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21 Jul 2005 : Column 2148W—continued

Care Homes

Mr. Burstow: To ask the Secretary of State for Health what steps her Department is taking to act on the recommendations of the recent Office of Fair Trading report into the care home sector. [13540]

Mr. Byrne: The Office of Fair Trading published a report on care homes for older people on 18 May 2005. The report made a number of recommendations to the Government, which the Government are currently considering.

Children's Hospices

Mr. Hancock: To ask the Secretary of State for Health (1) how much her Department has spent on (a) children's hospices and (b) children's palliative care in each of the last five years (i) in real terms and (ii) as a percentage of the overall NHS budget; [11265]

(2) if she will increase the core funding to children's hospice services from her Department. [11721]

21 Jul 2005 : Column 2149W

Mr. Byrne: The Department does not collect information on the funding of children's hospices and palliative care services for children.

Primary care trusts (PCTs) have received substantial increases in their baseline funding and there is no ceiling to the amount of funding which they can provide for children's palliative care. Children's hospice services are funded from a number of sources, including services commissioned by PCTs based on their assessment of children's needs and their priorities. They are best placed to make decisions on the local needs for palliative care and are able to take into account the needs of individual families and preferences.

In our ongoing dialogue with representatives of children's hospices, the Department continues to encourage them to engage actively with local national health service bodies over the contribution that hospices can make to the overall pattern of palliative care they commission for children and young people in their localities.

In our manifesto, we said we would increase the choice for patients with cancer and double the investment going into palliative care services, giving more people the choice to be treated at home.

Children's Oral Hygiene

Mr. Bone: To ask the Secretary of State for Health what plans she has to improve children's oral hygiene; and if she will make a statement. [11292]

Ms Rosie Winterton: At a population level, the fluoridation of water supplies offers the most potential for reducing dental disease in children. By reforming the relevant legislation we have given strategic health authorities a realistic option of fluoridating their water, provided they can show they have the support of the local population. In addition, advice on oral health promotion is given in schools and we have piloted the Brushing for Life" Scheme in areas with the highest levels of tooth decay including all Sure Start areas which do not receive fluoridated water. The scheme provides for health visitors to give packs containing a toothbrush, a tube of fluoridated toothpaste and a leaflet on oral hygiene to the parents and carers of young children when they attend child health clinics for development checks at eight months, 18 months and three years and above.

Clostridium Difficile

Ian Lucas: To ask the Secretary of State for Health when the terms of reference for the Healthcare Commission investigation into Clostridium difficile at Stoke Mandeville hospital, Buckinghamshire hospitals NHS trust, will be made available. [14013]

Jane Kennedy: The Healthcare Commission has today published the Terms of Reference.

Connecting for Health Smartcards

Mr. Bacon: To ask the Secretary of State for Health which primary care trusts have issued Connecting for Health smartcards with the same PIN number for every user. [13341]

21 Jul 2005 : Column 2150W

Mr. Byrne [holding answer 20 July 2005]: A number of smartcards issued during May 2005 by staff acting on behalf of NHS Connecting for Health, in connection with the national programme for information technology, to general practitioners within the Castle Point and Rochford, and the Southend primary care trust (PCT) areas. Though serious in itself, this breach of procedures has not posed a significant risk to the confidentiality of patient information.

An internal audit inquiry into the circumstances and details of this lapse in security arrangements has been commissioned by the Essex strategic health authority.

Local procedures have been further tightened to require ensuring smartcard end users change the passcode immediately on receipt of their card, and confirm in writing that this has been done. These will be regularly audited to ensure compliance. NHS Connecting for Health have also initiated a national confidence check' of smartcard registration procedures across all strategic health authorities, re-emphasising the very great importance which is attached to strict adherence to these.

Continuing Care

Mr. Gibb: To ask the Secretary of State for Health if she will make a statement on her intention to produce a national approach to continuing care as set out in her Department's press notice of 9 December 2004. [13392]

Mr. Byrne: The Department is currently working closely with selected stakeholders to produce a national framework for the assessment of continuing care, due for publication in early 2006. This should result in national eligibility criteria and suitable assessment methodologies for access to national health service continuing care. I have received a number of representations about the development of a national framework, all of which will be taken into account in its development. In accordance with Cabinet Office guidelines, we will consult on the official guidance and any legislation required later this year. I expect to make a formal response to the Health Committee report on national health service continuing care before the summer recess.

