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Health Services Planning

Mr. Burstow: To ask the Secretary of State for Health when the Government will reassess the priorities and

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planning framework for health and social services; and how future priorities and planning frameworks will take account of the needs of people with disabilities. [138462]

Dr. Ladyman: The Government has introduced a three year planning cycle to allow for greater stability in National Health Service and social care planning. We are aiming to announce the priorities and planning framework for the next three year period, 2005–06 to 2007–08, in autumn 2004. No decisions have yet been made about the contents of this priorities and planning framework.

Kaiser Permanente System

Tim Loughton: To ask the Secretary of State for Health if he will make a statement on the findings of his visit to the Kaiser Permanente healthcare system in the US, with particular reference to the costs of the system. [138834]

Dr. John Reid: During my visit to Washington DC in October, I visited the West End Medical Centre to meet staff and patients and to see at first hand how Kaiser Permanente serves its members. At the medical centre, I learnt about the way in which Kaiser involves patients in their own care, and heard a presentation about the prevention and treatment of diabetes. I was given a tour of the medical centre and talked to staff and patients. The costs of the Kaiser system have been studied by independent researchers whose comparison of the national health service and Kaiser was published in the British Medical Journal last year. Departmental officials are working with Kaiser to explore how we might learn from their approach in the next stages of NHS reform.

Long-term Care

Mr. Terry Davis: To ask the Secretary of State for Health what response he has given to the statement published in October by nine members of the Royal Commission on Long-Term Care. [139298]

Dr. Ladyman: No statement has been made in response to the statement by nine of the members of the Royal Commission on Long-Term Care which reported in 1999. However, we do not believe that making personal care free for everyone is the best use of limited resources. Instead we have significantly increased investment in other aspects of older people's services. We believe that investing in this way will secure greater benefits for older people than could have been achieved by simply providing free personal care.

The recent publication of performance indicators and star ratings for social services for 2002–03 demonstrates that the Government's policy is now having the desired effect with 81,500 people in England now receiving intensive home care to maintain their independence. The proportion of households over the age of 65 receiving intensive home care has risen from 7.9 per 1,000 in 1998–99 to 10.4 per 1,000 in 2002–03 and 57 per cent. of older people in England report that they were either very satisfied or extremely satisfied with the services they received in their own home.

Long-term Conditions

Mr. Burstow: To ask the Secretary of State for Health how the Government will ensure that the National

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Service Framework for Long Term Conditions is given sufficient priority by primary care trusts; and what the reasons were for the decision not to set milestones and targets. [138461]

Dr. Ladyman: Our strategy to support delivery of the NHS Plan is to set a clear national framework of standards backed up by strong inspection regimes and increasingly to give more responsibility to front-line health and social services providers so that local organisations have more flexibility and freedom to plan, resource and deliver services. As a result we set fewer central targets. Progress in policy areas not directly linked to national targets can be monitored and driven forward in a number of ways, for example:

Primary care trusts can set local targets and performance manage progress locally.

The Commission for Health Improvement (to become, subject to legislation, the Commission for Healthcare, Audit and Inspection) and the Social Services Inspectorate (to become, again subject to legislation, the Commission for Social Care Inspection) will take account of nationally set standards including national service frameworks when inspecting hospitals and other providers, and may undertake themed inspections.

Patients' forums will be able to identify where services are not meeting the standards.

Patient feedback, both informal and formal (for example, patient surveys), will provide a local means of identifying shortfalls in services.

Policies like the expert patients programme and the patients choice programme are also giving people an increasing say in local services and their own treatment.

Mental Health

Mr. Hancock: To ask the Secretary of State for Health (1) if he will make it his policy to exempt people with mental health problems from paying prescription charges; [136114]

(2) if he will assess the long-term effects upon NHS finances of providing free prescriptions for people with long-term mental health problems; and if he will make a statement. [136133]

Ms Rosie Winterton: We have no plans to make an assessment of the effects upon national health service finances of providing free prescriptions for people with mental health problems.

Prescription charges are expected to raise some £446 million for the NHS in 2003–04 and are a valuable source of revenue for the NHS.

Our policy is to help those who may have difficulty in paying prescription charges, rather than extending the exemption arrangements. There are extensive exemption, remission and prepayment arrangements which mean that around 85 per cent. of all prescribed items are supplied free of charge. Around 10 per cent. of items are paid for at the point of dispensing with another five per cent. going to holders of prepayment certificates.

Patients who are liable to pay may seek help through the NHS low income scheme or by using a prescription prepayment certificate need to pay more than £32.90 for four months or £90.40 for 12 months, for all the NHS medication that they are prescribed.

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Mr. Burstow: To ask the Secretary of State for Health what assessment his Department has made of whether the prevalence of physical illness amongst mental health service users is higher than amongst the general population. [138352]

Ms Rosie Winterton: The Office for National Statistics survey, "Psychiatric Morbidity Among Adults Living in Private Households", 2000, found that there was a clear relationship between the number of neurotic disorders present and the reporting of a physical complaint.

Just under 38 per cent, of adults with no neurotic disorder reported having a physical complaint while this figure rose to 57 per cent, of those with one neurotic disorder. Among those with two or more neurotic disorders, 67 per cent, reported at least one physical complaint.

The same survey found that people assessed as probably having a psychotic disorder were more likely than those without to report a longstanding physical health problem. Overall, 62 per cent, of those with probable psychosis reported a physical complaint, compared with only 42 per cent, of those without this disorder.

Tim Loughton: To ask the Secretary of State for Health how many mental health care beds in the independent sector have been occupied by NHS patients on average in the last five years, broken down by (a) number of patients and (b) bed days. [138492]

Ms Rosie Winterton: This information is not centrally available. However, individual primary care trusts would be able to provide details of the beds they have commissioned from the independent sector upon request.

Arrangements are being made for National Health Service use of the independent sector to be included in centrally returned data via hospital episodes statistics. In time, this will capture all activity sub-contracted by NHS trusts or commissioned by the NHS. Early estimates have been made in respect of general and acute activity only.

MRI Scans

Gregory Barker: To ask the Secretary of State for Health how many people in (a) East Sussex and (b) England are waiting for MRI scans; and what the longest time is that a patient has had to wait for an MRI appointment. [137081]

Mr. Hutton: Specific data on waiting times for diagnostic tests are not collected centrally. The central returns capture consultant speciality level data on waits for a first out-patient appointment and for in-patient admissions.

However, it is the Government's priority to ensure that all patients are seen quickly in the first instance so that if diagnostic tests are required they are requested sooner. Where this is not the case, we are determined to speed up the process. The national health service is committed to reducing the length of time that people wait before their treatment starts and the NHS Plan set targets for staged reductions in waiting times.

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Gregory Barker: To ask the Secretary of State for Health if he will make a statement on his plans to provide additional MRI scanning capacity in East Sussex. [137082]

Ms Rosie Winterton: Brighton and Sussex University Hospitals National Health Service Trust and Royal Surrey County Hospital NHS Trust have been identified as priorities for an additional magnetic resonance imaging scanner from central funding. Both scanners will be delivered by December 2004.

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