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22 May 2003 : Column 960W—continued
Elderly People
Mr. Paul Marsden: To ask the Secretary of State for Health how many deaths amongst old people in (a) Shrewsbury and Atcham and (b) Shropshire were attributed to cold in each year since 1997. [114758]
John Healey: I have been asked to reply.
The information requested falls within the responsibility of the National Statistician. I have asked him to reply.
Letter from Len Cook to Mr. Paul Marsden, dated 22 May 2003:
- As National Statistician, I have been asked to reply to your recent question concerning how many deaths amongst old people in (a) Shrewsbury and Atcham and (b) Shropshire were attributed to cold in each year since 1997. (114758)
- Cold is not recorded as a cause of death in itself, however hypothermial (subnormal body temperature) may be mentioned on the death certificate. For the period 1997 to 2001 (the latest year for which data are currently available) the total number of deaths of usual
22 May 2003 : Column 961W
- residents of (a) Shrewsbury and Atcham and (b) Shropshire, aged over 65 where hypothermia was mentioned anywhere on the death certificate was less than five in both cases.
- 1 Defined using the International Classification of Diseases, Ninth Revision (ICD-9) code N991.6 for the years 1997 to 2000, and, for the year 2001, the International Classification of Diseases, Tenth Revision (1CD-10) code T68).
Mr. Paul Marsden: To ask the Secretary of State for Health what the average cost of health services for an elderly person in (a) Shrewsbury and Atcham and (b) Shropshire in each year since 1997. [114762]
Mr. Lammy: This information is not held centrally.
Independent Complaints Advocacy Service
Clive Efford: To ask the Secretary of State for Health whether the Independent Patient Advocacy Services will be in place by the time community health councils are abolished; and if he will make a statement. [114166]
Mr. Lammy: The Department has put the contracts to provide the Independent Complaints Advocacy Service out to tender. Only organisations that can provide the service from 1 September 2003 will be considered for the contracts.
Clive Efford: To ask the Secretary of State for Health pursuant to his answer of 19 March 2003, Official Report, column 850W, on patient advocacy, which organisations will be invited to tender for interim contracts to become specialist complaints support providers. [114167]
Mr. Lammy: Tendering exercises of this kind follow Department of Health procurement guidelines, which protect the commercial confidentiality of tenderers while the invitation-to-tender process is underway.
Clive Efford: To ask the Secretary of State for Health on what basis individuals will be assessed to be suitable candidates to be specialist patient support providers under the Independent Complaints Advocacy Service. [114168]
Mr. Lammy: Those tendering to provide the interim Independent Complaints Advocacy Service (ICAS) will have to demonstrate that they can provide the service to the ICAS Standards set by the Department of Health. When primary care trust patients' forums commission or provide the service, they will abide by standards set by the Commission for Patient and Public Involvement in Health.
KPMG
Mr. Kilfoyle: To ask the Secretary of State for Health how many contracts his Department has awarded to KPMG since 1997. [113685]
Mr. Lammy: The Department does not centrally hold a record of individual contracts. However, our financial records show the following payments made by the Department, excluding its Agencies, to KPMG by fiscal year since April 1997.
| Value | |
|---|---|
| 1997–98 | 333.7 |
| 1998–99 | 166.9 |
| 1999–2000 | 222.8 |
| 2000–01 | 33.0 |
| 2001–02 | 1,715.2 |
| 2002–03 | 3,255.2 |
22 May 2003 : Column 962W
Liver Disease
Dr. Kumar: To ask the Secretary of State for Health if he will make a statement on research within the NHS into developing the technique of transplanting hepatocytes into those suffering a variety of liver diseases. [114312]
Mr. Lammy: Research on the transplantation of hepatocytes into those suffering from liver disease has been undertaken by Dr. Anil Dhawan of the Supra Regional Paediatric Service at King's College Hospital National Health Service Trust. The primary aim of the project is to develop the use of isolated hepatocytes for clinical cell transplantation in paediatric patients with liver-associated metabolic defects or acute liver failure, as an alternative to whole liver transplantation. The research involves the establishment of a new facility and a case control study. It has been funded by the Children's Liver Disease Foundation and the National Lotteries Charities Board.
