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Mr. Lansley: To ask the Secretary of State for Health what systems are in place to monitor compliance with Health Technical Memoranda (HTM), with particular reference to HTM 2022 on medical gas pipeline systems; and whether she expects these monitoring systems to change with the abolition of NHS Estates, as envisaged in the Department's review of arm's length bodies. 
Mr. Byrne: NHS Estates does not monitor compliance to health technical memoranda (HTM), including HTM2022. It is the responsibility of the health care provider to be aware of all best practice guidance and to manage and monitor medical gas pipeline systems in line with their duty of care and governance arrangements.
Mr. Lansley: To ask the Secretary of State for Health what estimate she has made of the number of available beds required in total in the NHS in England to achieve a national average bed occupancy rate of 82 per cent. 
Mr. Byrne: No such assessment has been made. Occupancy levels in national health service facilities vary, depending on the range and type of services they provide, and the way in which the admission and discharge of patients is managed. The Department does not have targets for occupancy levels, which are for the NHS locally to determine.
Mr. Lansley: To ask the Secretary of State for Health what targets for reduction will be attached to the hospital-acquired infections, other than methicillin resistant staphylococcus aureus, which are monitored under the mandatory surveillance schemes for NHS trusts. 
Mr. Lansley: To ask the Secretary of State for Health what assessment she has made of colloidal silver as a treatment for (a) MRSA and (b) other hospital acquired infections; and what research she has commissioned into its use. 
Although colloidal silver has antibacterial properties for treating meticillin resistant staphylococcus aureus (MRSA) and other hospital acquired infections it is not used as an alternative to antibiotics because of its toxicity when taken internally. We are not aware of any relevant studies on its efficacy.
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Caroline Flint: Following the publication in February 2004 of the National Institute for Health and Clinical Excellence's (NICE) clinical guideline on the assessment and treatment for people with fertility problems, we advised all primary care trusts to offer a minimum of one cycle of in vitro fertilization (IVF) by April 2005 to those who meet the clinical criteria, giving priority to couples with no children living with them, and to make progress to full implementation of the guideline in the longer term. The primary responsibility for the implementation of NICE guidelines rests with the national health service at local level and compliance with NICE guidance by NHS organisations will be considered by the Healthcare Commission during their review and performance assessment processes.
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Tim Loughton: To ask the Secretary of State for Health whether patients who have killed staff within the South West London and St. George's Mental Health Trust were classified as extremely disturbed and subject to a recommendation that they should always be approached for treatment by two or more members of staff. 
Jane Kennedy: I refer the hon. Member to the answer I gave on Tuesday 7 July 2005, Official Report, column 587W. There has been one incident where a member of staff at the South West London and St. George's Mental Health Trust was killed by a patient. This case attracted a large amount of media attention and is to be subject to an external independent inquiry. We would not wish to prejudice the findings of this inquiry, which will be made public as soon as is possible. In the meantime, we also have a duty to protect the patient confidentiality of the patient concerned.
To ask the Secretary of State for Health whether the use of electroconvulsive therapy is proportionately more common in the treatment of
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people with mental health problems aged over 65 than in the treatment of people with mental health problems of all ages. 
Ms Rosie Winterton: The latest information available on electro-convulsive therapy (ECT) is that contained in the Department's publication Statistical Bulletin Electro Convulsive Therapy: Survey covering the period from January 2002 to March 2002, England. This was a follow-up to an earlier survey of the period January to March 1999. Both surveys were undertaken to provide data on ECT that are not currently available elsewhere.
The 2002 survey confirmed the continuing downward trend in the number of administrations of ECT. It collected information from national health service and independent sector care settings, including nursing homes, on the total number of administrations of ECT in NHS and independent sector care settings including data on sex, age, ethnicity, legal status and method of consent. It found that in the period January to March 2002:
The prevalence rates for both men and women were lower in 2002 than in 1999. In 2002 2.8 per 100,000 men received treatment compared to 3.8 per 100,000 in 1999; additionally, 6.4 per 100,000 women were treated in the 2002 survey period, compared to 7.7 in 1999.
The incidence of the use of ECT was shown to rise with age in both of the survey periods. Overall, 13.5 per 100,000 population aged 65 and over underwent ECT in 2002; this compares to a prevalence rate of 5.6 in 45 to 64 year olds, 3.6 for 45 to 44 year olds and only 1.2 for 19 to 24 year olds.
In 1999, the statistics show a similar pattern with 15.1 per 100,000 population aged 65 and over undergoing ECT; this dropped to 8.0 per 100,000 in those aged 45 to 64, to 4.6 in those aged 25 to 44 and again to 1.5 in those aged 16 to 24.
Copies of the 2002 (ISBN: 1 84182 709 6) and 1999 (IBSN: 1 84182 089 X) surveys are available in the Library and on the Department's website at: www.dh. gov.uk/PublicationsAndStatistics/Statistics/Statistical WorkAreas/StatisticalHealthCare/StatisticalHealthCa reArticle/fs/en?CONTENT_ID=4086494&chk=QFb R7a.
Mr. Burstow: To ask the Secretary of State for Health what steps she will take to ensure that the public are able to compare investment and commissioning decisions of primary care trusts in developing specialist old age mental health services, in accordance with section 2.2.8 of the report, Better Health in Old Age. 
For the first time this year, the Department will be supporting service mapping of older people's mental health services. This exercise is planned for autumn 2005. It is envisaged that similar data collections will be supported annually. Finance data on older people's mental health services will also be included for the first time in this autumn's national finance mapping of mental health services. The results for older adults will be available to the public on the internet.
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