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20 Jan 2003 : Column 120W—continued
Consultants
Caroline Flint: To ask the Secretary of State for Health what proportion of hospital consultants in (a) Doncaster (b) Yorkshire and (c) England do not undertake private work. [89115]
Mr. Hutton: We do not collect information centrally about the proportion of consultants undertaking private practice. However, the Department collects statistics about the contractual status of consultants. While these statistics do not represent an accurate indication of the number of consultants undertaking private practice, they can give a broad indication of the amount of private practice undertaken in a region.
Maximum part-time contract holders are those practitioners that have opted for maximum part-time contracts, or who have been required to change their status to maximum part-time because the volume of private practice undertaken exceeds the limit of 10 per cent. that applies to other whole-time contract holders. Maximum part-time contract holders have no limit on the amount of private practice they are permitted to undertake.
Nationally 23.7 per cent. of all consultants hold maximum part-time contracts. The proportion of consultants on maximum part-time contracts in Yorkshire, at 19.4 per cent., is lower than the national average and in Doncaster the figure is considerably
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lower at 6.3 per cent, of all consultants. The table shows numbers of medical and dental consultants working maximum part-time contracts.
| numbers (headcount) | ||
|---|---|---|
| England at 31 March 2002 | All Contracts | of which Maximum Part-Time |
| England of which | 26,350 | 6,240 |
| Yorkshire(16) of which | 2,570 | 500 |
| Doncaster | 160 | 10 |
Notes:
Figures are rounded to the nearest ten
(16) Statistics for "Yorkshire" are based on the mean figures for North and East Yorkshire and Northern Lincolnshire Strategic health Authority (excluding Northern Lincolnshire), South Yorkshire Strategic Health Authority and West Yorkshire Strategic Health Authority.
Source:
Department of Health medical and dental workforce census.
Mr. Viggers: To ask the Secretary of State for Health, pursuant to the answer of 12 December 2002, Official Report, column 494W, on consultants, if he will list the specialities in which offers of appointment have been made under the NHS International Fellowship Scheme. [90312]
Mr. Hutton: We piloted the International Fellowship Scheme with an initial recruitment round in spring and summer 2002.
As a result of the pilot, 39 offers of appointment have been made and accepted, although subsequently two have been deferred due to personal reasons. A further six candidates have potential offers under negotiation. 17 candidates have been invited for interviews in the new year. Of the 37 offers of employment, two are in cardiothoracic surgery, seven in histopathology, 26 in psychiatry and two in radiology.
Contractor Fraud
Mr. Burstow: To ask the Secretary of State for Health how much contractor fraud was detected in the NHS in each of the last four years. [89030]
Mr. Lammy: The available figures are shown in the table:
| 1999–2000 | 2000–01 | 2001–02 | |
|---|---|---|---|
| Number of cases detected | 95 | 238 | 201 |
| Value of loss identified(17) (£) | 450,041 | 3,334,010 | 4,296,395 |
(17) Subject to recovery
The National Health Service Counter Fraud Service (NHS CFS) was created in 1998 and became operational during 1999–2000. Since then detection, referral, conviction and recovery rates for cases involving NHS fraud have improved significantly.
Every health body in England and Wales is also required, in Secretary of State Directions, to have a dedicated and accredited local counter fraud specialist (LCFS) who can be contacted by NHS staff to report any suspicion of fraud in the NHS. The presence of LCFS in each health body not only improves the
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detection rates for fraud and corruption but also contributes to a wider change in public and staff attitudes towards fraud in the NHS.
In addition, the NHS CFS has a fraud and corruption reporting line, which is a secure channel for members of the public and NHS staff to report any suspicion of fraud in the NHS.
Correspondence
Mr. Swayne: To ask the Secretary of State for Health when he plans to reply to the letter of John C. Wood of Barton-on-Sea of 21 November 2002. [90695]
Mr. Lammy: A reply was sent to Mr. Wood on 13 January 2003.
