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10 Jun 2003 : Column 846W—continued
Sixteen-week Rule
Chris Grayling: To ask the Secretary of State for Health if he will make a statement on discussions he has had with the European Commission on the proposed 16-week rule. [116898]
Mr. Hutton: The Department has been in discussions with the European Commission about the proposed Directive on Recognition of Qualifications, which includes a 16-week provision of services proposal, at the
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European Council Working Group and in bilateral discussions with the Commission, where our concerns with this proposal have been raised.
Sustainable Development
Mrs. Calton: To ask the Secretary of State for Health what assessment he makes of bids for (a) grants and (b) contracts awarded by his Department (i) of the environmental impact and (ii) against sustainable development criteria; who makes the assessment; and whether they are published. [114505]
Ms Blears: In specifying contracts for goods and services, there is a requirement to take environmental issues embodied in the Department's sustainable development strategy into account. This strategy forms a key part of the Department's policies and operations. Assessment against specified criteria (including environmental and sustainable development) is carried out as part of the overall tender evaluation process. The sustainable development principles, on which criteria for individual contract evaluation is based, can be found on the Department's website.
Criteria for awarding research grants and those provided under section 64 of the Health Services and Public Health Act 1968, and the assessment process, can
be found on the Department's website.
The Department is working closely with the Sustainable Development Commission to explore ways of strengthening the links between health, health care and sustainable development. The overall aim is to embed sustainable development in the Department's policy objectives for health and social services.
Mr. Roger Williams: To ask the Secretary of State for Health what remit relating to sustainable development is required by his Department's (a) executive agencies, (b) advisory non-departmental bodies, (c) executive non-departmental bodies, (d) tribunals, (e) public corporations and (f) other bodies. [116675]
Ms Blears: The Department's strategy on sustainable development reflects the Government's overall sustainable development strategy. The Department's strategy seeks to promote and encourage sustainable development principles throughout the Department and the national health service, including those agencies and other bodies for which the Department has responsibility.
Departmental agencies and other bodies may draw up their own sustainable development strategies. For example, the Department's NHS Purchasing and Supply Agency (PASA) has recently published its new sustainable development policy. This is available on the PASA website at http://www.pasa.nhs.uk/environment/
Progress on Department of Health sustainable development activity can be tracked on the Department's web page at http://www.doh.gov.uk/sustainabledevelopment.
Temporary Staff
Mr. Hancock: To ask the Secretary of State for Health if he will make a statement on the use of (a) temporary
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nurses and (b) locum doctors in the NHS, with particular reference to NHS institutions covering Portsmouth and the rest of Hampshire. [115093]
Ms Blears: A range of initiatives are underway to get better value for temporary staff in the National Health Service. Along with the roll-out of NHS Professionals, the aim is to reduce agency costs and to improve the quality of staff through agency framework agreements. Agency framework agreements fix the cost of agency staff, which can only increase in line with the recommendations of the pay review body.
NHS trusts are using the national medical locum agency contract, with the contract value in the first quarter being £15 million. This is expected to show an average saving of 6 per cent. per trust on the medical locum expenditure per annum.
The aim is to roll-out agency agreements and NHS Professionals to cover all aspects of the temporary healthcare labour market. This means covering not just nurses and doctors but also the Allied Health Professions and other healthcare professionals.
Medical locums are already covered by a national agency framework agreement, and a NHS Professionals service for doctors is being developed.
By ensuring that all temporary staffing demand is handled through NHS Professionals, the savings and outcomes from the agency project will be maximised. The new NHS Professionals Special Health Authority will enable better strategic management of the healthcare temporary staffing labour market and ensure that all NHS trusts are using NHS Professionals by April 2005.
Hampshire and The Isle of Wight Strategic Health Authority have advised that trusts in Hampshire and the Isle of Wight, including Portsmouth are working towards using NHS Professionals by the target date of April 2005 and are using, or working towards using, the national medical locum agency contract.
Tranquiliser Drugs
Mr. Paul Marsden: To ask the Secretary of State for Health if he will make a statement on the guidelines issued by his Department in prescribing tranquiliser drugs. [117578]
Jacqui Smith: The CSM (Committee on the Safety of Medicines) issued advice in 1980 on the use of benzodiazepines for short-term (two to four weeks) relief of severe anxiety. The CSM said that the use of benzodiazepines to treat short-term 'mild' anxiety was inappropriate and that benzodiazepines should be used to treat insomnia only when it is severe, disabling, or subjecting the individual to extreme distress.
In 1994, the Department of Health issued copies of "Guidelines for the Prevention and Treatment of Benzodiazepine Dependence", published by the Mental Health Foundation, to all health authorities and recommended their use by general practitioners. "Drug Misuse and Dependence—Guidelines on Clinical Management" was then issued in 1999. The British National Formulary (BNF), updated twice yearly, is
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issued free to all doctors, and gives guidance on the prescription of benzodiazepine drugs as well as management of benzodiazepine dependence.
This guidance has led to an overall reduction in prescribing of these drugs and the attendant dependence problems.
The National Institute for Clinical Excellence has started work on the development of a clinical guideline on the management of anxiety. This will cover both drug and non-drug (psychological) treatments.
Treatment Abroad
Mr. Waterson: To ask the Secretary of State for Health if he will list those countries where NHS patients have been sent for treatment in the last five years. [116683]
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.
In the last five years, NHS patients have been referred under the El 12 referral arrangements to Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Liechtenstein, Luxembourg, The Netherlands, Norway, Portugal, Spain, Sweden and Switzerland.
Under the direct referral scheme, patients have received treatment in France, Germany and Belgium.
Tuberculosis
Angela Watkinson: To ask the Secretary of State for Health if he will make a statement on the number of reported cases of tuberculosis in (a) London and (b) the London Borough of Havering in each of the past five years. [116484]
Mr. Hutton: The Health Protection Agency (HPA) is responsible for the number of cases reported to its statutory notifications of infectious disease (NOIDS) database. Therefore, the following table provides data of tuberculosis notifications from the NOIDS database, which collects surveillance data on all cases of clinically diagnosed tuberculosis, whether or not microbiologically confirmed. 2002 data is not yet available.
| 1998 | 1999 | 2000 | 2001 | |
|---|---|---|---|---|
| London | 2,444 | 2,509 | 2,938 | 2,917 |
| Havering | 12 | 25 | 62 | 49 |
Volatile Organic Compounds
Norman Baker: To ask the Secretary of State for Health if he will make a statement on the health implications of the inhalation of volatile organic compounds from products designed for indoor use. [117364]
Ms Blears: The adverse effects of deliberate inhalation of volatile organic compounds can vary greatly depending on the specific substance. Use can be fatal, even on the first occasion. Fatalities are mainly
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caused by the toxicity of the substance, cardiac arrhythmia (abnormal heart rhythm), inhalation and choking on vomit and asphyxia through the use of plastic bags over the face. In addition deaths can be caused by accidents while disorientated. These may include falls, vehicle accidents and drowning. A number of deaths and serious injuries have also been caused by fire or explosion when vapour from the substance ignites. More general effects include cold sweats, fainting, headache, nausea, vomiting, palpitations, confusion, dizziness and risk of accidental injury.
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