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12 Mar 2003 : Column 349W—continued

Post-traumatic Stress Disorder

Tim Loughton: To ask the Secretary of State for Health if he will set up a specialist centre of excellence within the NHS for dealing with post-traumatic stress disorder. [101084]

Jacqui Smith [holding answer 6 March 2003]: There are no current plans to set up a specialist centre of excellence within the national health service for dealing with post-traumatic stress disorder. Health authorities have a responsibility to provide services to meet the mental health needs of all those who are eligible. Decisions about treatment and care are taken on the basis of an individualised assessment of needs, the patients wishes, the evidence base for effective treatment and available resources.

The general practitioner remains the first port of call for anyone suffering from mental health problems. The Department published guidance to help GPs know more about the most effective treatments in the mental health national service framework and in specific guidance on psychological therapies and counselling. These are available on our website at

Red Button Alert Devices

Rev. Martin Smyth: To ask the Secretary of State for Health how many people have received a red button alert device, broken down by region. [98264]

Jacqui Smith: Information on the numbers of people receiving a red button alert device is not collected centrally.

Rheumatoid Arthritis

Mr. Laurence Robertson: To ask the Secretary of State for Health what steps he is taking to increase the access of patients to (a) Cox-2, (b) Anti TNFs and (c) metal on metal hip resurfacing; and if he will make a statement. [101659]

Jacqui Smith [holding answer 7 March 2003]: The National Institute for Clinical Excellence (NICE) was asked to appraise the use of infliximab (Remicade) and etanercept (Enbrel) in the treatment of rheumatoid arthritis. NICE issued its guidance on 22 March 2002, which recommended the use of etanercept for the treatment of juvenile idiopathic arthritis and etanercept and infliximab for adult rheumatoid arthritis.

NICE issued guidance on 26 July 2001 on the use of four drugs for the treatment of osteoarthritis and rheumatoid arthritis to the national health service in England and Wales. The four drugs, celecoxib, etodolac, rofecoxib and meloxicam, are Cox II selective inhibitors and are a type of non-steroidal anti-inflammatory drug used for short-term treatment of acute inflammation in joints caused by arthritis. They recommended they be considered in preference to standard treatments only when there is a high risk of patients suffering from gastrointestinal problems as a side effect of treatment.

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NICE also issued guidance on 19 June 2002 recommending the selective use of a technique called metal on metal hip resurfacing, used to treat hip disease. They recommended that metal on metal hip resurfacing be considered as an option for people with advanced hip disease who would otherwise receive conventional primary total hip replacements and are likely to live longer than the device is likely to last. It also recommended that information be collected on the long-term effectiveness of the technique.

On 5 December 2001, the Government announced that they would meet their commitment to ensure that patients receive drugs and treatments recommended by NICE on the NHS if deemed appropriate by their clinicians. Directions were issued on 11 December 2001 obliging health authorities and primary care trusts to provide appropriate funding for recommended treatments.

Stroke Care

Mr. Allen: To ask the Secretary of State for Health what mechanisms will be put in place to monitor the April 2003 milestone contained in Standard Five of the National Health Service Framework for Older People, for every hospital which cares for older people with strokes to have established clinical audit systems to ensure delivery of the Royal College of Physicians clinical guidelines for stroke care. [94580]

Jacqui Smith: "Improvement, Expansion and Reform", the priorities and planning framework for 2003–06, has the April 2004 milestone for specialised stroke services in all general hospitals caring for people with stroke as a key delivery target. The level of monitoring is currently being determined.

Other aspects of Standard Five will be monitored through existing information collections (including the Sentinel Stroke Audit), discussions with the field and through a network of older people national health service and social care leads.


Tim Loughton: To ask the Secretary of State for Health how many specialist tuberculosis nurses were employed in (a) the NHS and (b) each health authority in London last year. [100506]

Ms Blears: The number of specialist tuberculosis nurses employed in the national health service is not held centrally.

London is broken down by five sectors. The number of TB nurses in each sector is shown in the table.

SectorNumber of nurses
North West22
North Central13.5
North East19
South East12
South West6

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Mr. Kaufman: To ask the Parliamentary Secretary, Lord Chancellor's Department when the Lord Chancellor intends to reply to the letter to him dated 31 January from the right hon. Member for Manchester, Gorton with regard to unadopted roads. [101062]

Yvette Cooper: My noble Friend the Lord Chancellor replied on 6 March.

Industrial Action

Mr. Bercow: To ask the Parliamentary Secretary, Lord Chancellor's Department how many working days were lost owing to industrial action by staff in her Department, agencies and non-departmental public bodies in 2002. [101958]

Ms Rosie Winterton: None.

Ministerial Transport

Mr. Bercow: To ask the Parliamentary Secretary, Lord Chancellor's Department what her estimate is of the cost (a) ministerial cars and drivers and (b) taxis for her Department in 2002. [101853]

Ms Rosie Winterton: Part (a) of this question will be addressed in a letter from Mr. Nick Matheson, Chief Executive of the Government Car and Despatch Agency to the hon. Member for Buckingham. As for part (b), expenditure of £40,407 was incurred against the departmental taxi service contract between 1 April 2002 and 28 February 2003. This figure excludes any amounts spent on taxi hire outside of the departmental contract and reclaimed by officials as travel and subsistence expenditure. That information could be obtained only at disproportionate cost.


Church Repairs

Miss McIntosh: To ask the hon. Member for Middlesbrough, representing the Church Commissioners

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pursuant to his oral statement of 3 February 2003, Official Report, column 20, on Church Repairs and VAT, when he expects the review of the sixth VAT directive to be completed. [101642]

Mr. Bell: I understand that work is ongoing between Commission officials and member states to finalise the details of the revision to the Sixth Directive. The aim is to get sufficient agreement in the Council for the 'Recast' Directive to be formally adopted before the next enlargement of the EU, scheduled for May-June 2004.

The 'recasting of the Sixth VAT Directive' is a separate exercise to other elements of the Sixth Directive being revised, such as the reduced rates review, scheduled to take place later this year, or the Labour Intensive Services Experiment.

Clergy Pensions

Mr. Ben Chapman: To ask the hon. Member for Middlesbrough, representing the Church Commissioners if he will make a statement on the pension rights of clergy. [101436]

Mr. Bell: Clergy in office receive a stipend and are housed. When they retire they make their own housing provision, but they receive a pension from the State as well as that provided by the Church's clergy pension scheme. The basis for determining the benefits provided by the latter—a lump sum at retirement plus a pension—was designed to take into account all of these factors. The full service pension (payable after 37 years of service) has since April 2002 been £10,693 per annum and will increase by 3 per cent. from April 2003. The retirement lump sum is £32,079.

Following a thorough consultation with interested parties in the Church, culminating in a General Synod debate last November, it was decided to retain the defined benefit scheme. The Church has resisted the increasingly common alternative of moving to money purchase schemes, thereby shifting risk onto the employee, in a demonstration of its commitment to adequate provision for the clergy in their retirement.