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HEALTH

Accident and Emergency Services

Dr. Pugh: To ask the Secretary of State for Health if he will list seaside towns with a population in excess of 50,000 that have no accident and emergency provision for children within their boundaries. [118423]

Mr. Lammy: This information is not held centrally. Accident and emergency (A&E) provision, including paediatric A&E services, is planned locally to meet the needs of the local population.

Dr. Pugh: To ask the Secretary of State for Health what his Department's policy is on the minimum throughput capacity for an NHS accident and emergency department to deal effectively with children's emergency admissions. [118424]

Mr. Lammy: The Department expects all emergency patients, including children, to be taken in an emergency to the nearest appropriate hospital able to receive emergency admissions. Which hospital is most appropriate depends on the clinical condition of the patient. In some cases this will be the nearest hospital. In others it will be clinically more appropriate to stabilise the child and admit to a more distant hospital with specialist facilities.

Advocacy Services

Mr. Drew: To ask the Secretary of State for Health (1) what plans he has to support the work of citizens advocacy groups, with specific reference to the delivery of the Valuing People White Paper; [118289]

(2) what its Department's policy is on the provision of advocacy for those who have (a) learning disabilities and (b) mental health problems; [118290]

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(3) what role his Department has given to the British Institute of Learning Disabilities with regard to the distribution of moneys for the purpose of expanding advocacy services; [118291]

(4) what assessment he has made of the demand for advocacy services for those who have learning disabilities or mental health problems. [118292]

Jacqui Smith: The Government attaches great importance to the development of advocacy services as one of the means that enable the views of patients to be represented.

Our policies for improving services for people with learning disabilities, their families and carers are set out in the White Paper "Valuing People: A New Strategy for Learning Disability for the 21st Century" (Cm 5086) published in March 2001. The importance of advocacy is a theme running throughout the White Paper: effective advocacy services can make a real difference to the lives of people with learning disabilities and their families by helping them to put forward their views and play an active part in planning and designing services.

"Valuing People" announced the creation of two new funds, the Implementation Support Fund and the Learning Disability Development Fund, to provide central support for key aspects of the strategy. Money from the Implementation Support Fund is being used to support and develop self and citizen advocacy projects across the country. Two voluntary organisations, the British Institute of Learning Disabilities (BILD) and Values into Action (VIA) are running separate schemes to develop and fund citizen advocacy and self advocacy respectively on the Department of Health's behalf. Both organisations have steering groups to oversee the projects and to ensure fairness in the way the funds are allocated.

£900,000 from the Implementation Support Fund was allocated to advocacy projects in 2001–02 and £1 million in 2002–03; £1 million is being allocated in 2003–04. A further £300,000 was allocated in 2001–02 to administer the funding schemes and support development workers to work with and strengthen existing advocacy schemes and help set up new ones: this amount increased to £400,000 in both 2002–03 and 2003–04.

We announced in our report on learning disability, "Making Change Happen" (HC514–11), published in April 2003, that the Implementation Support Fund would continue until March 2006. The fund will support the same areas of work as at present. The learning disability task force, which has members drawn from both the self and citizen advocacy movements, will be involved in discussions about the detailed use of the Support Fund.

Mental health policies pay equal importance to the use of advocacy. The draft Mental Health Bill, published on 25 June 2002, provides for the first time that specialist mental health advocacy must be available for all patients being treated under compulsory powers and their nominated persons. This new duty ensures that patients can have the help of specialist advocacy when it is most needed. There are also proposals in the draft Bill for safeguards, including access to advocacy,

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for some adult patients who have a long-term incapacity to consent and who are in a hospital or nursing home receiving treatment for a serious mental disorder.

Age Discrimination

Mr. Jim Cunningham: To ask the Secretary of State for Health (1) if he will make a statement on the efforts made to address age discrimination in the NHS since 2000; [118498]

(2) how many representations he has received relating to age discrimination in the NHS in each of the last five years. [118499]

Jacqui Smith: Standard One of the older people's national service framework (NSF) sets out the commitment to address age discrimination in access to health and social care. Since its publication in March 2001 significant progress has been made in starting to tackle age discrimination:

There is a now a wider appreciation and awareness across health and social care of age discrimination as an issue.