Departmental Expenditure (Newsprint)
Mr. Bercow: To ask the Secretary of State for Health what the total expenditure of his Department was on newspapers, magazines and periodicals in 2002. [90518]
Mr. Lammy: The approximate total expenditure on newspapers, magazines and periodicals in 200–02 was £469,880.
The expenditure covers central purchasing through the Department's library, the Regional Offices and direct purchasing by individual units. The figures do not include expenditure by Agencies or official publications, which are published weekly, monthly or quarterly by The Stationery Office.
Disability and Discrimination Act
Mr. Paul Marsden: To ask the Secretary of State for Health if he will list for each primary care team what training they offer staff to comply with the Disability and Discrimination Act 1995. [86158]
Mr. Hutton: Data on the local training arrangements at primary care trust (PCT) or primary care team level is not collected centrally. However, the National Health Service Executive issued management guidance to NHS trusts, health authorities (HAs) and primary care groups on implementing Part III of the Disability Discrimination Act (DDA) in July 1999. HAs were asked to develop a strategy to ensure that Section 21 of the DDA was implemented across their premises including hospitals, primary care premises, health centres and clinics.
In addition, the Department has issued a guide, Doubly Disabled, to help NHS managers and staff improve their awareness of the needs of disabled people whether they are patients, carers or employees. A distance learning package on disability awareness for NHS staff, particularly front line staff, commissioned by the Department, has been available since November 1999.
Drugs (Black Market)
Tim Loughton: To ask the Secretary of State for Health what discussions he has had with pharmaceutical companies about drugs provided at cost to African countries being resold on the black market in the UK. [89938]
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Mr. Lammy: Officials from the Department and others have had extensive discussions with pharmaceutical companies about the problem of drugs sold at discounted prices to poorer countries being diverted into the European Union and other developed country markets. The subject was also discussed in the working group on access to medicines, chaired by my right hon. Friend, the Secretary of State for International Development, and which reported to the Prime Minister on 28 November 2002.
The report, a copy of which is available in the Library, recognised that measures to prevent diversion were one of the essential elements of a wider framework of measures to enable companies to offer substantially lower prices in poorer countries. The Government continue to work with the United Kingdom and industry internationally to take forward the proposals in the report.
Tim Loughton: To ask the Secretary of State for Health what action he has taken in collaboration with the Secretary of State for International Development to combat the illicit resale of drugs provided by pharmaceutical companies at cost to African countries into European markets. [89939]
Mr. Lammy: The working group on access to medicines, chaired by my right hon. Friend, the Secretary of State for International Development, included in its discussions possible measures for preventing discounted medicines destined for poorer countries from being diverted to the European Union and other developed markets. A copy of the report, published on 28 November 2002, is available in the Library.
There are a range of measures that could help—for example, effective control of distribution within the developing country; border measures in developed country markets; and differentiation of product packaging. These issues are under discussion as part of the follow-up to the working group report. In addition, the European Commission has published a draft Regulation to strengthen customs controls in this area. It is still under discussion among EU member states.
Regardless of these possible measures, any suspected sales in the United Kingdom of medicines that do not comply with the licensing requirements of the Medicines Act 1968 can be reported to and investigated by the Medicines Control Agency.
E. Coli
John McDonnell: To ask the Secretary of State for Health what plans the Government have for the implementation of the recommendations of the Task Force report on E. coli 0157. [88945]
Ms Blears: The Department has welcomed the report of the task force on E. coli 0157and has accepted its recommendations. Many of the recommendations have already been implemented. These include research into the epidemiology of E. coli 0157 infection, steps to increase the awareness of both the public and the medical profession of the risks of this infection and how to avoid them, and the production of guidance for farmers, schools and others at risk from recreational activities.
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John McDonnell: To ask the Secretary of State for Health (1) how the Government plan to reduce the number of cases of E. coli 0157; [88946]
- (2) what plans the Government have for improving the speed of detection of E. coli 0157 bacterium; [88948]
(3) what plans the Government have for the introduction of a standard testing protocol for the bacterium E. coli 0157 across the UK. [88949]
Ms Blears: The Public Health Laboratory Service (PHLS) undertakes microbiological and epidemiological surveillance of E. coli 0157 infections and has given a high priority to work on Vero cytotoxin-producing E. coli 0157.
