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4 Feb 2002 : Column 780W
Mr. Hancock: To ask the Secretary of State for Health what recent assessment has been made of staff shortages of (a) doctors, (b) nurses, and (c) scientific personnel in the Portsmouth and South East Hampshire health authority; and if he will make a statement. 
Ms Blears: We are aware of the difficulties that have been faced by trusts in the Isle of Wight, Portsmouth and South East Hampshire area in recruiting doctors, nurses and scientific personnel. A task force has been established locally, to look at staffing needs across the health authority. Details of local initiatives to recruit staff will be available from the chairmen of the health authority and national health service trusts.
Jacqui Smith: The National Health Service Purchasing and Supply Agency has negotiated a national contract for powered and manual wheelchairs (for England). The wheelchairs supplied under this contract conform to all relevant British and European safety standards.
Although health authorities and NHS trusts are expected to use this national contract they do have the freedom to purchase from different suppliers, depending on local circumstances. It is therefore their responsibility to ensure the contracts conform to all relevant British and European safety standards.
Jacqui Smith: The Medical Devices Agency, (MDA), maintains a database of all incidents reported to them concerning safety or quality problems with wheelchairs. MDA regularly carry out trend analysis on the content of reports received from United Kingdom, Europe and United States of America and also on the outcomes of any subsequent investigations. If these trends reveal the need for individual manufacturers to re-design their products or improve their usage instructions, labelling, repair instructions or quality control etc manufacturers are informed and MDA monitor the situation until appropriate improvements are made. Also, if any of these trends reveal a shortcoming in an issued British standard concerning wheelchairs or a need for a new standard, the MDA work with the British Standards Institution, (BSI), to make any necessary revisions or assist with the drafting of any new standard.
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Jacqui Smith: The Medical Devices Agency, (MDA), has specific responsibility on behalf of my right hon. Friend the Secretary of State to safeguard public health where medical devices are involved. MDA has an established wide ranging reporting system, which is open to users, carers and health care staff etc who wish to report safety or quality problems concerning medical devices. Within the Medical Device Regulations manufacturers are legally bound to report to MDA on any serious safety problems concerning their devices. MDA also carry out pro-active investigations on a range of manufacturers to ensure that they are in compliance with the requirements of the regulations.
Within this overall remit, MDA has a specific unit responsible for wheeled mobility devices where all reported incidents concerning the quality or safety of wheelchairs are considered. If the unit's investigation highlights a need for an improvement in a wheelchair's design, usage instructions or manufacturing process then appropriate action is taken with the manufacturer/supplier.
Mr. Paterson: To ask the Secretary of State for Health what specialist facilities are available for sufferers of Huntington's disease in (a) Northumberland, (b) Durham, (c) Cumbria, (d) North Yorkshire, (e) East Riding of Yorkshire, (f) Lincolnshire, (g) Norfolk, (h) Suffolk, (i) Essex, (j) Cambridgeshire, (k) Buckinghamshire, (l) Herefordshire, (m) Oxfordshire, (n) Berkshire, (o) Wiltshire, (p) Gloucestershire, (q) Hampshire, (r) Somerset, (s) Kent, (t) Sussex, (u) Isle of Wight, (v) Dorset, (w) Devon and (x) Cornwall. 
Jacqui Smith: Information on local service configuration in England, such as the availability of specialist facilities for patients with Huntington's disease, is not collected centrally. It is a decision for health authorities, in partnership with primary care groups/trusts and other local stakeholders, to assess the health needs of their populations, including those with Huntington's disease, and to commission services to meet those needs.
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Executive on the functions currently carried out in Scotland by the National Radiological Protection Board after the formation of the National Infection Control and Health Protection Agency; 
(3) what consultations the Chief Medical Officer had with agencies in Scotland prior to making his recommendations on the National Infection Control and Health Protection Agency. 
Yvette Cooper: Discussions are taking place between the Department and the Scottish Executive about how the proposals will affect Scotland. These discussions include consideration of how the functions currently exercised in Scotland by the National Radiological Protection Board might be affected by the proposed creation of the National Infection Control and Health Protection Agency.
Mr. Weir: To ask the Secretary of State for Health what plans he has to implement the recommendations contained in the report, Getting Ahead of the Curve-A Strategy for Combating Infectious Diseases. 
Yvette Cooper: The strategy includes a commitment to have updated plans in place by the end of 2002 for health care associated infection; tuberculosis; antimicrobial resistance; and blood-borne and sexually transmitted viruses. We hope to set up the new National Infection Control and Health Protection Agency at the latest by 1 April 2003, and will be working to have other elements of the strategy in place as soon as possible. Preparation of the strategy took account of a wide range of views, and we shall consult further as we work up the details of how to take particular components of the strategy forward.
