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Hospital Cleanliness

Mr. Breed: To ask the Secretary of State for Health if he will list those hospitals in Cornwall and Devon which failed to meet basic cleanliness standards according to the recent survey by NHS Estates. [147249]

Mr. Denham: I refer the hon. Gentleman to the reply I gave on 23 January 2001, Official Report, column 508W.

Nurses

Mr. Cox: To ask the Secretary of State for Health how many agency nurses were employed in the NHS in December 2000; and what the total cost of that employment was. [147242]

Mr. Denham: Information about the number of agency nurses is not collected centrally. Information on the annual costs of employing agency nurses is collected centrally after the end of each financial year. Information on the cost of employing agency nurses during individual months of the year is not collected centrally.

Computer Systems

Mr. Ruffley: To ask the Secretary of State for Health what plans he has to carry out a value for money and operational effectiveness audit of the NHS computer systems purchased through the South West regional procurement following full implementation, before employing this procurement methodology elsewhere. [147139]

31 Jan 2001 : Column: 218W

Mr. Denham [holding answer 25 January 2001]: The South West procurement exercise is a pilot from which lessons will be learned and applied elsewhere in the country to help implement acute EPR. Once the systems and services have been implemented, a post- implementation review will be carried out by each local community taking part and will be published, as required by the conditions of the business case approval.

Food Safety

Mr. Gordon Prentice: To ask the Secretary of State for Health what foods which have gone past their sell by date are routinely reprocessed by the food industry and sold to the public in another form; and if he will make a statement. [147382]

Ms Stuart: The information requested is not available centrally.

Whether or not the date mark on a food has expired, and whether or not a food has been reprocessed, it is an offence under the Food Safety Act 1990 to sell, or possess for sale, food that does not comply with food safety requirements. These are that food, not only for retail sale but throughout the food chain, must not have been rendered injurious to health, be unfit, or be so contaminated that it would be unreasonable to expect it to be eaten. The Act also makes it an offence to render food injurious to health, to sell to the purchaser's prejudice food which is not of the nature or substance or quality demanded, or to describe or present food falsely or misleadingly.

Orthopaedic Surgeons

Ms Rosie Winterton: To ask the Secretary of State for Health what the average cost of the education and training of a qualified orthopaedic surgeon is. [147268]

Mr. Denham: The information requested is not collected centrally in the form requested.

In order to qualify as an orthopaedic surgeon, a doctor would have to complete a medical degree, one year of general clinical training, a minimum of two years as a senior house officer and six years as a specialist registrar.

The costs to the National Health Service and Higher Education Funding Council in England of a five year undergraduate medical course plus a year of general clinical training are in the region of £160,000 to £200,000. The health service makes a significant investment in postgraduate medical education. Doctors in postgraduate training follow an apprenticeship model where their training is inextricably bound up with the service they provide. Even within specialties the length and type of training will vary according to the particular career path an individual chooses and their rate of progress. For these reasons it is not possible to put a meaningful figure to the cost of training individuals to completion of specialist training.

Food Standards Agency

Dr. Iddon: To ask the Secretary of State for Health, pursuant to his answer of 18 December 2000, Official Report, column 41-42W, if he will list the amendments to directives and proposed future directives the Food Standards Agency is seeking to allow food products to

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carry consumer information about disease risk exposure reduction; and if he will make a statement on the progress so far made in achieving these objectives. [147745]

Ms Stuart: The Food Standards Agency has made specific representations to the European Commission arguing for establishment of an effective and practical system for the verification and approval of health claims at European Union level. It has made the case for allowing valid disease risk reduction claims as an integral part of these arrangements. These initiatives form part of the Food Standards Agency's wide-reaching food labelling action plan to improve the quality and clarity of information available to consumers.

I understand the Commission is now reviewing this area of legislation with a view to making proposals later this year.

A summary of the changes being pursued has been published by the FSA in its action plan on food labelling, copies of which are available in the Library.

