---

18 Nov 2003 : Column 870W—continued

Performance Targets

Mr. Burstow: To ask the Secretary of State for Health pursuant to his Answer to the honourable Member for Truro and St Austell of 6th February 2003, Official Report, column 450W, on performance targets, how his Department will measure progress towards achieving the public service agreement target on value for money. [138199]

Mr. Hutton: The value for money Public Service Agreement (PSA) target requires that 'Value for money in the National Health Service and personal social services will improve by at least 2 per cent. per annum, with annual improvements of 1 per cent, in both cost efficiency and service effectiveness'.

For the NHS, the cost efficiency element of the PSA target will be measured by comparing data from the National Schedule of Reference Costs between one year and the previous year. Adjustments to this simple comparison will be made to take account of changes in casemix, quality investment, input price inflation and externally driven, one-off, cost-increasing events such as rising employer pensions contributions.

The quality element of the target will be assessed by comparing the estimated expenditure on increasing service effectiveness with data on quality from the NHS performance ratings exercise. A key element of this will be the value that can be placed on the lives saved from reducing mortality following health care interventions.

For personal social services, costs will be based on unit costs of services, after some adjustments to allow for increases in funding for quality improvements. The quality element will be based on the quality indicators published by the Department, in the social services performance assessment framework, for instance, waiting times for care packages.

Personal Care

Mr. Patrick Hall: To ask the Secretary of State for Health what plans he has to reassess the means test limit for personal care costs. [138928]

18 Nov 2003 : Column 871W

Dr. Ladyman: All individuals receiving residential care services are assessed as to their ability to pay for the cost of personal care and for their board and lodging. The capital limits used in the means test are subject to an annual review. Any revisions would be implemented from April 2004. Care from a registered nurse is free to individuals in all settings regardless of their financial position following an assessment of their care needs.

Pressure Ulcers

Mr. Burstow: To ask the Secretary of State for Health if he will estimate the number of pressure ulcers occurring in the NHS in (a) England and (b) each strategic health authority, in each of the last six years; if he will estimate the cost of pressure ulcers to the NHS in these years; and if he will make a statement. [138178]

Dr. Ladyman: This information is not held centrally. We are taking steps to improve services for patients with pressure ulcers.

A pressure ulcer risk assessment and prevention guideline was published by the National Institute for Clinical Excellence (NICE) in April 2001. An updated version of the guideline was published on 22 October 2003. The guideline outlines best practice for health professionals caring for individuals who are vulnerable to or at risk of developing pressure ulcers.

A wound care package of guidelines is also currently being developed by NICE, which will include a guideline on pressure ulcer treatment.

As part of the guideline development process, NICE estimated that the cost of treating pressure ulcers may be as high as £750 million a year.

Psychiatric Hospitals

Mrs. Brooke: To ask the Secretary of State for Health how many (a) in-patients and (b) in-patient beds there are in psychiatric hospitals in England and Wales; how many individuals serving prison sentences have been diagnosed with severe mental health problems; and if he will make a statement. [138450]

Ms Rosie Winterton: There were 178,065 admissions to National Health Service inpatient facilities under mental illness specialties in 2001–02, the latest year for which figures are available. The data has not been grossed for coverage and therefore has a provisional status.

Information about the number of beds in psychiatric hospitals in England is not available. However, the average daily number of mental illness beds for England in 2002–03 was 32,753. Questions about Wales are now matters for the devolved administration.

We cannot say precisely how many sentenced prisoners have been diagnosed with severe mental health problems. Based on data from a survey of mental ill-health in the prison population of England and Wales, undertaken in 1997 by the Office for National Statistics, the NHS Plan (2000) stated that at any time some 5,000 people with a serious mental illness will be in prison.

