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Oxygen

Mr. Boswell: To ask the Secretary of State for Health if he will make available at reasonable cost ambulatory and/or liquid oxygen to those with respiratory difficulties likely to benefit. [74640]

Mr. Lammy: I have no plans at present to change the arrangements under which oxygen is provided for patients who need it. The current review of the domiciliary oxygen service has not yet been concluded.

Asthma Nebulisers

Mr. Boswell: To ask the Secretary of State for Health what plans he has to make more asthma nebulisers available on prescription. [74639]

Mr. Lammy: We consider that asthma nebulisers are best provided to patients on loan from specialist National Health Services services. We have no current plans to make them available on general practitioner prescription.

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Hospital Chaplains

Mr. Brady: To ask the Secretary of State for Health if he will make a statement on the discussions between his officials and the Multi-faith joint First National Working Group in relation to advice and information for hospital chaplains. [73750]

Mr. Lammy: Department officials have been working closely for some time with the multi-faith joint national working group via their chosen representative, the Chief Executive of the hospital chaplaincies council to produce renewed advice on the provision of chaplaincy services in the National Health Service.

Mr. Brady: To ask the Secretary of State for Health if he will make a statement on the findings of the Patient Information Advisory Group with regard to the work of hospital chaplains. [73754]

Mr. Lammy: The patient information advisory group has advised me that National Health Service trusts should seek consent from patients before information about their religious affiliations can be passed to hospital chaplains. The NHS will need to develop systems for supporting the work of chaplains whilst recording and respecting the preferences of patients. I have placed a copy of the advisory group's advice in the Library.

Care Homes

Mr. Burns: To ask the Secretary of State for Health (1) what estimates his Department has made of the total cost to social services departments of the recent decision by the Competition Commission Appeal Tribunal on social services department funding of care home placements; [74789]

(2) what advice he will issue to social services departments in England on abiding by the recent Competition Commission Appeal Tribunal decision on social services department funding of care home placements; and if he will make a statement. [74790]

Jacqui Smith: The judgement by the competition commission appeal tribunal, in the case of Bettercare versus the Director General of Fair Trading, found that purchasing by a public body, in certain circumstances, is an economic activity carried out by an undertaking and therefore may be subject to the provisions of the Competition Act 1998. The judgement reflected a particular set of circumstances and is not of general application. In broad terms, the Competition Act is concerned with anti-competitive agreements and abuse of dominant market positions. We would not expect councils to be acting in ways that are inconsistent with the Competition Act. The Government's White Paper Modernising Social Services made clear that councils should apply best value principles when securing social care services, whether those services are directly provided or purchased from a private or voluntary sector organisation.

Mr. Djanogly: To ask the Secretary of State for Health how many residential care home places for elderly people were closed in the Huntingdon constituency during the last 12 months. [74221]

Jacqui Smith: The information is not centrally available.

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Children's Services

Mr. Burstow: To ask the Secretary of State for Health if he will publish the recent report into the preparation of the Social Services Inspectorate report on children's services in the London Borough of Haringey. [74435]

Jacqui Smith: The Social Services Inspectorate did not prepare a report into the preparation of the inspection of children's services in the London Borough of Haringey. The most recent published report is that of the Inspection of Children's Services February 2002, which was published on 1 July 2002.

Looked-after Children

Mr. Burstow: To ask the Secretary of State for Health if he will set out the GCSE exam performance of looked-after children in 2002. [74436]

Jacqui Smith: This information is not currently available. Data on the educational qualifications of care leavers aged 16 or more in year ending 31 March 2002 will be published by the Department in November 2002.

Social Services Inspectorate

Mr. Burstow: To ask the Secretary of State for Health what guidance he has given to the Social Services Inspectorate concerning the role of inspected social services departments assisting service users and carers in completing questionnaires distributed as part of a Social Services Inspectorate inspection. [74434]

Jacqui Smith: No guidance has been given to the Social Services Inspectorate (SSI) on this topic. SSI is committed to obtaining the views of service users as part of its assessment of social services functions. SSI has advised inspected authorities that they should offer independent help to users and carers when they are completing questionnaires as part of an inspection, particularly for those people who may have difficulties completing a questionnaire.

