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Leukaemia

Mr. Hancock: To ask the Secretary of State for Health (1) what the Department's estimate is of the average time scale for each of the three stages of chronic myeloid leukaemia; and if he will make a statement; [60006]

(2) how many people have died from chronic myeloid leukaemia in the last two years; and if he will make a statement; [60007]

(3) what criteria are used to assess which of the three stages of chronic myeloid leukaemia a patient is in; and if he will make a statement. [60005]

Ms Blears: Three phases of chronic myeloid leukaemia (CML) are usually definable; the chronic phase, an accelerated phase and the blast phase.

The chronic phase is typically of three to five years duration from diagnosis. The majority of patients are in chronic phase at presentation. Clinically, in the chronic phase there are less than 10 per cent. immature blood cells (called blast cells) and promyelocytes (one of the series of cells that gives rise to granulocytes—a type of white blood cell) in the bone marrow. There is an elevated white cell count and often an elevated platelet count.

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The accelerated phase of CML marks the transition to the blast phase typically lasting two to 15 months, but generally leading to a rapidly fatal blast crisis within six months. As the accelerated phase is associated with numerous haematological cytogenic and clinical signs and symptoms, no single set of criteria for its onset is accepted.

The blast phase is usually fatal within three to six months of onset. Clinically, the presence of 30 per cent. or more blast cells in the marrow or the presence of blast cells within the peripheral blood defines the blast phase.

There were 514 deaths due to chronic myeloid leukaemia occurring in 2000 and 465 deaths occurring in 1999.

NHS Dentistry

Mr. Sayeed: To ask the Secretary of State for Health what proportion of (a) children and (b) adults in England are registered with an NHS dentist. [59599]

Mr. Lammy: Arrangements are now in place to ensure that patients can gain access to national health service services simply by calling NHS Direct. This means that

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even if a patient chooses not to register with a dentist it will still be possible for that patient to access all forms of dentistry that are provided by the NHS.

60 per cent. of children and 43 per cent. of adults were registered with a general dental service (GDS) dentist in England at 31 March 2002.

Timber

Ms Walley: To ask the Secretary of State for Health if he will list the refurbishment projects that (a) are in progress and (b) will start within the next six months; and what action is being taken to ensure that these will procure certified timber. [59758]

Mr. Lammy: There are no refurbishment projects currently in progress in the buildings occupied by the Department for its own use, although a small project to fit out headquarter premises for the commission for patient and public involvement may commence within the next six months.

Environmental criteria are now contained as part of the specification in tendering contracts and include a requirement that timber products are from sustainable sources.

Diabetes

Mr. Laurence Robertson: To ask the Secretary of State for Health what training medical students receive in the diagnosis and treatment of diabetes; and if he will make a statement. [60121]

Mr. Hutton [holding answer 10 June 2002]: Individual university medical schools determine their own undergraduate medical curriculum in the light of recommendations from the General Medical Council's education committee, which has the statutory responsibility to determine the extent and knowledge and skill required for the granting of primary medical qualifications in the UK. This includes the range of problems that are presented to doctors and the range of solutions that have been developed for their recognition, investigation, prevention and treatment.

The undergraduate medical course is the first step in the continuum of medical education, laying down the foundation for future professional life. The undergraduate course is not intended to provide specialist medical education within which training in the diagnosis and treatment of diabetes would fall.

Mr. Laurence Robertson: To ask the Secretary of State for Health what plans he has to allow GPs to complete form C1EXAM3 when diabetes sufferers apply for C1(+E) licences; and if he will make a statement. [61939]

Mr. Spellar: I have been asked to reply.

There are currently no plans to allow general practitioners to complete the C1EXAM3 form. My right hon. Friend's honorary medical advisory panel on driving and diabetes advises that a specialist assessment by a consultant diabetologist is required when an insulin

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treated diabetes sufferer applies for a C1 (+E) licence. The situation will be reviewed should a system of accredited specialism in diabetes be introduced for general practitioners.

Mr. Swayne: To ask the Secretary of State for Health if he will make a statement about the financial provision he will make to implement the national service framework for the treatment of diabetes. [61514]

Mr. Lammy: The Budget provides the highest sustained growth in national health service history, with annual average increases of 7.4 per cent. In real terms over the five years 2003–04 to 2007–08. Decisions about the allocation of the increased funding will be announced later this year.

Alcohol Treatment Services

Mr. Cox: To ask the Secretary of State for Health what recent discussions his Department has had on the co-ordination of policies to reduce alcoholism in the United Kingdom. [60708]

Ms Blears: The NHS Plan said that the Government would implement a national strategy to tackle alcohol misuse in England by 2004 and we are on course to achieve this. We will consult fully with the devolved Administrations in Scotland, Wales and Northern Ireland as we develop this strategy. It is also the case that the devolved Administrations have consulted the Department in developing their own strategies for tackling alcohol misuse, including the strategy for Scotland that was published in January this year.