National health service organisations have checked their written polices to ensure they have no age bias. Only a very small number have been found that discriminated against older people. In these cases, procedures are being reviewed.


Our monitoring through strategic health authorities at October 2002 indicates that, 91 per cent. of areas had strategic and operational plans to address identified age discrimination.


Councils and care trusts have received guidance to make sure everyone has fair access to services—regardless of age.


In November last year we released a computerised information tool to enable those implementing the NSF at local level to compare their treatment rates in 10 different hospital procedures, in relation to different age groups.


We supported the development of a practice guide published in February 2002 by the King's Fund, "Auditing Age Discrimination—a practical approach to promoting equality in health and social care".


A reflection of this new attitude, coupled with some of the wider Departmental initiatives, can be seen in hospitals' greater action in providing surgery for older patients:


between 2000 and 2002, for example, breast cancer surgery for patients 85 and over rose by 13 per cent. and while coronary artery bypass grafts increased by 16 per cent. for those 65 or over, while the increase was 32 per cent. among patients 75 or over and 65 per cent. in the 85 plus age group.

We have funded Age Concern to run eight events on age discrimination across England during the current year.

Detailed, comprehensive information on representations of age discrimination made by organisations and individuals to the NHS are not collated centrally. The Department at a national level and local NHS organisations are continuing to work closely with older people and their representative bodies to identify individual and specific areas of concern and take action to address them.

Asbestos

Dr. Cable: To ask the Secretary of State for Health if he will list the actions his Department, its agencies and non-departmental public bodies are taking to comply with the requirements of the Control of Asbestos at Work Regulations 2002; whether he has made an estimate of the cost of compliance; and if he will make a statement. [117710]

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Mr. Lammy: The Department of Health, its agencies and non-departmental public bodies have implemented a programme of investigations to establish the presence, type and condition of asbestos containing materials in its buildings where the Department has an obligation to repair or maintain the building. Where asbestos containing materials have been found to be present, or have been presumed to be present, the risk posed by the asbestos has been reassessed and any additional measures required have been introduced.

Where the Department occupies premises but has no obligation to repair or maintain them, written information and documented proof is being sought from the owner/leaseholder.

Any additional measures required are normally included as part of ongoing maintenance but the cost of current works planned total about £1.245 million.

Audiology

Mr. Rosindell: To ask the Secretary of State for Health how many digital hearing aids have been issued on the NHS since they became available. [117853]

Jacqui Smith: A total of 83,397 digital hearing aids were fitted as part of the modernising hearing aid services (MHAS) project by the end of April 2003. We do not know the number of digital hearing aids fitted by those sites that have access to the NHS Purchasing and Supply Agency contract for digital hearing aids but are not part of the MHAS project, nor would we know of any digital hearing aids bought outside of the contract, as neither of these figures is collected centrally. Any site with the necessary training and equipment in place may apply for access to the procurement contract so that they can provide digital hearing aids on the national health service.

Mr. Rosindell: To ask the Secretary of State for Health if he will make a statement on hearing loss in England. [117854]

Jacqui Smith: The Medical Research Council Institute of Hearing Research estimates that there are now approximately 7.5 million people in England who are deaf or hearing impaired. Most of these people acquire their hearing impairment. It is estimated that 55.1 per cent. of people aged over 60 are deaf or hearing impaired compared, to 6.7 per cent. of the under 60s. The Royal National Institute for Deaf People estimates that 1.8 per cent. of young adults under 30 have a hearing impairment.

Mr. Rosindell: To ask the Secretary of State for Health what recent discussions he has had with the Royal National Institute for the Deaf; and if he will make a statement. [117855]

Jacqui Smith: Officials of the Department of Health are working very closely with the Royal National Institute for the Deaf, who are project managing the modernisation of the hearing aid services programme.

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