Information Systems

Mr. Burstow: To ask the Secretary of State for Health if he will set out the steps his Department has taken and plans to take to identify and remove incompatibility between NHS and social service information systems. [74427]

Mr. Lammy: The national strategic implementation programme for delivering 21 Century information technology support for the National Health Service, published by the Department in June 2002, sets out the actions required to meet the targets of the NHS Plan. A key element in this programme is the development of the integrated care records service (ICRS), which seeks to address the problems caused by the incompatibility of health and social service systems.

Over the last two years, the Department has also commissioned a number of projects that have sought to identify and provide practical solutions to the problems of integrating health and social care systems. Two of the projects within the electronic records development and implementation programme (ERDIP), supported by the NHS information authority, have developed joint records for use by all members of community mental

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health teams, including both health and social services staff. Also, within the Information for Social Care demonstrator programme, a number of the projects have addressed issues relating to the sharing and exchange of information between health and social care agencies.

These issues are also being progressed through the information strategies which support the national service frameworks, particularly those relating to mental health, older people and children's services.

Hepatitis C

Mrs. Helen Clark: To ask the Secretary of State for Health what evaluation he has made of the measures (a) available and (b) required to prevent, treat and manage cases of chronic hepatitis C infection. [73896]

Ms Blears: We published Hepatitis C Strategy for England for consultation on 14 August 2002 in recognition of the importance of hepatitis C as an important public health issue, as highlighted in the Chief Medical Officer's infectious disease strategy, Getting Ahead of the Curve. The strategy sets out the current situation and proposals to improve the effectiveness of prevention, diagnosis and treatment services for hepatitis C.

Following consultation, it is intended that the strategy will form the basis of an action plan, as proposed in Getting Ahead of the Curve. This will serve as a clear framework setting out actions that need to be taken by Government, the National Health Service and others to intensify efforts to tackle hepatitis C.

Folic Acid

Mrs. Helen Clark: To ask the Secretary of State for Health what responsibility the Food Standards Agency has with respect to informing Government policy on the fortification of flour with folic acid. [73894]

Ms Blears: The Food Standards Agency was asked to consider and provide advice on the practical risk management issues which were linked to options for achieving universal fortification of flour with folic acid.

Mrs. Helen Clark: To ask the Secretary of State for Health (1) what assessment he has made of the effects of fortifying flour with folic acid on (a) the occurrence of birth defects and (b) the incidence of cardiovascular disease in other countries; [73895]

(2) if he will ask the Scientific Advisory Committee on Nutrition to review evidence on the effects of folic acid in lowering homocysteine and reducing cardiovascular disease. [73893]

Ms Blears: The Committee on Medical Aspects of Food and Nutrition Policy (COMA, 2000), assessed the effects of folic acid on birth defects, such as neural tube defects (NTD), and estimated that fortification of flour with folic acid at a level of 240 micrograms per 100g could reduce the incidence of NTD affected pregnancies by 43 per cent. In terms of other countries, mandatory fortification has been implemented in the US, Canada and Chile. Recent research in some US States has linked the policy with a fall in the incidence of NTD. However,

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the level of fortification in other countries varies considerably from that recommended by COMA and therefore the results may not be directly comparable.

There is epidemiological evidence that increasing dietary folate may reduce blood levels of homocysteine, an independent risk factor for cardiovascular disease (CVD). However, the effect of increasing folate intake on the incidence of CVD is not as yet conclusive. Results of ongoing randomised controlled trials are awaited.

I have no plans at present to refer the matter of links between folic acid, homocysteine levels, and cardiovascular disease to the Scientific Advisory Committee on Nutrition. However, it is open to the Committee to review the developing evidence in this area if it feels this is appropriate.

Mrs. Helen Clark: To ask the Secretary of State for Health when he will make a decision on his policy on the fortification of flour with folic acid. [73892]

Ms Blears: The decision on this complex issue requires careful consideration of both the benefits and the possible risks of fortification. The options are currently being considered, in the light of the recommendations of the Committee on Medical Aspects of Food and Nutrition Policy (COMA, 2000); responses to the consultation process, carried out in 2000; and advice from the Food Standards Agency.

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