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Written Ministerial Statements
Wednesday 12 May 2004
INTERNATIONAL DEVELOPMENT
Higher Education Links Programme
The Secretary of State for International Development (Hilary Benn): Having reviewed the higher education links programme, I have decided to continue with a redesigned programme, maintaining current levels of annual investment (£3 million) but with some modifications to the existing scheme (which will end in March 2006). I expect the new scheme to commence in April 2005, with commitments being made over the following seven years (until March 2012).
The review report identified a number of strengths of the current scheme, but there were also some areas for improvement. The redesigned programme will tackle these issues.
The overall goal of the redesigned programme will be the reduction of poverty, the promotion of sustainable development in poor countries; and the building of human capital and skills. Only countries where DFID has bilateral country programmes will be eligible for funding; there will therefore be more emphasis on sub-Saharan Africa and low-income countries.
The revised programme should also support south-south links and links between southern partners and non-UK partners in the North, and it will also give more attention to science and technology. An independent evaluation will take place after five years.
DFID's Parliamentary Under-Secretary of State has written to Professor Robert Boucher, vice-chancellor of the University of Sheffield and Chair of the existing Higher Education Links Steering Committee, setting out the features of the new scheme. His letter is on DFID's website. Copies have been placed in the Library of the House.
HOME DEPARTMENT
Controls on Firearms
The Parliamentary Under-Secretary of State for the Home Department (Caroline Flint): The Home Office consultation paper on firearms controls is published today. Copies have been placed in the House Library. The paper invites a wide-ranging debate on the principles that should underpin firearms licensing and how the existing system might be improved. People will have until 31 August to respond.
United Kingdom Immigration Control
The Minister for Citizenship and Immigration (Mr. Desmond Browne):
The Government are firmly committed to maintaining effective immigration
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controls while at the same time ensuring that genuine passengers are able to pass through our ports with the least possible inconvenience.
The number of people arriving at UK airports who are found to be inadmissible is unacceptably high. Certain nationals, who are required to hold a valid visa to enter the UK, may transit this country for up to 24 hours without a visa. This provides a relatively easy and inexpensive way for those who are intent on circumventing our immigration controls to do so. Last year we introduced measures to tackle this problem with the introduction of a direct airside transit visa (DATV) requirement for 23 nationalities. For the three months following the introduction on 16 October of DATV regimes for Angola, Bangladesh, Cameroon, India, Lebanon and Pakistan, the number of asylum applications made at ports by those nationalities fell by 58 per cent. DATV requirements have been shown to work and we now need to take further action to strengthen the regime. Intelligence would suggest that some individuals travelling on Kenyan and Tanzanian documents to the United Kingdom are destroying these documents either en route or after gaining entry to the UK, and are then applying for asylum as Somalian nationals. Therefore from 00.01 hours on Thursday 13 May all nationals of Kenya and Tanzania wishing to transit the UK will require a visa to do so.
To avoid undue hardship for those who had already made their travel plans, we have agreed to operate a grace period. Until 23.59 hours on Wednesday 19 May, any transit passenger who bought their ticket on or before 12 May will not be refused entry solely on the basis of not holding a valid transit visa. Also, any person on the return leg of a journey they commenced before 13 May and who passed through the UK on the outward leg of their journey will be allowed to transit the UK without a visa until 23.59 on 9 June.
In parallel with those measures, we are introducing changes to the arrangements that allow certain groups of low risk passenger to be exempt from a transit visa requirement if they are in possession of specific documents. The exemption applying to those holding a valid visa for the United States of America or Canada has been widened to enable visa-free transit of the United Kingdom irrespective of the routing chosen to reach the USA or Canada. Similarly, a passenger returning from a trip to the USA or Canada will be able to transit the United Kingdom irrespective of the routing they choose providing they are in possession of an onward air ticket and they are not seeking to transit the UK more than six months since they last entered the USA or Canada with a valid visa.
We have also decided to introduce an exemption for holders of diplomatic or official passports issued by the Vietnamese Government, who will be exempt from the requirement to hold a visa when transiting the UK for up to 24 hours.
