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Bob Spink: To ask the Secretary of State for Health how many radiographers in London have left the NHS and been re-employed as agency staff during the last year; and if he will make a statement. [60874]

Mr. Hutton: The Department does not collect this information.

Private Finance Initiative

Mr. Hancock: To ask the Secretary of State for Health what the projected average time is from conception to completion for a National Health Service Private Finance Initiative project; and if he will make a statement. [61671]

Mr. Hutton: There is no prescribed timescale set by the Department for schemes to progress through the stages up to advertising a project in the Official Journal of the European Commission (OJEC). The length of time taken to produce the outline business case, undertake necessary consultations and obtain outline planning permission will depend upon circumstances specific to each scheme.

The current indicative timetable from OJEC to financial close to eighteen months for major schemes; since March 2002 new initiatives have been introduced to further enhance the procurement process and ensure that the National Health Service obtains the best value from the current market and these aim to reduce this period.

Mr. Hancock: To ask the Secretary of State for Health how many National Health Service Private Finance Initiative projects (a) have been, (b) are and (c) are projected to be behind their initial completion date; what the (i) projected start date, (ii) actual start date, (iii) projected completion date and (iv) actual completion date is in each case; and if he will make a statement. [61669]

Mr. Hutton: Indicative timetables are set for all schemes as part of good project management. Complex schemes experience difficulties for a variety of good reasons; these have their timetables revised as appropriate.

Firm completion dates (for example when the hospital is open) are only set once contracts are signed for private finance initiative (PFI) schemes. The private sector suffers penalties if the completion date is not met. To date, all major PFI schemes have been opened on or ahead of their planned completion target date.

Arms-length bank

Mr. Hoban: To ask the Secretary of State for Health what progress has been made in drawing up the legal and financial framework for the Arms-Length Bank controlled by the NHS. [64317]

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Mr. Hutton: Details regarding the legal and financial framework of the National Health Service Bank are under consideration.


Mr. McNamara: To ask the Secretary of State for Health what the relationship is between the professional and executive groups of a primary care trust and consultants in hospital trusts; and what guidance has he given to ensure regular meetings between hospital consultants and the primary care trust. [62313]

Mr. Hutton [holding answer 25 June 2002]: The Department has not issued any guidance on this subject and has no plans to do so. Devolving power within the national health service recognises that frontline clinicians are best placed to make decisions on how to run the local health service and gives the freedom for them to decide how they will develop relationships in running the health service locally. However, 'Shifting the Balance of Power: The Next Steps' (January 2002) makes it clear that primary care trusts (PCTs) need to develop close working relationships with partners in NHS trusts. The relationship that PCTs develop with their colleagues in NHS trusts, including consultants, will be central to PCTs effectively discharging their functions for example planning and commissioning services for their local populations. PCTs will need to ensure that they engage in effective dialogue with clinicians working within NHS Trusts if they are to secure the best possible services to meet the needs of the local population. It is, however, a matter for PCTs and hospitals to decide the detail of how they do this.

Car Parking Fees

Bob Russell: To ask the Secretary of State for Health (1) if he takes account of money received by hospital trusts from car parking fees in the allocation of funds; and if he will make a statement; [64712]

Mr. Lammy: National health service trusts can charge for car parking in order to raise additional income to improve the health service using income generation powers. Amounts collected from individual income generation schemes are not reported separately in trusts' accounts and the income raised is not taken into account in the allocation of funds to NHS trusts.

The Department issued guidance to NHS trusts in January 1996 in the booklet 'NHS income generation, car parking charges, A guide to Implementation'. A copy of this is available in the Library. It is left to individual hospitals to decide whether or not to charge for car parking and the cost of such charges in light of local circumstances. Where car parking charges are introduced,

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patients who are eligible to claim reimbursement of travelling expenses under the hospital travel costs scheme may have the charges reimbursed.

The Department of Health receives a small number of enquiries about car parking charges each year.

Psychiatric Beds

Mr. Burstow: To ask the Secretary of State for Health how many acute psychiatric beds were available for (a) children, (b) the elderly and (c) other ages in secure units within each (i) region and (ii) authority area in each of the last five years; what the occupancy rate was; and what delayed discharge issues occurred. [65251]

Jacqui Smith: Information is not available in the format requested.

Inappropriate Medication

Mr. Burstow: To ask the Secretary of State for Health (1) if he will estimate the (a) number and (b) percentage of over 75 year olds affected, and the cost to the NHS and the number of bed days lost from hospital wards from older people experiencing an adverse reaction or being prescribed inappropriate medication in the last 12 months; [65140]

Mr. Lammy: The Medicines Control Agency (MCA) and Committee on Safety of Medicines (CSM) receive reports of suspected adverse drug reactions (ADRs) submitted by doctors, dentists, pharmacists and coroners via the Yellow Card Scheme by doctors, and there is a legal requirement for companies to report 'suspected' ADRs to their drugs. In 2001, a total of 21,350 reports of 'suspected' ADRs were received through this scheme of which 1,964 ( 9 per cent.) occurred in patients over 75 years of age. The number of reports received via the yellow card scheme does not directly equate to the number of people who suffer adverse reactions to drugs for a number of reasons including an unknown level of under reporting. It is important to note that the reporting of a reaction does not necessarily mean it was caused by

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the drug and may relate to other factors such as the patient's underlying illness or other medicines taken concurrently.

According to the Department's hospital episode statistics (HES) it is estimated that 151,571 bed days were lost in patients over 75 years of age during 2001 due to the adverse effects of drugs, medicaments and biological substances in therapeutic use. This estimate is based on 16,747 finished consultant episodes (FCEs) where the primary reason for admission was due to adverse effects of drugs, medicaments and biological substances in therapeutic use. FCES are not the same as the number of patients treated because a hospitalised spell can consist of more than one FCE. These figures would only include adverse drug reactions occurring in hospital if a different FCE resulted where the primary cause was the adverse drug reaction. Cost of treatment is not recorded in HES.

Over the last 20 years, 'suspected' ADRs with a fatal outcome account for 2–3 per cent. of the reports submitted via the yellow card scheme. A total of 643 reports with a fatal outcome were received during 2001, of these 130 occurred in patients aged over 75 years. The Office of National Statistics also collates data on deaths certified by doctors and coroners as due to adverse effects of drugs in therapeutic use. The quality of these data may be inconsistent as many thousands of doctors write certificates with a wide variation in knowledge, training and practice. The latest available figures are for 2000, during which 84 of the 159 deaths that were certified as due to adverse effects of drugs occurred in persons aged 75 years and over.

Figures are not available on adverse reactions resulting from patients being prescribed inappropriate medication.

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