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30 Oct 2003 : Column 354W—continued
HEALTH
Ambulance Services
David Davis: To ask the Secretary of State for Health what estimate he has made of the number of deaths where the lateness of an ambulance was a factor in each year since 1997. [134665]
Ms Rosie Winterton [holding answer 27 October 2003]: This information requested is not collected centrally.
The latest information about ambulance performance is contained in the Department of Health Statistical Bulletin "Ambulance Services, England 2002–03".
Copies of the bulletin have been placed in the Library and are also available at www.doh.gov.uk/public/sb0313.htm
Ashford (Middlesex) Hospital
Mr. Wilshire: To ask the Secretary of State for Health pursuant to his answer of 14 October 2003, Official Report, column 212W, on Ashford (Middlesex) Hospital, if he will estimate how many of the 8,555 patients would have been treated over the five year period covered by the contract with Mercury Health Ltd. if the private sector treatment centre did not exist. [134057]
Mr. Hutton [holding answer 23 October 2003]: The treatment centre at Ashford plans to provide 8,555 procedures over the five years of the contract. Of this, it is estimated that 2,775 procedures are additional and 5,780 procedures will be transferred from the national health service to the new treatment centre. This transfer of patients to the new treatment centre will allow the trust to treat more patients and reduce waiting times in accident and emergency at St. Peter's Hospital (Surrey) by freeing up capacity in the hospital.
In addition, treatment centres are dedicated surgery units that are able to offer patients scheduled procedures at pre-booked times, protected from the pressures of emergency and seasonal demands.
Atkins Diet
Chris Grayling: To ask the Secretary of State for Health what guidance he is giving to hospital trusts regarding patients' requests to follow the Atkins diet while in hospital. [133933]
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Mr. Hutton: Decisions relating to specific dietary needs for patients are made by hospital dieticians in consultation with the patient and, where appropriate, nursing and medical staff.
Government advice on nutrition is that people should eat a healthy, balanced diet. They have no plans to issue any guidance relating to the provision of the Atkin's diet in hospitals.
Clinical Trials Directive
Mr. Laurence Robertson: To ask the Secretary of State for Health on what items the EU Clinical Trials Directive will require trials to be carried out; and if he will make a statement. [135002]
Ms Rosie Winterton [holding answer 28 October 2003]: The European Directive on the conduct of clinical trials was adopted in February 2001. The main aim of the Directive is to simplify and harmonise procedures across the Community while ensuring the protection of trial subjects and providing a safe environment for the development of new medicines. Member states are required to implement fully the Directive by 1 May 2004.
The scope of the Directive is wide and the UK Regulations will apply to all clinical trials on medicinal products for human use conducted in the UK, including academic and healthy volunteer studies, with the exception of non-interventional trials.
The former Health Minister my noble Friend the Lord Hunt of Kings Heath invited the Medical Research Council (MRC) and the Academy of Medical Sciences to co-ordinate a report on the impact of the Directive on academic studies. The impact assessment, prepared by the MRC with the active support of others including Cancer Research UK, the National Co-ordinating Centre for Health Technology Assessment and a number of academic experts formed the basis for a response to the Medicines and Healthcare products Regulatory Agency (MHRA) consultation on the draft regulations to implement the Directive into UK law earlier this year.
In responding to concerns, and to provide an environment in which patients are protected but high quality research is not inhibited, the Government have taken steps to attempt to influence the Commission in its consideration of a Commission Directive on Good Clinical Practice (GCP) and also in reviewing guidance that the Commission published earlier this year.
In another initiative, the Department and the MRC have announced a joint project to work with experts to find practical solutions to the issues identified in the impact assessment. Details of the project can be found on www.ncchta.org/eudirective/index.asp.
With our careful exploration of the impact on publicly funded research and organisations that support it and delays in the Commission finalising the GCP Directive and other guidance, the United Kingdom's implementing regulations are not expected to be made until early in 2004.
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Further information on the scope of the Directive and the proposed UK implementing regulations is available on the MHRA's website www.mhra.gov.uk on the Clinical Trials Directive pages.