|Diagnosis||04||1014||1544||4564||6574||7584||85 and over||Not known||Median||Total|
|S00 superficial injury of head||1,835||1,931||3,630||967||536||1,214||1,248||18||27||11,379|
|S01 open wound of head||4,877||3,642||8,567||2,753||1,172||2,191||2,652||29||28||25,883|
|S02 fracture of skull and facial bones||1,549||2,924||19,226||2,842||640||711||408||18||25||28,318|
|S03 dislocation sprain and strain of joints and ligaments of head||77||62||120||15||8||22||10||0||18||314|
|S04 injury of cranial nerves||5||3||43||13||4||0||0||0||32||68|
|S05 injury of eye and orbit||157||527||1,440||454||175||245||232||0||33||3,230|
|S06 intracranial injury||772||1,360||4,664||2,100||990||1,246||739||21||38||11,892|
|S07 crushing injury of head||0||0||3||1||0||1||0||0||40||5|
|S08 traumatic amputation of part of head||1||5||92||9||5||4||7||0||31||123|
|S09 other and unspecified injuries of head||6,279||7,964||13,974||4,150||1,624||2,587||2,562||35||23||39,175|
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An FCE is defined as a period of patient care under one consultant in one health care provider. The figures do not represent the number of patients, as one person may have several episodes within the year. The main diagnosis is the first of seven diagnosis fields in the Hospital Episode Statistics data set, and provides the main reason why the patient was in hospital. Figures in this table have not yet been adjusted for shortfalls in data.
Jacqui Smith: The Glasgow Coma Scale is the most widely used system for classifying the severity of head injuries. This scale assigns points to each patient based upon three categories: verbal function, eye opening, and best motor (movement) response. Additional information on severity is provided by X-ray and from CT and MR scans.
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Jacqui Smith: Rehabilitation for brain injuries is already defined as a specialised service, ie it has a planning population larger than the total population of several primary care teams and sometimes larger than the population of a strategic health authority. It was included in the National Specialised Services Definitions Set published by the Department on its website in December 2001.
Jacqui Smith: Around one million people a year receive a head injury in the UK, and over 100,000 of those attend hospital. We have hospital activity data on the number and type of injuries as shown in the table:
|S00-S09 Injuries to the head||199596||199697||199798||199899||19992000||200001|
|S00 Superficial injury of head||9,731||10,829||11,000||10,875||12,293||11,379|
|S01 Open wound of head||20,180||23,186||23,824||23,668||27,184||25,883|
|S02 Fracture of skull and facial bones||29,839||31,419||30,265||27,837||30,825||28,318|
|S03 Dislocation sprain and strain of joints and ligaments of head||317||381||367||410||349||314|
|S04 Injury of cranial nerves||78||63||94||96||106||68|
|S05 Injury of eye and orbit||3,655||3,503||3,320||3,255||3,591||3,230|
|S06 Intracranial injury||23,226||20,036||16,529||11,942||12,790||11,892|
|S07 Crushing injury of head||30||16||11||19||16||5|
|S08 Traumatic amputation of part of head||127||116||102||111||123||123|
|S09 Other and unspecified injuries of head||40,912||42,193||41,102||40,163||43,271||39,175|
1. A FCE is defined as a period of patient care under one consultant in one health care provider. The figures do not represent the number of patients, as one person may have several episodes within the year.
2. Data for 199596 to 199798 are adjusted for both coverage and unknown/invalid clinical data.
3. 199899 to 200001 data are not yet adjusted for shortfalls.
Jacqui Smith: The Department has said that the National Service Framework (NSF) for long-term conditions will have a particular focus on the needs of people with neurological disease and brain and spinal injury.
Mr. Berry: To ask the Secretary of State for Health if he will change the Government's response to the Health Committee's Third report of Session 200001 into Rehabilitation Following Head Injury, to take account of criticism from (a) Headway, (b) Rehab UK and (c) other organisations. 
Jacqui Smith: We are aware of the concerns expressed by Headway, Rehab UK and others about our response to the Health Committee's report. We do not, however, intend to change our response as there are a number of initiatives under way that will help improve services for people with head injury. These include the National Service Framework on long term conditions and the clinical guideline for the initial assessment, management and first referral of patients with head injury that the National Institute for Clinical Excellence has been asked to produce.
Mr. Berry: To ask the Secretary of State for Health what estimate he has made of the percentage of individuals who survived a head injury who (a) returned to work within a year, (b) return to work within five years and (c) never returned to work in the last five years; and if he will make a statement. 
We are keen to help ensure that disabled people, including those with head injury, are able to return to work whenever possible. Currently local authorities are taking the lead on joint investment plans on the Welfare to Work for disabled people initiative. The idea of these plans is to provide effective and joined up services for disabled people who want to work, to stay in work, or to move closer to the world of work.
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Mr. Berry: To ask the Secretary of State for Health what plans he has to introduce further measures to simplify the funding streams available to organisations offering vocational rehabilitation services to individuals with acquired brain injury. 
Jacqui Smith: The final stages of the process of rehabilitation for people who have acquired brain injury may be an individualised programme of employment rehabilitation delivered through the employment service's work preparation programme. The employment service has worked with the organisations delivering work preparation for people with brain injuries to produce a national framework. This will result in greater coherence within regions and countries in terms of the scope and duration of its individualised programmes.
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