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Dental Devices (Outsourcing)

Mr. Frank Field: To ask the Secretary of State for Health what plans his Department has to outsource custom-made dental devices to (a) Turkey, (b) Hungary, (c) China and (d) the Philippines. [133244]

Ms Rosie Winterton: Custom-made dental appliances are manufactured to the written prescription of the dentist responsible for the case in question. The choice of manufacturing laboratory is a matter for local decision. All dental laboratories in the European Union are registered with the competent authority, which in the United Kingdom is the Medicines and Healthcare products Regulatory Agency.

Manufacturers of custom made appliances from outside the European Union are required to designate an authorised representative within the European Union, who must register with the competent authority where they have their registered place of business. The manufacturer must meet the relevant requirements of the Medical Devices Directive (93/42/EEC) and must meet the same standards as devices manufactured within the European Union.

Diabetes

Mr. Sanders: To ask the Secretary of State for Health (1) what assessment he has made of Standard Three of the National Standards Framework for Diabetes; and if he will make a statement; [R] [135375]

(2) how his Department assists primary care trusts to meet Standard Three of the National Standard Framework for Diabetes; and if he will make a statement. [R] [135376]

Ms Rosie Winterton: "The New NHS and A First Class Service" introduced a range of measures to raise quality and decrease variations in service including national service frameworks (NSFs).

The NHS Plan re-emphasised the role of NSFs as drivers in delivering the modernisation agenda. NSFs are one element of the overall programme of modernisation. They are designed to help us to improve health and social well-being by:

providing services to more people, more quickly and to a higher standard;


improving the patient experience;


reducing variations in care across the country;


increasing compliance with evidence-based practice.

NSFs have challenging aims (the vision) for a particular service or care group. Ways to achieve those aims are described in a number of standards, focused as far as possible on the needs of patients and good outcomes, underpinned by:

the rationale and a clear statement of the evidence base;


good practice: key interventions and service models which have worked in practice (linked, wherever possible, to Social Care Institute for Excellence (SCIE) work and the National Institute for Clinical Excellence (NICE) guidelines and appraisals);


performance indicators to measure local and national progress.

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Standard 3 of the diabetes national service framework is about patient empowerment. All people with diabetes will receive a service that encourages partnership in decision-making and supports them in managing their diabetes.

This is reflected in the "Planning and Priorities Framework for the NHS 2003–06", which includes targets for the diabetes NSF. One such target states the need for primary care trusts to update practice-based registers for people with diabetes by March 2006. This will help to ensure that they receive systematic treatment regimens and advice to help support them in managing their own condition.

The above gives clinicians and other professionals, managers and service users the information and guidance they need to drive forward improvements locally . NSFs will be implemented and monitored in the same way as departmental policy generally, allowing maximum scope for local flexibility. The implementation/monitoring regime will differ from NSF to NSF. Essential elements include:

implementation guides covering, as appropriate, national actions to support local delivery through a number of underpinning programmes, such as workforce development and research and development;


national and local champions who will drive forward delivery of the standards with clinical colleagues and others;


national and local performance indicators to help strategic health authorities, primary care trusts and local councils to benchmark progress;


the Commission for Health Improvement using national standards to inspect and evaluate services;


empowered patients and users using standards to feedback on local services;


patients forums and other similar consultative groups identifying where services could be improved;


the Modernisation Agency, NICE, SCIE and the Improvement and Development Agency to promulgate, spread and support best practice.

Dysphasia

Mrs. Calton: To ask the Secretary of State for Health which primary care trusts support a dysphasia service; and which of these have received external funding. [132784]

Mr. Hutton: Most, if not all, primary care trusts will either directly provide or will commission services for people suffering from dysphasia. Such services may not necessarily be separately identified as dysphasia services but may form part of the service provided by speech and language therapy departments. Information is not available in sufficient detail centrally to show whether particular dysphasia services have received external funding.

Epidermolysis Bullosa

Virginia Bottomley: To ask the Secretary of State for Health what provision he is making for people suffering from epidermolysis bullosa; if he will meet representatives from the Dystrophic Epidermolysis Bullosa Research Agency; and if he will make a statement about epidermolysis bullosa. [136105]

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Dr. Ladyman: Patients with this condition are able to access the normal range of national health service services.

I will certainly consider any request to meet representatives of the Dystrophic Epidermolysis Bullosa Research Agency.

