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20 Nov 2003 : Column 1388W—continued

Junior Doctors

Mr. Norman: To ask the Secretary of State for Health how many junior doctors have been working longer than (a) 72 hours, (b) 56 hours and (c) 48 hours per week in the last month for which figures are available. [137765]

Mr. Hutton: Data currently collected on junior doctors' hours does not allow detailed analysis against the levels requested and simply indicates whether or not posts comply with the New Deal weekly limit of 56 hours a week. Initial figures from monitoring carried out in September 2003, suggest that 95 per cent. of junior doctors are working under 56 hours.

Kaiser Permanente

Tim Loughton: To ask the Secretary of State for Health what Kaiser Permanente facilities he visited on his recent trip to the US; whom he met; and what officials accompanied him. [138496]

Dr. John Reid: I visited a Kaiser Permanente facility in central Washington DC and met leading staff, including:

Marilyn J Kawamura—(president, Kaiser Foundation Health Plan of the Mid-Atlantic States)


Stanley J Kramer MD DABP FAAP—(area medical director, DC and Suburban Maryland Mid-Atlantic Permanente Medical Group)


Susan McDonagh MS RD CDE—(director, Regional Diabetes Program Mid-Atlantic Permanente Medical Group)


Robert M Crane—(senior vice president, Research and Health Policy Mid-Atlantic Permanente Medical Group)


Lyda Karm MD—(primary care centre lead, West End Medical Centre Mid-Atlantic Permanente Medical Group)

I was accompanied by a number of Departmental officials.

Living Wills

Tony Lloyd: To ask the Secretary of State for Health what advice his Department gives to (a) hospital trusts and (b) primary care trusts about the validity of living wills. [139721]

Ms Rosie Winterton: Health professionals cannot be required by living wills, or advance directives, to provide particular treatments, since they may not be appropriate. However, advance refusal of treatment may be valid. Guidance on the validity of advance refusals is included in the Department of Health's "Reference Guide to Consent for Examination or Treatment" published in March 2001. The reference guide is available at www.doh.gov.uk/consent.

20 Nov 2003 : Column 1389W

Locums

Mr. Jim Cunningham: To ask the Secretary of State for Health what the average cost per year in the NHS was of employing a locum for (a) heart disease care and (b) medical emergencies in the last year for which figures are available. [137149]

Mr. Hutton [holding answer 11 November 2003]: This information is not held centrally.

Mr. Geoffrey Robinson: To ask the Secretary of State for Health whether NHS trusts are able to pay unlimited amounts for replacement locums for suspended consultants. [137374]

Mr. Hutton [holding answer 12 November 2003]: National Health Service bodies are encouraged to use only commercial agencies listed in the National Medical Locum Agency Framework Agreement for the recruitment of locums. This is a list approved by the Department, with agreed quality standards and costs to help obtain value for money. Information on the amounts paid by trusts and the reasons for locums being employed are not held centrally.

National Service Framework for Long Term Conditions

Mr. Hancock: To ask the Secretary of State for Health how many (a) consultant neurologists, (b) physiotherapists and (c) speech and language therapists he estimates are needed to implement the National Service Framework for Long Term Conditions from 2005; how many of each group are in post; what action he is taking to make up any shortfall; and if he will make a statement. [140114]

Dr. Ladyman: The national service framework (NSF) for long term conditions will focus on improving the standard of neurology services across England. It will also address some of the generic issues that are important to people with non-neurological disabilities, such as access to rehabilitation services; provision of good quality information; support for carers; and, access to community equipment, assistive technology and wheelchairs.

We recognise the important role that doctors, allied health professionals and other professionals play in providing appropriate services and support for people with long term conditions, their families and carers. We are increasing the numbers of these professionals as part of the NHS Plan commitment to increase the national health service work force.

As at 30 June 2003, there were 407 consultants in neurology, representing an increase of 33 per cent. since September 1999. We are working towards increasing their numbers further and in 2003–04 have provided central funding to support implementation of a further 10 specialist registrar posts in neurology. Trusts will also have the opportunity to create up to an additional 20 locally funded specialist registrar training opportunities.

We are also increasing the numbers of speech and language therapists and physiotherapists entering training each year. There are now 140 more (an increase

20 Nov 2003 : Column 1390W

of 31 per cent.) training places for speech and language therapy and 811 more (an increase of 60 per cent.) for physiotherapy.

Additionally, as part of the process of developing the NSF work is in hand to consider relevant work force issues such as the need for increased numbers of staff but also for new ways of working, including skill mix, role extensions and multi-disciplinary working, based around patient needs. We expect that the group looking at these workforce issues will make recommendations on the future supply of professionals and development of new ways of working to inform national workforce planning processes.