Medicine Usage
Mr. Drew: To ask the Secretary of State for Health if he will launch an inquiry into how GPs and pharmacists may be better able to advise and counsel patients on how to use medicines more appropriately. [112454]
Mr. Lammy [holding answer 15 May 2003]: General practitioners and pharmacists are highly skilled health professionals with access to a range of sources of advice about the use of medicines. They are therefore well placed to advise and counsel patients.
Considerable progress is already being made on providing patients with more advice and counselling about their medicines. "Pharmacy in the Future—Implementing the NHS Plan", launched in September 2000, sets out a programme of reform through which pharmacists will play a full part in delivering better services to patients. The aim is for all primary care trusts to have schemes in place so that people get more help from pharmacists in using their medicines by 2004. Working closely with GPs and giving patients more information about the effective use of medicines is central to this progress.
Mental Health
Stephen Hesford: To ask the Secretary of State for Health how many primary care trusts have within their area talking treatments available for those with mental health problems on prescription from general practitioners. [115909]
Jacqui Smith: Although patterns and levels of provision vary as a result of staffing levels and local decisions on how to meet population needs within available resources, talking treatments are available to every primary care trust.
Psychological therapies, counselling and psychotherapy are listed in the mental health national service framework among the range of effective treatments for people with mental health problems, including those with severe and enduring mental illness.
22 May 2003 : Column 963W
Mr. Paul Marsden: To ask the Secretary of State for Health what financial assistance has been given to primary care trusts in the last year to support mental health services in treating drug users with mental health problems. [114231]
Ms Blears: Funding for those who suffer from dual diagnosis, that is drug users with mental health problems, is available from two main sources. These include the National Service Framework for Mental Health (1999) which was supported by additional investment of over £300 million by 2004 as announced in the NHS Plan and the pooled drug treatment budget which was increased to £243.6 million this financial year.
Tim Loughton: To ask the Secretary of State for Health (1) what assessment he has made of the percentage of service personnel returning from Iraq likely to need access to mental health services; and to what extent he has drawn on the experiences of the first Gulf conflict in making that assessment; [114736]
- (2) what provision has been made to meet the mental health needs of young soldiers returning from Iraq, with particular reference to those who have undergone combat experiences. [114735]
Jacqui Smith: Armed forces personnel returning from the Gulf who need mental health care would normally receive treatment from the Defence Medical Services. Treatment may also be provided by the National Health Service, if necessary. It is still too early to know whether any major mental health concerns will emerge among those who took part in Operation Telic.
Mr. Paul Marsden: To ask the Secretary of State for Health if he will list the address of each mental health NHS Trust in England. [114905]
Jacqui Smith : The address of each National Health Service mental health trust in England has been placed in the Library.
NHS Dentistry
Mr. Pike: To ask the Secretary of State for Health (1) if he will introduce provision within plans for the transition into new arrangements for NHS Dentistry contained within the Health and Social Care (Community Health and Standards) Bill to ensure that (a) patients and (b) dentists are kept informed of changes and to ensure that the livelihoods of dentists already providing NHS dentistry are safeguarded; and if he will make a statement; [113274]
- (2) what proposals he has included within the Health and Social Care (Community Health and Standards) Bill to attract (a) dentists, (b) dental nurses, (c) dental hygienists and (d) dental therapists into NHS dentistry; and if he will make a statement; [113273]
(3) what provisions there are in the Health and Social Care (Community Health and Standards) Bill which will increase the proportion of the NHS budget allocated to NHS dentistry. [113272]
Mr. Lammy: It is the intention of the Health and Social Care (Community Health and Standards) Bill to better match the provision of primary dental
22 May 2003 : Column 964W
services with local oral health needs through local commissioning of the service. This would enable local flexibility to be built into the system.
