38, 44, 46 121 158 175 124 128 150 141 133 177 138 139 Previous legislation (Fifth Schedule) and other Acts 233 31 29 15 12 43 50 34 15 30 61 1 From 1995-96, transfers between providers without a change in legal status are not included. Changes from informal to formal status while in hospital area also included. 2 From 1995-96, these admissions are counted under the appropriate section at the point when the patient was formally admitted to hospital. R Revised from bulletin published in December 2004. Source: KH15, KO37and KP90
Conal Timoney
Mr. Timoney is no longer a contractor with the Department. He is engaged for the Department via a short-term national health service contract. The Department does not comment on employment terms negotiated with the NHS.
Dementia: Westmorland
The information requested is not held centrally.
It is for primary care trusts to commission services for their local populations and to work with the local health community and other stakeholders to plan, develop and improve health services to meet the needs of the community, including people suffering dementia-related illnesses.
Dental Services
The Department has provided guidance for primary care trusts on managing under-delivery of commissioned services in the document ‘Primary care dental contracts: Advice on managing end-year issues ’. Copies have been placed in the Library and are available at
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_064321
Prior to April 2006, dentists providing general dental services were not subject to commissioning arrangements by primary care trusts (PCTs). Personal dental services pilot schemes were commissioned by PCTs but units of dental activity were not then available as a contract currency for setting or measuring levels of dental activity.
Guidance to primary care trusts on national health service orthodontic assessments and the index of orthodontic treatment need is set out in the document ‘Strategic Commissioning of Primary Care Orthodontic Services’, copies of which are placed in the Library and are also available at
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4139176
Since April 2006, patients no longer have to be registered with a dental practice to receive national health service care and treatment.
The closest equivalent measure to ‘registration’ is the number of patients receiving NHS dental services (‘patients seen’) in a given area over a 12-month period, expressed as a percentage, of the estimated population for that area. However, this is not directly comparable to the registration data for earlier years.
The numbers of patients seen as a per cent, of the population in the 24 month periods ending 31 March, 30 June, 30 September, 31 December 2006 and 31 March 2007 are available in Table F2 of Annex 3 of the NHS Dental Statistics for England Q4: 31 March 2007 report. Information is available at strategic health authority and primary care trust (PCT) area in England.
This report has been placed in the Library and is also available on-line at
www.ic.nhs.uk/pubs/dentalq4
Information cannot be made available at constituency level without disproportionate cost.
As from 1 October 2006, Morecambe Bay PCT was integrated into Cumbria PCT and North Lancashire PCT. Information for Cumbria PCT and North Lancashire PCT is included in the above report.
Dental Services: Greater London
The information requested could be provided only at disproportionate cost.
Departments: Contracts
The Department does not regularly collect data on contracts awarded to external suppliers by public bodies sponsored by the Department, including their spend. I refer the hon. Member to the answer given on 25 June 2007, Official Report, column 235W.
There is currently no mechanism for the Department to monitor contracts awarded by individual national health service trusts.
In terms of the procurement of the Framework for procuring External Support for Commissioners, there is no contractual advantage to the Department arising from the use of service category 27 over service category 11.
Departments: Land
The table identifies the larger sites in Hampshire in the ownership of the Secretary of State for Health that have been disposed of since 1997.
Disposal 1997 Part of Park Prewett, Basingstoke Part of Hazel Farm, Southampton 1998 Part of St. James’ Hospital, Portsmouth 1999 Part of Hazel Farm, Southampton St. Paul’s Hospital, Winchester Part of Prewett Park, Basingstoke 2000 Knowle Hospital, Fareham 2001 Part of Hazel Farm, Southampton Part of Lord Mayor Treloar, Alton 2002 Leigh House, Southampton 2003 Part of St. James’ Hospital, Portsmouth 2004 Part of Lord Mayor Treloar, Alton 2005 Part of Park Prewett, Basingstoke Part of Lord Mayor Treloar Part of Coldeast Hospital, Fareham Tatchbury Hospital, Calmore Part Hazel Farm, Southampton
It is the responsibility of local planning authorities to identify and release land for housing as part of the planning process. This means that the requirement for the provision of social housing will need to be negotiated and agreed with the local planning authority. The Government have implemented a number of initiatives to assist with land supply for housing. A register of surplus public sector land held by central Government bodies has been established. English Partnerships reviews the sites on the register to identify those which could have the potential for housing development. As at June 2007, there were over 700 sites on the register. Sites are continually being added as they are identified as surplus by landowners and removed once expressions of interest are received after a site has been marketed.
The Department for Communities and Local Government and English Partnerships also maintain the national land use database of previously developed land (NLUD-PDL). This covers vacant and derelict land and also land in use with potential for development in public and private ownerships. Information on the sites is available from the NLUD website
www.nlud.org.uk.
In addition, English Partnerships is developing the National Brownfield Strategy which will provide a coherent vision for the future development of brownfield land to underpin national, regional and local development aspirations. The strategy will help our target for building new homes on brownfield land thereby reducing pressures on the greenbelt.
Departments: Legislation
(2) what legislative provisions introduced by his Department since 1997 have been repealed.
Seven Acts of Parliament introduced by the Department since 1997 include some sections and schedules not yet brought into force:
Acts introduced by the Department of Health since 1997 Not yet in force National Health Service (Primary Care) Act 1997 (c.46) Section 26(2) Schedule 2 Part I paras 46 and 64(3) Schedule 3 Part II Health Act 1999 (c.8) Section 61 Care Standards Act 2000 (c.14) Section 64(1)(a) and (3)-(5) Schedule 4 para 5(7)(b), 12, 14(10)(b), (22) and (29) Schedule 5 paras 1 and 2 Health and Social Care Act 2001 (c.15) Section 26(1) and (3) Section 55(7) Community Care (Delayed Discharges etc.) Act 2003 (c.5) Section 14 Health and Social Care (Community Health and Standards) Act 2003 (c.43) Section 107 Section 116(3) Schedule 14 part 6 Health Act 2006 (c.28) Section 36(2)
18 Acts of Parliament introduced by the Department since 1997 include some sections and schedules now repealed, details as follows. Many of these were repealed as a consequence of the National Health Service Act 2006 (c.41) which consolidated much of the previous health legislation.
Acts introduced by the Department of Health since 1997 Repealed National Health Service (Primary Care) Act 1997 (c.46) Sections 1-9 Sections 11-20 Section 21(1) Section 22(1) Section 23(1) and (2) Section 24(1) Section 25(1) Section 26(1) Section 27(1) Section 28(1) Section 29(1) Section 31(1) Section 32 Section 33 Section 34(1) Section 36 Section 40(1) and (3) Schedule 1 Schedule 2 paras 3-31, 65, 691-81 National Health Service (Private Finance) Act 1997 (c.56) Section 1 Nurses, Midwives and Health Visitors Act 1997 (c.24) Whole Act repealed by Health Act 1999 Pharmacists (Fitness to Practise) Act 1997 (c.19) Whole Act repealed Community Care (Residential Accommodation) Act 1998 (c.19) Section 11 Section 3(2)1 Health Act 1999 (c.8) Sections 2-12 Section 13(l)-(4) and (6)-(11) Section 14 Section 15 Sections 17-42 Section 62(2), (3), (5) and (8) Section 66(6) Section 68(l)(a) and (4) Schedule 1 Schedule 2 Schedule 2A Schedule 3 paras 2(2), 8(3) and 11(3) Schedule 4 paras 2, 4-32, 331, 34-41, 701, 71, 75, 76-79, 81, 83, 84, 85(2)(b), 87, 881 and 89 Road Traffic NHS Charges Act 1999 (c.3) Whole Act repealed Care Standards Act 2000 (c.14) Section 6 Section 7 Section 9 Section 10(1) Section 22(8)(a)1 Section 32(8) Section 44 Section 45 Section 46 Section 47 Section 49(2) Section 51 Section 801 Sections 81-891 Section 89(4C)(d) Section 90 Section 91-991 Section 100 Section 1011 Section 102 Section 104 Schedule 1 paras 9-11, 15, 17, 27(a), 27(c) and 27(d) Schedule 2 para 6(5) Schedule 2A paras 4, 18, 21, 22, 24 Schedule 4 paras 2, 5, 61, 7, 81, 13, 14(4)-(6), 161, 24, 25, 25(2)(a)1, 26(2) and (4)1, 27(b) Carers and Disabled Children Act 2000 (c.16) Section 5 Section 9(a) Health Service Commissioners (Amendment) Act 2000 (c.28) Sections l(2)(b), (3)(c) and (d) Health and Social Care Act 2001 (c.15) Sections 1-4 Section 6 Section 7(2)-(5) Sections 8-13 Section 14(1) and (3) Sections 15-25 Section 261 Sections 27-38 Sections 40-43 Sections 45-48 Section 60 Section 61 Section 64(3) Section 68(2) and (3) Schedules 1-4 Schedule 5 paras 5, 8, 11 and 12 National Health Service Reform and Health Care Professions Act 2002 (c.17) Section 1 Section 2(1)-(4) Section 3 Section 4(1) and (2) Sections 5-18 Section 19(l)-(5) Section 20 Section 21 Section 22(1)-(3), (4), (8) and (9) Section 23 Section 24 Section 351 Section 36 Section 42(7) Schedule 1 paras 1-35, 37, 40-43, 46, 19-53, 55 Schedule 2 paras 1-10, 111, 12-37, 54, 55, 58, 64, 67-69, 72-82 Schedule 3 paras 1-11, 14-17 Schedule 4 Schedule 4 paras 4-20, 211, 22-24, 31-33, 36, 38, 43, 44, 45 and 49-51 Schedule 6 paras 1-15 Schedule 7 para 5 Schedule 8 paras 1-12, 18, 23-37 Tobacco Advertising and Promotion Act 2002 (c.36) Section 12(4) Health and Social Care (Community Health and Standards) Act 2003 (c.43) Sections 1-32 Section 33(2) Sections 35-40 Section 76(2)(f), (g) Section 77(3) Section 79(7) Section 80(5) Section 110 Section 112 Section 116(1) Sections 170-172 Section 174 Section 175 Sections 177-183 Section 187(1)-(7), (9), (10) Section 188 Section 189(l)-(3) and (4)1 Section 191 Section 192 Schedule 1 Schedule 2 paras 23-45, 83-85, 108, 109, 115-118, 123 and 124 Schedule 5 Schedule 6 para 3(2), (3), (9), (10), (14) and (15) Schedule 7 para 3(2), (6)-(8) Schedule 9 paras 9, 10, 141, 18(2), 26, 271, 32 Schedule 11 paras 7-32, 331, 35-45, 61(b), 62(3) and 69-74 Schedule 12 paras 1, 2(3), 3(2) and (4) and 4-8 Schedule 13 paras 4, 6(a) and (b) Human Fertilisation and Embryology (Deceased Fathers) Act 2003 (c.24) Section 2(2) and (3) Schedule para 111 Health Protection Agency Act 2004 (c.17) Schedule 1 para 2 Schedule 3 para 11 Health Act 2006 (c.28) Section 34 Section 35 Section 36(1) Sections 37-42 Sections 44-56 Section 74 Section 78(3) Schedule 3 Schedule 8 paras 6, 7-11, 12(a) and (b), 13(1)-(6), 14-20, 21(a), 21(b), 22-25, 29, 34, 36, 44(5), 46-50, 51 and 54 National Health Service Act 2006 (c.41) Section 132(9) 1 As from a day to be appointed.
(2) which Bills introduced by his Department in the last five years did not contain sunset clauses; and if he will make a statement.
The Department has not introduced any Bills containing sunset clauses in the last five years. The Department has no current plans for the future use of such clauses, but their use may be considered where appropriate.
None of the Bills introduced by the Department in the last five years have contained sunset clauses.
Departments: Members
A comprehensive list of all meetings that Ministers have held with hon. Members in the last 12 months could be obtained only at disproportionate cost.
Departments: Postal Services
Figures for the period 2004-07 are as follows.
Delivery services 2004-05 Royal Mail volume 306,700 letters Commercial carriers 88,000 letters/packets 2005-06 Royal Mail volume 634,627 letters Commercial carriers 90,324 letters/packets 2006-07 Royal Mail volume 359,600 letters Commercial carriers 91,364 letters/packets
Figures for before 2004 can be provided only at a disproportionate cost.
Where there is a particular requirement to deliver items in a set or urgent timeframe the Department will use commercial carriers for both national and international delivery including items that require signature.
Departments: Public Bodies
These are the residual costs from the funding of the English National Board for Nursing, Midwifery and Health Visiting, an arm’s length body which closed in March 2002.
Departments: Public Expenditure
Ministers and officials regularly discuss a wide range of issues with their counterparts in the Treasury. As was the case in previous Administrations, it is not the practice of the Government to provide details of all such meetings.
Diabetes: Greater London
This information requested is not held centrally. It is for primary care trusts to decide what services to provide for their local communities.
This information is not available in the format requested.
However, the following table shows the number of patients aged over 17 years with a record of a diagnosis of diabetes for the years 2004-05 and 2005-06. Data for 2006-07 will be published in September.
Patients aged less than 17 are considered to be cared for by hospital specialists and are not included in these numbers. Any increases in the number of patients from year-to-year cannot be assumed to represent an increase in the number of patients with diabetes, as it may reflect improved levels of recording by the practices.
SHA code Strategic health authority name PCT code PCT name Total list size Diabetes register count 2004-05 Q04 North West London 5AT Hillingdon 261,750 9,154 5H1 Hammersmith and Fulham 190,019 4,961 5HX Ealing 362,673 14,409 5HY Hounslow 251,041 9,180 5K5 Brent 349,145 15,236 5K6 Harrow 227,927 10,233 5LA Kensington and Chelsea 183,296 4,117 5LC Westminster 244,188 6,211 Q05 North Central London 5A9 Barnet 371,545 12,178 5C1 Enfield 282,866 9,708 5C9 Haringey 278,025 8,989 5K7 Camden 245,115 5,691 5K8 Islington 222,342 6,049 Q06 North East London 5A4 Havering 247,003 8,306 5C2 Barking and Dagenham 172,748 6,122 5C3 City and Hackney Primary Care Team 265,498 8,644 5C4 Tower Hamlets Primary Care Team 225,668 9,402 5C5 Newham Primary Care Team 310,022 13,805 5NA Redbridge 242,958 10,133 5NC Waltham Forest 250,877 10,076 Q07 South East London 5A7 Bromley 315,982 9,244 5A8 Greenwich 258,432 7,443 5LD Lambeth 344,588 9,875 5LE Southwark 280,231 8,759 5LF Lewisham 278,990 9,347 TAK Bexley Care Trust 221,611 7,589 Q08 South West London 5A5 Kingston 178,948 5,109 5K9 Croydon 359,874 13,052 5LG Wandsworth 311,003 8,856 5M6 Richmond and Twickenham 198,448 4,235 5M7 Sutton and Merton 389,319 12,414 2005-06 Q04 North West London 5AT Hillingdon 262,572 9,701 5H1 Hammersmith and Fulham 189,293 5,236 5HX Ealing 368,598 15,418 5HY Hounslow 251,943 9,794 5K5 Brent 342,752 15,928 5K6 Harrow 229,704 10,846 5LA Kensington and Chelsea 184,295 4,436 5LC Westminster 244,899 6,446 Q05 North Central London 5A9 Barnet 373,036 12,915 5CI Enfield 284,985 10,588 5C9 Haringey 241,664 8,468 5K7 Camden 237,437 5,893 5K8 Islington 223,519 6,494 Q06 North East London 5A4 Havering 247,642 8,924 5C2 Barking and Dagenham 176,497 6,546 5C3 City and Hackney Primary Care Team 260,413 8,676 5C4 Tower Hamlets Primary Care Team 223,888 9,812 5C5 Newham Primary Care Team 309,762 14,596 5NA Redbridge 254,138 11,802 5NC Waltham Forest 265,150 10,706 Q07 South East London 5A7 Bromley 317,407 10,084 5A8 Greenwich 262,226 8,072 5LD Lambeth 339,304 10,179 5LE Southwark 288,878 9,294 5LF Lewisham 283,095 10,161 TAK Bexley Care Trust 222,587 8,240 Q08 South West London 5A5 Kingston 180,952 5,478 5K9 Croydon 363,708 13,915 5LG Wandsworth 322,855 9,410 5M6 Richmond and Twickenham 191,245 4,413 5M7 Sutton and Merton 396,922 13,406
Dietary Supplements: Channel Islands
(2) whether the Food Standards Agency plans to raise at future meetings with the Bailiwicks of Guernsey and Jersey the implementation of the food supplements directive and the Nutrition and Health Claims Regulation.
