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Mental Health

30. Dr. Naysmith: To ask the Secretary of State for Health if he will make a statement on developments in the treatment of mental health patients in the Avon health authority area. [26390]

Ms Blears: Avon and Wiltshire Mental Health Partnership NHS Trust have plans in place to progress towards the achievement of the targets set out in the mental health national service framework. The trust is working closely with other local NHS bodies to finalise the outline business case for the £68 million scheme for the modernisation of mental health services in Avon.

Mr. Heald: To ask the Secretary of State for Health how much of the £56 million allocated for high security places for dangerous and severe personality disorder persons in the NHS and for hostel places has so far been spent; and how many NHS places and hostel places have been provided. [10528]

Jacqui Smith: New dangerous and severe personality disorder (DSPD) units at Rampton and Broadmoor will deliver 140 places for dangerous and severe personality disorder persons by 2004. These are complex schemes, involving major innovations both in design, and in the approach to service delivery.

Work has concentrated initially on the Rampton site. To date, there has been capital expenditure of £412,000 at Rampton with a projected spend of £500,000 by year end. This is being committed to meet the costs of early design work, design team fees, and to refurbish accommodation for the DSPD team in Rampton. Work will commence on site in March 2002, with completion due in June 2003, and the expenditure of capital has been profiled to achieve this output. The unit is planned to open in the autumn of 2003. Work on the unit at Broadmoor is at an earlier stage of development, and no capital has been committed. However, it is on target to open in 2004.

Revenue spend on the Rampton and Broadmoor developments is projected to be £0.35 million this year. This will meet staff costs. At Rampton these costs include the salaries for the project director, consultant psychiatrist, nurse manager, consultant psychologist, business manager, security adviser and secretarial staff. There are also running costs for the DSPD team accommodation, and the costs of a one off study tour of Holland and Germany. At Broadmoor these costs include salaries for the project director and consultant psychiatrist.

We have decided that money originally earmarked for community hostel places should be allocated to a range of pilot provision within medium secure units and community settings, in order to provide step down care from high security.

Two units will open in early 2003 with a total of 23 beds for offenders with severe personality disorder, and community teams will be established in three locations to deliver care and treatment to this client group in community settings from 2002–03. The capital allocation of £3.5 million for these schemes will be committed over 2002–03.

Work on both sites is proceeding more slowly than originally anticipated in order to ensure that robust local dialogue takes place in advance of any application for planning permission. It is now estimated that about

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£50,000 will be committed this year. This will meet the cost of training events for the new clinical teams, together with travel expenses, plus commissioning a study to look at the development of staff competencies and staff training needs in working with people with DSPD in forensic settings.

Ms Dari Taylor: To ask the Secretary of State for Health what recent progress he has made in improving the treatment of mental health patients. [26382]

Jacqui Smith: All of the targets set to be achieved by this date in the National Service Framework for Mental Health have been met. These include almost 500 additional secure beds; over 320 24-hour staffed beds; 170 assertive outreach teams; access to services 24 hours a day, seven days a week, 365 days a year for all those with complex mental health problems; investment to improve the physical environments in psychiatric wards; and guidance issued to ensure the safety, privacy and dignity of mental health patients.

Funding Formula

31. Linda Perham: To ask the Secretary of State for Health what plans he has to revise the funding formula for the allocation of resources to health authorities in England and Wales. [26391]

Mr. Hutton: A wide ranging review of the weighted capitation formula used to allocate resources to health authorities and primary care trusts in England is currently taking place. A key criterion of the new formula will be to contribute to the reduction of avoidable health inequalities. The intention is that, following the review, the new formula will be ready for 2003–04 allocations.

Issues relating to a review of the funding formula for resource allocation in Wales, are a matter for the National Assembly for Wales.


32. Mr. Heath: To ask the Secretary of State for Health what his policy is on the treatment of migrainous headaches and migraine. [26392]

Mr. Hutton: We would expect that patients suffering from migrainous headaches and migraine would normally be treated by their general practitioner in the first instance. If this failed to resolve the problem then patients could be referred to a consultant neurologist for further investigation and tests.

The National Research Register is a database of on-going and recently completed research projects funded by, or of interest to, the United Kingdom's national health service. The current issue, Issue 4, 2001, shows that there are 17 on-going projects looking at migraine with another 56 recently completed.

Overseas Treatment

33. Mr. Prosser: To ask the Secretary of State for Health what progress he is making on the provision of treatment for NHS patients overseas. [26393]

Mr. Hutton: Subject to contract, East Kent health authority plan to send 18 patients to France for treatment before the end of January and up to 80 in total by the end of March. West Sussex/East Surrey and Portsmouth HAs

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are largely concentrating on potential German providers; subject to agreements on contracts they will send a number of patients to Germany in February and March. In total it is hoped that around 200 or more patients will travel to France and Germany for treatment during the pilot period. Initial guidance to the national health service will be published shortly.

Mr. Laws: To ask the Secretary of State for Health how many people from (a) East Kent, (b) Portsmouth, (c) West Sussex/East Surrey and (d) other areas of England were sent to other European countries for health treatment between (i) 1 January and 31 December 2001 and (ii) 1 January and 30 January 2002; if he will make a statement on the comparative costs of such treatments compared with the NHS in England, taking into account travel costs; and if he will make a statement on the conclusions of the three test-bed pilot schemes for overseas treatments. [26913]

Mr. Hutton: No patients from East Kent, Portsmouth or West Sussex/East Surrey were sent to other European countries for treatment in 2001. Subject to contract, East Kent plan to send 18 patients to France for treatment before the end of January. Portsmouth plan to send one patient to France during the same period. West Sussex/ East Surrey will commence sending patients overseas in February. Portsmouth will send further patients overseas in February and March.

Direct comparisons of the costs of overseas treatment and national health service costs are not straightforward; for example, prices so far for hip and knee replacements include intensive rehabilitation which would not be included in standard NHS reference costs. In general the prices agreed so far for treatment overseas are in excess of NHS average reference costs but comparable to those in the United Kingdom private sector. However, we would expect better prices if and when we commit to larger volumes of patients travelling overseas to individual hospitals.

The test bed exercise continues until the end of the financial year. It is therefore too early to draw any firm conclusions.

Norfolk and Norwich Hospital

34. Mr. Bellingham: To ask the Secretary of State for Health what plans he has to improve physical access to the new Norfolk and Norwich hospital; and if he will make a statement. [26394]

Mr. Hutton: The national health service has spent over £4 million on improving the road to the new hospital and has deposited an additional £1 million for improvements to be carried out.

The Highways Agency has confirmed it cannot approve proposals for an access road from the A47 to the new Norfolk and Norwich university hospital on the grounds of safety.

Norfolk county council is considering other options for a second access road to the hospital site. The hospital trust continues to support any proposals for additional access provided such access is safe.

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Consultants' Contracts

35. Paul Farrelly: To ask the Secretary of State for Health what progress he is making in his negotiations with hospital consultants on their new NHS contracts, with particular reference to the proposed seven-year rule; and if he will make a statement. [26395]

Mr. Hutton: Our proposals for the new consultant contract, published in February 2001, incorporated improved remuneration and incentives for consultants within a more robust framework of contractual duties and responsibilities, and envisaged that for an initial period, perhaps of seven years, the terms of the contract would prevent newly appointed consultants engaging in similar work outside the national health service.

These proposals, alongside the British Medical Association's own proposals, form the basis of continuing negotiations.

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