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Mr. Gill: To ask the Secretary of State for Health what representations he has received from Wyre Forest district council regarding Kidderminster hospital; and if he will make a statement. 
Yvette Cooper: Representatives of Wyre Forest district council have written to Ministers on many occasions concerning their opposition to the relocation of services from Kidderminster hospital.
However, local general practitioners have publicly confirmed their belief that the move of services for clinical safety reasons was appropriate and local hospital clinicians have been fully engaged in the process.
The recently established Wyre Forest Primary Care Trust is also committed to supporting the changes that have taken place and is well placed to strengthen local influence and leadership on health service provision in Kidderminster.
The newly approved £13 million Ambulatory Care Centre offers an opportunity to further develop quality services and is good news for Kidderminster, as it maximises an effective and patient-focused service provision within those services that can be provided safely at the hospital.
Mr. Paul Marsden: To ask the Secretary of State for Health if he will list the current capital projects and their value in community and mental health services in Shrewsbury and Atcham; and if he will make a statement. 
Yvette Cooper: National Health Service trusts receive discretionary block capital with which to address small scale capital works. Shropshire's Community and Mental Health Services National Health Service Trust has received a £1.3 million discretionary block capital allocation, from which it is funding a programme of smaller estates projects throughout the county, most of which are to do with maintenance works.
Funding for larger capital projects must be pursued via the local NHS Executive regional office. The NHS Executive: West Midlands Regional Office is not currently dealing with any business cases for capital projects in Shrewsbury and Atcham. However, I am informed that Shropshire's Community and Mental Health Services National Health Service Trust is in the process
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of developing plans for replacement Child Development Centres and the replacement of Adult Acute Mental Health wards.
Mr. Paul Marsden: To ask the Secretary of State for Health what proportion of over 65-year-olds received flu immunisation in (a) the winter of 1997 and (b) the winter of 2000; and if he will make a statement. 
Yvette Cooper: Last year, we extended the recommended groups for influenza immunisation to include everyone aged 65 and over, irrespective of their underlying health, as well as younger people in established high-risk groups. This increase has led to record numbers of vaccine being made available, nearly 11 million this year compared to 7.8 million last year--an increase of 40 per cent. Previous policy was to vaccinate all those over 75 years of age.
Data collected from the Public Health Laboratory Service give an estimate from population samples that 45.2 per cent. of 65s and over were immunised in the winter of 1997-98.
Last year, for the first time, health authorities were set the target of achieving a minimum 60 per cent. uptake of immunisation among people aged 65 years and over in their areas--and also for the first time were required to provide accurate monitoring of uptake. Final data received from health authority flu co-ordinators at the end of December 2000, indicated that 65 per cent. of people aged 65 years and over received their flu immunisation.
Mr. Paul Marsden: To ask the Secretary of State for Health how many (a) general and (b) acute NHS hospital beds there were at the Royal Shrewsbury Hospital in each year for 1997 to date; and if he will make a statement. 
Yvette Cooper: National Health Service trusts provide healthcare, but may provide it at more than one site. Data are not collected on an individual site basis, but by entire NHS trust. The bed data for Royal Shrewsbury Hospitals NHS Trust are as follows.
|Year||Acute||General and acute||Total beds|
KH03 Department of Health
Mr. Cox: To ask the Secretary of State for Health how much funding his Department has given to the London Ambulance Service during the last 12 months. 
Mr. Denham: During the financial year 2000-01, the Department directly gave the London Ambulance Service £4.25 million; the London Ambulance Service's total income for 2000-01 was £121 million.
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Mr. Nigel Jones: To ask the Secretary of State for Health if he will make a statement on TB in Gloucestershire. 
Yvette Cooper: The latest available information from the Public Health Laboratory Service shows that the incidence of tuberculosis in Gloucestershire in 2000 was 5.3 cases per 100,000 population, compared to a national incidence of 10.9 per 100,000 population.
Mr. Dawson: To ask the Secretary of State for Health what his Department's policy is on the vaccination of children against TB. 
Yvette Cooper: United Kingdom immunisation policy against tuberculosis is set out in the UK Health Departments' Guidance "Immunisation Against Infectious Disease". A copy of the latest, 1996 published, edition is in the Library. UK immunisation policy is to offer BCG routinely to school children at between 10 and 14; to offer BCG at birth to specified high-risk groups; and to other specified high-risk groups.