The Food Standards Agency does not have any meetings planned to date with the Bailiwicks of Guernsey and Jersey to discuss implementation of the food supplements directive and the Nutrition and Health Claims Regulation in the Channel Islands.
The Food Standards Agency is writing to the Bailiwicks of Guernsey and Jersey, regarding the implementation of the food supplements directive and the Nutrition and Health Claims Regulation.
Doctors: Private Sector
The Department has made no such assessment. Training schedules for national health service staff in independent sector treatment centres (ISTCs) are agreed locally, subject to the meeting of accreditation standards. The number of junior doctor training posts available is based on local service requirements and future workforce planning needs in discussions with strategic health authorities, deaneries and trusts. When training is attached to activity, which is transferred from the NHS to a Wave 1 ISTC, junior doctors will complete the training in the ISTC.
All ISTCs in Wave 2 are required to provide training in up to 35 per cent. of clinical services that they provide for the NHS. This includes not only medical training, but also other clinical training such as nurse or Allied Health Professional training.
Doctors: Training
The Medical Training Application Service project was subject to the normal business approvals process. MTAS costs fell within delegated departmental approval limits so no specific information was supplied to HM Treasury.
The management of the application process locally is a matter for the deanery concerned.
Drugs: Greater London
Since 2001, the Department and the Home Office have provided for drug treatment in the form of the pooled drug treatment budget (PTB). This funding is allocated to the 149 drug action teams across the country to use, along with local mainstream funding, to provide for treatment and services according to the specific needs of each locality. We do not have information on drug treatment spend prior to 2001.
It is for primary care trusts to determine the level of expenditure on alcohol services within their area in line with local priorities. Information is not collected centrally on local spend; however the Alcohol Needs Assessment Research Project found that around £217 million was being spend on alcohol services during 2003-04. Funds from the PTB may be spent on alcohol services provided that adequate progress is being made on drugs priorities.
PTB allocations since 2001 for each London borough is shown in the following table.
DAT 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08 Barking and Dagenham 777 1,019 1,149 1,430 1,849 0.004808568 1,945 Barnet 955 1,205 1,309 1,576 2,030 0.005277353 2,210 Bexley 600 759 827 997 1,287 0.003345418 1,349 Brent 1,417 1,909 2,201 2,795 3,605 0.009372441 3,703 Bromley 716 901 978 1,175 1,510 0.003926924 1,728 Camden 2,017 2,466 2,599 3,033 3,914 0.010177088 4,401 City of London 14 23 31 44 58 0.000150157 69 Croydon 1,212 1,565 1,738 2,135 2,753 0.007156912 2,995 Ealing 1,794 2,135 2,188 2,480 3,195 0.008306342 3,622 Enfield 1,093 1,458 1,669 2,104 2,704 0.007030149 2,738 Greenwich 1,449 1,867 2,070 2,538 3,261 0.008479293 3,373 Hackney 2,112 2,749 3,077 3,806 4,920 0.012793309 5,197 Hammersmith and Fulham 1,340 1,616 1,679 1,931 2,500 0.006499001 2,955 Haringey 1,547 2,096 2,430 3,099 3,988 0.010369877 4,167 Harrow 542 689 754 914 1,185 0.003080281 1,365 Havering 566 711 770 924 1,192 0.003099463 1,280 Hillingdon 888 1,038 1,043 1,157 1,494 0.003883626 1,656 Hounslow 861 1,041 1,084 1,250 1,612 0.00419139 1,928 Islington 2,451 2,950 3,059 3,511 4,507 0.011718636 4,900 Kensington and Chelsea 1,817 1,999 1,999 2,099 2,699 0.007017021 2,973 Kingston upon Thames 658 725 725 761 977 0.002541271 1,092 Lambeth 2,439 3,266 3,748 4,739 6,083 0.015816438 6,425 Lewisham 2,023 2,586 2,847 3,468 4,469 0.011620522 4,604 Merton 804 949 964 1,081 1,389 0.003611393 1,567 Newham 2,164 2,984 3,509 4,529 5,801 0.015082032 5,835 Redbridge 678 929 1,087 1,398 1,798 0.004673789 1,933 Richmond upon Thames 687 756 756 793 1,021 0.002653966 1,233 Southwark 2,274 3,052 3,510 4,446 5,739 0.014920786 6,082 Sutton 568 662 664 733 940 0.002444265 1,143 Tower Hamlets 1,988 2,731 3,202 4,124 5,272 0.013709008 5,632 Waltham Forest 958 1,357 1,630 2,141 2,733 0.007104891 2,976 Wandsworth 1,663 2,000 2,073 2,378 3,063 0.007965414 3,383 Westminster 2,729 3,002 3,002 3,152 4,042 4,367 London total 43,801 55,195 60,371 72,741 93,590 0.010508613 100,826
Environment Protection: Dartmoor National Park
I am aware of the work undertaken by the Environmental Agency and others on Dartmoor. Owing to current diary pressures I am currently not able to accept the hon. Member’s kind invitation, but if he has particular concerns I would welcome his raising them with me in writing.
Eyesight: Testing
The information is not centrally available in the format requested.
Data on the number of people aged 60 and over who have had a free national health service eye tests are collected at primary care trust (PCT) level, rather than by geographical area. Data for the former North Yorkshire health authority and York and Selby PCT are shown in the table.
Financial year North Yorkshire HA York and Selby PCT 1999-2000 52,072 — 2000-01 61,787 — 2001-02 68,855 — 2002-03 70,278 — 2003-04 — 26,254 2004-05 — 26,619 2005-06 — 25,057 April to September 20061 — 12,956 1 Total shown is for the period April to September 2006 only. October to March 2007 figures are due to be published on 31 July. Source: The Information Centre for health and social care.
Gender Identity Disorder
Owing to the small number of treatment episodes involved and the need to protect patient confidentiality, the Department cannot disclose this information.
General Practitioners
It was clear from the rising number of complaints to the Health Service Commissioner that the previous model of provision by general practitioners (GPs) was not meeting patients’ expectations and was not sustainable.
In addition, the responsibility for out-of-hours care was affecting the ability to recruit and retain GPs.
General Practitioners: Passports
The countersigning of passports is not part of the work that primary medical services contractors are required to do as part of their contractual arrangements with the Primary Care Trust. Should a general practitioner countersign an application it is a private matter between the doctor and the applicant. General practitioners may make a charge for this service should they wish.
The Department does not issue guidelines on this matter.
Health Professions: Qualifications
The qualification requirements for the employment of clinical staff in Independent Sector Treatment Centres (ISTCs) are the same as those in the national health service. Surgeons must be registered with the General Medical Council and be on the specialist register in the specialty in which they are trained.
While both the NHS and ISTCs require the same level of qualifications for clinical staff, the process in which they are appointed differs.
All health practitioners employed in ISTCs are required to be registered with the relevant professional body, and providers are required to ensure that there is a programme of continuing professional development.
Health Professions: Regulation
The Department issued two Calls for Ideas in 2005. One was the Chief Medical Officer’s (CMO) “Call for Ideas” on the review of medical regulation and the other was by Andrew Foster, the then Director of Workforce, on the review of non-medical professional regulation. Neither of these were held as actual events. The CMO’s was published on the Department’s website, while Andrew Foster wrote to a range of stakeholders to seek their views. This included members of the non-medical review reference group, which met twice during the course of the review, in July and November 2005. The make-up of the group is as follows.
Percentage Healthcare professional regulatory bodies 25 Lay members of healthcare professional regulatory bodies 6 (which is included in the above) Public and patient representative organisations and members of the public 4.5 Health officials 14 Other health and social care regulators 3.5 Others 53
There has been extensive consultation leading up to the publication of the White Paper in February. The White Paper anticipated the need for new legislation on a number of issues. Some may require primary legislation but other changes can be made under section 60 of the Health Act 1999. The procedures for the latter require that a draft order is published and consulted upon at least three months before the amended order is laid before Parliament. Other matters requiring legislation will be considered by the stakeholder working groups which will be advising on implementation of the White Paper. We will be publishing their terms of reference and membership shortly.
Health Professions: Training
The numbers of pre-registration training commissions for most professions actually increased between 2004-05 and 2005-06 with the exception of nursing where numbers fell by about 1 per cent.
Workforce planning for the health service is challenging and complex and workforce needs are difficult to predict as technological advances and social changes lead to some skills becoming redundant while demand for others will suddenly increase.
Health Professions: York Hospitals NHS Trust
The information requested is set out in the following table.
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 All HCHS staff 3,596 3,660 3,504 3,517 3,732 3,224 2,842 3,111 3,247 3,302 3,519 All medical and dental staff 215 261 274 283 281 258 237 294 320 344 370 Medical and dental consultants 72 102 98 110 109 120 113 119 131 149 155 Other medical and dental staff 143 159 176 172 171 138 124 174 189 195 215 All non-medical staff1 3,381 3,399 3,230 3,234 3,451 2,967 2,605 2,817 2,927 2,958 3,149 Qualified nursing, midwifery and health visiting staff 1,310 1,362 1,235 1,268 1,375 1,132 915 948 990 1,023 1,111 Clerical and administrative 552 535 532 547 571 571 565 604 644 666 795 Nursing assistant/auxiliary 422 397 357 314 337 185 99 96 89 55 49 Others 1,098 1,106 1,106 1,105 1,168 1,078 1,027 1,170 1,204 1,215 1,194 1 More accurate validation processes in 2006 have resulted in the identification and removal of 9,858 duplicate non-medical staff records out of the total work force figure of 1.3 million in 2006. Earlier years’ figures could not be accurately validated in this way and so will be slightly inflated. The level of inflation in earlier years’ figures is estimated to be less than 1 per cent. of total across all non-medical staff groups for headcount figures (and negligible for full time equivalents). This should be taken into consideration when analysing trends over time. Sources: Information Centre for health and social care Non-Medical Workforce Census. The Information Centre for health and social care Medical and Dental Workforce Census.
Health Services
The working groups have been formed to perform an advisory role in the implementation of the White Paper “Trust, assurance and safety”. This includes those elements of the White Paper relating to the administration of local health bodies in England such as primary care trust and national health service trusts.
Health Services: Finance
(2) how much was allocated to each primary care trust for implementing the targets in the White Paper “Choosing Health”; and whether any of this funding was ring-fenced;
(3) what progress primary care trusts are making in delivering outcomes described in the White Paper “Choosing Health”; and if he will make a statement.
Primary Care Trusts (PCTs) were notified of their revenue allocations for 2006-07 and 2007-08 in February 2005. The allocations separately identify funding to support the initiatives set out in the White Paper “Choosing Health: Making healthy choices easier”, a copy of which is available in the Library.
There had been a move away from ring-fencing allocations to PCTs as it is for PCTs to determine how best to use the funds allocated to them to commission services to meet the needs of their local population.
The funding allocated to each PCT for implementing the targets in the White Paper “Choosing Health”, for the years 2006-07 and 2007-08 is provided in the following table.
“Choosing Health” White Paper funding PCT name 2006-07 2007-08 Ashton, Leigh and Wigan PCT 2,167 2,611 Barking and Dagenham PCT 1,303 1,570 Barnet PCT 1,024 2,032 Barnsley PCT 1,726 2,081 Bassetlaw PCT 356 707 Bath and North East Somerset PCT 533 1,056 Bedfordshire PCT 834 2,006 Berkshire East PCT 778 1,857 Berkshire West PCT 1,248 2,474 Bexley Care Trust 669 1,327 Birmingham East and North PCT 2,498 3,098 Blackburn with Darwen PCT 1,110 1,337 Blackpool PCT 1,096 1,320 Bolton PCT 1,870 2,254 Bournemouth and Poole PCT 1,082 2,142 Bradford and Airedale PCT 3,398 4,096 Brent Teaching PCT 712 1,696 Brighton and Hove City PCT 643 1,535 Bristol PCT 1,351 2,675 Bromley PCT 930 1,846 Buckinghamshire PCT 1,371 2,718 Bury PCT 1,196 1,440 Calderdale PCT 641 1,269 Cambridgeshire PCT 1,630 3,239 Camden PCT 631 1,516 Central and Eastern Cheshire PCT 946 2,266 Central Lancashire PCT 1,866 3,034 City and Hackney Teaching PCT 2,030 2,447 Cornwall and Isles of Scilly PCT 1,228 2,948 County Durham PCT 3,193 3,960 Coventry Teaching PCT 1,962 2,432 Croydon PCT 1,072 2,125 Cumbria PCT 2,822 3,753 Darlington PCT 235 562 Derby City PCT 886 1,757 Derbyshire County PCT 2,751 4,621 Devon PCT 2,285 4,543 Doncaster PCT 2,113 2,546 Dorset PCT 1,230 2,443 Dudley PCT 978 1,937 Ealing PCT 1,078 2,133 East and North Hertfordshire PCT 1,615 3,208 East Lancashire PCT 2,625 3,162 East Riding of Yorkshire PCT 646 1,553 East Sussex Downs and Weald PCT 749 1,794 Eastern and Coastal Kent PCT 1,804 4,197 Enfield PCT 645 1,543 Gateshead PCT 1,486 1,789 Gloucestershire PCT 1,729 3,433 Great Yarmouth and Waveney PCT 683 1,458 Greenwich Teaching PCT 1,740 2,098 Halton and St. Helens PCT 2,282 2,749 Hammersmith and Fulham PCT 1,276 1,537 Hampshire PCT 2,865 6,431 Haringey Teaching PCT 1,505 1,865 Harrow PCT 434 1,037 Hartlepool PCT 700 843 Hastings and Rother PCT 629 1,249 Havering PCT 787 1,560 Heart of Birmingham Teaching PCT 1,890 2,345 Herefordshire PCT 556 1,105 Heywood, Middleton and Rochdale PCT 1,515 1,825 Hillingdon PCT 767 1,522 Hounslow PCT 737 1,459 Hull PCT 1,615 2,000 Isle of Wight NHS PCT 502 999 Islington PCT 1,347 1,672 Kensington and Chelsea PCT 664 1,327 Kingston PCT 477 947 Kirklees PCT 1,249 2,475 Knowsley PCT 1,318 1,587 Lambeth PCT 1,812 2,246 Leeds PCT 1,687 4,028 Leicester City PCT 2,079 2,504 Leicestershire County and Rutland PCT 1,773 3,524 Lewisham PCT 1,558 1,931 Lincolnshire PCT 2,944 4,759 Liverpool PCT 3,345 4,146 Luton PCT 432 1,033 Manchester PCT 3,988 4,805 Medway PCT 834 1,661 Mid Essex PCT 983 1,956 Middlesbrough PCT 1,105 1,330 Milton Keynes PCT 677 1,351 Newcastle PCT 1,948 2,345 Newham PCT 2,211 2,665 Norfolk PCT 1,598 3,835 North East Essex PCT 1,036 2,060 North East Lincolnshire PCT 1,081 1,302 North Lancashire PCT 1,522 2,340 North Lincolnshire PCT 505 1,003 North Somerset PCT 617 1,227 North Staffordshire PCT 466 1,114 North Tees PCT 1,235 1,489 North Tyneside PCT 1,408 1,696 North Yorkshire and York PCT 2,011 4,224 Northamptonshire PCT 2,900 4,345 Northumberland Care Trust 2,046 2,465 Nottingham City PCT 1,741 2,158 Nottinghamshire County PCT 1,714 3,691 Oldham PCT 1,618 1,949 Oxfordshire PCT 1,717 3,414 Peterborough PCT 544 1,090 Plymouth Teaching PCT 826 1,638 Portsmouth City Teaching PCT 428 1,022 Redbridge PCT 751 1,489 Redcar and Cleveland PCT 979 1,179 Richmond and Twickenham PCT 510 1,013 Rotherham PCT 1,723 2,076 Salford PCT 1,761 2,120 Sandwell PCT 2,258 2,718 Sefton PCT 817 1,790 Sheffield PCT 1,272 3,035 Shropshire County PCT 870 1,728 Solihull Care Trust 439 1,049 Somerset PCT 1,604 3,190 South Birmingham PCT 2,057 2,551 South East Essex PCT 747 1,790 South Gloucestershire PCT 657 1,307 South Staffordshire PCT 2,160 3,609 South Tyneside PCT 1,173 1,413 South West Essex PCT 1,276 2,536 Southampton City PCT 787 1,560 Southwark PCT 1,697 2,103 Stockport PCT 901 1,783 Stoke on Trent PCT 1,594 1,975 Suffolk PCT 1,759 3,495 Sunderland Teaching PCT 2,117 2,549 Surrey PCT 3,032 6,011 Sutton and Merton PCT 1,131 2,244 Swindon PCT 578 1,147 Tameside and Glossop PCT 1,598 1,925 Telford and Wrekin PCT 514 1,022 Torbay Care Trust 509 1,012 Tower Hamlets PCT 1,925 2,321 Trafford PCT 696 1,378 Wakefield District PCT 2,350 2,833 Walsall Teaching PCT 1,780 2,144 Waltham Forest PCT 824 1,631 Wandsworth PCT 897 1,775 Warrington PCT 1,221 1,471 Warwickshire PCT 2,147 3,373 West Essex PCT 802 1,592 West Hertfordshire PCT 1,579 3,130 West Kent PCT 1,928 3,825 West Sussex PCT 2,295 4,660 Western Cheshire PCT 558 1,336 Westminster PCT 832 1,665 Wiltshire PCT 1,279 2,543 Wirral PCT 2,007 2,490 Wolverhampton City PCT 1,769 2,130 Worcestershire PCT 1,643 3,263 England 210,500 341,500
A Choosing Health progress report was published earlier this year and is available at the Department’s website at
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH074286
It shows that we have made significant progress over a wide range of areas and have created drivers for change through better engagement across systems and organisations, better information and new tools and techniques to support individual action to improve health. Two years through this three-year programme, examples of progress include the following:
Smokefree legislation was implemented on 1 July 2007
80 per cent. of people are now seen within 48 hours at a GUM clinic compared to 38 per cent. in 2004.