Foundation Hospitals

Ms Drown: To ask the Secretary of State for Health to which Government targets foundation hospitals will now have to adhere. [60517]

Mr. Lammy: Foundation trusts will be expected to deliver their contribution to Government targets and uphold national standards and guarantees to patients.

Ms Drown: To ask the Secretary of State for Health what extra flexibility foundation hospitals will have in pay over other NHS trusts. [60516]

Mr. Hutton: Foundation trusts will be able to use the flexibilities of the new pay system we are currently negotiating to modernise the work force including developing additional rewards for those staff who are contributing most. The full details of the flexibilities will be available once the pay modernisation negotiations are complete and the legislation is finalised.

Respiratory Syncitial Virus

Mr. Hancock: To ask the Secretary of State for Health how many children were re-admitted to hospital more than once during the year suffering from the respiratory syncitial virus in the last three years in the South East region, broken down by age; how many of these were re-admitted to the intensive care unit; and if he will make a statement. [60717]

Ms Blears: The information requested is not collected centrally.

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All information held on hospital admissions of children diagnosed with respiratory syncitial virus in the south east was contained in the answer given to the hon. Member by the Under-Secretary of State for Health, my hon. Friend the Member for Pontefract and Castleford (Yvette Cooper), on 10 May 2002, Official Report, column 401W.

Orthodontic Treatment

Dr. Fox: To ask the Secretary of State for Health if he (a) collates and (b) will publish details of waiting times for NHS orthodontic treatment. [61450]

Mr. Lammy: Information on waiting times for orthodontic treatment carried out in primary care, which accounts for the majority of orthodontic services, is not held centrally. However, information is available for patients who have been referred to hospital for treatment. Latest data show that at quarter ending 31 March 2002 there were 2,716 out-patients who had been waiting over 13 weeks for a first out-patient appointment with an orthodontic consultant and there were 130 in-patients waiting for orthodontic treatment.

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The intention to reform orthodontic treatment was signalled in the NHS dental strategy "Modernising NHS Dentistry—Implementing the NHS Plan" published in September 2000. The Department continues to work with the profession to see how reform might be achieved.

Dr. Evan Harris: To ask the Secretary of State for Health how many people were waiting for orthodontic treatment on 1 May in each year since 1996. [60722]

Mr. Lammy: Information on waiting times for orthodontic treatment carried out in primary care, which accounts for the majority of orthodontic services, is not held centrally. However, information is available for patients who have been referred to hospital for treatment. The tables show orthodontic treatment waiting times for in-patients and out-patients in hospitals.

The intention to reform orthodontic treatment was signalled in the NHS dental strategy "Modernising NHS Dentistry—Implementing the NHS Plan" published in September 2000. The Department continues to work with the profession to see how reform might be achieved.

Table 1: Waiting time for first out-patient appointment, Orthodontics consultant specialty, England

		Of those GP written referrals seen, the number who waited (weeks)				Of those GP written referrals seen, the percentage who waited (weeks)			GP written referrals still waiting, who have been waiting (weeks)
Quarter ended	Number of GP written referral requests seen	0 to less than 4	4 to less than 13	13 to less than 26	26 plus	less than 4 (per cent.)	less than 13 (per cent.)	less than 26 (per cent.)	13 to less than 26	26 plus
March 1996	24,965	4,805	9,598	6,173	4,389	19	58	82	3,978	3,524
March 1997	20,690	3,681	8,936	4,974	3,099	18	61	85	4,442	3,380
March 1998	19,236	2,784	7,838	5,911	2,703	14	55	86	5,170	5,258
March 1999	19,438	2,418	7,464	5,595	3,961	12	51	80	6,524	5,074
March 2000	23,175	3,036	7,971	7,009	5,159	13	47	78	5,225	4,614
March 2001	21,237	2,955	9,339	5,184	3,759	14	58	82	3,996	2,982
March 2002	21,176	3,484	8,980	5,597	3,115	16	59	85	2,713	3

Source:

Department of Health form QM08

Table 2: Patients waiting for elective admission, Orthodontics consultant speciality, England (ordinary and day case admissions combined)

	Total patients waiting for admission by month waiting
Quarter ended	Waiting	Less than 3	3–5	6–8	9–11	12–14	15–17	18 plus
March 1996	257	136	63	34	24	0	0	0
March 1997	253	119	91	28	15	0	0	0
March 1998	304	149	77	50	25	3	0	0
March 1999	184	74	61	29	16	3	1	0
March 2000	84	31	27	17	6	3	0	0
March 2001	170	77	50	26	14	3	0	0
March 2002	130	50	49	18	13	0	0	0

Source:

Department of Health form KH07

Dr. Evan Harris: To ask the Secretary of State for Health what guidance his Department gives on which orthodontic treatments should be made available on the NHS. [60720]

Mr. Lammy: Details of all orthodontic treatment that can be made available through general dental services are included in the statement of dental remuneration (SDR), which is issued to all dental practitioners and health authorities annually, in April. The Department does not give specific advice on what treatment a dentist or orthodontist should provide for patients, as this is a matter for the individuals' clinical judgment. However, the range of treatments available in the SDR was introduced in consultation with the profession and is considered adequate to ensure the best treatment outcome for all patients.

