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Hospital Meals

Mr. Burstow: To ask the Secretary of State for Health what the average cost per hospital meal was (a) before and (b) after implementation of the Government's Better Hospital Food programme; and if he will make a statement. [86881]

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Mr. Lammy [holding answer 12 December 2002]: The better hospital food programme is designed to improve the quality, availability and access to food in hospitals and is a long-term programme. An additional #38.5 million has been made available to support this programme.

The costs of providing meals varies, depending both on the particular dish involved and the method of production. Typically, a traditional system produces meals more cheaply, while a delivered meals service is more expensive. A report by the Audit Commission in September 2001 found average spending on food and beverages was #2.20 for a cook-serve system, #2.40 for a national health service operated cook-chill/freeze service, and #3.70 for a delivered meals service. However, there are a number of other issues such as overheads and capital replacement charges, which also vary according to the production system in use and which affect overall costs. There is therefore no average per meal cost.

As part of the better hospital food programme, acute hospitals have been asked to include in their menus each day three of the dishes designed for the NHS by the 'leading chef' team. These dishes encompass main meals, desserts, salads and sandwiches. There are now 200 'leading chef' dishes included in the NHS dish selector and average costs for these dishes is no greater than those for other dishes currently in use in NHS hospitals.

Hospital Trusts (Performance Ratings)

Mr. Dobson: To ask the Secretary of State for Health if he will list the hospital trusts which have had their star rating increased following the publication of the national tables in July. [86937]

Mr. Lammy [holding answer 12 December 2002]: One trust, The Royal National Hospital for Rheumatic Diseases, NHS trust, Bath, has had its performance rating reassessed since the publication of the national tables in July resulting in three stars being awarded.

Mr. Dobson: To ask the Secretary of State for Health how many hospital trusts which previously had a three star rating lost one or more stars in the tables published in July. [86938]

Mr. Lammy [holding answer 12 December 2002]: 16 of the acute trusts awarded three stars in the 2000–01 performance ratings lost one or more stars in the 2001–02 performance ratings, published in July 2002.

Stem Cell Research

Bob Spink: To ask the Secretary of State for Health if it is necessary to obtain a licence from the HFEA before conducting research into stem cell lines from human embryos, with particular reference to derivation and characterisation of such stem cells. [86523]

Ms Blears [holding answer 9 December 2002]: A licence from the Human Fertilisation and Embryology Authority is required to bring about the creation of embryos in vitro and to keep or use embryos for the purposes of a project of research. All applications for a licence to use embryos to source embryonic stem cell lines will be required to justify why embryonic stem cells

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are to be used and will be required to provide detailed information on the fate of the stem cells throughout the process.

Furthermore, it will be a condition of all these licences that a sample of all cell lines is placed in the Medical Research Council's (MRC) national stem cell bank. The subsequent use of any stem cell lines derived from embryos will be subject to a code of practice to be produced by the MRC stem cell bank steering committee.

Bob Spink: To ask the Secretary of State for Health when the HFEA was given authority to issue research licences to conduct research involving stem cell lines from human embryos. [86524]

Ms Blears [holding answer 9 December 2002]: Any research project involving the creation, keeping or using of human embryos outside the body must be licensed by the Human Fertilisation and Embryology Authority (HFEA). To grant a research licence, the HFEA must be satisfied that the research is Xnecessary or desirable" and that the use of human embryos is essential. Before 2001, the HFEA could grant licences for research projects only for the following specified purposes (Human Fertilisation and Embryology Act 1990 Schedule 2, para.3(2):

a) promoting advances in the treatment of infertility;

b) increasing knowledge about the causes of congenital disease;

c) increasing knowledge about the causes of miscarriages;

d) developing more effective techniques of contraception; or

e) developing methods for detecting the presence of gene or chromosome abnormalities in embryos before implantation.

In January 2001, Parliament passed regulations extending the purposes for which research licenses may be authorised to include:

f) increasing knowledge about the development of embryos;

g) increasing knowledge about serious disease;

h) enabling any such knowledge to be applied in developing treatments for serious disease.

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Before 2001, the HFEA could, therefore, grant a licence for research projects involving the use of embryos to create stem cell lines if the research was for one of the purposes listed in (a) to (e) above.

Bob Spink: To ask the Secretary of State for Health under what authority the HFEA gave a research licence to Professor Austin Smith at the Centre for Genome Research in Edinburgh to derive and characterise stem cell lines from human embryos in 1997. [86525]

Ms Blears [holding answer 9 December 2002]: The Human Fertilisation and Embryology Authority issued a licence to the assisted conception unit at the Royal Infirmary of Edinburgh, later varied to the Centre for Genome Research, in 1996 for the purposes specified in paragraph 3(2)(a), (b) and (e) of Schedule 2 to the Human Fertilisation and Embryology Act 1990.

Learning Disability Services

Paul Holmes: To ask the Secretary of State for Health what was the net health and social services expenditure on learning disability services over the past five years on a constant value basis; and what it will be in the next three years, adjusted for inflation at current values. [86314]

Jacqui Smith: Local authorities deliver services for people with learning disabilities within the framework of the White Paper XValuing People: A New Strategy for Learning Disability for the 21st Century" (Cm 5086), published in March 2001, and its associated advice and guidance. Within that framework it is for councils to decide on the level of current and future expenditure.

The overall level of funding for social services, including that for learning disability, will increase by, on average, 6 per cent. per annum in real terms over the next three years.

Information on net expenditure is not available in the form requested. Details of gross expenditure are in the table.

Table 10.2 Gross expenditure on services for people with learning disabilities# million

	1995–96	1996–97	1997–98	1998–99	1999–2000(25)	2000–01
	HCHS expenditure
Total expenditure, 2000–01 prices(21),(22)	28,172	26,387	26,975	27,760	28,793	30,099
Expenditure on people with learning disabilities	1,370	1,460	1,499	1,486	1,481	1,486
Percentage of total expenditure	4.9%	5.5%	5.6%	5.4%	5.1%	4.9%
In-patient	954	966	943	898	890	889
Out-patient	12	24	25	23	22	20
Day patients	49	64	63	67	65	62
Community	355	406	468	498	504	514
PSS expenditures
Total expenditure, 2000–01 prices(21)	9,602	10,271	10,739	11,356	12,315	12,848
Expenditure on people with learning disabilities	1,235	1,340	1,424	1,565	1,669	1,752
Percentage of total expenditure	12.9%	13.0%	13.3%	13.8%	13.6%	13.6%
Adults(24)	1,130	1,236	1,316	1,459	1,561	1,647
Assessment and care management(24)	105	103	108	107	108	105

⁽²¹⁾ Adjusted to 1999–2000 prices using HCHS deflator for NHS expenditure and 2000–01 prices using GDP deflator for PSS expenditure. Figures shown for 1999–2000 are not directly comparable with previous years due to estimations used and changes to the calculation methods.

⁽²²⁾ The HCHS expenditure information is based on profiles of expenditure provided by trusts but scaled to match health authorities' total expenditure. Thus, there is a possibility that the figures under estimate the expenditure on services purchased by health authorities from the private and voluntary sectors. It may be the case that hospital expenditure is over estimated and community expenditure is under estimated. These figures exclude health authority overheads.

⁽²³⁾ Includes administrative and clerical overheads.

⁽²⁴⁾ Adults aged 16–64. Excludes expenditure on mental health provision for children which cannot be separately identified.

⁽²⁵⁾ Figures shown for 1999–2000 are not directly comparable with previous years due to estimations used and changes to the calculation methods.

Source:

Health Select Committee (FPA-PES) and RO3 return (PSS EX1 from 2000–01)

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