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23 Feb 2004 : Column 300Wcontinued
Decisions on whether or not an individual patient should be referred to the Spinal Foundation is a matter for the clinician involved in the patient's care and is not something the Department would become involved in centrally.
Miss Melanie Johnson: Almost all group D streptococcal infections in humans are associated with enterococci or 'Streptococcus bovis group'. Data received by the Health Protection Agency Communicable Disease Surveillance Centre under a voluntary reporting system are shown in table 1.
|Number of reports of enterococci isolated from blood stream||Number of reports of 'Streptococcus bovis group' isolated from blood stream|
Health Protection Agency website: http://www.hpa.org.uk/infections/topics az/bacteraemia/gram pos.htm
|Finished consultant episodes|
1. A finished consultant episode (FCE) is defined as a period of admitted patient care under one consultant within one health care provider. Please note that the figures do not represent the number of patients, as a person may have more than one episode of care within the year. These figures represent a count of all FCEs where the diagnosis was mentioned in any of the 14 (7 prior to 200203) diagnosis fields in a HES record. A record is only included once in each count, even if a diagnosis is mentioned in more than one diagnosis field of the record.
Hospital Episode Statistics (HES), Department of Health
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Dr. Ladyman: Information on national health service spending on the treatment and rehabilitation of stroke is not collected centrally. Primary care trusts (PCTs) receive unified allocations to cover the costs of hospital and community health services, discretionary funding for general practice staff, premises and computers and primary care prescribing.
The level of funding made available for the drugs, staffing and other costs of providing stroke services are determined locally. It is for PCTs, in partnership with local stakeholders, to determine how best to use their funds to provide health services for their populations, including those with stroke.
Management of much of the research supported by NHS research and development funding is devolved and expenditure at project level is not held centrally by the Department. The main agency through which the government supports medical and clinical research is the Medical Research Council (MRC). The MRC is an independent body that receives its grant-in-aid from the Office of Science and Technology. The MRC spent an estimated £4.9 million on stroke research in 200203.
Mr. Havard: To ask the Secretary of State for Health what precautions are in force to protect people from the risk of transmission of transmissible spongiform encephalopathies through surgical instruments. 
Miss Melanie Johnson: Advice from the Spongiform Encephalopathies advisory committee indicates that good decontamination is key in reducing the risk of person to person transmission of variant Creutzfeldt-Jakob Disease (vCJD) through surgical instruments.
A circular (HSC 2000/032) was issued to the national health service on 18 October 2000, emphasising the importance of effective decontamination in preventing the spread of vCJD. In addition, the Department has surveyed the effectiveness of decontamination services and taken action to ensure all NHS hospitals in England had access to decontamination services of an acceptable standard by December 2001.
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Most medicines have only been tested for safe and effective use in the adult population and there are comparatively few medicines on the market that are specifically licensed for the treatment of children. This leads to prescribers having no option but to prescribe unlicensed and off-label medications in this patient population.
Normally, if a product has not been licensed for use in children because of a lack of clinical trial data and/or clinical experience, the summary of product characteristics contains statements to this effect and use in children is not recommended. However, further restrictions (contraindications) have been introduced with respect to the off-label or unlicensed use of specific medicinal products where there is evidence that the benefit/risk may be unfavourable.
The real solution to this problem lies not in restricting paediatric prescribing but in stimulating the development and testing of appropriately formulated medicines for use in the paediatric population. It is expected that the European Commission will adopt a proposal for a Regulation on medicines for paediatric use by the end of April 2004. It will contain a number of incentives and obligations to stimulate the development of medicines for children. In the mean time officials have been asked to develop a UK strategy to deliver, in the short and medium term, improved availability of medicines that are appropriately labelled and appropriately formulated for use in children.
Mr. Norman: To ask the Secretary of State for Health which of the European Working Time Directive pilot sites have a full complement of (a) senior specialist nurses and (b) nurse practitioners to cover doctors in training. 
Mr. Hutton: The Working Time Directive (WTD) pilot sites are managed by the Modernisation Agency (MA) as part of the wider work on WTD implementation. I understand from the MA that it is not possible to say what constitutes a full complement of these nurses, as each trust and service will have specific needs to be determined locally.
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Mr. Pond: Between 43 per cent. and 46 per cent. of pensioners in Great Britain were either in receipt of, or were entitled to but not receiving, council tax benefit in financial year 199798. Approximately 48 per cent. of pensioners are estimated to be entitled to council tax benefit in 200304.
Mr. Prosser: To ask the Secretary of State for Work and Pensions what plans he has to introduce assessed income periods for pensioners claiming council tax benefit; and what estimate he has made of the cost of this change. 
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Mr. Pond: The assessed income period (AIP) applies in pension credit. It is a period, normally five years, during which pensioners aged 65 or more will not need to report to the Pension Service changes to the money they have set aside for their retirement.
There are no plans to introduce similar arrangements for council tax benefit and therefore no estimate of cost has been made. However, the requirement for pensioners to complete annual reviews in housing and council tax benefit claims was removed in October 2003, and will be abolished for all other housing and council tax benefit recipients from April 2004.
Mr. Pond: We have already introduced a streamlined housing benefit/council tax benefit claim form for pensioners (HCTB1(PC)), and are currently considering the introduction of a council tax benefit claim form designed specifically for use by pensioners who do not require housing benefit.
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