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Written Answers

Volume 692: debated on Monday 11 June 2007

Written Answers

Monday 11 June 2007

Chemicals: Gardening

asked Her Majesty's Government:

Which formulations that include clopyralid are licensed for (a) garden use and (b) for use by contractors on municipal or institutional grasslands; and how they intend to alleviate any problems this chemical might cause for the composting of green waste by local authorities. [HL4158]

There are six pesticide products containing clopyralid licensed for garden use:

Verdone extra (M13113);

Verdone extra (M10635);

Verdone extra ready-to-use (M11758);

Verdone extra spot weeder (M10834);

Vitax lawnclear 2 (M13508);

Vitax lawnclear 2 ready-to-use (M13509); and

five pesticide products licensed for institutional grasslands:

Blaster (M10571);

Blaster (M13267);

Esteem (M12555);

Greenor (Ml 0909); and

Spearhead (M09941).

Because compost contaminated with clopyralid may harm some ornamental and vegetable crops, the labels of pesticide products containing it have a warning to avoid using any plant materials treated with the products for composting or mulching. Therefore, grass treated with clopyralid should not be composted or sent for composting.

asked Her Majesty's Government:

For what reasons ammonium sulphamate is no longer licensed for gardens or commercial use as a herbicide; whether they have received any reports of serious harm to people or the environment as a result of the use of this chemical; and whether the systems for licensing herbicides have produced the best result in this case. [HL4159]

Ammonium sulphamate is being withdrawn in accordance with an EC review of pesticides under Council directive 91/414/EEC as the dossier of studies submitted for the review of this chemical was judged to be incomplete. The use of ammonium sulphamate in gardens or for commercial use must cease by 22 May 2008.

We have not received any reports of serious harm to people or the environment as a result of the use of ammonium sulphamate. However, we support the EC review initiative as a whole. It aims to ensure that all existing pesticides meet modern standards to protect human health and the environment. Many older pesticides were licensed on the basis of limited data which do not meet these standards.

Children: Residential Assessments

asked Her Majesty's Government:

On how many occasions during the period 1 January 1999 to 31 December 2006 local authorities objected to residential assessments in proceedings under Section 38 of the Children Act 1989; and on how many occasions during that period local authorities made no objection. [HL3882]

No information is collected centrally about the stance taken by local authorities, where they are applicants in Section 31 proceedings, brought under the Children Act 1989, in response to proposals put forward by other parties relating to residential assessments.

asked Her Majesty's Government:

What was the average cost to the legal aid system of residential assessments in proceedings under Section 38 of the Children Act 1989 during the period 1 January 1999 to 31 December 2006; and what estimates have been made of (a) the medium and longer term impacts on children and families referred for residential as opposed to other forms of assessment; and (b) the medium and longer term costs to the state of each form of assessment. [HL3883]

Information on the cost to legal aid of proceedings under Section 38 is not recorded centrally and could only be obtained at disproportionate cost. No assessments have been made comparing the impact on children and families, or their costs, of residential or other forms of assessment.

Climate Change

asked Her Majesty's Government:

Further to the Written Answer by Lord Adonis on 17 May (WA 56), which, if any, of those experts who consider the film “An Inconvenient Truth” to contain misinterpretations of the evidence they have consulted in developing balanced teacher guidance on climate change. [HL3961]

The writers of the guidance to teachers which accompanied the climate change pack were chosen on the basis of their knowledge, expertise and experience to write material to support the teaching of geography, science and citizenship in schools. The department is not aware of the opinions of those persons on all aspects of the content of “An Inconvenient Truth”. However, all of the persons who contributed to the guidance are aware of the range of scientific opinions on climate change and its causes.

Court Martial: Costs

asked Her Majesty's Government:

What was the cost to public funds of (a) the defence teams; (b) the prosecution teams; and (c) other items, including advice of counsel on the likelihood of conviction and on the public interest in prosecuting, related to the court martial in the prosecution of (i) Colonel Jorge Mendonca; (ii) Sergeant Kelvin Stacey; (iii) Lance-Corporal Wayne Crowcroft; (iv) Private Darren Fallon; (v) Major Michael Peebles; (vi) Warrant Officer Mark Davies; and (vii) Corporal Donald Payne. [HL3947]

The Minister of State, Ministry of Defence (Lord Drayson): Only the estimated costs to public funds relating to the court martial of seven Army personnel can be provided, because some bills have yet to be submitted. The current estimated costs of the defence and prosecution teams are shown in the table below:

Prosecution Costs

Defence Costs

Counsel’s fees

£664,400

£6,083,900

Hotels

£28,200

£95,000

Car hire

£6,500

£100

Miscellaneous (travel, production of documents)

£55,900

£120,100

Additional costs include hotel, travel and subsistence costs for witnesses, catering, transcription costs, interpreters and translators and miscellaneous court administration costs. These are estimated at £369,800.