PCTs have played their part in these improvements in public health.
Health Services: Multiple Sclerosis
Annual fees to cover the cost of providing assessment and registration services are approved by the Secretary of State, after consideration of proposals submitted by the Healthcare Commission (HC). Assessment of the effects of fees is therefore for the Commission in the first instance.
The HC on its 2007-08 independent healthcare sector fee proposals between 20 December 2006 and 20 February 2007. We understand from the chairman of the commission that during the consultation period it received numerous representations from providers asking that fees should be reduced for voluntarily funded establishments.
The HC revised its proposals after considering the comments it received. For 2007-08, annual fees for multiple sclerosis therapy centres have been reduced from £1,566 to £1,225, a reduction of 22 per cent. This is the first time that regulatory fees under the Care Standards Act 2000 have been reduced. Fees for first time registrations have increased from £907 to £990.
Health Services: Prisons
Information on the coverage of health care in prisons is not collected centrally. It is for primary care trusts, working in partnership with prisons, to commission the arrangements for out of hours cover.
Local prisons do usually contain 24-hour health facilities with nursing cover. For example, all prisons in London (with the exception of HMP Latchmere House) have healthcare beds with 24-hour nursing services available.
Out-of-hours medical cover is usually provided by an on-call arrangement with local general practitioners as part of a General Medical Services contract.
Health Services: Public Appointments
These matters have not been decided.
Health Services: South East Region
The Department’s London regional team and their London strategic health authority colleagues support the involvement of local national health service organisations in major regeneration initiatives within the Thames Gateway and East London areas, and the major developments in Newham for the Olympic and Paralympic Games.
London’s primary care trusts (PCTs) jointly fund with the London Development Agency the Healthy Urban Development Unit, which offers practical help to all PCTs in London, including Newham PCT. The aim is to significantly improve the health of Londoners by developing partnerships that enable health organisations to engage early, influencing the plan- making process, and have a positive effect on the outcomes of planning applications.
Health Trainers
Progress on the introduction of health trainers to date has been good:
as forecast and planned, 1,200 health trainers have been trained and are in post as of 2006-07 year end;
competences have been signed off and exemplar job descriptions have been developed for tailoring by local health trainer partnerships;
a national implementation team has been put in place and now provides full regional coverage;
local training programmes have been developed and local evaluation has been put in place;
national accreditation has been developed, with support from technical advisers Skills for Health, to provide City and Guilds Level 3 and Royal Institute for Public Health Level 2 awards;
prisons have begun to introduce health trainers to the system, with around 80 health trainers now in place;
the Army expects to have trained 450 physical training instructor as health trainers by December 2007, with plans for a further 2,000 personnel to receive training in 2008;
Royal Mail plans to train some of their first aid staff as workplace health trainers;
the programme is also working with organisations such as Asda, Marks & Spencer, National Pharmacies and Football Foundation, and;
The Minister of State for Public Health (Dawn Primarolo) presented the first workplace Health Trainer certificate to Audrey Carlin, of T Allen Stockholder Ltd., on 3 July 2007.
Health trainers are employed in a variety of settings and the plurality of employment models means that we do not collect data by individual primary care trust.
The Department has been informed by the following primary care trusts that
Southampton primary care trust has 14 health trainers recruited and in training.
Hampshire primary care trust has 12 health trainers recruited and in training.
Portsmouth primary care trust has 11 health trainers recruited and in training.
Health: Disadvantaged
The 2010 inequalities targets for life expectancy, cardiovascular disease and cancer are based on narrowing the gap in mortality between the population as a whole and the fifth of local authority areas with the worst health and deprivation indicators (the spearhead group), and the primary care trusts that map to them, by 2010.
Life expectancy has increased for both males and females for England as a whole but it has improved more slowly in the spearhead areas. In England, average life expectancy for males is 76.9 and for females 81.1; in the spearhead group it is 74.9 for males and 79.6 for females. The slower rate of improvement in has led to a widening of the relative gap in life expectancy between England and the spearhead group. The latest data for 2003-05 show that the average life expectancy in the spearhead group was 2.61 per cent. lower than the England average for males, and 1.91 per cent. lower than the England average for females. Therefore, the relative gap has widened by 2 per cent. for men and 8 per cent. for women since the baseline (1995-97).
However, although the 2010 target for life expectancy is a challenging one, data for 2003-05 also show that some 60 per cent. of the 70 spearhead areas are on track to narrow their own life expectancy gap with that of England by 10 per cent. by 2010, compared to baseline for either males or females or both. The information is set out in the following table, with comparison data for 2002-04.
Data for 2003-05 have also shown continued improvements in CVD and cancer mortality inequalities between spearhead areas and the national average since the 1995-97 baseline. The absolute gap from circulatory disease has narrowed by 27.9 per cent., and we are on track to meet the 2010 target of at least a 40 per cent. reduction, There has been a 12.7 per cent. reduction in the absolute cancer inequality gap.
Targeted assistance to spearhead areas is being provided through a variety of programmes such as Communities for Health, Health Trainers, Life Check and smoking cessation as well as programmes on cancer, coronary heart disease and primary care.
The following table shows whether the 70 spearhead local authorities are on or off track to narrow their share of the life expectancy gap by 10 per cent. for males or females or both by 2010 according to 2003-05 data. The table also shows a comparison to 2002-04.
2003-05 2002-04 On track both On track male On track female Off track both On track both On track male On track female Off track both Hackney Yes — — — Yes — — — Hammersmith and Fulham Yes — — — Yes — — — Southwark Yes — — — Yes — — — Tower Hamlets Yes — — — Yes — — — Tameside Yes — — — — — Yes — Warrington Yes — — — Yes — — — Derwentside Yes — — — Yes — — — Hyndburn Yes — — — Yes — — — Islington — Yes — — — — — Yes Lambeth — Yes — — Yes — — — Lewisham — Yes — — — Yes — — Newham — Yes — — — Yes — — Knowsley — Yes — — — Yes — — St. Helens — Yes — — Yes — — — Wirral — Yes — — Yes — — Sunderland — Yes — — — — — Yes Halton — Yes — — — — — Yes Blackburn with Darwen — Yes — — — Yes — — Chester-le-Street — Yes — — — Yes — — Sedgefield — Yes — — — Yes — — Wear Valley — Yes — — — Yes — — Burnley — Yes — — — — — Yes Lincoln — Yes — — — Yes — — Wansbeck — Yes — — — Yes — — Tamworth — Yes — — — Yes — — Greenwich — — Yes — — — Yes — Haringey — — Yes — — — Yes — Bury — — Yes — — — Yes — Doncaster — — Yes — — — Yes — Gateshead — — Yes — — — Yes — Newcastle upon Tyne — — Yes — — — Yes — North Tyneside — — Yes — — — — Yes Birmingham — — Yes — — — Yes — Coventry — — Yes — Yes — — — Walsall — — Yes — — Yes — — Redcar and Cleveland — — Yes — — — Yes — Stockton-on-Tees — — Yes Yes — — — Barrow-in-Furness — — Yes — — — Yes Carlisle — — Yes — Yes — — — Corby — — Yes — — Yes — — Blyth Valley — — Yes — — — Yes — Nuneaton and Bedworth — — Yes — Yes — — — Barking and Dagenham — — — Yes — — — Yes Bolton — — — Yes — — — Yes Manchester — — — Yes — Yes — — Oldham — — — Yes — — — Yes Rochdale — — — Yes — — Yes — Salford — — — Yes — — — Yes Wigan — — — Yes — — — Yes Liverpool — — — Yes — — — Yes Barnsley — — — Yes — — Yes — Rotherham — — — Yes — — — Yes South Tyneside — — — Yes — — — Yes Sandwell — — — Yes — — — Yes Wolverhampton — — — Yes — — Yes — Bradford — — — Yes — — — Yes Wakefield — — — Yes — — — Yes Hartlepool — — — Yes — — — Yes Middlesbrough — — — Yes — — — Yes Blackpool — — — Yes — — — Yes Kingston upon Hull, City of — — — Yes — — — Yes North East Lincolnshire — — — Yes — — — Yes Leicester — — — Yes — — — Yes Nottingham — — — Yes — — — Yes Stoke-on-Trent — — — Yes — — — Yes Bolsover — — — Yes — — — Yes Easington — — — Yes — — — Yes Pendle — — — Yes — — — Yes Preston — — — Yes — Yes — — Rossendale — — — Yes — — Yes —
The most recent assessment of progress against the infant mortality aspect of the 2010 health inequalities target shows a slight narrowing of the health inequalities gap between the routine and manual group and the rest of the population for 2003-05, compared to 2002-04 and 2001-03. Infant mortality rates are at an all-time low for both groups. However, at 18 per cent. the gap is still wider than the 13 per cent. at the 1997-99 target baseline.
A further update on the infant mortality gap will be available later this year in the 2007 edition of ‘Tackling Health Inequalities: Status Report on the Programme for Action’.
Health: Nutrition
Present action to tackle obesity in adults includes the care pathways for national health service primary care professionals and a self-help guide, ‘Your Weight, Your Health’; the National Heart Forum's toolkit ‘Lightening the Load: tackling overweight and obesity’; work on foods high in salt, fat and sugar; front-of-pack labelling as an easy-to-understand way of helping individuals and families to make healthier food choices; the General Practice Physical Activity Questionnaire; Local Exercise Action Pilots; and the National Step-0-Meter Programme.
We will also continue to work closely with the National Institute for Health and Clinical Excellence to support dissemination and implementation of its guidance on physical activity public health intervention and on the prevention, identification, assessment and management of overweight and obesity in adults and children.
Regarding steps to tackle underweight, Government advice is that people should consume a healthy balanced diet, which includes a wide variety of foods, is low in fat, and is based on plenty of fruit and vegetables and starchy foods such as potatoes, bread, and other cereals. The diet should contain moderate amounts of meat, fish, meat alternatives, milk and dairy products and sparing or infrequent amounts of foods containing fat/foods and drinks containing sugar. Eating a balanced diet in combination with physical activity should enable people to maintain a healthy weight.
The information is not available in the format requested. Data on prevalence of different body mass index (BMI) values among adults aged 16 and over are available from the health survey for England. Data on the percentage of men and women in England with a body BMI of over 30 and under 18.5 are presented in Table 1, copies of which have been placed in the Library. Data are shown for the years 1997 to 2005 and are broken down by age group and gender.
Hearing Impairment
(2) what the average time interval between receiving a hearing test and the fitting of a hearing aid was in (a) Surrey, (b) Oxfordshire and (c) England in (i) 1997, (ii) 1998, (iii) 1999, (iv) 2000, (v) 2001, (vi) 2002, (vii) 2003, (viii) 2004, (ix) 2005 and (x) 2006;
(3) what assessment he has made of the effectiveness of the procurement of audiology service pathways from the private sector; and if he will make a statement;
(4) what assessment he has made of the procedures for the referral of NHS patients to the independent sector for the fitting of hearing aids; and if he will make a statement;
(5) what assessment his Department has made of the fitting of hearing aids by the independent sector following the abolition of the Hearing Aid Council; and if he will make a statement.
The Department does not collect data on waiting times for fitting of digital hearing aids. Since January 2006, the Department has been collecting data on the waiting times for audiology assessments. The latest figures, for May 2007, indicate that there are currently 1,322 people waiting over 13 weeks for assessments in Surrey and 13 people waiting over 13 weeks for assessments in Oxfordshire. In England as of May 2007, 73,381 people are waiting over 13 weeks for an assessment.
A National Framework Contract Public Private Partnership with David Ormerod Hearing Centres and Ultravox Holdings plc was in place from October 2003 until March 2007. It was fundamental to the National Framework Contract that the quality of service, and hearing aid, that the patient received mirrored those of the local NHS audiology department. Quality assurance was key in the initiative. Both companies demonstrated their commitment to meeting these standards and invested resources in terms of equipment, IT and staff training in order to do so.
Further independent sector capacity for audiology has been procured as part of the Phase 2 Diagnostics Procurement. Providers are subject to ongoing audit and must meet stringent key performance indicators through the delivery of the contract. Independent sector capacity is utilised at a local level alongside NHS capacity and is subject to the same standards and referral procedures.
The Hearing Aid Council, which is responsible for standards of professional practice, remains in operation and is working towards transferring its regulatory functions to other bodies in advance of its abolition.
Henderson Hospital: Finance
Revenue allocations are made directly to primary care trusts (PCTs), not national health service trusts or individual hospitals. NHS trusts receive most of their income through the commissioning arrangements they have with PCTs.
We understand that the Henderson hospital is managed by South West London and St George's Mental Health NHS Trust. We would advise the hon. Member to contact the chairman of the trust for information about the hospital budget. The contact details are:
John Rafferty
Chairman
South West London and St. George's Mental Health NHS Trust
Springfield University Hospital
61 Glenburnie Road
London
SW17 7DJ
Telephone: 020 8672 9911
Hip Replacements and Knee Replacements
Information on the median time waited for hip and knee replacement is set out in the following table.
Hip replacements Knee replacements 2001-02 220 276 2002-03 229 280 2003-04 217 252 2004-05 182 202 2005-06 158 168 Source: Hospital Episode Statistics, The Information Centre for health and social care.