Details of the review's progress were presented to the House in a written ministerial statement by my hon. Friend the Member for South Thanet (Dr. Ladyman) on 16 September 2004, Official Report, columns 175–77WS.

Counterfeit Medicines

Dr. Murrison: To ask the Secretary of State for Health what assessment she has made of (a) the extent of counterfeiting of medicines in England and (b) the impact of parallel trading on the counterfeiting of medicines. [13326]

Jane Kennedy: Two counterfeit products were discovered in the legitimate United Kingdom supply chain in August 2004. This was the first time in 10 years that counterfeit products are known to have reached the legitimate UK supply chain. Over 600 million prescriptions are written annually in the UK. Therefore
21 Jul 2005 : Column 2151W
these two discoveries of counterfeit medicines in the small numbers that reached the legitimate UK supply chain, prior to recall, needs to be viewed in that context.

There is no evidence to suggest that licensed parallel trade provides any more of an opportunity to introduce counterfeit medicines into the country over non-parallel traded products. In both of the recent UK counterfeit medicine cases of August 2004, parallel trade does not appear to be involved.

Data Collection

Mr. Kevan Jones: To ask the Secretary of State for Health pursuant to the answer of 12 July 2005, Official Report, column 985W, who is carrying out work on data collection. [13159]

Mr. Byrne [holding answer 18 July 2005]: The Department is supplied annually with data from providers of national health service services.


Mr. Burstow: To ask the Secretary of State for Health what percentage of people were registered with an NHS dentist in each primary care trust in London at the end of (a) March 1997, (b) March 2001 and (c) March 2005; what percentage of each population this represented in each year; how much was allocated to improve access to NHS dentistry in (i) 2004–05, (ii)2005–06, (iii) 2006–07 and (iv) 2007–08 in (A) total and (B) per 1000 head of population; how many additional NHS dental patient registrations she expects these resources to provide in (1) 2004–05, (2) 2005–06, (3) 2006–07 and (4) 2007–08; how many additional whole-time equivalent dentists are expected to become registered in (w) 2004–05, (x) 2005–06, (y) 2006–07 and (z) 2007–08; and how many NHS dentists there were at 31 December (aa) 1997, (bb) 2001 and (cc) 2004. [8013]

Ms Rosie Winterton: The main tables show the percentages of people registered with a national health service dentist in each primary care trust (PCT) in London as at 31 March for the years 2001 and 2005. Data are not available for 1997, as PCTs did not exist then.
21 Jul 2005 : Column 2152W

In 2004–05, the Department allocated a total of £50 million to strategic health authorities (SHAs) to improve access, choice and quality in NHS dentistry. The allocations to the five London SHAs are as follows:
SHAAllocation (£)
North Central London1,374,000
North East London1,853,000
North West London1,919,000
South East London1,664,000
South West London1,233,000

London SHAs also received resources as a result of the successful personal dental service (PDS) applications in 2004–05 and 2005–06. Allocations for 2006–07 and 2007–08 have not been made.

The criteria for distribution from the centre to the SHAs was based on weighted capitation, reflecting population and deprivation. From then, on it is up to individual SHAs to decide how to distribute these funds at a local level.

General dental service (GDS) patient registration is not the currency used to measure additional expenditure on NHS services.

In 2004–05, it was expected that SHAs would use their share of the £50 million resources to expand local services, by the end of October 2005, by the whole-time equivalent of:
SHAWhole-time equivalent
North Central London10
North East London13
North West London13
South East London12
South West London13

No whole-time equivalent target has been set for 2005–06, 2006–07, 2007–08 and no targets or resources have been set for these years.