Euro

asked Her Majesty's Government:

Whether they will open consultations with Slovenia, Malta and Cyprus, recent European Union entrants to the single currency, to ascertain possible advantage which the United Kingdom might gain from early entry; and [HL4099]

Whether they have made an estimate of the impact that United Kingdom entry to the euro-zone would have on United Kingdom domestic interest rates. [HL4100]

The Government's policy on membership of the single currency is unchanged. It remains as set out by the Chancellor in his Statement to the House of Commons in October 1997, and again in the Chancellor's Statement on the five tests assessment in June 2003.

Health Visitors

asked Her Majesty's Government:

What steps they are taking to ensure that a career as a health visitor is an attractive option; and what signs there are of their success in doing so; and [HL4054]

What steps they are taking to improve the professional framework for health visitors; and [HL4055]

What contribution (a) health visitors, and (b) nurses make to safeguarding children and promoting their welfare. [HL4056]

Health visitors and nurses working in the community have a key role in assessing local health needs and demonstrating to commissioners their contribution to better health outcomes, in particular for disadvantaged groups. Health visitors provide a progressive universal service to all families and identify health needs to enable them to work closely with the most vulnerable children and families. They focus on early intervention and prevention and much of the work of health visitors involves identifying where children are at risk, and in their contribution to child protection plans for specific children and their families.

We have introduced a number of policies aimed at the strengthening of prevention and the integration of services which has been consistently endorsed in Every Child Matters, the Chief Nursing Officer's review of the nursing contribution to vulnerable children; the National Service Framework for Children, Young People and Maternity Services, Our Health, our care, Our say, Maternity Matters, and, the policy review of children and young people.

We are reviewing the role of health visitors. This review is being informed by the views and experiences of a wide range of stakeholders, including front-line health visitors, which have been gathered through a series of regional events called “Let's Talk about Health Visiting”. These events engaged with practitioners, local leaders and commissioners in clarifying the role of health visitors for the future. This work is closely linked to the Modernising Nursing Careers career pathways and educational preparation of all nurses working in the community, ensuring the community workforce is fit for the future.

Health: Colitis and Crohn's Disease

asked Her Majesty's Government:

How many people (a) under the age of 10, and (b) aged between 10 and 20, have been diagnosed with ulcerative colitis and Crohn's disease in the past 12 months. [HL3983]

Health: Dentistry

asked Her Majesty's Government:

What steps they are taking to ensure that primary care trusts are ring-fencing budgets for commissioning primary dental services. [HL3803]

Primary care trusts (PCTs) receive individual budgets for primary dental care services that are separate from the unified budgets used for commissioning and providing other health services. Strategic health authorities (SHAs) and PCTs are expected, as a minimum, to maintain levels of investment in National Health Service primary dental care services across their areas. Where an individual PCT is unable to commit fully its budget for dental services—for example, because of the time needed to commission new services where a dentist retires or leaves—SHAs and PCTs are expected to work together to bring investment back to intended levels as soon as possible.

Health: Incontinence Items

asked Her Majesty's Government:

Whether the infrastructure payment for services proposed in the Department of Health consultation Arrangements for the Reimbursement Pricing of Stoma and Incontinence Appliances under Part IX of the Drug Tariff would affect dispensing appliance contractors differently dependent on their output. [HL3938]

In reviewing the arrangements under Part IX of the Drug Tariff, it has always been one of the department's stated objectives to ensure fair remuneration of valued services provided by the pharmacy and appliance contractors.

In the consultation document entitled Arrangements for the Remuneration of Services Relating to Appliances within Part IX of the Drug Tariff, it was proposed that dispensing appliance contractors would receive a banded infrastructure payment, depending on the volume of prescription items dispensed in one particular month. The purpose of this payment is to cover elements of service that are less volume-related compared to dispensing, such as operating within a clinical governance framework, requirements relating to dispensing repeatable prescriptions and provision of clinical information.

Views were sought on this proposal and the consultation closed on 2 April 2007. Given the volume of the responses to the consultation, the department has decided that it needs more time to analyse the information provided. Consequently, no changes will be implemented in July 2007 as proposed in the consultation documents.

In conducting this review, a key objective has been to maintain and improve the quality of patient care.

asked Her Majesty's Government:

Whether the proposals contained in the Department of Health consultation Arrangements for the Reimbursement Pricing of Stoma and Incontinence Appliances under Part IX of the Drug Tariff would restrict the ability of firms to choose the prices of the services they provide. [HL3939]

The prices of the services they provide is a commercial matter for providers and not something the department is looking at as part of the Part IX review it is conducting.