HIV Infection: Pregnancy
Information on the number of babies born in the United Kingdom and confirmed infected with HIV from 2002 to 2006 is shown in the following table.
Year of birth Maternal diagnosis before or at around time of delivery Infected children born to undiagnosed women Total infected 2002 12 24 36 2003 6 19 25 2004 10 20 30 2005 13 14 27 2006 8 9 17 Total 49 86 135 Note: Data include reports received by end of June 2007 and are subject to reporting delay. Source: National Study of HIV in Pregnancy and Childhood, Institute of Child Health, University College London
It is not possible to assess accurately what proportion of transmissions occurred prior to birth, at birth and after birth during this period. In utero transmission is uncommon, and most transmissions occur during labour and delivery, or through breastfeeding. Infant samples need to be taken within 48 hours of birth to make inferences about timing of transmission, and since the majority of infected infants were born to undiagnosed women, sufficient samples were not available.
If the woman is diagnosed before or during pregnancy, she can be offered:
antiretroviral therapy in pregnancy, at delivery, and for the infant after birth;
appropriate management of delivery, e.g. planned caesarean section; and
advice not to breastfeed.
If the woman is diagnosed at or shortly after delivery, the infant can still be offered antiretroviral therapy starting as soon as possible after birth, and the woman can still be advised not to breastfeed, both of which will reduce the risk of transmission if the baby was not already infected in utero.
Since the introduction of the routine recommendation of antenatal HIV testing in 2000, the majority of infected pregnant women have been diagnosed prior to delivery. In 2005, the latest year for which data are available, about 95 per cent. of infected pregnant women were diagnosed before delivery. During the 1990s, before antenatal testing was routine, the majority of infected women remained undiagnosed at delivery and therefore appropriate treatment and advice could not be offered.
Home Care Services: Oxygen
The number of items of correspondence received by the Department from hon. Members and the public concerning the home oxygen service in the last 18 months is shown in the following table. Not all were letters of complaint but to identify these separately would incur disproportionate cost.
Month and year Items of correspondence 2006 January 3 February 61 March 77 April 32 May 30 June 20 July 50 August 36 September 15 October 11 November 4 December 1 2007 January 9 February 3 March 13 April 3 May 1 June 3 Total 372
Expenditure on the home oxygen service prior to the introduction of the new service was not collected centrally.
Primary care trusts (PCTs) are responsible for managing the home oxygen service locally, including assessing how the new arrangements relate to waiting times, patient safety and emergency supply.
PCTs have access, on the home oxygen website, to a clinical assessment services commissioning framework, which outlines how these services, together with the new home oxygen service, can help reduce waiting times while supporting patients in managing their symptoms at home.
Under the terms of the contract, all suppliers are required to provide information and training on the safe and effective use of oxygen equipment provided to patients and their families. Suppliers also make clear to patients the dangers of using oxygen if they continue to smoke or use equipment close to fires or other naked flames. Suppliers are required to report any incident involving patient safety to PCTs. It is for PCTs to report all serious incidents and to take any appropriate follow-up action, whether reported by a supplier, health care professional or a patient, to strategic health authorities and the National Patient Safety Agency.
From national service data provided by suppliers, I am able to confirm that all new suppliers are meeting the response time target 99 per cent. of the time for emergency supply. This is a priority service and, under the terms of the contract, all suppliers are required to supply oxygen at home within four hours of receiving an order for emergency supply.
Homeopathy
(2) what homoeopathic services will be available to the residents of Brent following changes in funding for treatment at the Royal London Homoeopathic Hospital.
This is a local matter. The homoeopathic hospitals in the United Kingdom fall under the jurisdiction of the national health service in the area in which they are based. Any decisions on the services that any of these hospitals provide are the responsibility of those NHS healthcare organisations.
Hospital Beds
Provider data by strategic health authority are shown in the following tables. Commissioner data are not collected centrally.
SHA 1997-98 1998-99 1999-2000 2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 Q01 Norfolk, Suffolk and Cambridgeshire SHA 0.00432 0.00419 0.00415 0.00416 0.00411 0.00404 0.00404 0.00391 0.00364 Q02 Bedfordshire and Hertfordshire SHA 0.00255 0.00244 0.00240 0.00271 0.00268 0.00280 0.00276 0.00281 0.00270 Q03 Essex Strategic HA 0.00341 0.00343 0.00337 0.00329 0.00333 0.00326 0.00308 0.00311 0.00313 Q04 North West London Strategic HA 0.00481 0.00483 0.00425 0.00411 0.00400 0.00395 0.00378 0.00383 0.00367 Q05 North Central London Strategic HA 0.00575 0.00547 0.00508 0.00519 0.00493 0.00514 0.00503 0.00516 0.00504 Q06 North East London Strategic HA 0.00504 0.00484 0.00441 0.00426 0.00417 0.00417 0.00409 0.00403 0.00386 Q07 South East London Strategic HA 0.00433 0.00415 0.00404 0.00404 0.00401 0.00400 0.00407 0.00408 0.00394 Q08 South West London Strategic HA 0.00373 0.00378 0.00400 0.00401 0.00394 0.00358 0.00382 0.00371 0.00357 Q09 Northumberland, Tyne and Wear Strategic HA 0.00556 0.00542 0.00535 0.00532 0.00531 0.00530 0.00526 0.00517 0.00508 Q10 County Durham and Tees Valley SHA 0.00466 0.00471 0.00466 0.00473 0.00463 0.00452 0.00454 0.00440 0.00431 Q11 North & East Yorkshire & N Lincs SHA 0.00365 0.00348 0.00338 0.00335 0.00333 0.00338 0.00333 0.00328 0.00323 Q12 West Yorkshire Strategic HA 0.00462 0.00449 0.00442 0.00442 0.00439 0.00425 0.00430 0.00388 0.00369 Q13 Cumbria and Lancashire Strategic HA 0.00470 0.00450 0.00436 0.00431 0.00416 0.00410 0.00405 0.00390 0.00376 Q14 Greater Manchester Strategic HA 0.00480 0.00466 0.00467 0.00451 0.00468 0.00442 0.00443 0.00428 0.00419 Q15 Cheshire & Merseyside Strategic HA 0.00402 0.00405 0.00417 0.00427 0.00436 0.00430 0.00433 0.00430 0.00417 Q16 Thames Valley Strategic HA 0.00313 0.00308 0.00301 0.00295 0.00275 0.00294 0.00298 0.00296 0.00289 Q17 Hampshire And Isle of Wight Strategic HA 0.00349 0.00342 0.00336 0.00344 0.00332 0.00334 0.00332 0.00338 0.00311 Q18 Kent and Medway Strategic HA 0.00347 0.00327 0.00329 0.00317 0.00310 0.00304 0.00308 0.00307 0.00289 Q19 Surrey and Sussex Strategic HA 0.00385 0.00377 0.00354 0.00350 0.00358 0.00362 0.00360 0.00335 0.00321 Q20 Avon, Gloucestershire and Wiltshire SHA 0.00433 0.00424 0.00414 0.00402 0.00402 0.00409 0.00393 0.00388 0.00388 Q21 South West Peninsula Strategic HA 0.00429 0.00415 0.00411 0.00402 0.00378 0.00373 0.00390 0.00382 0.00370 Q22 Dorset and Somerset Strategic HA 0.00432 0.00420 0.00416 0.00419 0.00422 0.00425 0.00417 0.00407 0.00395 Q23 South Yorkshire Strategic HA 0.00465 0.00480 0.00473 0.00480 0.00488 0.00499 0.00493 0.00500 0.00492 Q24 Trent Strategic HA 0.00382 0.00379 0.00382 0.00373 0.00359 0.00350 0.00366 0.00356 0.00342 Q25 Leics, Northants and Rutland SHA 0.00345 0.00341 0.00339 0.00354 0.00343 0.00359 0.00358 0.00346 0.00335 Q26 Shropshire and Staffordshire SHA 0.00364 0.00373 0.00369 0.00357 0.00352 0.00341 0.00344 0.00340 0.00325 Q27 Birmingham and the Black Country SHA 0.00425 0.00428 0.00416 0.00423 0.00424 0.00426 0.00427 0.00420 0.00418 Q28 West Midlands South Strategic HA 0.00351 0.00337 0.00338 0.00338 0.00335 0.00325 0.00314 0.00318 0.00314 England 0.00413 0.00405 0.00396 0.00395 0.00390 0.00387 0.00387 0.00380 0.00368
SHA 1997-98 1998-99 1999-2000 2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 Q01 Norfolk, Suffolk and Cambridgeshire SHA 0.00215 0.00213 0.00212 0.00215 0.00213 0.00214 0.00219 0.00212 0.00198 Q02 Bedfordshire and Hertfordshire SHA 0.00099 0.00100 0.00100 0.00122 0.00128 0.00126 0.00129 0.00139 0.00127 Q03 Essex Strategic HA 0.00148 0.00146 0.00147 0.00149 0.00147 0.00149 0.00153 0.00151 0.00152 Q04 North West London Strategic HA 0.00259 0.00266 0.00240 0.00222 0.00219 0.00215 0.00215 0.00219 0.00207 Q05 North Central London Strategic HA 0.00312 0.00299 0.00287 0.00281 0.00271 0.00268 0.00277 0.00269 0.00263 Q06 North East London Strategic HA 0.00238 0.00233 0.00216 0.00222 0.00224 0.00225 0.00227 0.00221 0.00221 Q07 South East London Strategic HA 0.00232 0.00226 0.00225 0.00227 0.00221 0.00210 0.00209 0.00205 0.00193 Q08 South West London Strategic HA 0.00195 0.00193 0.00215 0.00214 0.00215 0.00203 0.00211 0.00217 0.00213 Q09 Northumberland, Tyne and Wear Strategic HA 0.00276 0.00276 0.00276 0.00274 0.00276 0.00274 0.00275 0.00273 0.00275 Q10 County Durham and Tees Valley SHA 0.00265 0.00262 0.00259 0.00259 0.00249 0.00241 0.00246 0.00239 0.00233 Q11 North & East Yorkshire & N Lincs SHA 0.00202 0.00190 0.00189 0.00192 0.00191 0.00197 0.00196 0.00195 0.00194 Q12 West Yorkshire Strategic HA 0.00249 0.00244 0.00242 0.00243 0.00238 0.00231 0.00229 0.00221 0.00216 Q13 Cumbria and Lancashire Strategic HA 0.00242 0.00247 0.00239 0.00243 0.00232 0.00232 0.00230 0.00221 0.00220 Q14 Greater Manchester Strategic HA 0.00283 0.00282 0.00282 0.00280 0.00283 0.00278 0.00282 0.00279 0.00271 Q15 Cheshire & Merseyside Strategic HA 0.00251 0.00251 0.00260 0.00267 0.00269 0.00270 0.00271 0.00276 0.00267 Q16 Thames Valley Strategic HA 0.00190 0.00186 0.00181 0.00165 0.00182 0.00185 0.00185 0.00185 0.00181 Q17 Hampshire And Isle Of Wight Strategic HA 0.00187 0.00181 0.00178 0.00191 0.00192 0.00195 0.00200 0.00201 0.00184 Q18 Kent and Medway Strategic HA 0.00167 0.00167 0.00169 0.00170 0.00162 0.00153 0.00155 0.00157 0.00154 Q19 Surrey and Sussex Strategic HA 0.00188 0.00183 0.00170 0.00177 0.00184 0.00182 0.00192 0.00184 0.00181 Q20 Avon, Gloucestershire and Wiltshire SHA 0.00232 0.00240 0.00240 0.00233 0.00234 0.00243 0.00244 0.00244 0.00258 Q21 South West Peninsula Strategic HA 0.00243 0.00245 0.00248 0.00250 0.00261 0.00258 0.00261 0.00257 0.00251 Q22 Dorset and Somerset Strategic HA 0.00221 0.00216 0.00216 0.00215 0.00214 0.00215 0.00223 0.00218 0.00215 Q23 South Yorkshire Strategic HA 0.00278 0.00288 0.00281 0.00283 0.00293 0.00308 0.00297 0.00302 0.00305 Q24 Trent Strategic HA 0.00212 0.00212 0.00217 0.00211 0.00202 0.00196 0.00194 0.00191 0.00186 Q25 Leics, Northants and Rutland SHA 0.00191 0.00192 0.00196 0.00194 0.00191 0.00199 0.00195 0.00190 0.00194 Q26 Shropshire and Staffordshire SHA 0.00177 0.00184 0.00183 0.00189 0.00190 0.00185 0.00185 0.00184 0.00179 Q27 Birmingham and the Black Country SHA 0.00252 0.00255 0.00255 0.00259 0.00260 0.00266 0.00262 0.00269 0.00269 Q28 West Midlands South Strategic HA 0.00199 0.00198 0.00200 0.00197 0.00206 0.00214 0.00205 0.00205 0.00204 England 0.00222 0.00221 0.00219 0.00219 0.00219 0.00219 0.00220 0.00219 0.00214
SHA 1997-98 1998-99 1999-2000 2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 Q01 Norfolk, Suffolk and Cambridgeshire SHA 0.00020 0.00019 0.00019 0.00019 0.00018 0.00017 0.00015 0.00015 0.00014 Q02 Bedfordshire and Hertfordshire SHA 0.00016 0.00015 0.00015 0.00019 0.00018 0.00017 0.00017 0.00017 0.00018 Q03 Essex Strategic HA 0.00022 0.00020 0.00020 0.00018 0.00018 0.00016 0.00016 0.00014 0.00015 Q04 North West London Strategic HA 0.00030 0.00028 0.00028 0.00021 0.00021 0.00019 0.00018 0.00019 0.00018 Q05 North Central London Strategic HA 0.00028 0.00028 0.00027 0.00025 0.00025 0.00021 0.00022 0.00022 0.00022 Q06 North East London Strategic HA 0.00032 0.00031 0.00028 0.00024 0.00026 0.00023 0.00023 0.00023 0.00023 Q07 South East London Strategic HA 0.00024 0.00023 0.00023 0.00023 0.00022 0.00022 0.00023 0.00021 0.00022 Q08 South West London Strategic HA 0.00020 0.00020 0.00020 0.00021 0.00022 0.00020 0.00020 0.00019 0.00019 Q09 Northumberland, Tyne and Wear Strategic HA 0.00025 0.00024 0.00021 0.00020 0.00018 0.00019 0.00018 0.00018 0.00018 Q10 County Durham and Tees Valley SHA 0.00028 0.00026 0.00024 0.00023 0.00021 0.00020 0.00019 0.00019 0.00019 Q11 North & East Yorkshire & N Lincs SHA 0.00020 0.00019 0.00019 0.00019 0.00021 0.00018 0.00018 0.00018 0.00017 Q12 West Yorkshire Strategic HA 0.00024 0.00024 0.00023 0.00021 0.00023 0.00022 0.00022 0.00020 0.00018 Q13 Cumbria and Lancashire Strategic HA 0.00022 0.00021 0.00020 0.00020 0.00020 0.00019 0.00020 0.00020 0.00018 Q14 Greater Manchester Strategic HA 0.00029 0.00026 0.00026 0.00025 0.00025 0.00024 0.00024 0.00022 0.00021 Q15 Cheshire & Merseyside Strategic HA 0.00022 0.00020 0.00021 0.00019 0.00021 0.00020 0.00019 0.00019 0.00019 Q16 Thames Valley Strategic HA 0.00020 0.00020 0.00020 0.00018 0.00017 0.00017 0.00017 0.00016 0.00017 Q17 Hampshire And Isle Of Wight Strategic HA 0.00019 0.00020 0.00020 0.00020 0.00019 0.00018 0.00017 0.00018 0.00015 Q18 Kent and Medway Strategic HA 0.00021 0.00019 0.00019 0.00019 0.00018 0.00016 0.00016 0.00014 0.00015 Q19 Surrey and Sussex Strategic HA 0.00019 0.00019 0.00018 0.00017 0.00016 0.00016 0.00015 0.00015 0.00014 Q20 Avon, Gloucestershire and Wiltshire SHA 0.00023 0.00021 0.00022 0.00022 0.00021 0.00021 0.00020 0.00020 0.00020 Q21 South West Peninsula Strategic HA 0.00023 0.00023 0.00023 0.00021 0.00018 0.00018 0.00018 0.00017 0.00015 Q22 Dorset and Somerset Strategic HA 0.00018 0.00016 0.00015 0.00015 0.00014 0.00014 0.00014 0.00014 0.00014 Q23 South Yorkshire Strategic HA 0.00015 0.00017 0.00017 0.00015 0.00020 0.00019 0.00021 0.00021 0.00021 Q24 Trent Strategic HA 0.00020 0.00018 0.00018 0.00018 0.00017 0.00017 0.00017 0.00017 0.00017 Q25 Leics, Northants and Rutland SHA 0.00020 0.00019 0.00019 0.00018 0.00018 0.00017 0.00017 0.00017 0.00013 Q26 Shropshire and Staffordshire SHA 0.00018 0.00018 0.00018 0.00017 0.00017 0.00017 0.00019 0.00018 0.00016 Q27 Birmingham and the Black Country SHA 0.00022 0.00021 0.00022 0.00020 0.00021 0.00020 0.00021 0.00019 0.00019 Q28 West Midlands South Strategic HA 0.00021 0.00020 0.00019 0.00020 0.00021 0.00019 0.00019 0.00018 0.00017 England 0.00022 0.00021 0.00021 0.00020 0.00020 0.00019 0.00019 0.00018 0.00018 Notes: 1. KH03 is a provider based collection so the data are not available at PCT level. 2. The data have been mapped to the 28 SHAs created 1 April 2002 to provide a timeseries comparison. 3. Population data are mid-year population estimates based on the 2001-1991 census 4. Beds totals include beds in wards open overnight, day only beds and residential care beds. Source: Department of Health form KH03 and ONS for population statistics.
