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Ms Stuart: We fully support the aims of the International Year of Volunteers. Everyone benefits from volunteering and my right hon. Friend the Prime Minister has issued a challenge to employers to give their employees paid time off to work in the community. This Department reacted positively to the challenge to support staff in undertaking voluntary activities. Department of Health staff are allowed a minimum of one day's paid leave per year to undertake voluntary activity. Furthermore, definitions of voluntary activity have been broadened, and managers are encouraged to exercise discretion and be flexible when considering requests for leave from work. We intend to undertake voluntary activity for a day during 2001.
Mr. Harvey: To ask the Secretary of State for Health what steps his Department has taken to ensure closer working practices to help reduce effects of winter pressures between social services and acute NHS hospitals; and if he will make a statement. 
Ms Stuart: In May 2000, the Department issued guidance to all National Health Service organisations and Social Services Departments setting out whole system arrangements to ensure that they, together, respond well
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to seasonal pressures, and provide high-quality services for local people throughout the year. In 2000-01, the Government have already invested an additional £63 million in intermediate care beds and staff to prevent avoidable hospital admissions, to facilitate prompt discharges from hospital, and to support independence and independent living, particularly for the elderly.
Local Winter Planning Groups (LWPGs) are in place across England to ensure that effective service and contingency planning is in place for winter 2000-01. The Department has assessed all LWPG winter plans and has put in place monitoring arrangements to ensure seasonal pressures are identified and addressed immediately. Expert teams of health and social care professionals are also visiting health and social care communities across England to provide support and advice, and to promote and share good practice.
Mr. Harvey: To ask the Secretary of State for Health what steps his Department has taken to disseminate best practice in dealing with winter pressures at (a) regional level, (b) health authority level, (c) trust level and (d) primary care group/trust level; and if he will make a statement. 
Ms Stuart: Local Winter Planning Groups (LWPGs) have been established across England to ensure effective service and contingency planning for winter 2000-01. LWPGs include representatives of all National Health Service organisations, local councils with social services responsibilities and other local partners including the voluntary and independent sectors.
Dr. Marek: To ask the Secretary of State for Health how many registered (i) nurses and (ii) midwives are aged (a) below 30, (b) 30 to 39, (c) 40 to 49, (d) 50 to 54, (e) 55 to 59 and (f) 60 years and over. 
|30 to 39||85,840||104,050|
|40 to 49||69,310||82,160|
|50 to 54||26,380||30,560|
|55 to 59||12,810||15,310|
1. Figures exclude learners and agency staff.
2. Figures are rounded to the nearest 10.
3. Totals may not equal the sum of component parts due to rounding.
Department of Health 1999 non-medical workforce census
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Mr. Denham: From the Department of Health Medical and Dental Workforce Census on 30 September 1999, there were around 140 Consultants in Neurosurgery in the National Health Service. Information about numbers of consultants specialising in spinal surgery is not collected centrally.
Dr. Tonge: To ask the Secretary of State for Health (1) what estimate he has made of the impact on the primary care costs were hospital pharmacies permitted to dispense 28 day supplies of drugs to patients; 
(3) what plans he has to introduce 28 day original pack dispensing from hospital pharmacies; 
(4) what plans he has to encourage patients to take with them all medicines they are taking when admitted to hospital. 
Ms Stuart: "Pharmacy in the Future--Implementing the NHS Plan" (a copy of which is in the Library) makes clear that we expect National Health Service hospitals in England to review their pharmacy systems to make them efficient, timely and safe, and more patient focused.
To see that changes are made, NHS Executive regional offices will be rolling out a medicines management performance management framework specifically for hospitals later this year and the Department will be establishing a collaborative programme in order to spread and share best practice. This is likely to include, in appropriate cases, the use of medicines which patients bring into hospital on admission and self-administration schemes on wards (including the use of patient bed-side boxes). Hospitals are also likely to dispense medicines on discharge and to out-patients more frequently in complete original packs. Many such packs are designed by their manufacturers to provide a course of treatment lasting 28 days, although this varies from product to product, and the quantity to be prescribed for any given patient must, of course, reflect their clinical needs.
Re-engineering systems in this way will reduce waste and improve the cost effectiveness of the NHS's spending on medicines generally. It may well involve spending being incurred within hospitals which was previously incurred within primary care. The size of any such shift will vary from place to place depending on current practice and on the nature of new arrangements agreed locally. Work is under way, co-ordinated by NHS Executive regional offices, to ensure that local health commissioners and hospitals work together to ensure suitable funding arrangements are in place.
Dr. Tonge: To ask the Secretary of State for Health what plans he has to ensure that hospital pharmacies conform with EU Directive 92/27/EEC on patient information; and what the estimated costs of such compliance are. 
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Ms Stuart: The Directive was incorporated into United Kingdom law by The Medicines (Marketing Authorisations etc.) Regulations 1994. These regulations apply to all people involved in the supply of medicines, including hospital pharmacies. It is the responsibility of the Medicines Control Agency to investigate suspected breaches of those regulations. We hold no information nationally on the cost to hospitals of meeting their obligations under these regulations.
Dr. Tonge: To ask the Secretary of State for Health what assessment he has made of the effectiveness of the Government's initiative to improve hospital cleanliness following the distribution of funds directly to hospital trusts for this purpose. 
Rapid assessments of all acute hospitals were carried out following initial visits in July. More detailed assessments have been made following further visits to the 400 hospitals by the patient environment action teams (PEAT). Some 300 experienced managers and professionals, drawn from the NHS, private sector and supported by patient organisations were involved in these visits.
Every trust has prepared an action plan, which has been agreed by the Department. NHS Estates will validate and support the action plans. Each trust has a board member who will take personal responsibility for hospital cleanliness.
Unannounced visits to hospitals will also be made in January, by the PEAT teams, to check that standards of cleanliness in our hospitals have improved, and that procedures are in place to ensure that these improved standards will be maintained. Once these visits have been completed we will be in a position to better assess how effective the initial stage of the programme has been.
To ensure that cleanliness in hospitals is maintained in the future we are drawing up a standard for cleanliness for all hospitals; these will be incorporated into the National Performance Assessment Framework and will be introduced next year.
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