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Obesity

Mr. Clappison: To ask the Secretary of State for Health what representations he has received concerning obesity and the introduction of national care standards; and what assessment he has made of the impact of care standards regarding obesity on (a) private clinics and (b) nursing homes. [96891]

Ms Blears: We have not received any representations concerning obesity and the introduction of national standards. We have not made any assessment specifically related to the impact of the standards regarding obesity in care (nursing) homes or private clinics.

However, national standards are designed to ensure care provision is fit for the purpose and meet the assessed needs of the home's residents. Among other things there are standards to ensure that care homes promote and maintain their residents health, that residents are given appropriate exercise and physical activity, and that residents receive a wholesome appealing balanced diet.

Out-Patient Waiting Lists

David Davis: To ask the Secretary of State for Health what the average waiting time for an out-patient appointment was in England in 2002. [97738]

Mr. Hutton: The estimated average waiting time for a first consultant outpatient appointment in England in 2002 was 7.25 weeks.

Overseas Nurses

Mr. Baron: To ask the Secretary of State for Health what the 25 countries were from which the highest number of overseas nurses were recruited in each of the last five years; and how many nurses were recruited from each country in each year. [98393]

Mr. Hutton [holding answer 24 February 2003]: This information is not held centrally. The Nursing and Midwifery Council registers all nurses who work in the United Kingdom and holds statistics for the number of overseas nurses who are accepted onto their register.

Pathology Services

Dr. Fox: To ask the Secretary of State for Health how many serious clinical incidents have taken place since

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Hammersmith Hospital took over the contract to provide pathology services to West Middlesex Hospital and Hounslow Primary Care Trust. [96718]

Mr. Hutton: There have been 167 serious untoward incidents reported to North West London Strategic Health Authority.

In order to ensure patient safety, the change in service provision in north-west London has been closely monitored. Clinicians have been required to use the serious untoward incident reporting system to highlight any incidents of the system not functioning smoothly. This is part of a culture of reporting potential risks, even where there has been no actual harm to patients. The aim is to identify and manage potential risks and therefore encourage their reporting.

Patient Choice

Dr. Fox: To ask the Secretary of State for Health how many patients in London waiting more than six months for elective surgery had a choice of alternative hospital in (a) 1998, (b) 1999, (c) 2000, (d) 2001, (e) 2002 and (f) 2003. [98924]

Mr. Hutton: The London patient choice project (LPCP) started offering choice on 23 September 2002 to patients with cataracts with the first operation on 1 October 2002. Between 1 October 2002 and 10 February 2003, 2,628 patients were offered choice. Of these, 1,859 accepted.

The LPCP was extended to include a range of surgical procedures in the specialties of general surgery; orthopaedics and ear, nose and throat in the week commencing 10 February 2003. It will be further extended to cover other specialties and procedures this summer.

Dr. Fox: To ask the Secretary of State for Health how many patients in London waiting more than six months for cataract surgery had a choice of alternative hospital in (a) 1998, (b) 1999, (c) 2000, (d) 2001, (e) 2002 and (f) 2003. [98931]

Mr. Hutton: The London patient choice project (LPCP) started offering choice on 23 September 2002 to patients with cataracts with the first operation on 1 October 2002.

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Mr. Dismore: To ask the Secretary of State for Health how many patients from Hendon he expects to be offered a change of hospital under patient choice in (a) this and (b) the next financial year; and if he will make a statement. [98933]

Mr. Hutton: Patients in Hendon are eligible for the London patient choice project. Barnet and Chase Farm National Health Service Trust has 1,024 patients who have been offered choice in the financial year 2002–03 and expects that, for the financial year 2003–04, a further 1,100 will be made a choice offer.

Mr. Dismore: To ask the Secretary of State for Health what treatments are available to patients in Hendon under "Patient's Choice", at hospitals other than those to which they were originally referred; and if he will make a statement. [98943]

Mr. Hutton: Patients in Hendon are eligible for the London patient choice project. This project started to offer choice for cataract patients who have already waited more than six months for treatment, in October 2002 and from March 2003 will be offering a similar choice in ear, nose and throat, general surgery and orthopaedics. The scheme rolls out to other surgical specialties such as gynaecology, urology and plastic surgery from summer 2003.

Dr. Fox: To ask the Secretary of State for Health how many choices of alternative hospital patients in London waiting for six months for cataract surgery have had since 1997, and what has been the average wait between referral and treatment in the alternative hospital. [99092]

Mr. Hutton: Patients are usually offered two alternative hospitals for cataract surgery.