Hospital Beds: Heart Diseases
The information is in the following table and footnotes.
Mean Median 2005-06 7 3 2004-05 7 3 2003-04 8 3 2002-03 9 4 2001-02 10 5 Notes: 1. ICD-10 Code: I50.0 Congestive Heart Failure 2. Bed Days During the Year Bed days within the year include only those days falling between 1 April and 31 March of the data year including unfinished episodes, unless otherwise stated. 3. 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. 4. Data Quality HES are compiled from data sent by over 300 national health service 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. 5. Assessing growth through time HES figures are available from 1989-90 onwards. During the years that these records have been collected the NHS there have been ongoing improvements in quality and coverage. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series. Changes in NHS practice also need to be borne in mind when analysing time series. For example a number of procedures may now be undertaken in outpatient settings and may no longer be accounted in the HES data. This may account for any reductions in activity over time. 6.Ungrossed Data Figures have not been adjusted for shortfalls in data (ie the data are ungrossed). Source: HES, The Information Centre for health and social care
Hospitals: Doctors
[holding answer 18 July 2007]: The information requested is not collected centrally.
Hospitals: Food
Information on the number, and percentage, of hospital main meals left untouched in England is in the following table. Information relating to individual national health service providers has been placed in the Library. Data were not collected before 2001-02.
England Total number untouched/unserved patient meals Average percentage untouched/unserved patient meals 2001-02 11,473,923 8.86 2002-03 14,582,371 10.44 2003-04 16,708,212 10.71 2004-05 10,707,712 10.26 2005-06 13,053,065 9.42
Food is left untouched or unserved for a variety of reasons, but generally a combination of sufficient food being provided in order to ensure patients have a choice and changing requirements, i.e. patients being discharged or moved, being absent for treatment or changing clinical status after the food orders have been made.
Since 2004-05, the data provided have not been collected on a mandatory basis and therefore will not be complete.
Hospitals: Infectious Diseases
The best available data are given as follows but will include both community and healthcare-acquired infections.
Methicillin-resistant Staphylococcus aureus (MRSA)
Information on age has only been collected under the mandatory surveillance scheme by the Health Protection Agency (HPA) since October 2005 and the latest data were published on 25 July 2007. The total number of cases of MRSA bloodstream infections in the 12 months from April 2006 to March 2007 in children aged under one year in England was 35.
The small numbers involved mean that the information is not available by named trust as this could result in deductive disclosure.
Clostridium difficile
Children under two years are not included in the mandatory surveillance scheme.
The HPA’s voluntary reporting scheme collects data on age and sex of cases. The scheme does not collect data on where infection was acquired (e.g. neonatal unit, or maternity unit). The following table shows the number of cases of Clostridium difficile for children from birth to one in England, Wales and Northern Ireland for 2005. Data for 2006 are not available yet.
Age 2005 Under 1 month 37 1 to 5 months 42 6 to 11 months 40
The aforementioned information is likely to be an underestimate as not all laboratories report. Furthermore, testing of children under two years of age may be limited owing to a general belief that the presence of C. difficile is not usually clinically significant in this age group as asymptomatic carriage, including production of toxins A and B, is common in this age group.
No other data on healthcare associated infections are available by age group.
The six deaths from methicillin resistant Staphylococcus aureus in persons aged under one, in 2005, occurred in five different hospitals.
Hospitals: Private Finance
(2) what the value of private finance initiative projects for which his Department is responsible was in each of the last five years, broken down by strategic health authority region;
(3) how many of the hospitals which have been opened through private finance initiative funding since 1997 have subsequently been closed, broken down by strategic health authority region.
The information for PFI schemes with capital value over £10 million is shown in the following table.
Capital value of PFI schemes opened or commenced construction in each of last five years Strategic health authority PFI schemes operational since 1997 2003 2004 2005 2006 2007(to date) Total East Midlands 1 312 19 354 0 29 714 East of England 4 15 0 0 66 412 493 London 19 224 0 443 1,541 33 2,241 North East 9 205 16 299 32 24 576 North West 4 0 512 0 478 0 990 South Central 7 30 19 365 47 207 668 South East Coast 4 29 0 0 0 36 65 South West 6 0 42 0 107 21 170 West Midlands 8 13 0 163 1,006 306 1,488 Yorkshire and the Humber 7 22 279 42 62 378 783 Totals 69 850 887 1,666 3,339 1,446 8,188
There are no instances of a PFI facility built since 1997 for the national health service that has subsequently closed.
Human Papilloma Virus: Vaccination
I refer the hon. member to the reply I gave to the hon. Member for Portsmouth, South (Mr. Hancock) on 19 July 2007, Official Report, columns 633-34W.
A detailed analysis is being carried out by the Joint Committee on Vaccination and Immunisation (JCVI) regarding the benefits and costs of introducing a human papilloma virus vaccine programme. This work is being externally peer reviewed to ensure its robustness. This review has not yet been completed and therefore JCVI will not be able to make its more detailed recommendation, including whether there will be a catch-up for older girls, until after its next meeting, on October 17.
A detailed analysis is being carried out by the Joint Committee on Vaccination and Immunisation (JCVI) regarding the benefits and costs of introducing a human papilloma virus (HPV) vaccine programme. This work is being externally peer reviewed by biologists working in the HPV field, mathematical modellers and economists in order to ensure its robustness.
The introduction of a comprehensive nationwide human papilloma virus vaccine programme will be a considerable undertaking for the national health service and many practical issues need to be discussed with stakeholders, particularly from the NHS. The Department will work with stakeholders, including primary care trusts and strategic health authorities, to plan for the introduction of the vaccine.
Influenza
Prophylaxis is being considered as part of the overall countermeasures strategy for pandemic influenza. No decisions have been made on the use of prophylaxis but the policy is being kept under review including the possible size of any stockpiles and the potential options for their use.
Influenza: Disease Control
Advice to businesses and organisations that are planning to make interventions available to their employees is that distribution should be carried out under the guidance of a medical practitioner, in line with their usual occupational health arrangements. Advice on planning for a pandemic is included in the draft national framework for responding to an influenza pandemic that was issued for public discussion in March. Workplace guidance for pandemic flu is also available from the Health and Safety Executive website.
The Joint Committee on Vaccination and Immunisation (JCVI) considered prioritisation issues connected with pandemic-specific vaccines and pre-pandemic vaccines which might be deployed to counter a flu pandemic. The group was presented with clinical, practical and public health considerations for the possible prioritisation of some or all of the following groups; healthcare workers, those at high risk of complications, those aged 18 years or younger to reduce disease transmission, those over 65, essential workers and enclosed communities. Another consideration was vaccination of the entire population.
The modelling subgroup of the Pandemic Influenza Scientific Advisory Group has considered the conclusions of a number of pieces of analysis (some commissioned specially for the group) on the role of both pre- and specific vaccines. This is discussed in the modelling summary published on the Department’s website. The results of the analysis and the conclusions of the subgroup were presented at the June JCVI meeting and there will be further presentations and discussion at the next meeting.
The conclusions of the discussion will feed into the considerations of the Department and the Cabinet Office, including discussions with other Government Departments, on future options for pandemic preparedness.
We continue to receive representations from a range of sources on the effectiveness of stockpiling both antivirals and pre-pandemic vaccine.
(2) pursuant to the answer of 9 March 2007, Official Report, column 2298W, on influenza, when he plans to publish a final framework.
The national framework is due to be published later in the year.
The United Kingdom policy on pre-pandemic vaccination has not yet been finalised and the appropriateness and cost-effectiveness of this countermeasure is still being assessed, along with manufacturing, distribution and storage capacity of producers.
Injuries: Children
The number of admissions of children (aged 0 to 14) to hospital as a result of unintentional injury in each of the last five years for which data are available is shown in the following table.
Financial year Number of admissions 2001-02 102,833 2002-03 97,493 2003-04 99,915 2004-05 99,517 2005-06 100,194 Notes: 1. A finished admission episode is the first period of in-patient care under one consultant within one healthcare provider. Admissions do not represent the number of in-patients, as a person may have more than one admission within the year. 2. Data are for International Classification of Diseases, Tenth Revision (ICD-10) codes V01 to X59, which cover external causes of accidental injury. Data represent a count of all episodes where this diagnosis was mentioned in any of the 14 (seven prior to 2002-03) diagnosis fields in a HES record. 3. HES are compiled from data sent by over 300 NHS trusts and primary care trusts 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. 4. When analysing time series of HES data, the impact of improvements over time in data quality and coverage, and of changes in NHS practice need to be borne in mind. For example, a number of procedures may now be undertaken in outpatient settings and may no longer be accounted in the HES data. This may account for any reductions in activity over time. 5. Figures have not been adjusted for shortfalls in data (ie the data are ungrossed). Source: Hospital Episode Statistics (HES), The Information Centre for health and social care.
The number of children (aged 0 to 14) who died as a result of unintentional injury in each of the last five years for which data are available is shown in the following table.
Number of deaths 2002 284 2003 274 2004 240 2005 231 2006 233 Notes: 1. Data are for deaths registered in each calendar year. 2. Cause of death is based on the final underlying cause, defined using the International Classification of Diseases, Tenth Revision (ICD-10) codes V01 to X59. 3. Data are for usual residents of England. Source: Office for National Statistics death registrations
Junior Doctors: Vacancies
At the end of round one, 85 per cent. of junior doctor training posts had been filled.
The round 2 recruitment is in progress and the estimated total fill rate for 1 August is around 90 per cent. This means that national health service hospitals should have the junior doctors they need in post to ensure that services run smoothly around the annual changeover of junior doctors in early August.
A new wave of junior doctors start working in NHS hospitals across the country in August, each year. We appreciate that there are more involved this year, but hospitals are used to dealing with a new influx of junior doctors. Hospital consultants every year quietly, and very competently, plan for that process.
All applicants who are in substantive NHS employment will continue to have employment while they progress through the next round. This will help cover any remaining gaps in August.
Link Up Service
The cross-Government strategy, “‘Opportunity Age’—meeting the challenge of a changing society”, was published by the Department for Work and Pensions (DWP) as a consultation document on 23 March 2005. The strategy outlines what can be done to meet the challenge of the changing demographics in the 21st century and looks specifically at the issues facing society as people live longer, healthier lives. It includes supporting active ageing and giving people more choice and independence in how they use the services at their disposal.
The Department was a major partner with the DWP in Opportunity Age. A specific theme of Opportunity Age was the development of LinkAge Plus pilots, which aim to build more effective links between central Government, local authorities and other organisations and deliver a fully integrated service to meet the needs of older people.
Eight LinkAge Plus pilots were established. LinkAge Plus is a two-year pilot programme, with funding available until March 2008. It was launched in September 2006 and aims to test models of partnership working and build up evidence of good practice to ensure joined up working. The Link Up service in Gateshead is one of these pilots.
Link Up offers advice and help to people in Gateshead aged 50 or over on a variety of topics, including health, benefits and how to stay healthy and active, and help with domestic tasks such as gardening and shopping.
Macular Degeneration
All primary care trusts (PCTs) are funding photodynamic therapy treatment for patients with both the wholly classic and the predominantly classic forms of wet age-related macular degeneration, in line with guidance from the National Institute for Health and Clinical Excellence (NICE).
NICE is currently carrying out an appraisal of Lucentis and Macugen, which are now both licensed for the treatment of wet age-related macular degeneration, and final guidance is due later in the year.
Where guidance from NICE is not yet available, PCTs are expected to apply local arrangements for the managed introduction of new technologies. These arrangements should include an assessment of the available evidence.
Medical Treatments Abroad
[holding answer 23 July 2007]: It has been assumed that the question relates to patients being referred abroad specifically for treatment. There are a number of different routes by which patients can be sent abroad for treatment. We only hold information where the relevant authorisation has to be given by the Department. Cost information is not available as claims do not separate the different categories of treatment and this could only be done at disproportionate cost. The following table shows the number of patients treated by country and treatment type where Departmental authorisation has been given.
Country Type of Treatment Number of cases Austria Lung transplant 1 Maternity care 5 Removal of screws 1 Total for country 7 Belgium Annual check for heart transplant 1 Atrial fibrillation 1 CTscan 2 Maternity care 21 Phalloplasty 2 Scan for epilepsy (ictal spect scan) 3 Total for country 30 Czech Republic Maternity care 11 Total for country 11 Finland Blood test 1 Cancer care 2 Cholecystectomy 1 Maternity care 4 Removal of implant 1 Total for country 9 France Bladder echocardiogram 1 Brain aneurysm treatment 1 Colonoscopy 2 Consultation 3 Ear reconstruction 2 EEG scan 1 Embolisation 1 Endoscopy 1 Gamma knife assessment 1 Maternity care 104 Photons 1 Pilondial sinus and abscess 1 Primary torsion dystonia 1 Proton beam therapy 3 Pudendal nerve compression 2 Renal transplant 1 Stereo-Electroencephalography 2 Steroid injection 1 Thyroidectomy 1 Trapped pudendal nerve 1 Urine test/injection 1 Unknown 4 Total for country 136 Germany Advanced radiosurgery/MRI scan 1 Cancer treatment 1 Chemotherapy 1 Cyberknife therapy 1 F-Dopa-Pet scan 1 Speech therapy 1 Heart stemcell therapy 1 Hernia 1 Intraluminal bare laser 2 Laser treatment of the tongue 2 Maternity care 44 Meg scan 1 Pet scan 1 Phalloplasty 1 Provision of hearing aid 1 Skin cancer 1 Stem cell therapy 1 Unknown 1 Total for country 63 Greece Maternity care 2 Total for country 2 Italy Maternity care 10 Total for country 10 Netherlands Chemotherapy 2 Genetic mutation analysis 1 Maternity care 8 Total for country 11 Norway Maternity care 1 Total for country 1 Poland Accident 1 Maternity care 21 Total for country 22 Slovak Republic Maternity care 3 Total for country 3 Spain Maternity care 27 Medication 1 Total for country 28 Sweden Carcinoid cancer 3 Ergonomics and physiotherapy 3 Lymph oedema 1 Maternity care 3 Neurendocrine pancreatic tumour 2 Octreotide treatment 2 Unknown 3 Total for country 17 Switzerland Maternity care 5 Total for country 5 Unknown Unknown 2 Total treatments abroad 357
Medical Treatments: Heart Diseases
These data are not collected centrally.