Sir Brian Mawhinney: To ask the Secretary of State for Health what his estimate is of the number of people diagnosed as suffering from ME in (a) England and (b) the (i) Cambridgeshire/Peterborough, (ii) Lincolnshire and (iii) Northamptonshire health authority areas. 
Yvette Cooper [holding answer 8 May 2001]: Information about actual numbers of people with myalgic encephalomyelitis (ME) also known as chronic fatigue syndrome, is very hard to come by because of the problems in producing a precise definition of the illness.
Estimates of the number of people diagnosed as suffering from ME in the specific health authority areas mentioned are not collected centrally.
Dr. Stoate: To ask the Secretary of State for Health how many patients were (a) diagnosed with heart failure and (b) diagnosed with myocardial infarction in each of the last five years. 
Yvette Cooper: The table contains data for National Health Service hospitals in England in the years 1995-96 to 1999-2000. The figures show the number of finished consultant episodes where the main diagnosis was myocardial infarction or heart failure.
|Myocardial infarction||Heart failue|
A finished consultant episode is defined as a period of patient care under one consultant in one health provider. The figures do not represent the number of patients, as one person may have several episodes within a year. The figures will also not show those people who received care wholly in a primary care setting.
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The main diagnosis is the first of seven diagnosis fields in the hospital episode statistics dataset and provides the main reason why the patient was in hospital.
Data for 1995-96 to 1997-98 are grossed for both coverage and unknown/invalid clinical data: 1998-99 and 1999-2000 are ungrossed.
Dr. Stoate: To ask the Secretary of State for Health what estimate he has made of the total number of undiagnosed heart failure sufferers. 
Yvette Cooper: Data published in the British Heart Journal in 1994 states that heart failure affects between 0.4 per cent. and 0.8 per cent. of the general population in the United Kingdom. However, the authors of that report estimated that the prevalence of heart failure is more likely to be in the region of 1.5 per cent., which suggests about two thirds of people with heart failure are undiagnosed.
We recognise that heart failure is a previously under-recognised area, which is why Chapter Six of the National Service Framework for coronary heart disease deals specifically with its diagnosis and treatment.
Dr. Stoate: To ask the Secretary of State for Health what assessment he has made of the use of (a) beta blockers and (b) ACE inhibitors in the treatment of heart failure; and if he will make a statement. 
Yvette Cooper: Our position on treatment of heart failure is set out in the National Service Framework for coronary heart disease. The NSF standard states that people with a confirmed diagnosis of heart failure should be offered treatments most likely to both relieve symptoms and reduce their risk of death. First line treatment should be with ACE inhibitors, which can be used in combination with beta-blockers.
We have also commissioned the National Institute for Clinical Excellence to produce a clinical guideline on the management of heart failure. Work on this should start shortly.
Information on the use of ACE inhibitors and beta- blockers for heart failure is not currently collected. However, as part of the NSF implementation programme, by 2002, every hospital will have clinical audit data describing the delivery of key treatments such as ACE inhibitors and beta-blockers for heart failure. By 2003, every primary care team will collect audit data including the number and percentage of people with confirmed heart failure or left ventricular dysfunction who are being prescribed an ACE inhibitor.
Dr. Stoate: To ask the Secretary of State for Health what recent guidance he has issued to enable general practitioners accurately to identify heart failure patients. 
Yvette Cooper: The National Service Framework for coronary heart disease, published on 6 March 2000, provides guidance on the identification and diagnosis of heart failure patients. This includes advice on service models and an algorithm for the assessment of suspected heart failure.
We have also commissioned the National Institute for Clinical Excellence to produce a clinical guideline on the investigation and management of heart failure. Work on this is due to start later in the year.
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Dr. Stoate: To ask the Secretary of State for Health what recent steps he has taken to enable (a) hospitals and (b) general practitioners to develop accurate and speedy diagnoses of heart failure. 
Yvette Cooper: Our position on the treatment of heart failure is set out in chapter 6 of the National Service Framework for coronary heart disease. The NSF standard states that doctors should arrange for people with suspected heart failure to be offered appropriate investigations that will confirm or refute the diagnosis.
We need to improve access to echocardiography to help more people to get a quick and accurate diagnosis of heart failure. As a first step, money from the Treasury Capital Modernisation Fund has funded the purchase of over 50 echocardiography machines.
We have also commissioned the National Institute for Clinical Excellence to produce a clinical guideline on the investigation and management of heart failure. Work on this is due to start later this year.
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