HEALTH
Cardiac Arrhythmias and Sudden Cardiac Death
The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson):
The national service framework for coronary heart disease, published in
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March 2000, heralded a new era for the development of fast and modern services for the prevention and treatment of heart disease.
With significant progress now secured for patients with coronary artery disease, the national health service is now well placed to deliver similar improvements for patients with arrhythmia and with syndromes that can lead to sudden cardiac death.
Dr. Roger Boyle, the national director for heart disease, is today launching a consultation paper on a new national service framework chapter for these conditions. The views received will be considered by a new expert group that is being established by the Department of Health to take forward the task of writing the new national service framework chapter.
The Government have already shown their determination to tackle coronary heart disease through the publication of the national service framework. The prospect of a new the national service framework chapter setting out the standards and models of care for patients with arrhythmia marks a major step forwards for cardiac patients in England.
Copies of "New NSF Chapter on Arrhythmias and Sudden Cardiac Death: A Consultation Paper", have been placed in the Library.
New NSF Chapter on Arrhythmias and Sudden Cardiac Death
The national service framework for coronary heart disease, published in March 2000, heralded a new era for the development of fast and modern services for the prevention and treatment of heart disease. Four years on from its publication, the combination of a clear set of national standards, sustained levels of investment and reform and redesign of services has delivered real improvements for patients. Primary care has made extraordinary progress in ensuring that patients with heart disease are on the right combination of drugs to lengthen their lives. Waiting times for bypass surgery and angioplasty have fallen dramatically. Patients with a heart attack are treated quickly with life-saving clot busting drugs.
With significant progress now secured for patients with coronary artery disease, the NHS is now well placed to deliver similar improvements for patients with arrhythmia and with syndromes that can lead to sudden cardiac death. These patients have already benefited from the substantial growth in NHS staff, equipment and facilities. The Government have now agreed to drive further progress for these patients by working with patients, families and NHS professionals to develop new NSF standards or practice recommendations for these conditions.
The strength of the existing NSF has been that it is based on the views of clinicians, patients and their families. Its aims and approaches have credibility with those who deliver it and those who benefit from it. The aim of this consultation paper is to invite initial comments from everyone with an interest in these issues to ensure that we can build a similar consensus for this new NSF chapter.
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The views received will be considered by a new expert group that is being established by the Department of Health to take forward the task of writing the new NSF chapter. Detailed membership of the group will be published shortly, but it will include patients, relatives of patients, patient organisations, professional bodies, experts in the field, health service managers and other Government Departments with an interest. The group will be chaired by Dr. Roger Boyle, national clinical director for heart disease, and is aiming to produce the new chapter within twelve months.
The attached paper sets out the proposed scope of the work and how we propose to take the work forward. In addition to your comments on this way forward, we would welcome specific views on:
Whether the scope covers all the aspects of these conditions which the new NSF chapter should cover;
Examples of existing good practice in the management of these conditions that might inform the work of the expert group;
Views on the obstacles to progress on developing state of the art services for these patients, and suggestions on how these might be overcome;
Areas where further research is needed to improve understanding of these conditions;
Views on what the immediate, medium term and long term priorities should be for these services; and
How best to ensure that the patient, family and carer perspective is at the forefront of policy and service development.
Details of how to respond to this consultation are included at the end of this document.
The group will be composed of external stakeholders similar to the expert external reference groups who helped create the national service framework for coronary heart disease with voluntary and professional organisations being invited to take part. Patients, cardiologists, GPs, nurses and members of voluntary and professional organisations (including CRY, the Ashley Jolly SAD Trust, Hearty Voices, the British Cardiac Society and the British Pacing and Electrophysiology Group) will be asked to join. Representatives from Wales, Scotland and Northern Ireland will also be invited.
We will be holding a stakeholders' event during the consultation period to raise awareness of the new group and invite wider consultation and participation. This will help to ensure that the key issues are covered and that the outcomes address the needs of all the interested parties. If you would be interested in attending this event, please e-mail your name and contact details to Jennifer.francis@doh.gsi.gov.uk
We propose four key workstreams for the expert group to manage its work, sudden cardiac death and screening; acute care; cardiac interventions; and patient involvement and support.
