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Vitamin B12
Mrs. Helen Clark: To ask the Secretary of State for Health, pursuant to the oral statement of 19 December 2001, Official Report, column 395, when and in what form the research on the prevalence of vitamin B12 deficiency and its diagnosis among adults over 65 years of age will be published. [40776]
Yvette Cooper: A common concern expressed in the Department of Health/Food Standards Agency consultation on folic acid was the potential risks for older people. It was
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therefore necessary to have more information on the potential risks before proceeding with any course of action. This included:
- an estimation of the prevalence of vitamin B12 deficiency in older people aged 65 and above;
the appropriate methodology for the diagnosis of vitamin B12 deficiency;
the feasibility of routine identification of vitamin B12 deficiency in older people.
Mrs. Helen Clark: To ask the Secretary of State for Health what assessment he has made of the benefits for disease prevention if vitamin B12 is added to folic acid in flour fortification. [40778]
Yvette Cooper: The Committee on Medical Aspects of Food and Nutrition Policy (COMA) recommendation (2000) on the fortification of flour with folic acid aimed to minimise the number of people having intakes of folic acid which may mask vitamin B12 deficiency.
The committee did consider combined fortification of flour with B12 and folic acid. It would be necessary to fortify foods with very large amounts of vitamin B12 to allow for the low absorption in people with pernicious anaemia, which is the chief cause of severe B12 deficiency.
- "At present there is inadequate information on the amount of vitamin B12 that would be required to prevent deficiency in the population, especially those with pernicious anaemia. Although there is no formal evidence of toxicity from vitamin B12, any exposure of the whole population to levels many times their usual intake or requirements should be considered with particular caution".
Therefore, this option was not recommended.
Human Rights Act
Mr. Woodward: To ask the Secretary of State for Health what monitoring of compliance with the Human Rights Act 1998 in (a) residential care homes and (b) nursing homes his Department has undertaken in the last three years; and what resources have been made available for this. [38368]
Jacqui Smith [holding answer 6 March 2002]: The Human Rights Act 1998 came into force on 2 October 2000. The Act did not create new rights, but enabled the European Convention on Human Rights to be enforced in United Kingdom courts. Best practice in residential and nursing home care should be fully compatible with the convention.
Until 31 March 2002, local councils and health authorities respectively are responsible for registering and inspecting residential care and nursing homes under the provisions of the Registered Homes Act 1984. The Social Services Inspectorate carries out performance monitoring of local council inspection units. Local Authority Circular LAC(2000)17 expects local councils to ensure that procedures and practices comply with the Human Rights Act.
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From 1 April 2002, the National Care Standards Commission will be responsible for registration and inspection of residential care homes and nursing homes, under the Care Standards Act 2000, taking account of national minimum standards, which are fully compatible with the Human Rights Act.
Cervical Screening
Dr. Fox: To ask the Secretary of State for Health what the uptake among Asian women in Luton has been of cervical screening in each quarter since 1998. [40880]
Yvette Cooper: Figures for uptake of cervical screening are not collected by ethnic group.
Luton primary care trust and Luton health action zone are working with the community to increase the level of uptake in the difficult to reach Asian women groups.
Union Duties
Mr. Bercow: To ask the Secretary of State for Health when he intends to answer the question of 13 February from the hon. Member for Buckingham regarding staff involvement in union duties. [41577]
Yvette Cooper: I refer the hon. Member to the reply my hon. Friend the Parliamentary under Secretary of State for Health (Ms Blears) gave on Wednesday 27 February 2002, Official Report, column 1405W.
Helicopter Ambulances
Mr. Wiggin: To ask the Secretary of State for Health whether ambulance trusts can be reimbursed by charity for the cost of staff who serve on helicopter ambulances. [40894]
Ms Blears: [Holding answer 7 March 2002]: From April 2002, the NHS will meet the cost of approximately £150,000 for equipping each air ambulance helicopter with a paramedic crew. The staff who crew these aircraft are responding on behalf of NHS ambulance trusts to emergency patients who would otherwise be conveyed by land ambulances.