The review of Part IX of the drug tariff is concerned with what the National Health Service pays for items and for services. The department is trying to ensure that there is transparency for the NHS between the reimbursement price for items and remuneration for services provided; there is none today. The department also wants to ensure that the NHS and the taxpayer are getting value for money. In addition, a key objective is to maintain and improve the quality of patient care.

This is why there have been two recent consultations. One set out proposals for reimbursement levels for item price, Arrangements for the Reimbursement Pricing of Stoma and Incontinence Appliances under Part IX of the Drug Tariff. The other, Arrangements for the Remuneration of Services Relating to Appliances within Part IX of the Drug Tariff, set out proposals relating to service provision, both what that service should be and the remuneration that the NHS would make for such services. Here the intent was to ensure fair remuneration of valued services provided by the pharmacy and appliance contractors. It was also designed to make sure that the services provided by all dispensing contractors are to the same standard no matter where in England a user of appliances may live.

Given the volume of the responses to the consultation, the department has decided that it needs more time to analyse the information provided. Consequently, no changes will be implemented in July 2007 as proposed in the consultation documents.

asked Her Majesty's Government:

When they plan to implement changes relating to the reimbursement pricing of stoma and incontinence appliances; and [HL3942]

What consideration they have given to the potential for disruption in supply of stoma and incontinence prescriptions to National Health Service patients in the event that dispensing appliance contractors reduce their stockholdings to protect against financial losses before the introduction of price revisions for these items in June. [HL3943]

It has been announced that due to the volume of responses received to the consultations that closed on 2 April 2007, the department has decided that it needs more time to analyse the information provided. This analysis needs to take account of comments made about the department's proposals regarding reimbursement for items and on the proposed levels of remuneration for particular services, such as home delivery and product customisation.

Consequently, no changes will be implemented in July 2007 as proposed in the consultation documents. Moreover, we do not expect that the review will be completed before the end of the year.

Should any changes in the current arrangements be agreed, sufficient time will be allowed for the new arrangements to be implemented.

In conducting this review, a key objective has been to maintain and improve the quality of patient care.

asked Her Majesty's Government:

What is the maximum price reduction in percentage terms for any stoma or incontinence appliance listed in the proposed new pricing categorisation of these appliances. [HL3944]

It has been announced that given the volume of responses received to the consultations that closed on 2 April 2007, the department has decided that it needs more time to analyse the information provided. Consequently, no changes to the current reimbursement prices for items will be implemented in July 2007 as proposed in the consultation document on item price entitled Arrangements for the Reimbursement Pricing of Stoma and Incontinence Items under Part IX of the Drug Tariff.

The analysis needs to take account of comments made about the department's proposals regarding reimbursement for items and review its proposals in light of this.

In conducting this review, a key objective has been to maintain and improve the quality of patient care.

asked Her Majesty's Government:

What assessment they have made of the value to the National Health Service of dispensing contractors' sponsorship of specialist nurses in the last year for which information is available; and [HL3945]

What consideration they have given to the impact of the changes proposed in the review of stoma and incontinence items and services on dispensing contractors' sponsorship of specialist nurses. [HL3946]

No assessment has been made. The sponsorship of specialist nurses by dispensing appliance contractors is not part of the scope of the Part IX review.

The review of Part IX of the drug tariff is concerned with what the National Health Service pays for items and for services. The department is trying to ensure that there is transparency for the NHS between the reimbursement price for items and remuneration for services provided; there is none today. The department also wants to ensure that the NHS and the taxpayer are getting value for money. In addition, a key objective is to maintain and improve the quality of patient care.

The most recent consultations closed on 2 April 2007. Given the volume of the responses to the consultation, the department has decided that it needs more time to analyse the information provided. Consequently, no changes will be implemented in July 2007 as proposed in the consultation documents.

Health: Maternity

asked Her Majesty's Government:

Whether it is standard practice for National Health Service hospitals to operate a quota system for the taking on of new maternity cases according to the expected birth date; and [HL4025]

On what geographical basis National Health Service hospitals take on new maternity cases; and [HL4026]

Where expectant mothers are able to give birth if, once being referred back to their general practitioner, a place at a local hospital cannot be found for them; and [HL4027]

How far they require expectant mothers to travel in order to give birth if their local hospital is no longer taking on maternity patients. [HL4028]

Local National Health Service organisations in England are responsible for the development of maternity services. The 2007-08 NHS operating framework requires them to undertake reviews of their maternity services, identify the gaps and barriers to service development and set out their local strategy for delivery of the recommendations in Maternity Matters—Choice, Access and Continuity of Care in a Safe Service, published on 3 April.

Distance should not be the only factor, as safety, risk and travelling times are equally important. Wherever women have their babies, the local maternity network will ensure easy access to, and transfer between, all levels of care in a responsive and timely manner.

