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Patients (Testing)
Mr. Andrew Turner: To ask the Secretary of State for Health (1) under what circumstances it is lawful for patients to be tested without their knowledge or consent; and if he will make a statement; [14127]
- (2) what guidance and legislation applies to staff of accident and emergency departments on testing girls under the age of 10 years for pregnancy without their knowledge or agreement or that of their parents. [14126]
Ms Blears [holding answer 12 November 2001]: In treating a child, the welfare of the child must be paramount. While in most circumstances we would expect a child and, where relevant, his or her parents to be involved in decisions about that child's treatment or care, in certain circumstances—for example emergencies—this may not be possible.
A range of tests would be carried out in the case of abdominal pain, intended to facilitate a diagnosis, dependent upon whether or not the health professional involved considers the test to be an appropriate medical response to the symptoms presented. Ectopic pregnancy can be life threatening. The test described does not involve any form of physical intervention as the child is asked to give samples to enable the tests, and will voluntarily agree to provide these samples. Therefore there can be no question of assault by staff. The potential of pregnancy in a very young child may raise the question of abuse which, once the child's health has been safeguarded, may require further investigation. Following the case of Gillick, the courts have held that children who have sufficient understanding and intelligence to enable them to understand fully what is involved in an intervention will also have the capacity to consent to that intervention.
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While there is no English statute setting out the general principles of consent, case law ("common law") exists. The Department has published the "Reference Guide to Consent for Examination or Treatment", (March 2001) which provides guidance in this respect. This states:
- "A life threatening emergency may arise when consultation with either a person with parental responsibility or the court is impossible, or the persons with parental responsibility refuse consent despite such emergency treatment appearing to be in the best interests of the child. In such cases the courts have stated that doubt should be resolved in favour of the preservation of life and it will be acceptable to undertake treatment to preserve life or prevent serious damage to health".
(Section 3.8.5, page 17.)
We announced in the NHS Plan (paragraph 10.22) that we intend to ensure that good practice in consent for examination and treatment is in place in clinical and research settings, with changes to be introduced from the end of 2001. Guidance for health professionals and leaflets for patients have been produced to inform people about their rights and responsibilities earlier this year. Ministers are currently considering a model consent policy and revised consent forms for the national health service.
Endometriosis
Mrs. Brooke: To ask the Secretary of State for Health (1) how many cases of endometriosis diagnosed at (a) Dorset County, (b) Poole General and (c) Royal Bournemouth hospitals in the 1999–2000 data year were classified stage three or four; [13943]
- (2) how many endometriosis patients from Dorset were referred out of county for laser treatment during the data year 1999–2000; [13944]
(3) how many cases of endometriosis were diagnosed in the 1999–2000 data year at (a) Dorset County, (b) Poole General and (c) Royal Bournemouth hospitals. [13942]
Ms Blears [holding answer 14 November 2001]: The Department does not collect information showing the number of patients diagnosed with endometriosis, or the classification of the condition. The hon. Member may wish to contact the chief executives of the national health service trusts concerned for further information.
Information from the health episode statistics database shows that no patients from Dorset were referred out of the health authority area for laser treatment for endometriosis.
NHS Reconfiguration Panel
Mr. Hinchliffe: To ask the Secretary of State for Health if he will make a statement on the composition of the NHS reconfiguration panel; when he expects appointments to this body will be made; what the remit of the panel is; and what measures he is taking to ensure its independence. [14301]
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Ms Blears [holding answer 14 November 2001]: Composition of the independent reconfiguration panel (IRP) will follow the modernisation board model of one third professionals, one third managers and one third patients' and citizens' representatives. Dr. Peter Barrett has been appointed chair of the IRP. The members are being selected through open competition and the interviews are due to take place shortly. The aim is to complete the appointments process by the end of the year.
The panel's draft terms of reference were outlined in the press release accompanying Dr. Barrett's appointment. These will need to be agreed with the panel membership before being confirmed. The panel will provide authoritative advice to the Secretary of State on referred proposals for national health service service change. The panel will publish the advice it gives in relation to each proposal referred to them by my right hon. Friend the Secretary of State.
The IRP will have a crucial role in advising on the outcome of significant reconfigurations, making the process more transparent and accountable. It is important to have public confidence in the panel and the processes it will use in its deliberations.
We propose to hold a simulation exercise early in the new year to which all major stakeholders will be invited to participate. We are also committed to consulting widely on the criteria that the panel will use. The simulation exercise will form part of the consultation process.