National Care Standards
Mr. Andrew Turner: To ask the Secretary of State for Health what flexibility he has introduced into the national care standards to meet the needs of care homes with small rooms and their residents and those which support drug and alcohol dependency. [41271]
Jacqui Smith [holding answer 7 March 2002]: Existing homes, including local authority homes, will have until 2007 to comply with some of the more challenging environmental space standards. We decided that the requirement for existing single rooms to have a minimum of 10 square metres of usable floor space should be postponed until April 2007. In addition, the standards include flexibility to allow some rooms down to 9.3 square metres to remain in use after 2007, provided additional compensatory facilities are made available.
We have listened to concerns from the drug and alcohol sector and have amended the standards for care homes for younger adults to meet those concerns.
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The draft standards said that new homes should accommodate up to 16 people in groups of up to eight. The final standards raise the limits to 20 and 10, and allow homes that accommodate people for less than six months further flexibility.
The draft standards said that there should be one WC for each two people and one bathroom for three people, in both cases adjacent to bedrooms. The ratio has been changed to 1:3 for both WCs and bathrooms, and existing homes have been given two more years (until 2004) to reach the standard. The standards say that facilities should be "near" bedrooms.
The draft standards said that all service users should be offered a single room. Existing shared accommodation is to be phased out by 2004, unless people choose to share. New provision would be built with single rooms. The standards now recognise the concept of a clinical need for sharing in the substance misuse sector. In existing homes, up to four people may continue to share a room where there is a clinical need, and in new premises, rooms can be shared by two. The standards also recognise that two people may choose to share a room.
We have also issued statutory guidance to the National Care Standards Commission, which says the commission should consider whether care homes can fulfil the needs to service users without making environmental changes to meet the standards. The guidance particularly covers issues of room size, lifts, baths and shared rooms.
Mr. Andrew Turner: To ask the Secretary of State for Health how the national care standards take account of the desire of married couples to share rooms. [41212]
Jacqui Smith [holding answer 7 March 2000]: Standard 23 of the standards for care homes for older people allows residents who wish to share a room to do so. Standard 23.10 states that in new build, extensions and all first time registrations, service users wishing to share accommodation should be offered two single rooms for use, for example, as bedroom and sitting room.
In the standards for care homes for younger adults, standard 25.8 recognises that two people may choose to share a room.
Mr. Andrew Turner: To ask the Secretary of State for Health what representations he has received on the accuracy of the estimate by the regulatory impact assessment of the cost of implementing national care standards. [40886]
Jacqui Smith [holding answer 7 March 2002]: Ministers at the Department have received only one representation as to the accuracy of the regulatory impact assessment for the implementation of the regulations and national minimum standards for care homes.
Mr. Andrew Turner: To ask the Secretary of State for Health what the basis is for the assessed capital cost of changes in the physical environment for younger adults contained in annexe A of the national care standards full regulatory impact assessment. [40889]
Jacqui Smith [holding answer 7 March 2002]: The basis for the assessment of the capital cost for changes in the physical environment for younger adults final regulatory impact assessment for care homes was the same as that used for the estimated costs during
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consultation. A survey undertaken by the Department in 1999 indicated that only 13 per cent. of care homes in this sector would have difficulty in meeting the 10 sq.m. room requirements. It also showed that 7 per cent. of homes had more than 20 per cent. of places as shared places. As a result of the flexibilities introduced in relation to overall room sizes and additional flexibilities for homes dealing with drug and alcohol rehabilitation we estimated that between no more than 10 to 15 per cent. of homes in this sector would be significantly affected.
