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Patient Confidentiality

Mr. Gibb: To ask the Secretary of State for Health what access (a) civil servants outside the national health service and (b) Ministers have to the private medical records of individuals. [31317]

Ms Blears: Neither Ministers nor civil servants outside of the national health service have access to the private medical records of individuals. Disclosures of information contained in medical records to Ministers and civil servants must comply with data protection, common law and human rights requirements.

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Private Finance Initiative

Lynne Jones: To ask the Secretary of State for Health, pursuant to the answer of 26 June 2001 to the hon. Member for Chesterfield (Paul Holmes), Official Report, column 69W, what recent studies his Department has commissioned, undertaken and reviewed concerning the use of private finance within the national health service; and whether these demonstrate that the private finance option is better value for money when compared to the publicly funded alternative. [31458]

Mr. Hutton: The Department internally reviews all private finance initiative projects through the business case approval system as laid out in the Department's capital investment manual. To be approved, the business case must demonstrate that, overall, the private finance option is value for money when compared to the publicly funded alternative, the public sector comparator, and that it provides improved facilities for the national health service. NHS trusts are required to monitor performance throughout the lifetime of the PFI contract.

Because of PFI, eight major new hospitals have opened and another 15 are under construction, representing capital investment in the NHS of over £2 billion.

The Department has commissioned no external studies into the use of PFI in the NHS.

GP Prescribing Budget

Andy Burnham: To ask the Secretary of State for Health which health authorities have advised general practitioners to suspend temporarily the prescribing of statins in order to reduce the expected overspend on the general practitioners prescribing budget. [31108]

Ms Blears [holding answer 29 January 2002]: We are not aware of any health authorities offering such advice to their general practitioners. GPs should continue to prescribe medicines considered appropriate to meet the clinical needs of patients.

Gluteraldehyde

Mr. Greg Knight: To ask the Secretary of State for Health which NHS hospitals in England and Wales use (a) Cidex and (b) Gluteraldehyde as a disinfecting agent; what assessment he has made of the safety implications for staff and patients of its continued use; and if he will make a statement. [30879]

Yvette Cooper [holding answer 29 January 2002]: It is common practice within national health service hospitals to use chemicals to disinfect medical devices such as flexible endoscopes, and some surgical instruments where the device cannot be decontaminated by conventional methods which employ steam at high temperature. The most common chemical used is Gluteraldehyde, of which Cidex is a brand name. Information on which chemicals are used at individual hospitals in England is not collected centrally.

Gluteraldehyde falls under the Control of Substances Hazardous to Health (COSHH) Regulations and is subject to strict control and continuous monitoring at local level. An annual risk assessment is required of how this substance is being used in the clinical setting. Where operating procedures suggest that exposure risk from inhalation is high, there is a requirement under the Health and Safety at Work Act to undertake environmental

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monitoring of the area. Monitoring is carried out by a qualified person with immediate corrective action being taken where necessary. This is included in the Controls Assurance Standards.

Whittington Hospital

Mr. Lansley: To ask the Secretary of State for Health what steps he took to ensure that no information containing sensitive personal data relating to patients at Whittington hospital, Mrs. Rose Addis, Mr. J. Scott-Faulkner and Mr. S. Hockley was processed, beyond that deliberately made public by the patients themselves. [31379]

Ms Blears [holding answer 29 January 2002]: Responsibility for the processing of data relating to patients at the Whittington hospital rests with the hospital, subject to guidance issued by the Department. Guidance issued in March 1996 made it clear that patient consent should be sought prior to disclosing confidential information to the media and that even where patients themselves make details public, national health service bodies remain bound by patient confidentiality.

Mr. Lansley: To ask the Secretary of State for Health who (a) inside and (b) outside the NHS has had access to the patient records of Mrs. Rose Addis, Mr. S. Hockley and Mr. J. Scott-Faulkner since 20 January; whether such access was for medical purposes; and if the explicit consent of the data subject was obtained for such access. [31382]

Mr. Hutton [holding answer 29 January 2002]: The operational procedures of the Whittington hospital are the responsibility of the hospital. Guidance issued by the Department makes it clear that all national health service bodies are expected to comply with all relevant legal requirements, including those relating to data protection and patient confidentiality.

Mr. Lansley: To ask the Secretary of State for Health who the Caldicott Guardians and data protection officers are in respect of patient records at the Whittington hospital for patients Mrs. Rose Addis, Mr. J. Scott-Faulkner and Mr. S. Hockley. [31378]

Mr. Hutton [holding answer 29 January 2002]: Dr. Norman Parker, medical director at the Whittington hospital national health service trust is the Caldicott Guardian. Mr. Leo Bremner is the data protection officer.

