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Care Services (York)

33. Hugh Bayley: To ask the Secretary of State for health what steps his Department is taking to stimulate an increase in the number of nursing and residential care home beds and the availability of domiciliary care services in York. [82649]

Jacqui Smith: York was one of the 55 councils targeted for extra resources as part of the Building Care Capacity Grant. They are receiving nearly £1 million over the two years 2001–03, which they are spending on additional capacity in the independent care sector.

As my right hon. Friend the Secretary of State announced on 23 July, we will be providing an extra £1 billion to councils over the next three years. These extra resources can be used to further stabilise the care home sector. It will also ensure that by 2005, there will be twice as many older people receiving the intensive help that they need to live at home than there were in 1995.

Heart Disease

34. Fiona Mactaggart: To ask the Secretary of State for Health what he plans to do to prevent early deaths from heart disease in the areas where this is most common. [82650]

Ms Blears: The Government place a strong emphasis on reducing inequalities in health. The recently published planning and priorities framework set key targets for the national health service over the next three years. This document requires the NHS to 'contribute to a national reduction in death rates from coronary heart disease (CHD) of at least 25 per cent. in people under 75 by 2005 compared to 1995–97, targeting the 20 per cent. of areas with the highest rates of CHD'.

A further target, which requires the establishment of practice-based registers to cover the majority of patients at high risk of CHD, will focus the actions of primary care on the prevention of CHD.

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The national service framework for CHD sets standards for the prevention, treatment and rehabilitation of CHD. This requires primary care trusts (PCTs) to set in place policies to reduce smoking, to promote healthy eating, to promote physical activity and to reduce overweight and obesity. It is through focusing on these areas that PCTS in areas with high rates of CHD will make progress in reducing premature deaths from CHD.

Smallpox Vaccine

35. Mr. Dalyell: To ask the Secretary of State for Health if he will make a statement on the availability of smallpox vaccine. [82651]

Mr. Hutton: Yesterday I gave a written ministerial statement setting out how the national health service would respond to a potential smallpox terrorist attack.

There are three components to the Department's preparation for response to a possible smallpox emergency: improved vaccine stocks, a plan of action setting out the steps to be taken in the event of an outbreak, and as a first step, immunising staff who could deal safely with any potential smallpox cases.

Copies of the Department's smallpox plan have been placed in the Vote Office and will be placed in the Library.

Private Health Care

36. Mr. Jim Cunningham: To ask the Secretary of State for Health if he will make a statement on his policy on the use of private health facilities by the NHS. [82652]

Mr. Hutton: Our policy is to promote greater plurality and diversity in the provision of national health service care, including the use of private and voluntary sector providers where they offer high clinical standards and value for money.

Pulmonary Disease

37. Mr. Blizzard: To ask the Secretary of State for Health what steps he will take to reduce the number of deaths from chronic obstructive pulmonary disease. [82653]

Ms Blears: The major cause of chronic obstructive pulmonary disease (COPD) is smoking. That is why the Government have set up a comprehensive smoking cessation service. In the four-year period to 2003, we have allocated £73 million to the national health service to provide a national NHS smoking cessation service. Smoking cessation aids have also been made available on NHS prescription. Additionally an important element of the overall tobacco strategy is the health education programme to which some £55 million has been allocated in the period 1999–2000 to 2002–03.

Officials are holding a meeting in the new year with the National Asthma Campaign, British Thoracic Society and the British Lung Foundation on 28 February to discuss respiratory illness in the national service framework (NSF) for older people, and the effect of general NSF principles including rehabilitation on COPD patients.

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Expert groups such as the British Thoracic Society have developed clinical guidelines for the treatment of COPD.

Pulmonary rehabilitation is increasingly offered in COPD, particularly to older people, to help them achieve their highest level of function and independence. It has been shown to improve exercise capacity, and to reduce anxiety and depression.

Acrylamide

39. Mr. Roger Williams: To ask the Secretary of State for Health if he will make a statement on acrylamide. [82655]

Ms Blears: Acrylamide has been found to occur in a wide range of home-cooked and processed foods including chips and crisps. It has not been found in uncooked or boiled foods, and appears to be formed during cooking by methods such as frying and baking.

Acrylamide has been shown to cause cancer in laboratory animals. However, this is not a new risk, as it is likely that we have been exposed to acrylamide in food for generations.

The Food Standards Agency is commissioning research and surveillance to ascertain the reason for, and extent of, acrylamide formation, but in the meantime has advised that on the basis of current evidence people should eat a balanced diet including a variety of fruit and vegetables, and that as part of a balanced diet people should moderate their consumption of fried and fatty foods.

Hospital Discharges

Helen Jones: To ask the Secretary of State for Health if he will review statutory guidance on hospital discharge to ensure that the needs of carers in paid employment are taken into account during discharge planning. [84233]

Jacqui Smith [holding answer 2 December 2002]: In discharging people from hospital, account should be taken of the needs and personal circumstances of

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carers, including any extra support needed by carers in paid employment. This will be emphasised in the forthcoming revision of the hospital discharge workbook.

Care Homes (Insurance)

Mr. Burstow: To ask the Secretary of State for Health what assessment he has made of the implications for care home insurance liability of the postponement of criminal records bureau checks and the protection of vulnerable adults list. [84592]

Jacqui Smith [holding answer 2 December 2002]: A criminal record disclosure forms one of many checks persons caring for vulnerable adults have in order to work with this client group. Measures are already in place to ensure the projection of vulnerable adults from abuse. Persons caring for vulnerable adults continue to be subject to rigorous pre-employment checks, including confirming previous employment history and taking up references, to ensure their suitability for the position in question. Therefore these postponements should not represent an increase in the insurance liability of care homes.

Agency Nurses (West Sussex)

Tim Loughton: To ask the Secretary of State for Health how much each primary care trust in West Sussex has spent this year on agency nursing staff. [83290]

Ms Blears: The information requested is not collected centrally.

Angina Treatments

Mr. Pickthall: To ask the Secretary of State for Health how many patients are being treated under the pilot schemes for enhanced external counterpulsation for angina; which hospitals are involved in the pilots; and what the cost is of a course of treatment. [83588]

Ms Blears [holding answer 28 November 2002]: The national research register, a register containing details of research funded by, or of interest to, the National Health Service, has details of the following projects involving enhanced external counterpulsation.

Project	Hospital	Number of patients	Status
Does EECP help patients with refractory angina?	Hammersmith hospital	15	complete
Does EECP help increase exercise capacity in heart failure?	Hammersmith hospital	20	ongoing
How does the efficacy of EECP for the relief of angina compare in patients whose angina is not controlled by usual medical therapy?	Castle Hill hospital, Hull	12	complete

No information is available about cost.

Antibiotics

Mr. Burstow: To ask the Secretary of State for Health what assessment he has made of the amount of over-prescribing of antibiotics in the NHS; and if he will make a statement. [84802]

Ms Blears: We have no direct evidence of over-prescribing of antibiotics in the National Health Service. Data from the prescription cost analysis system show that the number of prescriptions dispensed in the community in England was 23.3 per cent. lower in 2001 than in 1995, 37.9 million items compared to 49.4 million items.

Our strategy to combat infectious disease Getting Ahead of the Curve identified antimicrobial resistance as a priority and a targeted action plan is being developed. This will build on existing initiatives to promote prudent prescribing of antibiotics.

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