Mr. Andrew Turner: To ask the Secretary of State for Health how many residential and nursing care provisions he estimates meet the national care standards; how many have programmes to upgrade their homes to meet the standards; and what proportion each represents of all care homes. [41241]
Jacqui Smith [holding answer 7 March 2002]: Following analysis from responses to the original consultation on the national minimum standards for care homes, "Fit for The Future?" the Department estimated that 50 per cent. of local authority and 20 to 25 per cent. of independent care homes for older people would have difficulty meeting the standards as proposed at that time. Subsequently the standards were amended and flexibilities introduced in relation to space standards.
For care homes for younger adults a departmental survey estimated that 13 per cent. of homes would have difficulty meeting the room size standards. The additional flexibilities introduced following consultation on the standards for both sectors has, in the view of the Department, significantly reduced the number of providers likely to have difficulty meeting the standards.
The National Care Standards Commission will not have a comprehensive picture of how many care homes meet the standards, how many producers have established programmes to upgrade their homes and what proportion this represents of all care homes, until it completes the first round of inspections of all homes after 1 April 2002.
Mr. Andrew Turner: To ask the Secretary of State for Health to what extent the cost to local authorities of purchasing places at care homes complying with the national care standards is met by the local government financial settlement for 2002–03. [41209]
Jacqui Smith [holding answer 7 March 2002]: The local government finance settlement for 2002–03 takes full account of the cost to local authorities of purchasing places at care homes complying with the National Care Standards Commission's requirements.
Mr. Andrew Turner: To ask the Secretary of State for Health which representative organisations constituted the reference group referred to in paragraph 12.1 of the national care standards full regulatory impact assessment. [41210]
Jacqui Smith [holding answer 7 March 2002]: The following organisations were members of the reference group for the development of national minimum standards for care homes for younger adults.
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CHANGE
Drugscope
Independent Healthcare Association
Leonard Cheshire
Local Government Association
Mental After Care Association
National Association of Adult Placement Services
National Association of Inspection and Registration Officers
National Autistic Society
National Centre for Independent Living
National Institute for Social Work
National Heads of Registration and Inspection
NHS Confederation
Norwood Ravenswood
NSF Registered Homes
Oxfordshire county council
People First
Portland College
Richmond Fellowship
Royal Association for Disability and Rehabilitation
Royal College of Nursing
Royal College of Psychiatry
Royal National Institute for Deaf People
SENSE
Turning Point
Voluntary Organisations Disability Group.
Jacqui Smith [holding answer 7 March 2002]: The information provided by the provider at paragraph 9 of annexe A of the full regulatory impact assessment was a general statement from that provider. That estimate was not disaggregated into its constituent parts and it was impossible to reach a conclusion as to its accuracy. On that basis the Department concluded that the estimate of overall compliance cost based on survey evidence was a more reasonable estimate.
Mr. Andrew Turner: To ask the Secretary of State for Health for what reason his regulatory impact assessment for national care standards does not cite as a benefit of option 1 the saving of money which under option 2 would have to be spent on alterations of homes to meet new standards. [41272]
Jacqui Smith [holding answer 7 March 2002]: The regulatory impact assessment for regulations and national minimum standards for care homes does not cite option 1 as a money saving option for good reason. In the first instance keeping the status quo does not mean that there are no additional costs incurred. If the system of regulation is left as of now with local authorities and health authorities regulating providers locally this would lead to increased subsidies for the cost of regulation included in the funding to these authorities. Those who responded to the White Paper "Modernising Social Services" were unanimous that regulatory costs should be
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borne by both providers and commissioners of services and that the new National Care Standards Commission should be funded through full cost recovery.
Finally, option 1 would do nothing to improve the standards of care and accommodation afforded to service users.
Mr. Andrew Turner: To ask the Secretary of State for Health what plans he has to monitor the responses to the national care standards and to amend the regulations. [41211]
Jacqui Smith [holding answer 7 March 2002]: The national minimum standards will be continuously monitored. We propose to review them within the first three years of operation, and in the light of the review consider any changes needed.
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