Information is not collected in the form requested. It is possible to separate spending on medical devices and pharmacological management devices specifically for treatment for congestive heart failure from figures for such spending related to cardiac conditions generally.
On heart and lung transplants only national figures are available for procedures commissioned under the auspices of the National Specialist Commissioning Advisory Group. The following figures are for national commissioning across England, Scotland and Northern Ireland and include assessment, organ retrieval and follow-up services for both heart and lung transplant.
£ million 2002-03 30.1 2003-04 31.4 2004-05 33.8 2005-06 35.7 2006-07 37.8
(2) what the average cost of an occupied bed day was for patients with congestive heart failure in each of the last five years, broken down by strategic health authority.
These data requested are not held centrally.
Members: Correspondence
A reply was sent to the hon. Member on 24 July 2007.
Mental Health Services: Children
Information about medical child mental health specialists has been placed in the Library. It is not possible to separately identify child mental health nurses.
Mental Health Services: Manpower
The information requested is shown in the following tables.
Headcount Full-time equivalent Headcount Full-time equivalent Headcount Full-time equivalent Headcount Full-time equivalent All staff 52,667 47,385 51,504 46,316 51,730 46,273 51,930 46,823 Consultant Psychiatrists 2,447 2,206 2,627 2,359 2,808 2,525 2,904 2,621 Mental Health Nurses 50,220 45,179 48,877 43,957 48,922 43,748 49,026 44,203 Nurse Consultant n/a n/a n/a n/a n/a n/a n/a n/a Modern Matron n/a n/a n/a n/a n/a n/a n/a n/a Manager 1,137 1,106 1,119 1,085 1,070 1,036 1,154 1,113 Other 1st level 43,509 39,297 42,963 38,685 43,494 38,965 44,363 40,061 Other 2nd level 5,574 4,776 4,795 4,186 4,358 3,747 3,509 3,029
Headcount Full-time equivalent Headcount Full-time equivalent Headcount Full-time equivalent Headcount Full-time equivalent All staff 54,274 48,046 55,183 49,172 56,907 50,127 59,601 52,342 Consultant Psychiatrists 2,959 2,633 2,979 2,673 3,229 2,920 3,555 3,231 Mental Health Nurses 51,315 45,413 52,204 46,499 53,678 47,207 56,046 49,111 Nurse Consultant 36 36 75 70 95 94 130 126 Modern Matron n/a n/a n/a n/a n/a n/a n/a n/a Manager 1,464 1,416 1,423 1,377 1,731 1,677 2,021 1,974 Other 1st level 46,112 40,927 47,673 42,590 48,775 43,120 50,924 44,785 Other 2nd level 3,703 3,033 3,033 2,461 3,077 2,317 2,971 2,226
Headcount Full-time equivalent Headcount Full-time equivalent All staff 61,136 53,328 59,866 52,957 Consultant Psychiatrists 3,759 3,432 3,805 3,474 Mental Health Nurses 57,377 49,896 56,061 49,483 Nurse Consultant 142 138 144 141 Modern Matron 168 165 225 222 Manager 1,764 1,718 1,823 1,763 Other 1st level 52,668 45,965 52,299 46,009 Other 2nd level 2,635 1,909 1,570 1,348 n/a = Not applicable. Notes: 1. Mental health nurses are those qualified nurses who work within the community psychiatry, other psychiatry, community learning disabilities and other learning disabilities areas. 2. More accurate validation processes in 2006 have resulted in the identification and removal of 9,858 duplicate non-medical staff records out of the total work force figure of 1.3 million in 2006. Earlier years’ figures could not be accurately validated in this way and so will be slightly inflated. The level of inflation in earlier years’ figures is estimated to be less than 1 per cent. of total across all non-medical staff groups for headcount figures (and negligible for full-time equivalents). This should be taken into consideration when analysing trends over time. Sources: 1. Information Centre for health and social care non-medical workforce census 2. The Information Centre for health and social care medical and dental workforce census
Mental Health Services: Young People
The number of new cases dealt with by specialist child and adolescent mental health services (CAMHS) in England was as follows.
Cases 2002 9,822 2003 16,632 2004 27,892 2005 31,330 2006 29,170 Source: CAMHS mapping data 2002-06
Midwives: Manpower
It is important that these assessments are made locally as they know their local needs best and can ensure that services are developed to meet these needs.
The 2007-08 national health service operating framework requires local NHS organisations to undertake a review of their maternity services, identify the gaps and barriers to service development and set out their local strategy for delivery of maternity matters. The review needs to include an assessment of their workforce capacity.
Between September 1997 and September 2006, the (headcount) number of midwives employed in the NHS has increased by 2,084 (9 per cent).
Midwives: Training
A total of 2,116 planned student midwifery training places were commissioned for the 2007-08 academic year. Information on the number of planned training places for subsequent years is not available centrally.
When determining the number of training places needed, the existing number of midwifes, the expected number of graduates and policy priorities such as Maternity Matters are expected to be taken into account.
Strategic health authorities will have the final decision on how many places to commission. The Department has a service level agreement with local strategic health authorities (SHAs) which expects them to make decisions and plans based on long-term workforce planning using national and local data sources with support from the national workforce review team. It is for individual SHAs to decide on the appropriate organisations to consult.
Multiple Sclerosis: Drugs
The review period for Sativex concluded on 19 July 2007 when the applicant for the marketing authorisation, GW Pharmaceuticals Ltd, withdrew the application in all concerned member states (Netherland, Denmark, Spain and the United Kingdom). No further review on Sativex is possible until another application is submitted by the company.
Musculoskeletal Disorders: Health Services
The Musculoskeletal Services Framework (MSF) was published as good practice guidance and it is for local organisations to decide how best to implement it. The Department will not be monitoring local implementation formally, but will continue to monitor indicators such as waiting times and to liaise with stakeholders such as those represented on the National Orthopaedics Co-ordinating Group.
The Department of Health does not receive any submissions on changes to the Quality and Outcomes Framework (QOF).
The independent expert panel which advises the negotiating parties to the general medical services contract on the evidence for changes to the QOF invited submissions for a review of QOF in 2005. The panel received two submissions in relation to falls, one in relation to osteoarthritis and seven in relation to osteoporosis. All submissions were considered and the expert panel produced reports which have been published on the University of Birmingham website.
As part of the ongoing development of the framework, indicators will be subject to continuing review in the light of emerging evidence, in the context of a value for money agreement. The expert panel again invited patient groups and professional bodies to submit evidence on current or potential future areas in QOF by 28 February this year. The panel has now concluded oral sessions with submitting groups. NHS Employers, which holds the contract with the expert panel and negotiates changes to the contract with the British Medical Association, intends to make further information available on this process soon.
NHS Direct
The NHS Direct Trust has provided the following information.
Calls offered 2002 7,375,970 2003 8,168,357 2004 8,611,418 2005 8,104,166 2006 7,336,604 1 Defined as the number of calls offered received by NHS Direct. This is the combined total of calls to NHS Direct’s out-of-hours services and calls to the 08454647 telephone line. Sources: 1. NHS Direct. The figures have not been validated by the Department 2. NHS Direct NHS Trust National Operations Centre
The “Choosing Health” White Paper commitment to develop and implement telephone, internet and digital services is being delivered through the new NHS Choices website, available at www.nhs.uk/Pages/homepage.aspx. This currently incorporates a Live Well area; a local services search facility; and personalised, national health service accredited content that reflects the interests and needs of different age groups across a spectrum of issues and factors which can impact upon length and quality of life. Further services, including testing of SMS text messaging and digital television, will be added later this year.
NHS Treatment Centres
The Department does not collect this information centrally. Primary Care Trusts are responsible for commissioning NHS walk-in centres.
NHS Treatment Centres: York
The information requested is contained in the following table.
Organisation Attendances 2003-04 Selby and York PCT 39,221 2004-05 Selby and York PCT 36,194 2005-06 Selby and York PCT 28,058 2006-07 North Yorkshire and York PCT 24,338 Notes: 1. Attendances at WiCs were not collected as part of the QMAE return prior to 2003-04. Throughout this period the organisations above only reported one WiC each quarter. 2. On 1 October 2006, Selby and York PCT merged with three other PCTs to form North Yorkshire and York PCT. Source: Department of Health dataset QMAE.
NHS: Accountancy
All national health service bodies are required to publish their accounts locally. The accounts must be presented at a public meeting held no later than 30 September following the end of the financial year (31 March).
The National Audit Office publishes the NHS summarised accounts for strategic health authorities, primary care trusts and NHS trusts. The publication dates for the last five financial years were:
2001-02: 21 March 2003
2002-03: 28 April 2004
2003-04: 24 June 2005
2004-05: 7 June 2006
2005-06: not yet published
NHS: Drugs
In line with the Government response to the Health Committee’s report “The Influence of the Pharmaceutical Industry”, the Department and the Department for Business, Enterprise and Regulatory Reform (BERR) have put in place formal arrangements to ensure close working between both Departments on issues relating to the pharmaceutical industry.
The directors of the Medicines, Pharmacy and Industry Group (MPIG) in the Department and the Business Relations Group at BERR meet regularly and work closely in taking forward this agenda. In addition, officials in the Industry Branch within MPIG and in the BioScience Unit of the Business Relations Unit meet on a quarterly basis. They also work closely on a day-to-day basis taking forward policy relating to the United Kingdom-based pharmaceutical industry. These formal relations were put in place in 2005 and continue today.
The Department sponsors the pharmaceutical and medical devices industries. It does not sponsor the nutraceutical, food supplements and specialist nutritional products industries, and similar relations with BERR are not required.
NHS: Finance
A table showing the funds per capita for each primary care trust in England and the England average for the years 2003-04 to 2007-08 has been placed in the Library.
The cost of the new contract for the delivery of general medical services was just one of the many components that made up the Department’s 2002 Spending Review settlement.
Copies of “A guide to resource accounting and budgeting for the NHS”, issued by the Department’s Finance Directorate, have been placed in the Library. It can also be found on the Department’s website at:
www.dh.gov.uk/en/Policyandguidance/Organisationpolicy/Financeandplanning/Allocations/DH_4000346
The Department's Ministers and officials regularly discuss a wide range of issues with their counterparts in HM Treasury. As was the case in previous Administrations, it is not the practice of the Government to provide details of all such meetings.
The Department holds records of correspondence between the Department and HM Treasury.
NHS: Greater London
Changes in services are a matter for the local national health service. Specific proposals as a result of the Darzi review have not yet emerged.
Under a private finance initiative contract, trusts may terminate the contract with notice at any time, without having to prove right and regardless of any prejudice to the private sector. In these circumstances, compensation would be payable to the contractor on a trust default basis aiming to put the contractor in a position that is ‘no better, no worse’ than it would have been had the contract run for its full length. A value for money case for exercising this option must be made. To date no estimates have been made by the Department on the termination liabilities of any PFI scheme, costs which would be met by the individual trust involved.
NHS: ICT
The outgoing director general of Connecting for Health will be stepping down from his role in the Department and he will not be eligible for severance pay. A final day of service has not been agreed between the Department and the director general and dependent upon his last day of service this will determine eligibility for bonus payments. The director general for Connecting for Health will continue to accrue pension benefits under the Principal Civil Service Pension Scheme in the usual way until his final day of service.
(2) whether responsibility for delivering Connecting for Health will lie with (a) Ministers and (b) the new Chief Executive of Connecting for Health.
The Chief Executive of NHS Connecting for Health is accountable, through the national health service Chief Executive, to Ministers for the strategic direction of the national programme for information technology and for management of the contracts between the Department and local service providers. The programme contracts provide appropriate mechanisms for negotiating contract changes where that is necessary.
Responsibility for local implementation, and realising the benefits of the technology, rests with the strategic health authority (SHA) chief executives as senior responsible owners for the programme within the NHS. In this way SHAs, together with NHS trusts and primary care trusts, are able to participate in the choice of systems and services, and in the planning and timing of deployments to better match the programme to local NHS priorities.
There are no current plans to alter these arrangements.
A final day of service has not yet been agreed between the Department and the Director General and it is unknown whether there will be an overlap with any successor at this stage.
Step-in rights are one of a number of provisions in the contracts between NHS Connecting for Health and its prime contractors under the national programme for information technology whose exercise is reserved, on an exceptional basis and in the event of certain critical circumstances, for the purpose of maintaining continuity of delivery and service for the NHS.
Action was taken to exercise this provision in relation to iSoft on a contingency basis, and a joint team of appropriately experienced NHS and private sector programme managers and software engineers identified for the purpose. There have been no standby costs, but some limited expenditure has been incurred in monitoring the circumstances surrounding the recent uncertainty over the future of iSoft. However, this has not been recorded separately and could be provided only at disproportionate cost.
NHS: Information
Information prescription pilots are taking place in 20 areas around England in a range of health and social care settings, and they include many different health and social need conditions and needs. A full list has been placed in the Library.
Each pilot site is involving a range of service users, professionals, carers and support staff, but there are no counts of the numbers of people involved, and more people will continue to be involved as the pilots progress. The initiative in total has a funding of £1.35 million in 2006-07, and £2.5 million in 2007-08.
Information prescriptions are being developed for everyone with a long-term condition or social care need, as described in the 2006 White Paper ‘Our Health, Our Care, Our Say’.
The 20 information prescriptions pilot sites are being assessed by an independent evaluation consortium. They will be producing a final report on the work of the pilots in February 2008, which will be used to inform the national roll-out of information prescriptions.
The information prescriptions initiative has a funding of £2.5 million in the financial year 2007-08. Plans for full roll-out will be developed based on the learning from the 20 sites which are piloting information prescriptions.
NHS: Pay
This information is not collected centrally.
NHS: Sick Leave
The national health service sickness absence rate has fallen from 4.8 per cent. in 2001 to 4.5 per cent. in 2005.
The following table shows sickness absence rates from 2001 to 2005. This is broken down by strategic health authority (SHAs) for 2003 to 20051. The Information Centre for health and social care advises that the quality of data is not high enough prior to 2003 to break this information down by SHA. Sickness absence rates for 2006 are not included because a refresh exercise is being undertaken. Final 2006 figures will be available in August.
1 For previous structure of 28 SHAs. It is not possible to reproduce this for the current structure of 10 SHAs.
2001 2002 2003 2004 2005 England 4.8 4.6 4.7 4.6 4.5 Norfolk, Suffolk and Cambridgeshire n/a n/a 4.5 4.6 4.6 Bedfordshire and Hertfordshire n/a n/a 4.6 4.4 4.2 Essex n/a n/a 4.7 4.6 4.4 North West London n/a n/a 4.0 4.1 4.0 North Central London n/a n/a 4.1 4.0 3.8 North East London n/a n/a 4.1 4.4 4.1 South East London n/a n/a 4.7 4.2 3.9 South West London n/a n/a 4.2 4.1 4.3 Northumberland, Tyne and Wear n/a n/a 5.4 5.2 5.7 County Durham and Tees Valley n/a n/a 4.8 4.8 4.6 North and East Yorkshire and Northern Lincolnshire n/a n/a 4.4 4.3 4.4 West Yorkshire n/a n/a 4.8 4.4 4.5 Cumbria and Lancashire n/a n/a 4.8 4.8 5.0 Greater Manchester n/a n/a 5.2 4.8 5.0 Cheshire and Merseyside n/a n/a 5.4 5.3 5.4 Thames Valley n/a n/a 3.9 4.0 3.9 Hampshire and Isle of Wight n/a n/a 4.4 4.3 4.2 Kent and Medway n/a n/a 4.8 4.9 4.5 Surrey and Sussex n/a n/a 4.0 3.9 4.0 Avon, Gloucestershire and Wiltshire n/a n/a 4.7 4.7 4.5 South West Peninsula n/a n/a 4.8 4.4 4.6 Dorset and Somerset n/a n/a 4.6 4.3 4.4 South Yorkshire n/a n/a 4.3 4.3 4.0 Trent n/a n/a 5.1 4.9 4.8 Leicestershire, Northamptonshire and Rutland n/a n/a 4.9 4.7 4.7 Shropshire and Staffordshire n/a n/a 5.4 5.0 5.0 Birmingham and The Black Country n/a n/a 4.8 4.7 4.4 West Midlands South n/a n/a 5.2 4.8 4.7 n/a = Not applicable, sickness/absence data are not available by SHA area prior to 2002. Notes: 1. Data for 2002 are of insufficient quality to produce data at a SHA level. 2. Sickness absence rate is defined as the amount of time lost through absences as a percentage of staff time available. 3. This does not cover maternity leave, carers leave or any periods of absence agreed under family friendly/flexible working policies. 4. General Practitioners and their staff are not included in the aforementioned figures. 5. Figures for strategic health authority areas are an average of all primary care trusts, other trusts and the strategic health authority organisations in that area. 6.Figures are for the calendar year. Sources: The Department’s Sickness/Absence survey 2000-04 The Information Centre for health and social care sickness/absence survey 2005
NHS: Working Hours
The new deal contract monitoring returns give an indication of national health service readiness for fully implementing the working time directive 48-hour week for doctors in training. Monitoring information for September 2006 is published on the NHS Employers website at
www.nhsemployers.org/pay-conditions/pay-conditions-467.cfm.