Electro-convulsive Therapy
Mr. Burstow: To ask the Secretary of State for Health what the trends have been in the use of electro-convulsive therapy in the last 15 years; and what research his Department has undertaken into the trends. [14937]
Jacqui Smith [holding answer 15 November 2001]: The most recent information available concerning trends in the administration of electro-convulsive therapy (ECT) is contained in the one-off survey covering the period from January 1999 to March 1999, England only, that was undertaken to provide an up-to-date and accurate snapshot picture of the use of electro-convulsive therapy (ECT). A copy of this document is available in the Library.
The results of the ECT survey showed that in keeping with the trend from 1985 through 1999–91 the number of administrations of ECT has declined. The estimated 65,930 administrations of ECT compares with 105,466 reported administrations in 1990–91 and 137,940 in 1985.
Waiting Lists
Mr. Burns: To ask the Secretary of State for Health how many people have been waiting more than 13 weeks for an out-patient appointment (a) on the latest day for which figures are available and (b) for the previous quarter, in the Mid Essex hospital trust area. [14966]
Mr. Hutton: The information requested is given in the table.
Total number of patients waiting 13 weeks or more for an outpatient appointment at Mid Essex hospital services national health service trust at quarter 1 2001–02 (June 2001) and quarter 2 2001–02 (September 2001).
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| 2001–02 | Number |
|---|---|
| Quarter 1 (June 2001) | 2,146 |
| Quarter 2 (September 2001) | 2,439 |
Source:
QM08 quarterly return
Mr. Burns: To ask the Secretary of State for Health how many people were (a) waiting for inpatient treatment and (b) waiting more than 12 months for inpatient treatment, on the latest day for which figures are available in the Mid Essex Hospital Trust area. [14967]
Jacqui Smith: The information requested is given in the table.
Total number of patients waiting and the number of patients waiting over 12 months for hospital treatment at Mid Essex hospital services national health service trust in September 2001.
| Number | |
|---|---|
| September 2001 | |
| Total waiting | 8,968 |
| Waiting over 12 months | 683 |
Source:
Monthly waiting list return
Digital Hearing Aids
Tim Loughton: To ask the Secretary of State for Health if the July 2000 NICE guidance on NHS audiology services and digital hearing aids was published before the financial contract for the NHS bulk purchasing of digital hearing aids for the first wave sites had been completed. [15677]
Jacqui Smith: Yes. The National Institute for Clinical Excellence guidance was published in July 2000 and the bulk purchasing contract was completed at the beginning of October 2000.
Tim Loughton: To ask the Secretary of State for Health (1) if he will set out the timetable for the evaluation of digital hearing aids under the 20 first wave sites; [15680]
- (2) what guidance his Department has given to the 20 NHS sites providing digital hearing aids for the financial year 2002–03; [15681]
(3) pursuant to his answer to the hon. Member for Vale of York (Miss McIntosh) of 29 October 2001, Official Report, column 560W, on digital hearing aids, what evaluation has been made of the impact that an extra £25 million extra expenditure on audiology services will have; and by what date his Department expects to make a decision as to the speed and scale of the modernisation of NHS audiology services. [15676]
Jacqui Smith: Twenty national health service trusts are participating in the modernising hearing aid services pilot project, which is addressing the most effective hearing aids for NHS patients, the best ways of supplying hearing aids and how a modernised hearing aid service can best be delivered to NHS patients. £11 million has been invested since May 2000 and up to 18,000 people will have benefited by March 2002.
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The Institute of Hearing Research is evaluating the modernisation project on behalf of the Department. Interim reports have been made available to the Department, based on limited data at this stage, suggesting that there is benefit to patients from a digital hearing aid fitted in a modernised service. The evaluation is on-going and further reports are expected to be available in March and December 2002.
Detailed guidance on patient protocols, when to fit various aids etc., has been given to those sites participating in the pilot. Guidance will be updated based on the experience of the pilot sites. Subject to favourable evaluation, we will make decisions about how best to spread the modernised services, including the provision of digital hearing aids, throughout the NHS. We have earmarked funds to begin roll-out and up to £25 million will be invested by 2003–04 subject to further favourable evaluation. Funding decisions for 2002–03 will be made in time to allow sites to make plans for delivering services for that financial year.
Tim Loughton: To ask the Secretary of State for Health what steps his Department is taking to monitor the number of people who have decided to purchase digital hearing aids from overseas. [15678]
Jacqui Smith: No such steps are being taken. People who purchase digital hearing aids overseas are not required to inform the Department of their purchase.
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