SNOMED

Mr. Burstow: To ask the Secretary of State for Health what steps he is taking to ensure that the SNOMED clinical coding system is implemented within the NHS. [31545]

Ms Blears [holding answer 30 January 2002]: The SNOMED clinical terms first release is due at the end of January 2002 and, in the national health service, will be for implementation testing only. An evaluation and refinement programme has been funded which will examine implementation issues in both the primary care sector (the ADVENT project) and across a broad range of clinical specialities (multi-professional quality assurance—MPQA). In parallel, an implementation scoping study will address issues around costs, migration from read codes, supplier involvement, and education and training

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requirements in the service. This will lead to the development of a costed implementation plan for roll-out of SNOMED CT across the NHS.

Non-executive Posts (Epsom and Ewell)

Chris Grayling: To ask the Secretary of State for Health if he will list the proportion of non-executive posts filled by people living in the Epsom and Ewell constituency in health authorities and trusts covering the constituency (a) in 1997 and (b) at the latest available date. [31384]

Ms Blears [holding answer 30 January 2002]: The information requested is given in the table:

Non-executive posts on national health service boards serving the Epsom and Ewell constituency occupied by people living in Epsom and Ewell

	1997 (April)	2002 (January)
East Surrey health authority	1 (6)	0 (5)
Epsom and St. Helier NHS trust	1 (6)	1 (6)
Surrey Ambulance NHS trust	1 (6)	1 (6)
Surrey Oaklands NHS Trust	1 (6)	1 (5)
Total	4 (24)	3 (22)

Note:

Figures in brackets give total number of non-executives on board.

Winter Deaths

Chris Ruane: To ask the Secretary of State for Health how many winter excess deaths there were, by region, in each of the last 10 years (a) in total number and (b) as a percentage of the elderly population; and what recent measures the Government have taken to reduce the number of winter excess deaths. [30611]

Yvette Cooper [holding answer 30 January 2002]: The information requested is shown in the table.

The information is not available as a percentage of the elderly population.

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The causes of excess winter deaths are complex but cold weather and illnesses such as influenza play an important part.

We have introduced a programme of measures, outlined in the United Kingdom fuel poverty strategy, aimed at ensuring people, especially older people, are able to keep adequately warm at reasonable cost.

Health professionals have been encouraged to identify cold/health related issues and raise awareness of help available.

A "Keep Warm, Keep Well" campaign operates in England each winter which provides free booklets for the public and special literature for health professionals; a telephone helpline, and advice on how those most in need may apply for grants (such as the Home Energy Efficiency Scheme—a scheme providing grants for comprehensive packages of insulation and heating improvements for those most vulnerable to cold-related ill health); advice on benefit payments; as well as the health benefits of keeping warm.

Influenza vaccine is offered free to everybody aged 65 and over and to those of any age who are in at risk groups, for example with conditions where their health would be at particular risk if they caught influenza. At risk groups are those with chronic heart disease; chronic respiratory disease (including asthma); renal disease,; diabetes mellitus; and immunosuppression due to disease or treatment and also to residents of long-stay residential homes or care facilities.

In 2000–01, 65 per cent. of those aged 65 and over were immunised (the target was a minimum of at least 60 per cent., it was also the first time a target had been set).

Final monitoring figures at the end of December 2001, show that 68 per cent. of those aged 65 and over were immunised this winter. This is 3 percentage points higher than the 65 per cent. target set at the start of the campaign.

Excess winter deaths⁽⁴³⁾ by age-group and Government office region of usual residence, 1991–92 to 1999–2000, and 2000–01⁽⁴⁴⁾