Children (Medicines)

Mr. Burstow: To ask the Secretary of State for Health what plans his Department has to establish a centrally- held record of suspected adverse reactions among children to medicines. [147772]

Ms Stuart [holding answer 29 January 2001]: The Medicines Control Agency and its independent scientific expert advisory committee, the Committee on Safety of Medicines, have responsibility for monitoring the safety of medicines in the United Kingdom.

One of the key data sources used in monitoring is the yellow card scheme. This scheme receives spontaneous reports of suspected adverse drug reactions, including those in children, from doctors, dentists, coroners and pharmacists. All reports are entered on the adverse drug reactions on line information tracking database maintained by the MCA.

MRSA

Mr. Caton: To ask the Secretary of State for Health what steps he is taking to reduce infection by Methicillin-Resistant Staphylococcus Aureus in NHS hospitals. [147873]

Mr. Denham: The recently published NHS Plan implementation programme makes it very clear that, as a core requirement, National Health Service organisations must have effective systems in place to prevent and control hospital acquired infection (HAI), including methicillin-resistant staphylococcus aureus (MRSA).

New evidence-based multi-professional guidelines commissioned by the Department for the prevention of HAI, including multi-drug resistant organisms, were published in January 2001 as a supplement to the Journal of Hospital Infection.

Mr. Caton: To ask the Secretary of State for Health what measures are taken to test-screen possible carriers of Methicillin-Resistant Staphylococcus Aureus in NHS hospitals. [147836]

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Mr. Denham: There are different patterns of MRSA incidence throughout the country. Expert opinion is that it is not desirable or practical to screen all patients for MRSA but this is a matter for local determination. Mandatory surveillance of blood stream infections, including those caused by MRSA, is to be introduced from April 2001. This will enable National Health Service trusts more effectively to target interventions at patients most at risk.

Mr. Caton: To ask the Secretary of State for Health what assessment he has made of the incidence of Methicillin Resistant Staphylococcus Aureus infection in NHS hospitals. [147842]

Mr. Denham: Aggregate data on numbers of incidents of methicillin resistant "Staphylococcus aureus" (MRSA) voluntarily submitted by trusts for specialist microbiological tests since 1996 are given in the tables. These data are routinely available on a regional basis only. Data on "Staphylococcus aureus" bacteraemias (blood infections) showing the proportion resistant to methicillin in England and Wales are published quarterly by the Public Health Laboratory Service in the Communicable Disease Report, copies of which are available in the Library. More comprehensive information about bacteraemias, including MRSA, will be collected from all acute trusts from 1 April 2001 and data will be published from 1 April 2002.

Incidents of MRSA 1996-2000

	Incidents of MRSA
	1996	1997	1998
Anglia and Oxford	237	297	223
North Thames	539	544	289
North West	176	259	215
Northern and Yorkshire	150	224	202
South and West	206	254	101
South Thames	421	385	220
Trent	99	123	109
West Midlands	121	102	69
Wales	158	176	169
Total	2,107	2,364	1,597

	Incidents of MRSA
	1999	2000
Eastern	80	60
London	290	170
Northern and Yorkshire	170	70
North West	180	90
South East	170	100
South West	40	10
Trent	100	30
West Midlands	30	50
Wales	130	40
Total	1,190	620

Notes:

1. For 1996 and the first half of 1997 data have been amalgamated to the approximate boundaries of the new Regional Office areas. This allows for comparison with subsequent years.

2. An incident is three or more patients infected or colonised by the same strain of MRSA in the same month from the same hospital.

3. The criteria for submission of isolates of MRSA (and other isolates of staphylococcus aureus) to the PHLS for specialist tests have been revised twice since 1996 (in January 1998 and in January 2000).

4. These revised criteria have led to a fall in the number of incidents of MRSA that were reported to the PHLS and cannot be used as a reliable estimate of the total number of cases of MRSA.

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