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3 Jun 2003 : Column 351W—continued

Smoking

17. John Robertson: To ask the Secretary of State for Health what action he is taking to combat (a) cancer, (b) cardiovascular disease and (c) other conditions linked to smoking. [116540]

Ms Blears: To help prevent conditions linked to smoking we have established a comprehensive tobacco programme focussed on delivering a reduction in the number of smokers. As part of this, between April 1999 and December 2002 over 529,000 people set a quit date with the help of the national health service smoking cessation services.

Care Homes

18. Sir Nicholas Winterton: To ask the Secretary of State for Health if he will make a statement on care homes. [116541]

Jacqui Smith: Care homes can play an important role for older people. In recent years, the Government have provided substantial increases in the level of funding for social services which councils can use to increase fee levels if that is what is needed.

We are also committed to improving the quality of care, and this is evident in the development of national minimum standards for care homes.

Ambulance Services

19. Mr. Wiggin: To ask the Secretary of State for Health if he will make a statement on ambulance services. [116542]

Mr. Lammy: The ambulance service in England has made real progress. Compared with 1997, trusts are responding more quickly to a significantly larger number of calls. Ambulances are better equipped and paramedics are better trained. The service still faces challenges, but with support and investment it will continue to succeed. The national average for category A response times has been over 75 per cent. since March 2003.

Waiting Lists

20. Mr. Battle: To ask the Secretary of State for Health if he will make a statement on his Department's suspension policy with regard to waiting lists. [116543]

Mr. Hutton: Patients can be suspended from the waiting list for medical reasons that make them unfit for treatment or due to social reasons such as family commitments, holidays or other reasons. The period of suspension is then subtracted from the patient's total waiting time.

This guidance has been in place throughout the lifetime of this Government and was in place prior to the Government coming to power.

Patients (Treatment Abroad)

21. Mr. Waterson: To ask the Secretary of State for Health how many NHS patients have been sent abroad for treatment in each of the last five years. [116544]

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Mr. Hutton: Patients can be referred for treatment abroad under the European Union-wide health care co-ordination regulations (the E112-scheme) or through direct referral from their national health service trust.

The number of patients referred for treatment abroad under each of these systems between 1998 and 2002 are as follows:

In 2002 there were 1,120 E112 referrals and 228 direct referrals.

In 2001 there were 1,139 E112 referrals and no direct referrals.

In 2000 there were 1,099 E112 referrals and no direct referrals.

In 1999 there were 861 E112 referrals and no direct referrals.

In 1998 there were 813 E112 referrals and no direct referrals.

Pregnant Mothers (Infections)

22. Mr. Cameron: To ask the Secretary of State for Health what representations he has received about Group B streptococcus infections and pregnant mothers; and if he will make a statement. [116545]

Jacqui Smith: A few representations have been received on the issue of screening. The Health Technology Assessment Programme is currently looking at evaluation of rapid testing for women in early labour. The National Screening Committee will then review the evidence for screening when the evaluation is complete. Until then it should not be offered to pregnant women except in the context of a research project approved by an ethics committee.

Dental Treatment

23. Mr. Beith: To ask the Secretary of State for Health what recent steps have been taken to secure access to NHS dental treatment in the Berwick-upon-Tweed constituency. [116546]

Mr. Lammy: I refer the hon. Member to my reply to him on 18 March at column 758. The Government are aware that Northumberland Care Trust has been concerned about access to NHS dentistry in Berwick-upon-Tweed. We approved funding for the Trust to appoint a part-time salaried dental practitioner to work in the Berwick Royal Infirmary to address these issues in the short term while longer-term solutions are considered and my officials are supporting the local NHS to recruit to the post.

Puchasing and Supply

24. Mr. Sheerman: To ask the Secretary of State for Health what steps he is taking to improve purchasing and supply practices in hospitals and primary healthcare trusts. [116547]

Mr. Hutton: The national health service Purchasing and Supply Agency is leading a major reorganisation across the service. A middle tier of supply management confederations, run locally by healthcare trusts, will

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improve performance of their non-pay spend. To date, there are six pilots and 18 other developing confederations.

Accident and Emergency Departments

25. Mr. Viggers: To ask the Secretary of State for Health what changes are planned for the greater use of local hospitals in the diagnosis and treatment of accident and emergency cases. [116548]

Mr. Hutton: Changes to services are the responsibility of the local NHS. New guidance on service change, "Keeping the NHS Local—A New Direction of Travel", was published on 14 February 2003. It sets out core principles for service change that the NHS must now follow. It challenges the view that 'biggest is best', and sets out a range of strategies and options to help the NHS keep services local.

Chris Grayling: To ask the Secretary of State for Health what assessment the Avon Ambulance trust has made of delays at accident and emergency departments since the Commission for Health Improvement Report in October 2002; what conclusions that assessment reached; and if he will place a copy of the assessment in the Library. [111754]

Ms Blears: Avon Ambulance service national health service trust advises that it has refined its monitoring and reporting procedures to assess the causes and impact of delays in the transfer of care at local hospital accident and emergency departments. Working in close collaboration with the new emergency care networks, a number of improvements are now being implemented locally. Further information about the assessment can be obtained from the trust chief executive.