It is also the intention of the Bill that providing oral health services to national health service patients becomes a more attractive option to general dental practitioners by making it possible to pay them differently. The current item-of-service remuneration system is widely recognised as the main reason for dentists' disaffection with NHS work as they are paid only for treatments rather than oral health care. Under this proposed approach, the whole dental team would be better able to advise patients on improving their oral health allowing further improvement of the quality and patient focus of their care. In addition, NHS dentists and other members of the dental team will increasingly become part of the NHS family, participating in local dental public health programmes and benefiting from primary care trust (PCT) support networks and in due course, to NHS occupational health services. By contracting with a PCT, dental practices will receive a more secure and predictable income in return for a longer term commitment to the NHS.
All stakeholders are being kept abreast of the proposed changes. The patients forum has met officials and is broadly supportive. A working group, led by the Department's Director for Patient Experience and Public Involvement and including patient representatives, will undertake a review of the charging regime. To improve patient experience of NHS dentistry, each PCT will be required to publish information about the primary dental services in its area.
A series of events for dentists was held by the NHS Modernisation Agency earlier this year. The events were designed to explain the proposals in "NHS dentistry—Options for Change" and to encourage their involvement. Workshops for PCTs are being run by the national primary and care trust development programme and the Department of Health. In addition, learning events are being provided for local dental committee representatives by the British Dental Association, together with the NHS Modernisation Agency.
The legislation before Parliament proposes transitional arrangements under which a dentist already providing general dental services must be offered a new GDS contract, the terms of which would include remuneration.
Subject to Parliament, funding will be allocated to PCTs, which will then hold a predictable financial resource to secure primary dental services. Funding for primary care dentistry, hitherto held centrally and administered by the Dental Practice Board, will then be part of PCT general allocation, which has in recent years seen a higher rate of growth than that in the general dental service. Over time, PCTs will be better able to target these resources and to increase their spend on dentistry in the light of local circumstances.
Funding is being made available for a support team for NHS dentistry to support local health economies during this period of substantial change to develop their
22 May 2003 : Column 965W
capacity for local commissioning of primary care dentistry and to assist them in addressing immediate or potential access issues.
Mr. Dhanda: To ask the Secretary of State for Health (1) what action he is taking to encourage dentists to continue to offer dental treatment on the NHS; [113742]
- (2) what action he is taking to protect patients who are having dental treatment on the NHS withdrawn by their dental practice; [113741]
(3) if he will make a statement on dental practices which are withdrawing NHS treatment for existing patients while offering to continue treatment through private dental plans. [113740]
Mr. Lammy: I refer my hon. Friend to the response I gave my hon. Friend the Member for Burnley (Mr. Pike) today.
General dental practitioners are independent contractors and, as such, are free to choose whether they wish to provide national health service or private dentistry or a combination of the two. However, very few practices are exclusively private, with only about 5 per cent. offering no NHS treatment. Under their NHS terms of service, dentists who stop offering NHS services are required to complete any outstanding treatment on the NHS or notify the appropriate primary care trust if this is not possible.
A number of initiatives have been introduced in recent years to encourage dentists to continue to offer dental treatment on the NHS:
- The commitment payments scheme was introduced in 2000 to encourage dentists' commitment to the NHS. Dentists who have offered NHS treatment to patients for five years or more and who have a certain level of NHS commitment receive extra payments. Dentists in England earned an extra £23 million under the scheme in 2002–03.
£10 million was made available between 1997–99 under the Investing in Dentistry scheme to allow dentists to increase their NHS commitment or start new practices in areas of poor access.
A Dental Care Development Fund of £4 million was made available in 2000–01 along with £6 million Dental Action Plan money in 2001–02 to allow practices to grow and treat more patients.
A Modernisation Fund of £35 million was made available in 2001–02 for practices to expand or improve their premises.
In addition, a number of dental access centres (DAC) have been set up primarily in areas where access to NHS dentistry is difficult. Patients do not have to be registered to receive treatment in a DAC.