Health: Rampton Hospital

asked Her Majesty's Government:

How many hours of individual psychiatric therapy are provided to women in Rampton Hospital every week. [HL4031]

The women's service at Rampton Hospital, consisting of 50 beds, has a psychiatric establishment of 3.5 full-time consultant psychiatrists, three being consultant forensic psychiatrists and 0.5 being a consultant psychiatrist in learning disabilities; two full-time staff grade doctors; and a specialist psychiatric registrar. The standard set with commissioners for the service is a ratio of one consultant per 15 patients; the current establishment slightly exceeds this standard. Each consultant psychiatrist and associated psychiatric team do not allocate a specific number of hours to each patient per week. The level of input required by patients varies on a daily basis according to their presentation and clinical needs. All patients are monitored closely by their consultant psychiatrists and receive psychiatric input as required.

Ward rounds are timetabled on a monthly basis and patients can request appointments with their consultants in between these meetings. In addition to this, staff-grade doctors see all patients to address physical and mental health issues and liaise closely with the respective consultants.

asked Her Majesty's Government:

What is the average length of stay for women in Rampton Hospital; and what is the process for transition or release. [HL4033]

The average length of stay for women at Rampton Hospital, including those on trial leave, was 4.5 years as of April 2007. It should be noted, however, that this average figure is based on a broad variation among individual patients.

Patients are discharged from Rampton Hospital when their assessed level of risk is such that their treatment can be continued in conditions of lesser security. This typically involves patients transferring to medium secure units, but in the near future will also include the new women's enhanced medium secure services available in London, Leicestershire, and the north-west. There are regular care programme approach meetings, at least yearly but initially six months after admission, where the patient's care pathway is reviewed in the presence of commissioners and representatives from the regional secure units. The progress of individual patients is also subject to independent review by mental health review tribunals, which have the power to discharge patients, albeit with the need for agreement of the Ministry of Justice for those patients on restriction orders. A small number of patients who are not responding to treatment may be returned to prison.

Schools: Environment Learning

asked Her Majesty's Government:

What plans they have to reverse the recent decline in school field visits to nature reserves and out-of-classroom environment learning experiences for schoolchildren in England. [HL4125]

Recent research by the National Foundation for Educational Research (NfER), co-sponsored by the Department for Education and Skills, suggests that provision for learning outside the classroom has either stayed broadly the same or increased over the past five years. Within this, visits to field studies centres, nature reserves, and other natural environments remain a popular and significant element, particularly in primary and special schools.

Through the Learning Outside the Classroom Manifesto launched last November, we have formed a partnership dedicated to increasing the quality and quantity of out-of-classroom learning opportunities for all children and young people. This builds on a range of previous work, including the popular growing schools programme, which has helped a large number of schools to make greater use of their own grounds and visits to farms and the countryside to support teaching and learning.

The work now being taken forward as part of the manifesto promotes the use of out-of-classroom opportunities across the whole curriculum. To support this, the department is now commissioning a major “out and about” package of training and guidance to support schools and early-years settings to provide more and better opportunities for learning outside the classroom. We are also working closely with provider organisations to help them co-ordinate their efforts and meet schools' needs more effectively.

Utilities

asked Her Majesty’s Government:

Whether, in view of complaints about cost, time delays and performance, they will review the monopolistic position of utility companies connecting services to new buildings. [HL3974]

Ofgem, the regulator for the gas and electricity industries, recently reviewed competition in gas and electricity connections. The review showed that competition has developed well in the gas connections market, where more than half of all new domestic gas connections are done by independent providers. However, Ofgem found that the performance of some electricity network companies in connecting new premises is unacceptable. Ofgem has therefore proposed formal licence requirements on electricity distribution network operators (DNOs) regarding mandatory standards for the provision of information and services to independent connections providers. These will replace the existing voluntary standards and be consistent with the requirements which cover gas connections. If DNOs failed to meet the proposed new standards, Ofgem has powers to investigate and take enforcement action.

In addition, from this year, Ofgem will be monitoring compliance with a recently revised licence condition which specifically prohibits DNOs from discriminating in favour of their own affiliates in the provision of connections information and services.

As well as the formal licence requirements, Ofgem has proposed “good practice” measures across a number of connections issues and will be working with DNOs to see that these are taken forward.

Ofwat, the regulator of the water and sewerage industry, is working with the water companies and developers to develop levels of service for the provision of water supplies (both the pipework and connection) to new buildings. This will ensure companies deliver services to developers within an acceptable timeframe.

Under measures to increase competition contained in the Water Act 2003, developers may choose their own contractor to lay pipework under an agreement for adoption by the water company (self-lay). Ofwat has recently reviewed the operation of the self-lay market as part of its internal review of competition within the water industry.

Connections to sewers can be undertaken by either the appointed sewerage company or the developer's own contractors.