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Sudden Cardiac Death and Screening
It is estimated that 200–400 young people die from sudden cardiac death syndrome each year. Dari Taylor MP's recent Private Members Bill highlighted a number of important issues that the new NSF chapter will need to address. These include:
Raising awareness of signs and symptoms of conditions that may lead to sudden cardiac death;
Support for those who have lost relatives or friends;
Considering the feasibility of guidelines on how these deaths are certified;
Setting standards or practice recommendations around how suspected cases are treated in primary care;
Promoting models of good practice for local use; and
Design of an evidence-based protocol that clarifies when it is recommended that patients and/or their relatives should ideally be invited for screening.
For many patients the first sign of their cardiac condition is an emergency admission to hospital. Those who know they have the condition but whose care is not well managed may also need urgent treatment. Arrhythmia is consistently in the top 10 reasons for hospital admission, using up significant A&E time and bed days. This workstream will cover:
Design of a care pathway showing the ideal treatment of those who require emergency care for these conditions;
Outlining what information patients require when in hospital to help them successfully manage their condition after discharge;
Considering the feasibility of setting or practice recommendations around readmission rates for those with conditions which could be better managed; and
Development of a set of audit indicators and suitable performance indicators that might be used locally around emergency care for those with arrhythmias and conditions which may lead to sudden cardiac death.
Since publication of the NSF there have been significant improvements in both the technology and the clinical capacity to intervene to treat arrhythmias and related conditions, giving more options for this group of patients in terms of both diagnosis and treatment. New emerging technologies such as the implantable cardioverter defibrillator (ICD) or more sophisticated pacing devices, with good medical evidence for their use, has given the cardiologist many more treatment options in 2004 compared to the 1990s. This workstream will cover:
Design of a care pathway for the diagnosis, management and treatment of arrhythmias and conditions which may lead to sudden cardiac death (considering cardiomyopathies, atrial fibrillation and electrical conduction disorders);
Identification of models which deliver the appropriate interventions reliably; and
Development of audit measures and suitable performance indicators around the care and treatment of people with these conditions, which might be used locally.
Patient Involvement and Support
Patients with a lifelong or long term cardiac problem need continuing support to help them manage their condition and live as full a life as possible. Assistance also needs to be available for carers and family members
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where they wish it. Patients need to be involved in decisions about their own care and in helping to shape the planning of services. This workstream will include:
Design of care pathway for management and control of specific conditions (for example, atrial fibrillation);
Development of guidance on monitoring patients with chronic conditions;
Identifying effective ways of providing emotional support to patients and their relatives where appropriate; and
Identifying effective means of involving patients in their own care and in influencing the way that services are provided.
Ideas and proposals should reach the project team by 4 August 2004 at the latest.
The Department of Health would welcome contributions throughout the consultation. Emerging issues and contributions will be fed into the discussions of the expert group and used to develop the proposed new NSF chapter on arrhythmias and sudden cardiac death.
The information you send to us may need to be passed to colleagues within the Department of Health and/or published in a summary of responses to this consultation. We will assume that you are content for us to do this and, if you are replying by e-mail, that your consent overrides any confidentiality disclaimer that is generated by your organisation's IT system, unless you specifically include a request to the contrary in the main text of your submission to us.
Website: www.dh.gov.uk/consultations
Code of Practice on Consultation
We will ensure that this consultation meets the following criteria:
Consult widely throughout the process, allowing a minimum of twelve weeks for written consultation at least once during the development of the policy.
Be clear about what your proposals are, who may be affected, what questions are being asked and the timescale for responses.
Ensure that your consultation is clear, concise and widely accessible.
Give feedback regarding the responses received and how the consultation process influenced the policy.
Monitor your department's effectiveness at consultation, including through the use of a designated consultation coordinator.
Ensure your consultation follows better regulation best practice, including carrying out a regulatory impact assessment if appropriate.
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