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Correspondence
Mr. Cran: To ask the Secretary of State for Health when a substantive reply will be given to Sarah Markham's letter of 28 November 2001, concerning payments to nursing students. [36834]
Mr. Hutton: A reply was sent on 21 February.
Mrs. Gillan: To ask the Secretary of State for Health when he will reply to the letters from the hon. Member for Chesham and Amersham dated 24 August and 21 September 2001 concerning a constituent and enzyme potentiated desensitisation treatment. [34846]
Yvette Cooper: A reply was sent on 13 February.
Drug Abuse
Mr. Cameron: To ask the Secretary of State for Health how many drug misusers were receiving treatment by type of service in (a) 2000 and (b) 1997. [37572]
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Ms Blears: Information on the number of drug misusers in treatment in England in 2000–01 is given in table 1; comparable information is not available for earlier years. Information on the numbers of drug misusers who presented for treatment for the first time or for the first time after a gap of six months, for both 1997 and 2000 is given in table 2. Both tables exclude treatment in prisons.
| Type of service | Number |
|---|---|
| England | 118,522 |
| Inpatient | 2,424 |
| Community: specialist services | 103,094 |
| Community: general practitioners | 8,180 |
| Structured day programmes | 706 |
| Residential rehabilitation | 1,902 |
| Others | 2,216 |
Source:
DH, Regional Drug Misuse Databases
| Type of service | 1 April to 30 September 1997 | 1 April to 30 September 2000 |
|---|---|---|
| England | 21,996 | 33,093 |
| Inpatient | 455 | 428 |
| Community: specialist services | 18,647 | 28,624 |
| Community: general practitioners | 1,571 | 1,429 |
| Structured day programmes | 11 | 175 |
| Residential rehabilitation | 516 | 759 |
| Others | 795 | 1,678 |
Source:
Statistics from the Regional Drug Misuse Databases on drug misusers in treatment in England, 2000–01
Psychiatric Extra-contractual Referrals
Dr. Murrison: To ask the Secretary of State for Health what the cost has been of psychiatric extra-contractual referrals (1) of offenders since 1997; [37220]
- (2) to the private sector since 1997. [37219]
Jacqui Smith: The information requested is not collected centrally.
Child Poverty
David Hamilton: To ask the Secretary of State for Health how many children between the ages of 10 and 14 are living in persistent poverty in (a) 2001–02 and (b) 1991–92; and if he will make a statement. [35682]
Malcolm Wicks: I have been asked to reply.
The information requested is not available.
Food Poisoning
Mr. Jim Cunningham: To ask the Secretary of State for Health what plans the Government have for the introduction of licensing for food businesses. [37310]
Yvette Cooper: I am advised by the Food Standards Agency that there are no current plans to introduce new licensing provisions for food businesses.
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The immediate priority for the Food Standards Agency, which has responsibility for food safety matters, is to improve standards generally among food businesses. It is doing this through initiatives to increase the uptake of food safety management systems designed to enable food businesses to identify and control food hazards and the recently launched campaign to increase hygiene awareness among caterers.
The Board of the Food Standards Agency has indicated that it will keep the issue of wider licensing under review in the light of progress with these initiatives.
Overseas Treatment
Tim Loughton: To ask the Secretary of State for Health how many patients from the West Sussex Health Authority area have received treatment in continental European hospitals under the NHS scheme; where; for what conditions; when he will be able to give the cost; what other establishments in the other country were assessed; what cost comparisons were made; and for what reason the hospital used was selected. [37768]
Mr. Hutton: As of 26 February, seven patients had undergone knee replacement surgery in the Lutherhaus Hospital in Essen and the Eduardus Krankenhaus in Cologne under a contract between West Sussex Health authority and Germedic. Of these, four come from the West Sussex Health Authority Area and three from East Sussex. The latter group were all on a waiting list at a trust in West Sussex.
The costs of these procedures are commercially confidential. They are comparable to the cost of purchasing individual procedures in the United Kingdom private sector.
These patients have travelled under the auspices of Germedic, a company which facilitates treatment in German hospitals for non-German patients. Germedic proposed the use of these hospitals to West Sussex, who then satisfied themselves that the hospitals were suitable for their patients.
Patients are travelling to Germany from West Sussex as part of a pilot scheme. Subject to evaluation of the pilot, arrangements will be put in place for securing overseas treatment for National Health Service patients on an ongoing basis. Decisions about the choice of hospital will be based on quality, convenience and choice.