Agency Workers

Mr. Bercow: To ask the Secretary of State for Health how many agency workers have been employed by the Department in each of the last two years; and at what cost to public funds. [115199]

Mr. Lammy: The Department does not hold information on the number of employees under contract from agencies supplying temporary staff.

The amount spent on staff from these agencies for the period requested is shown in the following table.

	£
2001–02	7,589,927
2002–03	9,917,896

Note:

The accounts for 2002–03 are not final and are subject to some adjustment.

Asbestos-related Cancer Deaths

Mr. John Robertson: To ask the Secretary of State for Health how many people in the UK died from cancers caused by exposure to asbestos for each year since 1998. [114832]

Mr. Nicholas Brown: I have been asked to reply.

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In the three years 1998 to 2000 (the most recent year for which data are available), there were 1541, 1613 and 1628 deaths from the cancer mesothelioma in Great Britain. Mesothelioma is almost always caused by asbestos exposure. A further 1500 to 3000 lung cancer deaths per year are estimated also to be attributable to asbestos, but these cannot be individually distinguished from lung cancers due to other causes such as smoking.

Autism

Mrs. Iris Robinson: To ask the Secretary of State for Health what plans he has to improve services for sufferers of autistic spectrum disorders. [115066]

Jacqui Smith: Autism is one of the least understood but most frightening and difficult of conditions. People with autism lead isolated lives. Their social and communication difficulties place great stress on their families. It is important that we should all be sensitive to their needs.

Children with autistic spectrum disorders will benefit from the programmes to improve services for disabled children. The Quality Protects (QP) programme to improve children's social services has made disabled children a priority area. From 2001–02 to 2003–04, £60 million from the children's services special grant has been earmarked for services for disabled children and their families—£15 million in 2001–02 and 2002–03 and £30 million in 2003–04. Last year's QP management action plans show that more family support services are being provided, particularly home based respite care and sitting services. The Carers Grant is increasing from £85 million this year to £185 million by 2005–06. Approximately 20 per cent. is spent on children's services, mainly to carers of disabled children to fund the provision of short term breaks. Direct payments were introduced in the Carers and Disabled Children Act 2000 and are increasing the flexibility and choice for parents in the provision of services.

Disabled children are also a priority area within the development of the children's national service framework (NSF). NSFs were established to improve services through setting national standards to drive up quality and tackle existing variations in care. The Children's NSF will develop new national standards across the NHS, social services and interface with education. It will be about putting children and young people at the centre of their care. The NSF will include care pathways/exemplar diagrams illustrating optimum approaches to delivering services in a number of different areas. It will show how families should receive multi-agency early intervention and support based on their needs. One of the exemplars will be on services for children with autism.

The Department of Health, in association with the Department for Education and Skills, published good practice guidance on autistic spectrum disorders last year. The guidance was primarily aimed at schools and local education authorities but was also relevant to health and social services providers. We will also be working with the Department for Education and Skills on the new Special Educational Needs Action Programme which, among other things, will promote effective approaches to teaching and learning for children with autism.

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People with autism are benefiting from funding of over £200,000 which the Department made through the Section 64 Scheme of Grants to Voluntary Organisations between 1998–99 and 2001–02. We are currently devoting a further £154,000 over three years to the National Autistic Society project "Independence and Autism: Good Practice for Service Providers". This will support the development of new services to enable adults with autism or Asperger's Syndrome to live independently.

The "Valuing People" White Paper directly covers every adult with autism who also has a learning disability. Implementation guidance, issued in August 2001, makes clear that adults with Asperger's Syndrome or higher functioning autism are not precluded from using learning disability services, where appropriate, and may require an assessment of their social functioning and communication skills in order to establish their level of need. By bringing together a wide range of local statutory agencies, Valuing People gives us the scope to improve opportunities and services for people across the autistic spectrum.

Adults with autism will also gain, along with others, from the investment we are making to improve standards in health and social care services. In particular they will benefit from the NHS Plan, the mental health NSF, which covers the mental health needs of adults with autism, and Fair Access to Care Services.

Mr. Hunter: To ask the Secretary of State for Health if he will take measures to increase the number of centres which provide for the diagnosing and treating of autistic children who suffer from inflammatory bowel disease; and if he will make a statement. [115463]

Jacqui Smith: We recognise the problems that occur for children who suffer autistic spectrum disorders, and for their families. We will continue to work on what more we need to do to improve services for autistic children. We will also seek to ensure diagnosis and treatment provisions consistent with demand. Primary care trusts (PCT) have a pivotal role here, in ensuring an appropriate level of services to meet the health care demands of their local population. For those children with bowel symptoms suggestive of inflammatory bowel disease (IBD), local paediatricians and paediatric gastroenterologists have the necessary expertise to investigate and manage IBD in children with, and without autism.

The children's national service framework (NSF) will set new national standards which will help to ensure better access and smoother progression in the provision of services for children, from initial contact and diagnosis with the National Health Service, via a general practitioner surgery or NHS hospital. The NSF will include care pathways/exemplar diagrams illustrating optimum approaches to delivering services in a number of different areas and one of these will be on services for children with autism.

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