Over recent months officials have had helpful discussions with the profession on possible changes to the current system and the Department will continue to work with the profession on this.

Dr. Evan Harris: To ask the Secretary of State for Health how many people per 1,000 of the population were provided with orthodontic treatment in each year since 1996, broken down by health authority. [60721]

Mr. Lammy: The available information is shown in the table and quantifies the number of claims made for the

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provision of orthodontic appliances in the general dental service (GDS) per 1,000 population by health authority (HA) in England for each year from 1996–97 to 2001–02.

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The figures for HAs will be affected by some patients receiving treatment in a different HA area from one in which they reside.

General dental service: number of claims for orthodontic appliances per 1,000 population⁽²⁸⁾, 1996–97 to 2001–02England

Health authority	1996–97	1997–98	1998–99	1999–2000	2000–01	2001–02
Avon	4.9	5.1	5.6	6.5	6.5	8.3
Barking and Havering	5.6	7.6	6.2	7.4	7.6	7.2
Barnet, Enfield and Haringey	8.0	9.2	8.2	8.2	9.5	9.6
Barnsley	2.2	1.9	2.1	2.0	2.1	1.4
Bedfordshire	5.0	5.7	5.7	3.6	1.9	1.7
Berkshire	7.3	8.1	7.4	5.6	5.8	6.7
Bexley, Bromley and Greenwich	6.0	6.1	6.8	7.2	7.7	7.5
Birmingham	4.4	4.6	4.6	4.7	5.0	4.8
Bradford	2.0	1.9	1.9	2.1	1.8	1.9
Brent and Harrow	9.3	4.3	3.1	3.1	3.3	3.8
Buckinghamshire	3.8	4.4	5.5	4.8	4.2	4.3
Bury and Rochdale	5.5	5.8	6.5	5.3	5.9	6.0
Calderdale and Kirklees	3.3	3.5	3.8	3.6	4.0	4.3
Cambridge and Huntingdon(29)	6.8	5.7	4.9	—	—	—
Cambridge(29)	—	—	—	4.4	4.1	5.4
Camden and Islington	1.1	1.5	1.9	1.9	2.4	2.6
Cornwall and Isles of Scilly	2.6	2.9	3.0	3.5	3.5	3.3
County Durham	2.5	2.2	2.3	2.5	2.3	2.6
Coventry	2.5	2.7	2.8	3.0	3.1	3.3
Croydon	6.5	6.9	6.9	6.6	6.7	6.4
Doncaster	4.3	4.4	5.0	5.2	5.7	6.1
Dorset	4.3	3.9	3.9	3.9	4.0	3.6
Dudley	2.6	3.1	3.4	3.7	3.7	3.8
Ealing, Hammersmith and Hounslow	1.8	2.1	2.6	3.2	3.8	4.0
East Kent	4.2	3.0	3.4	3.7	3.6	4.0
East Lancashire	4.3	3.6	3.7	3.6	3.3	3.3
East London and The City	2.8	3.0	3.1	3.5	4.8	4.2
East Norfolk(29)	6.0	5.8	5.7	—	—	—
East Riding	2.4	2.5	2.7	3.1	3.1	3.0
East Surrey	4.2	4.6	5.2	4.8	5.5	6.1
East Sussex, Brighton and Hove	3.8	4.7	4.6	4.5	4.0	4.0
Gateshead and South Tyneside	1.8	1.6	1.9	2.0	1.9	1.7
Gloucestershire	4.5	4.8	5.8	6.5	6.4	5.9
Herefordshire	2.9	2.8	2.8	3.3	4.5	4.7
Hertfordshire	6.5	6.7	6.6	6.4	7.9	8.9
Hillingdon	8.0	7.0	8.4	8.3	7.5	6.2
Isle of Wight, Portsmouth and South East Hampshire	3.9	3.4	3.5	3.1	2.5	1.8
Kensington, Chelsea and Westminster	0.7	2.9	4.6	4.7	5.6	6.8
Kingston and Richmond	4.7	6.3	4.6	5.8	7.9	7.2