Maintenance Costs

Simon Hughes: To ask the Secretary of State for Health what the backlog maintenance cost to reach estate code condition was in each English region for (a) NHS trusts and (b) mental health trusts in the last six years. [137367]

Mr. Hutton [holding answer 10 November 2003]: The backlog of maintenance should be seen in the context of a National Health Service estate in England comprising 25 million square metres, with a book value of £24 billion and a replacement cost of around £72 billion. Current record investment of £4 billion in 2003–04, rising to over £6 billion in 2005–06, will regenerate the NHS estate and reduce maintenance because by 2040, 40 per cent. of the estate will be less than 15 years old.

The information requested is shown in the tables.

Backlog maintenance covers a wide variety of conditions, including that which is just below compliance standard. The figures provided do not indicate levels of risk to patients. Trusts manage high-risk deficiencies as a priority in order to ensure that premises are intrinsically safe and not of concern to local enforcement bodies.

Expenditure to reach Estate code Condition B£000

Region	All Trusts	Mental Health Trusts	All Trusts	Mental Health Trusts
Northern and Yorkshire	419,592	3,400	462,610	3,400
Trent	228,870	3,956	275,801	3,887
Anglia and Oxford	282,095	11,322	295,617	7,065
North Thames	631,576	2,790	627,669	2,418
South Thames	357,978	12,182	410,080	11,559
South West	254,959	729	200,737	652
West Midlands	369,410	6,407	421,888	4,480
North West	291,981	4,246	332,659	610

Note:

Data was collected on a regional basis until 1998–99. Thereafter, the data is provided by current strategic health authority.

20 Nov 2003 : Column 1391W

Expenditure to reach Estate code Condition B£

	1999–2000		2000–01		2001–02		2002–03
SHA	All Trusts	Mental Health Trust	All Trusts	Mental Health Trusts	All Trusts	Mental Health Trusts	All Trusts	Mental Health Trusts
Avon, Gloucestershire & Wiltshire	110,148	20,558	144,430	20,772	156,320	24,268	210,485	23,103
Bedfordshire and Hertfordshire	92,888	0	74,700	0	88,374	0	93,713	0
Birmingham and the Black Country	236,566	3,120	242,567	443	238,409	4,461	273,457	5,122
Cheshire & Merseyside	80,836	1,195	114,202	0	120,527	2,108	162,227	7,752
County Durham & Tees Valley	59,899	4,710	71,981	3,710	64,771	2,257	63,400	3,088
Coventry, Warwickshire, Herefordshire & Worcestershire	111,800	0	105,578	0	113,326	0	103,936	0
Cumbria & Lancashire	95,932	0	98,182	0	86,668	3,017	97,037	8,274
Dorset & Somerset	20,414	322	81,912	299	46,922	198	47,232	683
Essex	56,188	198	33,601	206	73,059	1,347	82,418	6,790
Greater Manchester	177,741	410	196,548	409	182,568	1,891	208,612	4,175
Hampshire and Isle of Wight	51,265	0	71,469	1,043	83,466	1,399	95,647	841
Kent and Medway	90,041	0	63,484	0	48,165	0	132,217	0
Leicestershire, Northamptonshire & Rutland	103,171	0	87,493	0	131,741	0	123,329	0
Norfolk, Suffolk & Cambridge	95,045	7,643	97,920	5,753	77,670	4,941	107,464	7,506
North & East Yorkshire & North Lincolnshire	87,377	0	96,167	0	79,208	0	74,712	0
North Central London	142,825	235	148,664	1,532	160,339	1,912	184,037	8,673
North East London	205,857	0	154,846	0	198,147	12,320	183,518	12,417
North West London	180,295	4,501	169,449	893	208,508	11,256	206,462	19,603
Northumberland, Tyne and Wear	79,375	3,400	85,350	3,400	69,900	12,560	81,097	11,865
Shropshire and Staffordshire	86,735	510	110,165	1,031	107,248	0	109,047	0
South East London	206,604	9,807	231,143	16,191	211,815	1 9,043	183,153	30,629
South West London	76,653	2,318	58,718	2,183	72,550	5,890	173,254	74,725
South West Peninsula	34,592	0	54,172	0	45,322	0	41,214	0
South Yorkshire	47,926	0	45,539	0	60,685	0	71,016	0
Surrey and Sussex	97,256	0	139,703	0	150,917	0	110,686	1,889
Thames Valley	157,007	5,886	107,789	5,291	137,491	7,105	169,529	3,277
Trent	132,619	5,178	141,509	4,018	138,988	7,732	157,253	4,755
West Yorkshire	191,170	0	214,594	0	225,153	0	263,354	14,416

Notes:

1. The figure provided for All Trusts include those given for Mental Health Trusts.

2. Owing to changes in structure at all levels in the NHS during the period of the question, direct comparison at regional level between years is not always possible even for organisations with the same name.

3. The figures provided for Mental Health Trusts derive only from those designated by the Department of Health as being exclusively Mental Health and exclude any trusts where Mental Health services only form part of the Trust's defined functions.

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