The main table also shows the number of dentists by London SHA as at 31 December in the years 1997, 2001 and 2004.
Percentage of people registered with a NHS dentist in each PCT in London as at 31 March each year

North West London SHA485452534144534143
Brent Teachingn/an/an/a574649564648
Hammersmith and Fulhamn/an/an/a463436494142
Kensington and Chelsean/an/an/a272122241819
North Central London SHA465150514042523941
Haringey Teachingn/an/an/a604850624952
North East London SHA404947453739453639
Barking and Dagenhamn/an/an/a413536423536
City and Hackney Teachingn/an/an/a283130262928
Tower Hamletsn/an/an/a312828282526
Waltham Forestn/an/an/a543942523842
South East London SHA484848634449644549
Greenwich Teachingn/an/an/a613844624146
South West London SHA544849561528553439
Richmond and Twickenhamn/an/an/a602835542127
Sutton and Mertonn/an/an/a513740564043

n/a=Population data not available.
(52)2003 estimated population figures.
1.The number of registrations are based on a snapshot of the Dental Practice Board's registration database taken at the end of March each year and subsequent retrospective notifications of changes to registrations have not been included.
2.An active registration is a patient registered with a dentist at the end of March each year.
3.Some double counting may occur in the totals when a patient has been newly registered with a dentist in one PCT, but not yet de-registered from a dentist in another PCT. These considerations contribute to some of the month-to-month fluctuations at PCT level.
4.Most PDS schemes that have registrations have a re-registration period in excess of 15 months, so the figures for PDS schemes are generally higher than they would have been for the same attendance pattern under GDS.
5.Some PDS schemes do not have any registrations, e.g. dental access centres and will not therefore be included in these figures.
6.A dentist with a GDS or PDS contract may provide as little or as much NHS treatment as he or she chooses or has agreed with the PCT.
7.The Dental Practice Board has no information concerning the amount of time dedicated to NHS work by individual dentists.
8.The patients' registrations have been allocated to areas according to the postcode of the dentist's surgery.
9.The areas have been defined using practice postcodes within the current boundaries.
10.There are a small number of unallocated registrations.

21 Jul 2005 : Column 2153W

Number of NHS dentists with GDS and PDS in London as at 31 December

North West London SHA1,0251,0761,086
5K5Brent Teaching161166176
5H1Hammersmith and Fulham133162153
5LAKensington and Chelsea868692
North Central London SHA637722734
5C9Haringey Teaching129129137
North East London SHA529601664
5C3City and Hackney Teaching1008789
5C4Tower Hamlets657197
5C4Tower Hamlets657197
5NCWaltham Forest8190106
South East London SHA626666713
5A8Greenwich Teaching95103116
South West London SHA636699714
5M6Richmond and Twickenham96107116
5M7Sutton and Merton166193204

1.The figures are based on the numbers of dentists with open GDS or PDS contracts.
2.The dentists include principals, assistants and trainees.
3.Prison contracts have not been included in this analysis.
4.The figures provide a snapshot of the number of individual dentists with an open contract at 31 December.
5.A dentist with a GDS or PDS contract may provide as little or as much NHS treatment as he or she chooses or has agreed with the PCT.
6.The Dental Practice Board has no information concerning the amount of time dedicated to NHS work by individual dentists.
7.The figures provide an accurate figure taking into account any notifications received up to 31 January 2005.
8.The figures given by PCT and SHA include all dentists practising in that area.
9.Some dentists may have an open GDS or PDS contract in more than one PCT or SHA and therefore they will appear in the figures for each PCT in which they practise.

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21 Jul 2005 : Column 2155W

Steve Webb: To ask the Secretary of State for Health what the local distance standards for access to NHS dentistry are for each primary care trust; and what (a) maximum and (b) average distance patients in England are expected to travel to receive NHS dental care under locally agreed standards. [8086]

Ms Rosie Winterton: The information requested has been placed in the Library.

Steve Webb: To ask the Secretary of State for Health how many calls to NHS Direct about access to an NHS
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dentist there were in (a) England and (b) each strategic health authority in each month since November 2001, broken down by (i) emergency, (ii) urgent, (iii) routine and (iv) other calls. [8089]

Ms Rosie Winterton: Calls to NHS Direct about access to a national health service dentist in each month since November 2001 by emergency, urgent, routine and other are shown in the table. The information relates to England only. Similar information for each strategic health authority area is not routinely collected.