18 Nov 2003 : Column 872W

Smallpox Vaccine

Chris Grayling: To ask the Secretary of State for Health how many NHS staff were given smallpox vaccine in 2002–03; and how many suffered ill-effects as a result of the immunisations. [135758]

Mr. Hutton: As of 4 November 2003, the number of health care workers who have been vaccinated in England stood at 262. Of this total, 128 are doctors, 116 are nurses, 15 are scientists and three are from other areas.

Information on suspected vaccine-associated adverse events experienced as part of the current vaccination programme have been collected by the Health Protection Agency and the Medicines and Healthcare Products Regulatory Agency. The type of adverse reactions noted after smallpox vaccinations so far were mostly non-serious; the majority were expected reactions to successful vaccination with smallpox vaccine or are known to occur after any vaccination. These included reactions at the site of injection, fever, feeling unwell and swollen glands. Two vacinees were hospitalised, one with suspected encephalitis and one with severe local cellulitis. A further four people developed cellulitis at the injection site. Two vacinees reported shortness of breath. One vacinee retrospectively reported having experienced retrospective symptoms of suspected mycocarditis though no confirmation tests were carried out. Adverse experience occurring after vaccination does not necessarily mean that the vaccine caused the problem. Other factors, such as an underlying illness present before vaccination, must be considered as possible alternative causes.

Social Services

Mr. Burstow: To ask the Secretary of State for Health pursuant to his answer of 6 October 2003, Official Report, column 1351W, on social services, how the figure published in paragraph 2.79 of the Chief Inspector of Social Services Annual Report was derived. [134068]

Dr. Ladyman [holding answer 27 October 2003]: The Department is working towards achieving a guideline figure of 5 per cent. vacancy rates across the social care work force. The figures published in paragraph 2.76 are based upon current data published in the Social Services Workforce Survey 2002, gathered by the Employers Organisation on behalf of the Department.

The figure of 50,000 whole-time equivalent (wte) people to join the work force is derived from an estimated 20,000 wte people coming into the system to staff service development and an additional 30,000 wte identified from SR2002 funding, estimated to be sufficient to bring vacancy rates down to the 5 per cent. guideline.

The figures about the number of care trusts were extracted from the delivery and improvement statements which are those self reported to Social Services Inspectorate by all councils in May 2002. Each council was asked to report on progress with care trust planning.

We can confirm that the actual number of children's trusts is 35. The number previously reported in the published Chief Inspector's report of 34 was an error.

18 Nov 2003 : Column 873W

Strokes

Mr. Burstow: To ask the Secretary of State for Health if he will list the average waiting time of those waiting for a scan after a suspected stroke; and if he will make a statement on waiting times for these scans. [138181]

Dr. Ladyman: This information is not collected centrally. The target in this area is to achieve a computed tomography or magnetic resonance imaging scan in less than 48 hours. The summary report of the 2001–02 National Sentinel Stroke Audit reported that more patients than ever had brain imaging, with at least 83 per cent. meeting that target.

Mr. Burstow: To ask the Secretary of State for Health if he will publish the research his Department has commissioned on the cost of (a) treating and (b) caring for patients who have had a stroke. [138182]

Dr. Ladyman: The Department has not commissioned any recent research on the cost of treating and caring for patients who have had a stroke.

Valuing People

Tim Loughton: To ask the Secretary of State for Health what measures within Valuing People are aimed at children; and what plans he has to expand its remit. [138495]

Dr. Ladyman: Our proposals 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. Valuing People had a chapter on disabled children which set out Government objectives and proposals for maximising opportunities for disabled children and supporting young people's transition into adulthood. In particular, it set out how we would develop an integrated approach to supporting disabled children. In Making Change Happen (HC 514), our 2003 annual report to Parliament on learning disability, we highlighted the progress we had made towards the achievement of the objectives.

The Green Paper, Every Child Matters gave further commitments to improving services for disabled children and their families, particularly through: the development of the children's national service framework, which will set new national standards across the National Health Service, social services and interface with education for children; the development of the children trusts pathfinders, a significant number of which will focus on disabled children and their families; and the forthcoming special educational needs action programme.

---