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15 Sept 2003 : Column 624W—continued
Care Standards Act
Mr. Hammond: To ask the Secretary of State for Health what assessment he has made of the impact on voluntary organisations concerned with the care of the elderly of the registration fee imposed by the Care Standards Act 2000. [130703]
Dr. Ladyman: The fees payable by care providers registered under the Care Standards Act were the subject of a wide-ranging public consultation in 2001. As part of the funding arrangements, we expect the costs associated with regulatory fee increases to be passed on by providers through increased fees to service users and commissioners of services. This would mean, for example, that local authorities would pay higher amounts and their financial settlements from central Government reflect this.
The Government are committed to a review of the framework for regulatory fees in 2004. This review will include a further public consultation.
Prosthetic Services
Mr. Hancock: To ask the Secretary of State for Health what recent assessment his Department has made of the ability of prosthetic services to meet the needs of users; and if he will make a statement. [128320]
Ms Rosie Winterton: It is for primary care trusts to assess the ability of their prosthetic services to meet the needs of users, as part of their general duty to determine what level of resources to devote to the treatment of different conditions in their localities. Strategic health authorities are responsible for the performance management of primary care trusts.
Linda Perham: To ask the Secretary of State for Health what guidance he gives to hospitals with regard to skin colour matching in the provision of prosthetic limbs. [128274]
Ann Winterton: The National Health Service Purchasing and Supply Agency issues guidance on the availability of products, which enables skin colour
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matching in the provision of prosthetic limbs. It is for local clinicians and service providers to decide what products to use in individual cases.
Mr. Hancock: To ask the Secretary of State for Health what funding has been made available for silicone cosmesis for prosthetics users in each of the last three years; how much was made available to each of the prosthetics centres in each of the last three years; how many patients were treated; what plans he has for the future funding of this service; and if he will make a statement. [128322]
Ms Rosie Winterton: Baseline allocations of £0.5 million in 2001–02, £1.5 million in 2002–03 and £2.0 million in 2003–04 were expected to be used for the provision of silicone cosmesis for artificial limbs. Spending on silicone cosmesis through the National Health Service Purchasing and Supply Agency, which probably represents most if not all spending on silicone cosmesis, was £81,858 for 2001–02, £410,479 for 2002–03, and £137,502 in the first quarter of 2003–04. Information is not held centrally on the sums made available to individual prosthetics centres, nor on numbers of patients treated with silicone cosmesis. In future years primary care trusts will remain free to determine what amounts from their baseline allocations to use for the provision of silicone cosmesis.
Pulmonary Care
Mr. Laurence Robertson: To ask the Secretary of State for Health if he will make a statement on the provision of pulmonary rehabilitation services in Gloucestershire. [129027]
Ms Rosie Winterton [holding answer 11 September 2003]: The National Institute for Clinical Excellence is currently developing a guideline on the management of chronic obstructive pulmonary disease (COPD) in primary and secondary care. It is due to publish the guideline in 2004. In January 2003 the Respiratory Alliance published their guidance, "Bridging the Gap", which aims to help primary care trusts (PCTs) to commission and deliver high quality allergy and respiratory care.
In line with our policy of "Shifting the Balance of Power", it is up to PCTs, in conjunction with strategic health authorities (SHAs) to take this work forward. I have been advised by the Avon, Gloucestershire and Wiltshire SHA that in Gloucestershire patients with COPD have access to support within the primary care setting and also secondary care services within the wider hospital respiratory team. The local PCTs in Gloucestershire are jointly funding a project post to look at ways in which delivery of the current service can be improved, and to consider the development of future initiatives including COPD rehabilitation.
Redundant/Empty Hospital Buildings
Dr. Fox: To ask the Secretary of State for Health what the cost was of maintaining redundant and empty hospital buildings in each region in the last six years. [127335]
Mr. Hutton: Information on the cost of redundant and empty properties held by national health service organisations is not held centrally.
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Until these properties are sold they must be maintained both for health and safety reasons and to ensure the best price is obtained for them. Sales of these properties have generated considerable receipts for re-investment in the NHS in recent years, as shown in the table.
| 2001–02 | 2002–03 | |
|---|---|---|
| Receipts from sales | 160 | 151 |
Stroke Services
Mr. Burstow: To ask the Secretary of State for Health pursuant to his answer of 5 August 2003, Official Report, column 958W, on stroke services, how many and what percentage of hospitals have had a working specialist stroke unit in each (a) region and (b) strategic health authority in each of the last six years for which figures are available. [129122]
Dr. Ladyman: The most comprehensive source of information is the National Sentinel Stroke Audit, carried out by the Royal College of Physicians. The audit was commissioned by the national health service in 1998 and was last updated in 2002. The results can be found at http://www.rcplondon.ac.uk/pubs/strokeaudit 01–02.pdf.
The 2002 audit shows that 73 per cent. of trusts that participated had a stroke unit, compared to 56 per cent. three years earlier. The audit shows that 80 per cent. of trusts that participated have a consultant physician with specialist knowledge of stroke who is formally recognised as having principal responsibility for stroke services. While it is recognised that some services need to increase their capacity, the audit notes that very significant improvements have already been made.
Our major vehicle for further improving standards for stroke services is through the older people's national service framework (NSF), which sets specific milestones for improvement by 2004 of stroke services in primary care trusts, specialist services and general hospitals that care for people suffering from a stroke. Our document, "Improvement, Expansion and Reform", which sets for the NHS a priorities and planning framework for 2003–06, makes clear that implementation of the older people's NSF is a top priority and that the 2004 milestone around specialist stroke services is a key target.
We monitor progress against the key milestones in the NSF. From the information gathered so far, we know that 83 per cent. of the hospitals which have replied now have plans to have a specialist stroke service in place by April 2004.
Tooth Decay
Mr. Hepburn: To ask the Secretary of State for Health what measures the Department is taking to reduce the number of children with tooth decay. [128895]
Ms Rosie Winterton: Due mainly to the introduction of fluoride toothpaste and the fluoridation of water in some areas of the country, there has, over the last 20 years, been
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a major improvement in oral health. Nearly 60 per cent. of 5-years-olds now have no experience of tooth decay. However, significant variations remain which, in areas where drinking water is not fluoridated, are strongly associated with economic and social deprivation. The Government are committed to reducing these inequalities and have made provision in the Water Bill, currently before Parliament, to give communities with
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high levels of tooth decay a real option of having their water fluoridated. We have also established the "Brushing for Life" scheme in areas of poor dental health, whereby families with young children receive free fluoridated toothpaste, toothbrushes and advice on oral hygiene when attending child health developmental checks at aged eight months and 18 months and three years.