Lambeth, Southwark and Lewisham	1.0	2.1	2.9	4.2	3.8	3.1
Leeds	4.8	5.1	5.9	5.8	6.0	6.6
Leicestershire	3.3	3.8	3.7	3.7	3.7	4.8
Lincolnshire	2.0	2.4	2.7	2.3	2.5	2.6
Liverpool	7.0	7.0	7.2	6.6	6.5	5.5
Manchester	3.1	2.9	3.1	2.6	2.8	2.7
Merton, Sutton and Wandsworth	4.5	4.1	2.8	2.7	3.3	4.5
Morecambe Bay	3.2	3.5	3.6	3.7	3.4	3.4
Newcastle and North Tyneside	3.5	4.4	3.8	4.5	3.8	4.2
Norfolk(29)	—	—	—	4.7	4.7	4.7
North and East Devon	4.5	4.6	5.0	4.6	5.1	6.4
North and Mid Hampshire	2.2	2.2	2.6	2.5	3.1	3.6
North Cheshire	6.3	5.7	6.7	7.3	7.1	7.1
North Cumbria	3.0	2.5	2.6	2.3	2.6	2.3
North Derbyshire	4.5	4.8	4.6	4.3	4.5	4.3
North Essex	6.6	5.9	6.2	5.8	5.2	5.3
North Nottinghamshire	5.8	5.8	6.6	5.9	6.0	5.9
North Staffordshire	3.4	3.3	3.2	2.9	3.1	2.8
North West Anglia(29)	3.8	4.0	4.8	—	—	—
North West Lancashire	5.7	7.4	8.9	9.6	8.9	8.8
North Yorkshire	4.4	4.3	4.6	4.5	4.2	4.4
Northamptonshire	3.6	3.8	3.8	4.4	4.3	4.8
Northumberland	2.3	2.1	2.0	1.8	1.6	1.6
Nottingham	6.3	6.9	6.4	6.8	5.7	7.4
Oxfordshire	3.8	4.0	4.1	4.9	4.9	5.6
Redbridge and Waltham Forest	7.9	6.3	7.6	7.4	7.8	8.1
Rotherham	3.5	3.6	3.6	3.2	2.8	2.7
Salford and Trafford	5.3	5.4	7.0	8.4	8.0	8.4
Sandwell	0.7	1.1	2.2	2.3	2.8	4.2
Sefton	2.5	2.2	2.4	1.5	1.4	1.0
Sheffield	5.8	5.0	4.6	4.4	4.8	5.2
Shropshire	3.1	3.1	2.9	3.1	5.6	4.3
Solihull	4.0	4.5	4.5	4.0	5.7	7.1
Somerset	3.5	3.2	3.4	3.6	4.4	4.6
South and West Devon	4.8	4.6	4.9	4.2	4.3	4.7
South Cheshire	9.0	9.8	11.0	11.1	11.0	10.6
South Derbyshire	2.7	3.0	2.9	3.0	3.4	3.7
South Essex	4.7	3.9	2.9	2.4	3.4	3.4
South Humber	2.5	2.7	2.8	2.3	2.5	2.3
South Lancashire	3.3	3.9	3.5	5.1	6.2	6.1
South Staffordshire	3.0	2.8	2.8	2.7	2.6	2.7
Southampton and South West Hampshire	4.4	4.0	4.0	4.5	4.2	4.6
St. Helens and Knowsley	2.6	3.2	3.0	2.2	2.4	1.7
Stockport	6.5	6.5	6.3	5.2	5.7	5.4
Suffolk	4.9	5.0	5.4	4.9	5.4	5.7
Sunderland	2.8	3.0	3.3	3.2	2.9	3.4
Tees	3.1	3.0	3.6	3.8	3.9	4.4
Wakefield	3.0	2.3	1.9	2.0	3.0	4.9
Walsall	2.2	2.2	2.0	2.2	2.7	2.7
Warwickshire	2.1	2.1	2.4	2.9	3.2	3.4
West Kent	3.9	4.8	5.9	5.8	8.5	8.9
West Pennine	6.3	7.0	5.7	6.2	7.4	4.5
West Surrey	7.9	8.4	8.8	8.3	8.8	8.6
West Sussex	6.4	7.3	7.9	7.9	7.9	8.0
Wigan and Bolton	5.9	6.5	6.3	5.5	5.9	5.7
Wiltshire	4.3	4.8	4.3	4.8	5.4	4.5
Wirral	5.2	6.0	6.7	7.1	9.0	9.7
Wolverhampton	1.8	2.2	2.7	2.8	3.2	3.7
Worcestershire	6.6	5.8	6.3	5.8	5.7	7.4
England	4.4	4.6	4.7	4.7	4.9	5.1

⁽²⁸⁾ ONS 1996–2000 mid year population estimates based on the 1991 census are used to calculate the number of orthodontic claims per 1,000 population.

⁽²⁹⁾ In April 1999 Cambridge and Huntingdon, East Norfolk and North West Anglia were replaced by Cambridge and North Norfolk health authorities.

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