Research by the PHLS has led to significant improvements in laboratory methods for the detection of E. coli 0157 from clinical specimens as well as animals and foods. They produced guidelines on the testing of samples for E. coli 0157 in 2000. These guidelines include advice from the advisory committee on microbiological safety of food that all diarrhoeal stool samples submitted to public health laboratories for testing should be examined for E. coli 0157. Shared protocols for testing E. coli 0157 are being developed with the veterinary laboratories agency to ensure consistency in both animal and human diagnostics. In addition to providing full identification and typing for all E. coli, the PHLS reference laboratory also subtypes E. coli 0157 using a range of methods, and is currently evaluating a simple non-invasive test for antibodies to E. coli 0157 in saliva. Molecular methods for the detection of E. coli 0157 are now used routinely.
The Food Standards Agency has set itself a target of reducing foodborne disease by 20 per cent., by April 2006. This includes foodborne cases of E. coli 0157. The strategy for achieving this target, which was published on the Agency website (www.food.gov.uk) in July 2001, involves a range of measures to reduce microbial contamination of foods and to improve food handling and preparation. Laboratory reports of E. coli 0157 in the UK fell from 1,139 cases in 2000 to a provisional figure of 1,049 in 2001.
The Department has taken steps to increase the awareness of both the public and the medical profession of the risks of this infection and how to avoid them. The Department has worked with the Health and Safety Executive (HSE), the Scottish Executive, the Department for Environment, Food and Rural Affairs and the Department for Education and Skills in producing guidance for farmers, for schools and for those at risk from recreational activities. The Department, together with the HSE, is also planning to undertake a renewed educational and public awareness campaign on the risks in the agricultural environment.
John McDonnell: To ask the Secretary of State for Health what plans the Government have to set up a central data base on the incidence, diagnosis and treatment of E. coli 0157 to assist in the treatment and diagnosis and long term monitoring of the effects of infection from E. coli 0157. [88987]
Ms Blears: The Public Health Laboratory Service (PHLS) is developing plans for a central database on the incidence, diagnosis and treatment of E. coli 0157. All
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food-borne incidence of confirmed E. coli 0157 is already recorded by the PHLS communicable disease surveillance centre.
John McDonnell: To ask the Secretary of State for Health (1) if he will consult the charities and voluntary organisations concerned with the issue of infection from E coli-0157 on the future development of services for research, diagnosis and treatment of E coli-0157 related conditions; [88992]
- (2) what plans the Government have for research into the causes, prevention and treatment of the infection by E coli-0157 and the long-term care of those suffering from the consequences of infection; [88991]
(3) what research the Government have undertaken into whether the use of certain types of antibiotics can help spread the E coli-0157 bacteria in patients; and what action is planned as a result. [88947]
Ms Blears: There are a number of research projects in progress that are directed at both providing a better understanding of the virulence mechanisms of E coli-0157 and leading to improved typing methods for application in epidemiological investigations. A number of case-control studies have already been conducted in the UK and have helped to define the risk factors for E coli-0157infection.
Enhanced surveillance of E coli-0157 infections has been co-ordinated by the Public Health Laboratory Service (PHLS). A study of childhood haemolytic uraemic syndrome (HUS) is also being conducted by the PHLS in association with the British Paediatric Surveillance Unit, the British Association of Paediatric Nephrologists, the Scottish Centre for Infection and Environmental Health and the Royal Hospitals Aberdeen national health service trust.
The use of antibiotics for the treatment of uncomplicated diarrhoea is discouraged. The Department has issued specific advice to medical personnel to ensure that they are aware that the use of antibiotics for the treatment of E coli-0157 may increase the risk of severe kidney disease.
The task force on E coli-0157 consulted widely with relevant charities and voluntary organisations. Officials representing both the Department and the Food Standards Agency (FSA) regularly meet representatives of HUS charities to discuss matters including research, diagnosis and treatment. The FSA has regular meetings with stakeholders to discuss its policies and their implementation.
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