Age group	1991–92(45)	1992–93(45)	1993–94(45)	1994–95(45)	1995–96(45)	1996–97(45)	1997–98(45)	1998–99(45)	1999–2000(45)	2000–01(46)
	England, Wales and elsewhere
0–64	2,740	2,120	2,120	2,200	2,900	3,040	1,700	3,100	3,770	2,300
65–74	6,360	4,710	4,160	5,490	7,070	6,970	4,200	6,950	7,440	3,300
75–84	13,500	9,330	9,290	9,700	14,370	17,540	7,870	16,340	16,840	8,400
85+	12,250	9,490	10,330	9,910	15,850	20,140	9,130	20,450	20,390	11,000
All ages	34,850	25,650	25,900	27,290	40,190	47,690	22,900	46,840	48,440	25,000
	North-east
0–64	260	160	210	130	250	130	110	90	280	100
65–74	510	280	340	270	520	500	360	470	480	300
75–84	930	550	630	400	650	920	530	890	1,030	600
85+	560	420	440	420	650	680	550	920	880	500
All ages	2,260	1,410	1,610	1,210	2,080	2,230	1,550	2,370	2,680	1,500
	North-west
0–64	430	530	330	230	630	510	280	630	420	200
65–74	1,050	740	510	960	1,000	1,070	500	1,230	1,090	600
75–84	2,020	1,310	1,050	1,410	2,060	2,260	980	2,600	2,060	1,300
85+	1,480	1,320	1,080	1,190	1,940	2,520	1,010	2,880	2,520	1,600
All ages	4,980	3,880	2,980	3,790	5,630	6,360	2,770	7,350	6,090	3,800
	Yorkshire and the Humber
0–64	340	40	190	120	250	240	210	260	350	200
65–74	800	500	620	520	820	700	480	810	680	500
75–84	1,520	870	1,170	1,030	1,440	1,810	860	1,800	1,690	800
85+	1,320	1,060	1,120	1,100	1,530	1,800	910	1,890	1,900	1,000
All ages	3,970	2,470	3,110	2,780	4,030	4,540	2,460	4,760	4,620	2,600
East midlands
0–64	260	230	240	240	170	250	130	310	350	200
65–74	640	460	350	580	500	470	360	550	590	300
75–84	1,150	700	900	850	1,110	1,280	700	1,560	1,270	800
85+	1,090	790	980	660	1,140	1,540	820	1,680	1,620	1,000
All ages	3,140	2,180	2,470	2,330	2,930	3,540	2,000	4,090	3,820	2,200
	West midlands
0–64	380	270	280	250	250	410	250	470	440	300
65–74	670	520	320	600	880	740	510	750	950	400
75–84	1,260	970	860	700	1,580	1,650	800	1,730	1,810	1,000
85+	1,060	830	950	760	1,460	1,740	900	1,920	2,090	900
All ages	3,370	2,590	2,400	2,310	4,160	4,530	2,460	4,860	5,290	2,600
	East
0–64	150	180	170	240	180	240	170	130	330	100
65–74	560	400	550	560	480	710	410	640	670	200
75–84	1,180	850	1,010	1,110	1,380	1,720	930	1,590	1,800	1,000
85+	1,240	940	1,220	1,090	1,830	2,320	1,030	2,440	2,070	1,200
All ages	3,130	2,360	2,940	3,000	3,870	5,000	2,540	4,800	4,880	2,400
	London
0–64	300	310	290	380	440	430	150	420	470	300
65–74	720	560	490	530	860	870	320	670	930	300
75–84	1,690	1,220	1,130	1,370	1,680	2,240	930	1,690	2,050	800
85+	1,540	1,260	1,240	1,230	1,840	2,390	1,120	2,160	2,430	1,400
All ages	4,240	3,360	3,150	3,500	4,830	5,940	2,520	4,940	5,870	2,800
	South east
0–64	360	160	90	220	310	420	250	370	630	300
65–74	660	840	530	690	940	870	570	890	1,050	200
75–84	1,790	1,360	1,340	1,330	2,230	2,770	990	2,190	2,470	1,000
85+	1,760	1,400	1,780	1,750	2,670	3,600	1,410	3,260	3,530	1,600
All ages	4,560	3,770	3,750	3,990	6,150	7,650	3,210	6,710	7,680	3,200
	South-west
0–64	110	120	310	280	250	300	120	230	310	300
65–74	440	220	330	550	690	600	400	420	620	200
75–84	1,380	850	810	920	1,320	1,830	700	1,380	1,580	500
85+	1,420	990	1,150	1,100	1,880	2,320	1,020	2,100	2,220	1,200
All ages	3,350	2,180	2,600	2,850	4,140	5,060	2,240	4,130	4,730	2,300
	Wales
0–64	240	200	50	200	180	120	90	230	220	200
65–74	360	260	180	270	420	490	360	540	420	200
75–84	610	670	420	570	920	1,050	480	930	1,090	600
85+	780	490	370	600	910	1,220	350	1,200	1,150	600
All ages	1,980	1,610	1,010	1,650	2,440	2,880	1,290	2,900	2,880	1,700
	England
0–64	2,590	2,010	2,100	2,090	2,720	2,930	1,660	2,900	3,570	2,100
65–74	6,050	4,510	4,050	5,250	6,690	6,520	3,890	6,430	7,070	3,100
75–84	12,900	8,670	8,900	9,110	13,450	16,490	7,410	15,430	15,770	7,800
85+	11,470	9,000	9,960	9,300	14,940	18,910	8,770	19,250	19,250	10,400
All ages	33,010	24,190	25,020	25,750	37,810	44,850	21,740	44,010	45,650	23,400
	England and Wales
0–64	2,820	2,210	2,150	2,290	2,910	3,050	1,760	3,130	3,790	2,300
65–74	6,410	4,770	4,230	5,520	7,120	7,010	4,260	6,970	7,490	3,300
75–84	13,520	9,340	9,320	9,690	14,380	17,540	7,890	16,360	16,850	8,400
85+	12,250	9,490	10,330	9,900	15,850	20,130	9,120	20,450	20,400	11,000
All ages	35,000	25,810	26,030	27,400	40,250	47,730	23,030	46,900	48,520	25,000

⁽⁴³⁾ Excess winter deaths are defined by the Office for National Statistics as the difference between the number of deaths during the four winter months (December to March) and the average number of deaths during the preceding autumn (August to November) and the following summer (April to July).

⁽⁴⁴⁾ Provisional.

⁽⁴⁵⁾ Rounded to the nearest 10.

⁽⁴⁶⁾ Provisional, rounded to the nearest 100.

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