Tim Loughton: To ask the Secretary of State for Health how many NHS patients have been treated in continental hospitals since 1 January; and through which health authorities. [37314]
Mr. Hutton [holding answer 26 February 2002]: Between 1 January and 15 February a total of 50 national health service patients travelled overseas to receive treatment in continental hospitals under the current pilot scheme. Forty two of these patients have come from the East Kent Health Authority area; West Sussex Health Authority has sent seven patients and the Isle of Wight, Portsmouth and South East Hampshire Health Authority so far has sent one patient.
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Anaesthetic Breathing Systems
Andrew Mackinlay: To ask the Secretary of State for Health what reporting regime exists for incidents where the anaesthetic breathing system is believed to have (a) been blocked and (b) malfunctioned. [36263]
Ms Blears: The Medical Devices Agency (MDA), an executive agency of the Department, currently operates two systems for reporting adverse incidents involving medical devices.
Incidents involving blocked or malfunctioning breathing system components should be reported to the MDA by health care professionals or the National Health Service through the user reporting system or, if the report comes from a manufacturer, through the agency's vigilance reporting system.
At the beginning of each year, the MDA publishes advice in the form of a safety notice to health care professionals to encourage them to report adverse incidents and to outline how to do so. MDA's website also provides advice on reporting incidents involving medical equipment, together with reporting forms and an online reporting facility.
MDA liaison officers have been appointed for each health authority, NHS trust and social services department in England (also for the majority of primary care trusts) with a dual role of raising awareness of the need for incident reporting and secondly to ensure that any safety advice issued by MDA is disseminated within their organisation to those who need to know.
The mandatory scheme for reporting adverse incidents relating to medical devices, often termed vigilance reporting, is an obligation laid upon all European Member States via the Medical Devices Directives. These Directives have been implemented in United Kingdom law via the Consumer Protection Act which places statutory obligations on manufacturers to report incidents which led to, or could have led to, death or serious injury.
Andrew Mackinlay: To ask the Secretary of State for Health if he will make a statement on the police investigation into blockages discovered in anaesthetic breathing systems, as part of Operation Orcadian; and when he expects these will be concluded. [36264]
Ms Blears: After discussion with the Essex police I am able to make the following statement.
A police investigation commenced with the tragic death of Tony Clowes at Broomfield Hospital, Chelmsford on 18 July 2001. Further incidents involving blocked anaesthetic breathing equipment components came to light and a linked enquiry was launched headed by Essex Police under the name Orcadian.
The basis of the enquiry and the linking process was to look for a common factor. As the enquiry progressed a number of other incidents were reported from a number of sources, including patients who felt they may have been involved in an incident in the past. Some manufacturing faults were also reported.
In many cases the information available is, or was, very scant. There have been difficulties in obtaining accurate accounts and records for incidents that are historic and
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which may not have been considered significant at the time. Some of the incidents involved date back to the late 1980s.
During the course of the investigation, experiments were carried out which showed that a blockage could be replicated whilst the items were in storage. This finding changed the focus of the enquiry from 'whom' to 'how'.
To date no common factor has been found although the enquiry is still ongoing.
Orcadian has been a joint enquiry involving nine police forces and the close co-operation of the National Health Service, Health and Safety Executive and the Department of Health.
The Medical Devices Agency (MDA) has assisted the police by providing Orcadian with advice on breathing systems and their use. Since the enquiry began, the MDA has published three Hazard Notices to advise and alert users to related safety issues as they have emerged from the police enquiry.
It is difficult to predict at this stage when Orcadian will be concluded.
Andrew Mackinlay: To ask the Secretary of State for Health how many incidents relating to the blockage of anaesthetic breathing systems are believed to have occurred within the NHS in each of the past three years; and if he will make a statement. [36265]
Ms Blears: The Medical Devices Agency (MDA) report that there are three main ways in which anaesthetic breathing system components can become blocked. These are: manufacturing problems; user error; and possible tampering.
The MDA adverse incident database holds the following information for each type of blockage over the past three years:
| Manufacturing problem | User error | Possible tampering | |
|---|---|---|---|
| 1999 | 1 | 1 | (42)— |
| 2000 | 2 | 1 | (42)— |
| 2001 | 4 | 9 | 7 |
(42) None reported
The increase in reports for 2001 may be attributed to the publication, by MDA, of three hazard notices raising the awareness of the possibility of blockages, together with the raised profile brought about by media coverage of the police Operation Orcadian.
Some of the reports relating to possible tampering are historical events that were reported following MDA's action and the police investigation. All seven incidents are subject to ongoing investigation within Operation Orcadian.
Those reports categorised as manufacturing problems were investigated by MDA and appropriate corrective action has been taken by the manufacturer to reduce the likelihood of re-occurrence. In some cases the product was recalled.
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