Essex Ambulance Service

Mr. Francois: To ask the Secretary of State for Health how many full-time ambulance paramedics were employed by the Essex Ambulance Service on 1 September 2003. [132635]

Ms Rosie Winterton: Published figures are not yet available for September 2003. As at 30 September 2002, there were 210 full-time ambulance paramedics employed by the Essex Ambulance Service National Health Service Trust. In addition, a further 23 were employed on a part-time basis, giving a total whole-time equivalent of 220.

Source:

Department of Health Non-Medical Workforce Census.

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General Practitioners

Mr. Nigel Jones: To ask the Secretary of State for Health if he will estimate the additional cost to the NHS of providing out of hours treatment following acceptance of the new GPs' contract. [134244]

Mr. Hutton: This is a matter for local decision and depending on how services are reconfigured. We are making available an extra £138 million from 2003–04 to 2005–06 to support these changes. These resources are in addition to the average of £6,000 released by each general practitioner who opts out of his/her responsibility for out-of-hours services.

Mr. Burstow: To ask the Secretary of State for Health what percentage of (a) adults, (b) children and (c) the total population are registered with a general practitioner in (i) England, (ii) each region and (iii) each strategic health authority. [133725]

Mr. Hutton: At 30 September 2002 (the latest published data), 51,522,391 people were recorded as registered with a general practitioner or provider of personal medical services. The table provides details by strategic health authority (SHA). It is not possible to express these figures accurately as a percentage of total population as the phenomenon of "list inflation" means that registered populations are typically larger than actual populations. This phenomenon arises where a patient moves his or her registration and for a transitional period may be registered on two lists. Similarly, an individual who dies or moves abroad may remain on a list for a time.

Patients England of Unrestricted Principals and Equivalents (UPEs)⁽⁹⁾ by strategic health authority in as at 30 September 2002Number (headcount)

SHA code	SHA name	All patients	Under 16	16 and over
Q01	Norfolk, Suffolk and Cambridgeshire	2,177,943	402,226	1,775,717
Q02	Bedford and Hertfordshire	1,690,454	342,940	1,347,514
Q03	Essex	1,646,695	320,293	1,326,402
Q04	North West London	2,040,719	351,554	1,689,165
Q05	North Central London	1,394,454	249,041	1,145,413
Q06	North East London	1,647,642	352,690	1,294,952
Q07	South East London	1,629,989	311,813	1,318,176
Q08	South West London	1,409,652	256,397	1,153,255
Q09	Northumberland, Tyne and Wear	1,428,122	262,895	1,165,227
Q10	County Durham and Tees Valley	1,166,109	226,726	939,383
Q11	North and East Yorkshire and Northern Lincolnshire	1,671,717	315,685	1,356,032
Q12	West Yorkshire	2,175,033	435,650	1,739,383
Q13	Cumbria and Lancashire	1,943,598	375,381	1,568,217
Q14	Greater Manchester	2,662,307	538,021	2,124,286
Q15	Cheshire and Merseyside	2,440,943	472,683	1,968,260
Q16	Thames Valley	2,284,737	448,969	1,835,768
Q17	Hampshire and Isle of Wight	1,790,410	340,689	1,449,721
Q18	Kent and Medway	1,608,226	322,293	1,285,933
Q19	Surrey and Sussex	2,650,943	481,421	2,169,522
Q20	Avon, Gloucestershire and Wiltshire	2,227,736	423,386	1,804,350
Q21	South West Peninsula	1,610,145	286,706	1,323,439
Q22	Somerset and Dorset	1,181,982	211,154	970,828
Q23	South Yorkshire	1,348,408	261,130	1,087,278
Q24	Trent	2,621,590	495,018	2,126,572
Q25	Leicestershire, Northamptonshire and Rutland	1,568,323	311,591	1,256,732
Q26	Shropshire and Staffordshire	1,494,796	286,852	1,207,944
Q27	Birmingham and the Black Country	2,436,973	505,083	1,931,890
Q28	Coventry, Warwickshire, Herefordshire and Worcs	1,572,745	298,861	1,273,884
	England total	51,522,391	9,887,148	41,635,243

⁽⁹⁾ UPEs include CMS unrestricted principals, PMS Salaried and PMS Contracted GPs.

Source:

Department of Health General and Personal Medical Services Statistics.

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