Collection of the 2007 new deal monitoring information will commence this autumn.
Nurses: Children
In 2006 the census data reported a total of 18,634 qualified nursing staff working within the paediatric area of work. The validation process prior to publication identified and removed 135 duplicate records from the paediatric area of work.
Nurses: Manpower
This information has been placed in the Library.
The annual workforce census does not identify mental handicap nurses, treatment nurses or community midwives seperately from the rest of the nursing workforce. Comprehensive data on school nurses have only been collected centrally since 2004.
Projected figures for each year to 2010, broken down by health trust are not collected centrally.
The annual workforce census does not identify the number of specialist nurses.
The workforce census records the number of qualified nurses, midwives and health visitors under the several different branches of nursing which are acute, elderly and general, paediatric, maternity, psychiatry, learning disabilities, community services and education staff.
Workforce planning is a matter for local determination. It is for local workforce planners to determine the specialist nursing needs of their local population with appropriate support from the workforce review team, national workforce projects and NHS Employers.
Nurses: Recruitment
As part of modernising nursing careers, the Nursing and Midwifery Council is reviewing the content and level of pre-registration education. If a graduate workforce is deemed appropriate, the costs and benefits of such a change will be taken into account.
Nutrition: Costs
‘Tackling Child Obesity—First Steps’, a joint report from the National Audit Office, Healthcare Commission and Audit Commission published in February 2006, put the cost of obesity to the national health service at around £1 billion a year, with an additional £2.3 billion to £2.6 billion a year cost to the economy as a whole. Information on the cost of undernutrition to the NHS is not collected centrally.
Nutrition: Health Services
Currently there are eight points available in the quality and outcomes framework (QOF) rewarding practices for maintaining a register of patients aged 16 and over with a body mass index (BMI) greater than or equal to 30. The register includes people whose BMI has been recorded in practice as part of routine care.
There are currently no plans to incorporate indicators of nutrition and diet in the QOF. However, as part of the ongoing development of the framework, indicators will be subject to continuing review in the light of emerging evidence, in the context of a value for money agreement.
Obesity: Young People
The obesity public service agreement (PSA) will be assessed by comparing Health Survey for England figures for aggregate three-year periods, which are used to account for the limited sample size.
This is a very challenging PSA target. Progress has been made:
Ofcom and the Committee of Advertising Practice have announced restrictions to limit advertising of products high in fat, sugar and salt to children;
80 per cent. of pupils participate in at least two hours of high quality physical education and school sport a week;
new, tougher nutritional standards for school food have been announced; and
the Top Tips for Top Mums campaign helps parents tackle the four key barriers to children eating fruit and vegetables (cost, fussy eaters, limited time/cooking skills and a lack of structured meal occasions).
Internationally, our approach is regarded as good practice, informing, for example, the WHO Europe Charter on Counteracting Obesity published in November 2006.
Organs: Donors
The Department launched “Saving Lives, Valuing Donors: A transplant framework for England” in 2003 and the National Service Framework for Renal Services in 2004. These set out the Department's key aims for organ and tissue transplantation over the following 10 years. Government investment in hospital-based funding has helped increase donor rates and an organ donor taskforce will report to Ministers in autumn 2007 on how organ donor rates can be further improved.
Patients
The Department has not used models to determine patient flows between major general hospitals. This work is considered at a local level.
Patients: Nutrition
Information on the average expenditure on each patient main meal is in the following table. The actual amounts shown are as collected from the national health service in the financial year in question. Information on the basis of constant prices is neither collected nor calculated centrally. The data were not collected before 2001-02.
In respect of hospital food services, there is no relationship between cost and quality.
Average amount spent per patient main meal (£) 2001-02 2.19 2002-03 2.41 2003-04 2.37 2004-05 2.60 2005-06 2.65
In-patients are expected to receive three main meals per day. The expenditure shown includes the cost of provisions and staff costs.
Since 2004-05, the data provided have not been collected on a mandatory basis and therefore may not be complete.
The information requested is not collected centrally.
The Department intends to publish the action plan, which was discussed at the second Nutrition Summit on 17 July, in the autumn. A wide range of stakeholders are involved in its development. These stakeholders are shown in the following list.
Age Concern
Association of Directors of Adult Social Services
British Medical Association
British Association for Parenteral and Enteral Nutrition
British Dietetic Association
Caroline Walker Trust
Commission for Social Care Inspection
Council of Europe Alliance
English Community Care Association
Food Standards Agency
Healthcare Commission
Help the Aged
Hospital Caterers Association
Local Government Association
National Association of Care Caterers
National Health Service Core Learning Unit
National Institute of Health & Clinical Excellence
National Nurses Nutrition Group
National Patient Safety Agency
Patients Association
People First
Purchasing and Supply Agency
Royal Institute of Public Health
Royal College of Nurses
Skills for Care
Skills for Health
Sustain
United Kingdom Home Care Association
Water UK
Physiotherapy: Manpower
This information is not collected centrally. The annual work force census, published by the Information Centre for health and social care, does not identify physiotherapists by grade.
The total number of physiotherapists employed in the NHS increased by 5,577 between 1997 and 2006 (the latest data we have) to 19,820.
There were 537 physiotherapy graduates registered on the national health service jobs talent pool as at 17 July 2007.
Pregnant Women: Alcoholic Drinks
(2) what assessment he has made of the training, guidance and resources available in the NHS for routine screening of alcohol consumption by pregnant women;
(3) what research he has (a) commissioned and (b) evaluated on the clinical management of individuals affected by foetal alcohol spectrum disorders; and what support systems are available to them and their carers and families.
The Department is not responsible for setting curriculums for health professional training. However, the Department does share a commitment with statutory and professional bodies to ensure that all health professionals are appropriately trained, so that they have the skills and knowledge to deliver a high-quality health service to all groups of the population, whatever their condition.
The Department has funded the production of guidance to support the effective delivery of high quality training on substance misuse, including alcohol, within undergraduate medical education in the United Kingdom. Compilation of Substance Misuse in the Undergraduate Medical Curriculum was overseen by an expert steering group and published by the International Centre for Drugs Policy in April 2007.
Although the Department has not made an assessment of the training, guidance and resources available in the national health service for routine screening of alcohol consumption by pregnant women, midwives routinely ask about alcohol consumption during booked antenatal appointments. The Department has also recently reworded its advice on alcohol and pregnancy. The revised advice states that pregnant women or women trying to conceive should avoid drinking alcohol. If they do choose to drink, to minimise the risk to the baby, they should not drink more than one to two units of alcohol once or twice a week, and should not get drunk.
The Department has not commissioned or evaluated research on the clinical management of individuals affected by foetal alcohol spectrum disorders (FASD). However, the Government welcome the British Medical Association’s recently published guide for health care professionals on FASD which will serve to raise awareness of this and provide important advice for diagnosis and those caring for patients affected by this condition.
Prescriptions: Contraceptives
The information available on supply of contraception and contraceptive devices supplied by community contraceptive clinics has been placed in the Library. Data in each age group under 16 can be provided only at disproportionate cost.
The information shown as follows is for prescriptions dispensed in the community (almost all of these prescriptions are written by general practice). Data by age are not available.
Regular methods of contraception1 Contraceptive devices2 1997 8,246.0 102.8 1998 8,246.1 99.4 1999 8,245.4 96.1 2000 8,241.7 89.7 2001 8,239.7 85.5 2002 8,237.1 82.3 2003 8,234.1 81.7 2004 8,231.3 81.4 2005 8,223.4 87.7 2006 8,208.9 101.9 1 Includes tablets, injections (including depo injections) and patches. 2 Includes implants, IUDs and IUSs. Source: Prescription information is taken from the Prescription Cost Analysis (PCA) system, supplied by the Prescription Pricing Division (PPD) of the Business Services Authority (BSA), and is based on a full analysis of all prescriptions dispensed in the community ie by community pharmacists and appliance contractors, dispensing doctors, and prescriptions submitted by prescribing doctors for items personally administered in England. The data do not cover drugs dispensed in hospitals.
The information available on emergency hormonal contraception (EHC) supplied by community contraceptive clinics is shown in the following table.
Thousand All ages Of which: Under 16 1997-98 205.1 22.5 1998-99 209.9 21.5 1999-2000 233.0 23.1 2000-01 228.8 25.2 2001-02 192.0 25.5 2002-03 188.0 26.9 2003-04 1183.2 27.0 2004-05 174.1 24.4 2005-06 164.5 22.0 1 Data revised in 2004-05 publication. Notes: Data prior to 2004-05 reused with the permission of the Department of Health. Source: The Information Centre KT31 return.
The available data on the number of items of EHC prescribed by general practitioners are shown in the following table. Data by age are not available.
Year1 General practitioners (Thousand) 2003 368.2 2004 333.2 2005 302.9 2006 280.6 Source: 1 ePACT system, this contains a maximum of 60 months data
Information is not available on the supply of EHC by hospital accident and emergency departments and school nurses and up until the end of 2006 no pharmacists had written prescriptions for EHC.
Sexually Transmitted Diseases
(2) what assessment his Department has made of the impact of the incidence of genital warts on genito- urinary medicine clinical resources.
Genital warts is the most frequently diagnosed viral sexually transmitted infection (STI) in genito-urinary clinics in England. In 2006, the highest rates of genital warts were in both the 16-19 and 20-24 year age groups in women and in the 20-24 year old age group in men. Most cases of genital warts are asymptomatic and resolve spontaneously in healthy individuals.
To tackle the spread of STIs we have set a target that 100 per cent. of patients attending a genito-urinary medicine service are offered an appointment to be seen within 48 hours. We are already seeing excellent progress on this. Data from the Genito-Urinary Medicine Access Monthly Monitoring return showed that in May 2007, 85 per cent. of first attendances were offered an appointment to be seen within 48 hours of contacting a service. This compares with 58 per cent. in May 2006.
Last November we launched a new adult sexual health campaign, “Condom Essential Wear”, which aims to normalise condom use among sexually active adults. The campaign focuses on STIs most prevalent in the target 18-24 year old age group.
Skills for Health
Skilled for Health early adopter partnerships are planned between local health and education bodies to provide local models of delivery for wider dissemination and as models of best practice to support wider rollout. Learning from these partnerships will be used to inform primary care trust (PCT) programmes.
Phase 1 of Skilled for Health was completed in 2006 and the teaching resources developed were published in November 2006 as part of the embedded learning curriculum content for the Skills for Life programme. They are available at no cost to PCTs and their partners from Prolog (0845 60 222 600). Copies are available in the Library. Information on how these materials are being used locally to establish Skilled for Health programmes in PCTs in not collected centrally.
Smoking: Health Hazards
The information is not available in the format requested. Figures are available from Hospital Episode Statistics on the number of Finished Consultant Episodes (FCEs) in national health service hospitals in England with a primary diagnosis of diseases that can be caused by smoking. It is acknowledged that not all these FCEs which can be caused by smoking will be attributable to smoking as there are other contributory factors in these diseases. Therefore for England, the relative risks of these diseases for current and ex-smokers compared to non-smokers can be used to estimate smoking-attributable FCEs. The following tables provide either the number of FCEs that can be caused by smoking or estimates of the number of smoking-attributable FCEs.
Table 1 shows the number of FCEs in England, for people of all ages, with a primary diagnosis of various diseases which can be caused by smoking for 1996-97 through to 2005-06.
Table 2 shows the number of FCEs in England, for those aged 35 and over, with a primary diagnosis of various diseases which can be caused by smoking, and estimates of the number of these which can be attributed to smoking. Figures have been provided for 2004-05, as this is first and most recent year for which data on estimates of diseases which can be attributed to smoking are available. Figures are shown for those aged 35 and over only, because relative risks used to estimate the attributable numbers are only available for this age group.
Table 3 shows the number of FCEs in Hampshire and Isle of Wight strategic health authority (SHA), for all ages, with a primary diagnosis of various diseases which can be caused by smoking for 1996-97 through to 2005-06.
Relative risks of diseases for current and ex-smokers are not available at SHA level, so analysis estimating the numbers of smoking-attributable FCEs at SHA level cannot be provided.
