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Abortion
Mr. Gareth R. Thomas: To ask the Secretary of State for Health what action his Department has taken in response to the audit of abortion services in 1999 by the Royal College of Obstetricians and Gynaecologists; and if he will make a statement. [43329]
Yvette Cooper: The audit of abortion services funded by the Department provided valuable baseline data on abortion services prior to the publication of the Royal College of Obstetricians and Gynaecologists' (RCOG) Evidence Based Guideline The Care of Women Requesting Induced Abortion.
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The audit found good awareness of and compliance with the RCOG guidelines available at the time and the report informed the development of the our sexual health and HIV strategy, which was issued for consultation in July 2001. The strategy recommends that services should be developed in line with the Royal College's guidelines ensuring that women meeting the legal requirements for an abortion are referred without delay. In addition, we have set a target in the strategy that from 2005, commissioners should ensure that women who meet the legal requirements have access to an abortion within 3 weeks of their first appointment with their general practioner or other referring doctor.
An action plan setting out how the strategy will be implemented will be published in the spring. The audit data will help us monitor progress in improving services.
Suicide
Mr. Hancock: To ask the Secretary of State for Health if he will make a statement on the research commissioned by him in the last five years on (a) suicide, (b) assisted suicide and (c) voluntary euthanasia, with special reference to practice in European jurisdictions. [43321]
Ms Blears: The Department commissioned a research project on suicide in high risk occupational groups, conducted by Professor Keith Hawton and colleagues at the centre for suicide research, University of Oxford. The project was funded over the period 1 December 1993 to 30 June 2000.
In addition, the Department funds the national confidential inquiry into suicides and homicides by people with mental illness to ensure that everyone involved with mental health services learns and implements lessons from the factors associated with serious incidents. The inquiry, led by Professor Louis Appleby, is crucial to gaining a better understanding of the circumstances surrounding homicides and suicides committed by people with mental illness.
Safety First, the 5 year report on suicide and homicide by psychiatric patients, builds on Professor Appleby's earlier report "Safer Services" published in 1999. The Department is committed to taking necessary action in response to the findings of the Inquiry. We have already published the national service framework for mental health and national plan which specifically address a number of the recommendations out lined in the earlier report. The key findings and further recommendations outlined in Safety First will be given full consideration and will help to inform the national suicide prevention strategy that we are currently developing.
In addition, the Department has funded:
A trial of social work interventions for adolescents who have attempted suicide.
A pilot study of mental health crisis cards.
Factors underlying and maintaining nurses' positive therapeutic attitudes to patients with severe personality disorder.
A study "Does dialectical behaviour therapy (DBT) reduce deliberate self-harm in female patients with borderline personality disorder?"
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Suicides and open verdicts on the Railway Network
An investigation into recent temporal trends and geographic patterns of suicide.
Lay understandings of suicide, its aetiology and preventibility: a qualitative analysis of interviews with bereaved relatives.
A case control study of suicide among persons not known to mental health services.
The role of primary care in suicide prevention
Psychosocial characteristics of attempted suicide patients in Oxford
Evaluation of the effects of legislation about the availability of paracetamol and asprin on suicide and attempted suicide
A study to determine the psychological distress experienced by parents bereaved by suicide or by other uncertain causes.
There are currently no directly funded research projects, funded by the Department into assisted suicide or voluntary euthanasia.
Hospital Beds
Mr. Jim Cunningham: To ask the Secretary of State for Health how many hospital bed places have been created in (a) England and (b) Coventry since 1997. [43526]
Mr. Hutton: Annual information on the average daily number of available and occupied beds for England, regional office areas and each NHS trust is on the Department of Health web site www.doh.gov.uk/hospitalactivity.
NHS Hospitals
Mr. Hancock: To ask the Secretary of State for Health how many applications to register parts of NHS hospitals as town or village greens there have been; when these applications were made; how many applications were successful; how many have been refused by his Department; and if he will make a statement. [43823]
Ms Blears: Applications for the registration of land as a town or village green are made to the appropriate registration authority who would advise Department officials, or the National Health Service trust owner if appropriate, about the application. The Department is aware of seven applications made between 1992 and 2000, three of which were refused by the registration authority concerned, two have been successful and two are outstanding.
These applications are handled by the relevant registration authority. They make the decisions whether they are successful or not.
Care Resources
Dr. Evan Harris: To ask the Secretary of State for Health what increased resources have been spent in the last year on (a) primary care and (b) secondary care in (i) each English health authority and (ii) England. [43609]
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Mr. Hutton: The increase in primary care and secondary care expenditure for each English health authority and for England, between 1999–2000 and 2000–2001, is shown in the table.
Notes:
1. In many health authorities there are factors which distort the expenditure. These include:
the health authority acting in a lead capacity to commission healthcare on behalf of other health bodies;
asset revaluations in NHS Trusts being funded through health authorities;
some double counting of expenditure between health authorities and primary care trusts within the health authority area; and
the calculation is not precise as relevant expenditure in primary care trusts is not analysed completely into the purchase of primary and secondary healthcare. Prescribing services expenditure has been added in to primary health care expenditure but there may be other elements of expenditure which cannot be identified which should be incorporated within the answer.
Expenditure cannot therefore be reliably compared between health authorities.
Allocations provide a much more reliable measure to identify differences between funding of health authorities.
2. Source: Health authority audited summarisation forms 1999–2000 and 2000–2001 Primary care trust audited summarisation schedules 2000–2001
3. Expenditure is taken from health authority and primary care trust summarisation forms which are prepared on a resource basis and therefore differ from cash allocations in the year. The expenditure is the total spent on primary and secondary healthcare by the health authority and by the primary care trusts within each health authority area. The majority of General Dental Services expenditure is not included in the health authority or primary care trust accounts and is separately accounted for by the Dental Practice Board. An element of expenditure on pharmaceutical services is accounted for by the Prescription Pricing Authority and not by health authorities.
4. Health authorities and primary care trusts should account for their expenditure on a gross basis. This results in an element of double counting where one body acts as the main commissioner and is then reimbursed by other bodies. The effect of this double counting within the answer cannot be identified.
5. Major increases in expenditure and reductions in individual cases can be explained as follows:
The increase in Dorset health authority is due to the majority of expenditure being double counted between the health authority and primary care trusts (£38,408,000 primary, £133,761,000 secondary).
The £87,121,000 increase in secondary care expenditure in Sefton health authority is due mainly to an extra £63million included in its accounts as it was the lead body in the region for mental health secure commissioning in 2000–01.
The reduction in secondary care in Herefordshire is caused by Herefordshire PCT taking over the commissioning of community health services in 2000–01 from the health authority and netting off the expenditure against income, resulting in a £14,484,000 apparent reduction in 2000–01.
The apparent decrease in secondary care expenditure in Merton, Sutton & Wandsworth health authority of £20,754,000 is caused by the treatment of asset revaluations in NHS trusts. The reduction is solely a result of accounting practice agreed with their auditors.
Decreases in secondary care expenditure in Brent and Harrow, East Sussex, Brighton and Hove, Hillingdon, South Humber and West Kent health authorities are also caused by the treatment of asset revaluations in NHS trusts.
Decreases in primary care expenditure in Northumberland and Shropshire health authorities in principally due to lower drug costs in 2000–01.
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