Epsom and St Helier Hospitals
Chris Grayling: To ask the Secretary of State for Health pursuant to the answer of 14 October 2003, Official Report, column 217W, on Epsom and St. Helier hospitals, which minister has responsibility for the South West London Strategic Health Authority. [135278]
Mr. Hutton: I have regional responsibility for London which includes, the South West London Strategic Health Authority.
Foundation Hospitals
Mr. Gordon Prentice: To ask the Secretary of State for Health from whom the Government received the original idea of foundation hospitals; and if he will make a statement. [134607]
Mr. Hutton: The development of national health service foundation trusts came out of the system of earned autonomy which was developed in conjunction with three-star NHS trusts who were asked to identify the barriers staff and management face and to list the freedoms that would allow staff to deliver improvements to patients more quickly.
General Practitioners
Chris Grayling: To ask the Secretary of State for Health how many full-time equivalent practice-based general practitioners there have been in London in each of the past five years. [133723]
Mr. Hutton: The number of full-time equivalent practice-based general practitioners in London in the last five years is shown in the table.
| All GPs (excluding GP retainers)(15) | |
|---|---|
| September 1997 | 4,225 |
| September 1998 | 4,212 |
| September 1999 | 4,198 |
| September 2000 | 4,217 |
| September 2001 | 4,212 |
| September 2002 | 4,288 |
| June 2003 | 4,399 |
(15) Practitioners (excluding GP Retainers) include GMS Unrestricted Principals, PMS Contracted GPs, PMS Salaried GPs, Restricted Principals, Assistants, GP Registrars, Salaried Doctors (Para 52 SFA) and PMS Other.
Whole-time equivalents are estimated based on results from the 1992–93 GMP Workload Survey
Full time = wte, Half time = 0.6 wte, Job share = 0.65 wte and three-quarter time = 0.69 wte. 1997 to 1999 data is as at 1 October each year.
Source:
Department of Health General & Personal Medical Services Statistics.
Chris Grayling: To ask the Secretary of State for Health how many registered general practitioners will be involved in out-of-hours services in London after the implementation of the GP contract; and how many were involved under the old arrangements. [133735]
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Mr. Hutton: Under the current national general medical services (GMS) contract, all general practitioners are responsible for the care of their registered patients for 24 hours each day of the week. Regulations now allow GPs to transfer this responsibility during the out-of-hours period to accredited providers or to delegate it to other GPs. Under the new GMS contract, which is to be introduced from April 2004, GPs will be able to opt out completely from responsibility for care during the out-of-hours period. Primary care trusts are currently working with their local GPs to establish how many intend to exercise this option.
Integrated Care
Chris Grayling: To ask the Secretary of State for Health when he expects to publish the interoperability standards for the new integrated care record services. [133920]
Mr. Hutton: The interoperability standards for the integrated care records service (JCRS) are part of an evolutionary process that began publicly with the output based specification (OBS), available at www. doh.gov.uk/ipu/programme/index.htm.
The OBS requires conformance to various standards, for example, Health Language 7 (HL7) Version 3 for interoperability and SNOMED for clinical terminology. In addition, specific interchange standards, for example, those required to enable an out-patient appointment to be booked electronically, are being developed in conjunction with HL7 (www.hl7.org.uk) and the United Kingdom information technology trade representative body, Intellect (www.intellectuk.org).
JCRS is also taking account of the interoperability standards published in the electronic Government interoperability framework (www.egif.gov.uk) by the Office of the e-Envoy.
Chris Grayling: To ask the Secretary of State for Health what the results have been of the Gateway reviews of the NHS Integrated Care System. [134282]
Mr. Hutton: New and large-scale procurement projects in central Government are subject to gateway reviews. The process examines a project at critical stages to provide assurance that it can progress successfully to the next stage. The review provides project teams with advice and guidance from fellow practitioners and in order to maintain the integrity of the advice, this is held to be completely confidential by both parties. The gateway review process is not an audit.
Recommendations are made to the senior responsible officer on good practice in key areas such as programme management, risk management and involving key stakeholders. The national programme is implementing any recommendations which arise from each stage in the gateway review.