Finished Consultant Episodes Selected diagnoses ICD-10 diagnoses codes 1996-97 1997-98 1998-99 1999-2000 2000-01 All diseases caused in part by smoking 1,214,661 1,317,024 1,381,450 1,408,136 1,418,914 Cancers caused in part by smoking 261,007 298,917 303,065 315,727 315,856 Lung C33-C34 62,032 70,952 73,794 79,604 78,805 Upper respiratory sites C00-C14,C32 14,092 18,343 19,227 20,812 17,999 Oesophagus C15 22,175 25,159 26,511 30,049 32,463 Bladder C67 76,415 81,525 84,351 83,341 80,504 Kidney C64-C66,C68 9,553 10,280 10,192 10,897 11,134 Stomach C16 23,428 25,072 25,609 26,468 28,552 Pancreas C25 11,315 12,677 13,222 14,589 16,300 Unspecified site C80 15,846 24,894 17,555 17,037 16,923 Myeloid leukaemia C92 26,151 30,015 32,604 32,930 33,176 Respiratory diseases caused in part by smoking 203,582 214,277 243,872 249,038 238,193 Chronic obstructive lung disease J40-J44 111,395 119,911 135,006 140,092 136,271 Pneumonia J10-318 92,187 94,366 108,866 108,946 101,922 Circulatory diseases caused in part by smoking 507,096 551,899 563,886 564,624 575,174 Ischaemic heart disease I20-I25 322,317 354,688 363,098 366,081 378,532 Peripheral Arterial Disease I739 31,168 31,924 29,763 27,967 26,576 Cerebrovascular disease I60-I69 130,116 140,189 144,800 145,479 144,661 Aortic aneurysm I71 13,645 14,235 14,914 14,657 14,963 Myocardial degeneration/ infarction I51 1,853 1,972 2,030 2,132 2,157 Atherosclerosis I70 7,997 8,891 9,281 8,308 8,285 Diseases of the digestive system caused in part by smoking 74,969 78,991 80,066 82,575 79,634 Stomach/duodenal ulcer K25-K27 54,974 57,031 56,575 57,024 52,934 Crohn’s disease K50 13,203 15,071 15,969 17,231 18,317 Periodontal disease K05 6,792 6,889 7,522 8,320 8,383 Other diseases caused in part by smoking 168,007 172,940 190,561 196,172 210,057 Senile cataract H25 54,189 58,875 74,410 79,898 95,127 Hip fracture S72 70,544 72,265 74,798 76,668 75,365 Spontaneous abortion O03 43,274 41,800 41,353 39,606 39,565
Selected diagnoses ICD-10 diagnoses codes 2001-02 2002-03 2003-04 2004-05 2005-06 All diseases caused in part by smoking 1,463,872 1,551,970 1,632,929 1,671,282 1,730,478 Cancers caused in part by smoking 317,438 329,310 336,250 345,755 373,212 Lung C33-C34 76,867 79,252 84,251 89,900 98,340 Upper respiratory sites C00-C14,C32 16,882 16,910 17,976 19,281 21,308 Oesophagus C15 34,844 37,104 38,106 38,756 42,121 Bladder C67 78,597 79,778 78,977 78,561 83,362 Kidney C64-C66,C68 11,581 12,883 13,314 14,289 15,968 Stomach C16 28,900 29,418 29,197 28,952 30,806 Pancreas C25 17,986 19,184 21,040 23,105 25,938 Unspecified site C80 17,200 17,713 17,301 17,532 17,656 Myeloid leukaemia C92 34,581 37,068 36,088 35,379 37,713 Respiratory diseases caused in part by smoking 263,422 281,221 323,295 338,920 357,154 Chronic obstructive lung disease J40-J44 144,010 149,914 174,140 177,369 178,683 Pneumonia J10-318 119,412 131,307 149,155 161,551 178,471 Circulatory diseases caused in part by smoking 588,209 621,943 634,149 641,253 653,511 Ischaemic heart disease I20-I25 387,073 408,893 418,344 421,386 428,262 Peripheral Arterial Disease I739 24,641 22,656 20,391 18,903 17,856 Cerebrovascular disease I60-I69 151,340 164,255 167,142 172,180 178,321 Aortic aneurysm I71 14,362 15,065 15,277 15,564 15,606 Myocardial degeneration/ infarction I51 2,398 2,615 2,982 3,057 3,524 Atherosclerosis I70 8,395 8,459 10,013 10,163 9,942 Diseases of the digestive system caused in part by smoking 77,901 77,995 80,453 80,631 87,023 Stomach/duodenal ulcer K25-K27 49,653 48,173 46,857 44,544 44,549 Crohn’s disease K50 20,152 21,610 24,750 26,922 32,288 Periodontal disease K05 8,096 8,212 8,846 9,165 10,186 Other diseases caused in part by smoking 216,902 241,501 258,782 264,723 259,578 Senile cataract H25 97,103 108,817 124,618 128,044 115,903 Hip fracture S72 78,445 89,075 90,739 92,626 97,475 Spontaneous abortion O03 41,354 43,609 43,425 44,053 46,200 1 The data include private patients in the NHS (but not private patients in private hospitals). 2 The data refers to Finished Consultant Episodes (FCE). An FCE is defined as a period of admitted patient care under one consultant within one healthcare 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 The primary diagnosis is the first of up to 14 (7 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. 4 The figures include people whose gender was not known or not specified. 5 Figures shown are based on all ages. Source: Hospital Episode Statistics. The Information Centre, 2006
Number/percentage Diagnosis (ICD 10) Observed FCEs5 Attributable number6 Attributable percentage All diseases caused in part by smoking 1,573,395 559,800 36 Cancers caused in part by smoking 335,707 172,400 51 Lung 89,547 75,800 85 Upper respiratory sites 18,614 12,900 69 Oesophagus 38,484 26,200 68 Bladder 78,177 30,500 39 Kidney 12,132 3,400 28 Stomach 28,639 7,300 25 Pancreas 22,967 6,000 26 Unspecified site 17,244 6,300 37 Myeloid leukaemia 29,903 4,200 14 Respiratory diseases caused in part by smoking 315,927 177,300 56 Chronic obstructive lung disease 176,294 147,300 84 Pneumonia 139,633 30,000 21 Circulatory diseases caused in part by smoking 636,226 158,100 25 Ischaemic heart disease 419,513 106,200 25 Peripheral Arterial Disease 18,797 15,800 84 Cerebrovascular disease 169,584 24,200 14 Aortic aneurysm 15,457 9,500 62 Myocardial infarction 2,802 600 21 Atherosclerosis 10,073 1,900 19 Diseases of the digestive system caused in part by smoking 59,765 26,400 44 Stomach/duodenal ulcer 41,879 22,200 53 Crohn’s disease 15,205 3,000 20 Periodontal disease 2,681 1,200 46 Other diseases caused in part by smoking 225,770 25,500 11 Age related cataract among those aged 45 and over 127,111 15,500 12 Hip fracture among those aged 55 and over 85,641 9,200 11 Spontaneous abortion 13,018 700 6 1 An FCE is defined as a period of admitted patient care under one consultant within one healthcare provider. Figures do not represent the number of patients, as a patient may have more than one episode of care within the year. 2 Figures have been presented for adults aged 35 and over unless otherwise specified 3 More information on the methodology used to calculate these estimates are available in the Statistics on Smoking: England, 2006 publication produced by The Information Centre for health and social care, which is available in the House of Commons. 4 The data include private patients in NHS hospitals (but not private patients in private hospitals). 5 Observed admissions only includes those where gender was recorded 6 Estimated attributable number, rounded to the nearest 100. Source: Hospital Episode Statistics (HES). The Information Centre
Finished Consultant Episodes ICD-10 diagnoses codes 1996-97 1997-98 1998-99 1999-2000 2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 All diseases caused in part by smoking 39,083 42,227 45,139 46,511 49,257 51,104 54,516 58,350 60,982 60,338 Cancers caused in part by smoking 8,401 9,925 9,496 9,578 10,312 10,104 10,403 10,304 10,730 11,218 Lung C33-C34 1,757 2,017 1,851 1,926 2,125 2,176 2,106 1,972 2,063 2,367 Upper respiratory sites C00-C14,C32 475 532 572 477 542 516 511 491 572 527 Oesophagus C15 654 801 797 1,019 1,091 1,152 1,138 1,119 1,043 1,144 Bladder C67 2,486 2,906 2,941 2,758 2,905 2,669 2,771 2,703 2,690 2,711 Kidney C64-C66,C68 355 485 410 429 482 602 575 570 665 631 Stomach C16 633 760 675 757 686 654 741 695 666 563 Pancreas C25 408 415 450 406 547 567 553 587 521 706 Unspecified site C80 519 602 588 531 505 638 855 755 763 575 Myeloid leukaemia C92 1,114 1,407 1,212 1,275 1,429 1,130 1,153 1,412 1,747 1,994 Respiratory diseases caused in part by smoking 5,760 5,834 6,865 7,701 7,489 9,327 10,659 13,354 14,031 13,696 Chronic obstructive lung disease J40-J44 2,517 2,598 3,230 3,516 3,592 4,987 5,655 7,264 7,338 7,043 Pneumonia J10-J18 3,243 3,236 3,635 4,185 3,897 4,340 5,004 6,090 6,693 6,653 Circulatory diseases caused in part by smoking 15,841 16,711 18,222 18,363 20,342 20,370 22,541 23,000 23,451 22,422 Ischaemic heart disease I20-I25 9,737 10,702 11,491 11,446 13,329 13,356 14,650 15,236 15,214 14,385 Peripheral Arterial Disease I739 1,179 997 835 698 839 753 751 684 601 592 Cerebrovascular disease I60-I69 4,226 4,203 4,716 5,135 5,207 5,364 6,030 5,904 6,522 6,229 Aortic aneurysm I71 517 513 614 554 517 507 528 513 565 528 Myocardial degeneration/ infarction I51 67 114 101 110 153 107 135 93 123 236 Atherosclerosis I70 115 182 465 420 297 283 447 570 426 452 Diseases of the digestive system caused in part by smoking 2,793 3,166 3,530 3,550 3,351 3,438 3,231 3,389 3,828 3,943 Stomach/duodenal ulcer K25-K27 1,984 2,094 2,220 2,178 1,893 1,850 1,677 1,508 1,730 1,645 Crohn’s disease K50 484 607 599 589 763 989 927 1,124 1,349 1,433 Periodontal disease K05 325 465 711 783 695 599 627 757 749 865 Other diseases caused in part by smoking 6,288 6,591 7,026 7,319 7,763 7,865 7,682 8,303 8,942 9,059 Senile cataract H25 2,005 2,266 2,802 3,074 3,253 3,281 3,115 3,548 4,038 4,119 Hip fracture S72 2,768 2,849 2,934 3,088 3,336 3,421 3,846 3,904 4,048 4,050 Spontaneous abortion O03 1,515 1,476 1,290 1,157 1,174 1,163 721 851 856 890 1 The data include private patients in the NHS (but not private patients in private hospitals). 2 The data refers to Finished Consultant Episodes (FCE). An FCE is defined as a period of admitted patient care under one consultant within one healthcare 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 The primary diagnosis is the first of up to 14 (7 prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was in 4 The figures include people whose gender was not known or not specified. 5 Figures shown are based on all ages. Source: Hospital Episode Statistics. The Information Centre, 2006
Smoking: Public Expenditure
I refer the hon. Member to the answer given on 17 April 2007, Official Report, column 590W.
Surgery
Information has been placed in the Library.
Vaccination: Aluminium
(2) what assessment he has made of the safe levels of aluminium in vaccines routinely provided to (a) babies and (b) children.
Aluminium salts are an essential ingredient of some vaccines in enhancing the protection offered by the vaccine. The safety record of aluminium in vaccines has been demonstrated over more than 50 years of use. There are no serious health risks associated with the small quantities of aluminium in some vaccines. As with many vaccine ingredients, aluminium can cause localised reactions such as redness, swelling and/or tenderness at the injection site.
The information on levels of aluminium in childhood vaccines is in the following table.
Aluminium content PL number Vaccine (disease) Formulation SPC (2)* Label 00011/0245 Meningitec Vial (Meningitis C) Aluminium phosphate 0.5mg per 0.5ml 0.125mg A13+ Aluminium phosphate 0.125mg A13+ 00116/0351 Neisvac-C (Meningitis C) Aluminium hydroxide 0.5mg per 0.5ml Aluminium hydroxide hydrated 0.5mg A13+ Aluminium hydroxide hydrated 0.5mg A13+ 06745/0076 M-M-R II vaccine injection (Measles, Mumps and Rubella) None present n/a n/a 06745/0120 Pediacel injection (Diphtheria, tetanus, pertussis, polio and haemophilius influenzae type b (Hib)) Aluminium phosphate 1.5mg per 0.5ml 0.33±0.05mg A13+ calculated Aluminium phosphate 06745/0121 Repevax injection (Diphtheria, tetanus, pertussis, polio) Aluminium phosphate 0.33mg per 0.5ml 0.33mg Aluminium phosphate 0.33mg 06745/0122 Repevax injection (Diphtheria, tetanus, pertussis, polio) Aluminium phosphate 0.33mg per 0.5ml 0.33mg Not legible 06745/0123 Revaxis injection (Tetanus, diphtheria, polio) Aluminium hydroxide 0.35mg per 0.5ml Aluminium hydroxide 0.35mg Not legible 10592/0110 Priorix vaccine injection (Measles, Mumps and Rubella) None present n/a n/a 10592/0209 Infanrix IPV vaccine injection (Diphtheria, tetanus, pertussis, polio) Aluminium oxide hydrated 0.5mg 0.5mg Aluminium hydroxide 10592/0216 Infanrix-IPV-Hib vaccine (Diphtheria, tetanus, pertussis, polio, haemophilius influenzae type b (Hib)) Aluminium hydroxide 0.5mg per 0.5ml Aluminium hydroxide hydrated 0.5mg A13+ Aluminium hydroxide 10592/0217 Menitorix (Haemophilius influenzae type b (Hib/(Meningitis C)) None present n/a n/a 13767/0013-14 Menjugate vaccine injection and aluminium hydroxide solvent (Meningitis C) Aluminium hydroxide 1mg per 0.5ml Not on sentinel aluminium hydroxide 0.3 to 0.4mg A13+ Not on sentinel EU/1/../167/... Prevenar (Pneumococcal) Aluminium phosphate 0.5mg per 0.5ml Aluminium phosphate 0.5mg Aluminium phosphate 0.5mg Source: Taken from electronic Medicines Compendium (eMC)
Vaccination: Children
The information required is in the following table.
Age What is given How it is given 2 months old Diphtheria, tetanus, pertussis (whooping cough), polio and Haemophilus influenzae type b (Hib) (DTaP/IPV/Hib) One injection Pneumococcal infection (Pneumococcal conjugate vaccine, PCV) One injection 3 months old Diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (Hib) (DTaP/IPV/Hib) One injection Meningitis C (meningococcal group C) (MenC) One injection 4 months old Diphtheria, tetanus, pertussis, polio and Haemophilus influenzas type b (Hib) (DTaP/IPV/Hib) One injection Meningitis C (meningococcal group C) (MenC) One injection Pneumococcal infection (Pneumococcal conjugate vaccine, PCV) One injection Around 12 months old Haemophilus influenza type b (Hib) and meningitis C (Hib/MenC) One injection Around 13 months old Measles, mumps and rubella (German measles) (MMR) One injection Pneumococcal infection (PCV) One injection 3 years and 4 months to 5-years-old Diphtheria, tetanus, pertussis (whooping cough) and polio (dTaP/IPV or DTaP/IPV) One injection Measles, mumps and rubella (MMR) One injection 13 to 18-years-old Diphtheria, tetanus, polio (Td/IPV) One injection
York Hospitals NHS Trust
The requested information is set out in the following table.
Main specialty Main specialty description FCEs 100 General Surgery 9,512 101 Urology 6,244 110 Trauma and Orthopaedics 5,371 120 Ear, Nose and Throat (ENT) 2,181 130 Ophthalmology 3,509 140 Oral Surgery 1,574 180 Accident and Emergency 1,693 190 Anaesthetics 2,018 300 General Medicine 20,389 303 Clinical Haematology 1,206 330 Dermatology 26 370 Medical Oncology 225 400 Neurology 468 410 Rheumatology 568 420 Paediatrics 4,835 430 Geriatric Medicine 9,193 502 Gynaecology 9,199 560 Midwife episode 2,998 810 Radiology * 822 Chemical Pathology 376 Notes: 1. Finished Consultant Episode (FCE) An FCE is defined as a period of admitted patient care under one consultant within one healthcare provider. The figures do not represent the number of patients, as a person may have more than one episode of care within the year. 2. Main Specialty The main specialty refers to the specialty under which the consultant is contracted. 3. Specialty Care is needed when analysing Hospital Episode Statistics (HES) data by specialty, or by groups of specialties (such as acute). Trusts have different ways of managing specialties and attributing codes so it is better to analyse by specific diagnoses, operations or other recorded information. 4. Low Numbers Due to reasons of confidentiality, figures between 1 and 5 have been suppressed and replaced with ‘*’(an asterisk). 5. Data Quality HES are compiled from data sent by over 300 national health service trusts and primary care trusts 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. 6. Ungrossed Data Figures have not been adjusted for shortfalls in data (ie the data are ungrossed). Source: HES, The Information Centre for Health and Social Care.
The requested information is show in the following table.
Day case/inpatient Median wait Maximum wait December 2006 Day case 8.5 weeks 25 to <26 weeks December 2006 Inpatient 7.8 weeks 25 to <26 weeks March 2007 Day case 6.7 weeks 19 to <20 weeks March 2007 Inpatient 6.5 weeks 19 to <20 weeks Source: Department of Health, NHS Finance, Performance and Operations.
Westmoreland General Hospital
(2) if he will consider supporting the provision of full consultant-led acute admissions services at Westmorland General Hospital.
It is the responsibility of primary care trusts (PCTs) locally to plan and commission services to meet the needs of its residents and in line with the resources available.
Proposals relating to the Westmorland General Hospital, which is managed by the University Hospitals of Morecambe Hospital Trust, were consulted on between June and September 2006. The preferred option has since been subject to further work and will now be taken forward as part of the Cumbria whole systems review. Consultation is due to begin in September.