The average wait between referral and treatment would be between two and four weeks, not including the time it may take to contact the patient and for them to make a decision. The contact process usually commences before the patient reaches six months on the list.

Where a patient is found to have a second cataract, they are expected to be treated within one and three months, should they so choose.

Dr. Fox: To ask the Secretary of State for Health how many choices of alternative hospital the 100,000 extra patients identified by him in his speech of 11 February will have; and who will determine their eligibility. [99102]

Mr. Hutton: The precise range of choice offered to patients is being designed on a project by project basis. Some projects are offering choice for those patients already on a waiting list for six months, and in others choice is being offered at the point of booking into an out-patient clinic.

For the six month waiting patients, a choice of one alternative treatment centre will be offered. For choice at the point of booking, two alternative treatment centres will be offered.

All projects will produce patient care pathways for each procedure, utilising nationally available guidance and advice. The pathways that cover eligibility criteria will then developed with clinicians. The trust on whose waiting list the patient is held before the start of the choice process.

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Dr. Fox: To ask the Secretary of State for Health who will determine whether a patient in London waiting more than six months for elective surgery is eligible to choose an alternative hospital. [99105]

Mr. Hutton: The London patient choice project takes as a starting point that the whole process of choice must be safe and quality assured from the patient perspective. The project has therefore produced patient care pathways for each procedure. These utilise nationally available guidance and advice, such as that published by the Royal Colleges and the Department of Health, as a core foundation. The pathways that cover eligibility criteria have then been developed in conjunction with clinicians in London.

The trust on whose waiting list the patient is held before the start of the choice process, checks whether the patient falls within the eligibility criteria for choice. However the transfer of clinical responsibility does not take place until the patient has been seen and accepted in a pre-admission clinic in the alternative hospital.

Problematic Drug Users

John Mann: To ask the Secretary of State for Health how many problematic drug users were known to the social services as children. [98147]

Ms Blears: We are not aware of any relevant statistics held centrally on how many problematic drug users were known to the social services as children.

Prostate Cancer

Mr. Frank Field: To ask the Secretary of State for Health what progress has been made on the Government's campaign to tackle effectively prostate cancer; and if he will make a statement. [97137]

Ms Blears: Good progress has been made since the national health service prostate cancer programme was launched on 6 September 2000, setting out the Government's approach to improving prostate cancer services in England and Wales.

As part of the prostate cancer risk management programme (PCRMP), evidence-based primary care resource packs were sent to all general practitioners in England from 23 September 2002 to aid them in counselling men who are worried about prostate cancer, ensuring the men make an informed choice about whether or not to have a prostate specific antigen (PSA) test.

Other elements of the PCRMP include ensuring that a systematic and standardised follow-up pathway is available for individuals whose test result is above the PSA threshold and action to improve the quality of laboratory testing of PSA samples. Primary care and laboratories were informed of recommendations from the scientific reference group, which supports the PCRMP, in September 2002.

By 2003–04, the Department will be directly funding £4.2 million of research a year on prostate cancer. This is a 20-fold increase compared with 1999–2000. Two National Cancer Research Institute prostate cancer research collaboratives have been established in Newcastle and London. Funded research includes studies on various treatments for prostate cancer,

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improving the PSA test and ethnic differences in prostate cancer incidence. The National Cancer Research Institute considered prostate cancer as part of its strategic analysis in 2002, but made no specific recommendations.

The Department is funding a Section 64 grant to the Prostate Cancer Charity to increase further information about prostate cancer. This is supporting the creation, review, provision and dissemination of a range of awareness material, supported by £135,000 over three years. 92.4 per cent. of patients with suspected urological cancers, including prostate, were seen for their first out-patient appointment within two weeks of their general practitioner deciding they should be urgently referred, and the hospital receiving the referral within 24 hours, in April to June 2002.

The cancer services collaborative is modernising cancer care, including prostate cancer, by reducing unnecessary delays in the system for patients throughout the cancer journey.

The number of consultant urologists grew from 382 in 2000 to 427 in 2001, and is set to grow to 504 in 2005. There may be around an additional 100 trained specialists available to take up consultant posts in urology.

The Government welcomed the launch of the prostate cancer charter for action on 29 January 2003. We look forward to working closely with the charter. To ensure better collaboration and communication between the charter members, the Government intend to set up a prostate cancer advisory group, allowing us to combine the expertise of the voluntary sector with the national health service for the benefit of patients.

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