A range of dental treatments is available under the NHS to unregistered patients through the occasional treatment arrangements. This ensures that those patients who require urgent treatment can receive it without registering with a dentist.
22 May 2003 : Column 966W
Mr. Burstow: To ask the Secretary of State for Health pursuant to his Answer of 12th May, Official Report, column 107W, on NHS dentists, what the gross increase in the number of dentists treating NHS patients was. [114632]
Mr. Lammy [holding answer 20 May 2003]: 4,922 dentists joined the general dental service (CDS) between September 1997 and September 2002. Due to dentists leaving the CDS on retirement and for other reasons in the same period, the overall increase of dentists was 1,672.
Mr. Paul Marsden: To ask the Secretary of State for Health how many dental practices in (a) Shrewsbury and Atcham and (b) Shropshire accept new patients for treatment on the NHS that are (i) elderly, (ii) children, (iii) unemployed and (iv) disabled. [114760]
Mr. Lammy: Shropshire and Staffordshire Strategic Health Authority has provided the following information.
In Shrewsbury and Atcham, one practice is currently accepting children up to age 18. One practice is currently accepting adults eligible for free National Health Service dental care. This includes patients who are pregnant, or claiming benefits.
In Shropshire, there are thirteen practices currently accepting children. Seven practices are currently accepting adults eligible for free NHS dental care. This includes patients who are pregnant, or are claiming benefits.
In addition, there are dental access centres (DACs) in Shrewsbury, Oswestry, Whitchurch, Market Drayton, Bridgnorth, Ludlow, Craven Arms and Telford. Patients do not need to be registered to receive treatment in a DAC.
No separate figures for elderly patients, unemployed patients, or patients with disabilities are available.
Mr. Hancock: To ask the Secretary of State for Health if he will make a statement on NHS dentistry, with particular reference to (a) Portsmouth and (b) the rest of Hampshire. [114863]
Mr. Lammy: I refer the hon. Member to the response I gave my hon. Friend, the Member for Burnley (Peter Pike) today, at columns 964-66W.
I recognise that the access to routine national health service dental in Southern Hampshire and the Isle of Wight remains difficult. Access is particularly difficult in Fareham and Gosport, East Hampshire and Southampton City primary care trusts.
Five dental practices in Portsmouth City PCT are currently accepting new NHS patients for registration, although all have waiting lists.
Arrangements are in place across Hampshire to ensure that patients with an urgent need for treatment can be seen within 24 hours. The PCT helpline staff can make an appointment the same day, or within 24 hours, for such patients in either a dental access centre, or with one of a number of general dental practitioners who have contracted with the PCT to provide a number of urgent appointments.
22 May 2003 : Column 967W
Three out-of-hours emergency dental service facilities operate in Hampshire.
It is anticipated that with the local commissioning of primary dental services proposed in the Bill currently before Parliament, PCTs would be better placed to address local access issues as they arise.
Mr. Hoban: To ask the Secretary of State for Health what plans he has to provide additional resources to primary care trusts for commissioning dental care under the proposals set out in the Health and Social Care (Community Health and Standards) Bill. [114522]
Mr. Lammy: Subject to Parliament, funding will be allocated to primary care trusts as part of each PCT's general allocation.
The exact allocations are yet to be determined.
Mr. Gordon Prentice: To ask the Secretary of State for Health how many dentists have been recruited from (a) within the EU and (b) other countries to work in NHS dentistry since 2000. [113548]
Mr. Lammy: Information on the number of dentists who joined the general dental service, by country of qualification, in the years 2000–02 in England and Wales, is shown in the table.
| Year ending 31 December | 2000 | 2001 |
|---|---|---|
| EU (not including UK) | 230 | 197 |
| UK | 670 | 693 |
| Other Countries | 198 | 172 |
Note:
Excludes dentists whose status is currently shown as Statutory Exam or Awaiting Entry
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