The national information technology programme is fully committed to external reviews being undertaken on a timely basis.
Chris Grayling: To ask the Secretary of State for Health what estimate he has made of the cost of maintenance of the Integrated Care Records database in (a) 2003–04 and (b) 2004–05. [134283]
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Mr. Hutton: The integrated care records service (ICRS) is one element of the National Programme for Information Technology in the national health service. Central funding for the National Programme for IT in the NHS is to be made available from the Spending Review 2002 as follows—£370 million in 2003–04, £730 million in 2004–05 and £1.2 billion in 2005–06.
The costs for the ICRS are being calculated as part of the on-going procurement and financial management processes within the Spending Review 2002 envelope.
Maintenance costs are subject to current procurement negotiations.
Chris Grayling: To ask the Secretary of State for Health what estimate he has made of the cost of establishing the database for Integrated Care Records System; and how long he expects the inputting of the records to take. [134284]
Mr. Hutton: The integrated care records service (ICRS) is one element of the national programme for information technology in the national health service. Central funding for the national programme for IT in the NHS is to be made available from the Spending Review 2002 as follows—£370 million in 2003–04, £730 million in 2004–05 and £1.2 billion in 2005–06.
The costs for the ICRS are being calculated as part of the on-going procurement and financial management processes within the SR 02 envelope.
Exact costs are subject to current procurement negotiations. Due to commercial confidentiality and sensitivity, it would not be in the public interest to reveal the details of the negotiations and the potential costs.
The content of the ICRS databases will be generated initially from information already held within NHS systems. This process will be undertaken by local service providers as part of the initial implementation phase during 2004.
The ICRS is not about entering historical data but about improving the capture, use and quality of current data and future support to patient care.
Chris Grayling: To ask the Secretary of State for Health if he will place in the Library the definition of the requirements for potential vendors of the NHS Integrated Care System. [134285]
Mr. Hutton: The initial output based specification for the integrated care record service was published in May 2003 and a revised and updated version providing refinements to the specification was published in August 2003.
These had been previously issued to short-listed suppliers to enable them to submit proposals in the national information technology programme procurement process and made available on the Department's website at www.doh.gov.uk/ipu/programme/index.htm.
Copies of both documents will be placed in the Library, but it must be noted that this document is a dynamic set of requirements and specifications that is subject to on-going review and updating.
30 Oct 2003 : Column 359W
Chris Grayling: To ask the Secretary of State for Health whether patients will be required to contribute to the cost of creating their electronic patient records on the NHS Integrated Care System. [134286]
Mr. Hutton: Patients will not be required to contribute towards the costs of their records on the integrated care records service.
Chris Grayling: To ask the Secretary of State for Health what discussions he had with outside bodies (a) in the UK and (b) abroad about the introduction of an integrated care records system. [134357]
Mr. Hutton: Discussions have taken place with numerous stakeholders across Government Departments and the national health service through Royal Colleges, the NHS Confederation and other professional and representative bodies.
The recent meetings of the national clinical advisory board and the patient advisory board are major steps to improving the direct engagement and involvement of key clinical stakeholders and patient and carer representatives.
The national clinical advisory board is chaired by Professor Peter Hutton, Chairman of the Academy of Medical Royal Colleges. It consists of representatives from some 30 branches of the health service, including general practices, consultants, nurses, dentists, health visitors, midwives and pharmacists. It will meet every three months but will carry out work in between in sub-committees, providing the national programme with structured input from health care professionals.
The public advisory board is chaired by Marlene Winfield OBE, Head of Public Engagement for the national programme for information technology. The membership is made up of individuals drawn from groups such as the Patients Association, the Long-term Medical Conditions Alliance, Help the Aged, Mencap, Islington Health and Race Forum, Carers UK, the National Consumer Council and the Consumer's Association. It will initially meet every two months and will help to give detailed and structured input into the national programme.
Discussions are on-going with the health departments of Wales, Scotland and Northern Ireland. Finally we have held discussions with other jurisdictions including but not limited to the United States of America and several European countries.
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