TotalEmergencyUrgentRoutineNot known
November 200110,9221,1432,5426,546691
December 200110,0231,4563,2744,482811
January 200213,0641,6053,0787,1241,257
February 200210,3161,0732,9025,535806
March 200213,3361,0613,8496,7421,684
April 200215,4721,6664,2418,3221,243
May 200215,6931,5064,2878,3611,539
June 200214,7261,5514,5987,1451,432
July 200216,0321,5394,1648,8271,502
August 200215,7971,5844,6468,3031,264
September 200214,8621,3873,8868,2291,360
October 200215,9121,4093,4579,6711,375
November 200215,7701,4563,3819,5051,428
December 200214,6291,7294,3087,1491,443
January 200317,8601,6143,64810,9521,646
February 200313,5761,2203,0757,9681,313
March 200315,3251,4163,4079,0931,409
April 200315,8631,3993,5109,4461,508
May 200316,2571,4713,9779,3071,502
June 200317,4041,5633,82310,4851,533
July 200319,0121,5814,19210,7232,516
August 200318,0161,8064,20110,4711,538
September 200319,4721,7084,11711,3502,297
October 200319,8291,5293,73310,9053,662
January 200419,7021,4623,61312,7261,901
February 200418,2581,5753,65311,3121,718
March 200419,3301,3923,50312,5061,929
April 200416,3831,3952,68010,5591,749
May 200416,2021,7623,9498,7011,790
October 200423,8502,6494,43114,4262,344
November 200423,1172,1584,05914,0352,865
December 200419,5502,6034,60210,2062,139
January 200520,4402,0203,21512,7342,471
February 200517,2241,6192,34211,5841,679
March 200517,5471,7252,73911,3181,765
April 200519,7531,8452,89012,8442,174

1.Routine includes calls requesting routine information only about where to find a dentist and calls requesting routine dental health advice and information about where to find a dentist.
2.Data for November and December 2003 and June to September 2004 is not available.

Lynne Featherstone: To ask the Secretary of State for Health how many dentists in Greater London have live personal dentist service contracts; how many dentists in Greater London have applied for personal dentist service contracts; and if she will make a statement. [8692]

Ms Rosie Winterton: As of 31 May 2005, there are 119 personal dental service (PDS) contracts operating in Greater London. As of 30 June 2005, there are 221 applications for PDS contracts which had been made to the Department.

Mr. Lansley: To ask the Secretary of State for Healthhow many graduates in dentistry qualified in (a) 2003–04 and (b) 2004–05. [9286]

Ms Rosie Winterton: In England 578 dental students graduated in 2003–04. The provisional figure for 2004–05 is 588.

Steve Webb: To ask the Secretary of State for Health how many dentists there are in (a) England and (b) each strategic health authority (i) in total and (ii)who are recorded on NHS.UK as accepting new NHS patients. [9374]

Ms Rosie Winterton: Information on the number of dentists in the United Kingdom, by strategic health authority (SHA) is shown in the table.
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Information about dentists taking on new national health service patients is not centrally collected. However, some information about dental practices within primary care trusts (PCTs) currently taking on new NHS patients can be found on the NHS website at aspx

Not all dentists who are accepting new patients indicate this on NHS.UK. However PCTs and NHS Direct are able to provide this information to local people.
General dental service (GDS) and personal dental service (PDS), number of dentists in England by SHA area as at 31 March 2005

Avon, Gloucestershire and Wiltshire SHAQ20993
Bedfordshire and Hertfordshire SHAQ02841
Birmingham and The Black Country SHAQ27880
Cheshire and Merseyside SHAQ151,020
County Durham and Tees Valley SHAQ10411
Cumbria and Lancashire SHAQ13746
Dorset and Somerset SHAQ22521
Essex SHAQ03628
Greater Manchester SHAQ141,032
Hampshire and Isle of Wight SHAQ17771
Kent and Medway SHAQ18644
Leicestershire, Northamptonshire and Rutland SHAQ25535
Norfolk, Suffolk and Cambridgeshire SHAQ01883
North and East Yorkshire and Northern Lincolnshire
North Central London SHAQ05743
North East London SHAQ06679
North West London SHAQ041,101
Northumberland, Tyne and Wear SHAQ09567
Shropshire and Staffordshire SHAQ26571
South East London SHAQ07708
South West London SHAQ08717
South West Peninsula SHAQ21738
South Yorkshire SHAQ23500
Surrey and Sussex SHAQ191,388
Thames Valley SHAQ161,107
Trent SHAQ24948
West Midlands South SHAQ28683
West Yorkshire SHAQ12800

1.The figures given by SHA include all dentists practicing in that area. Some dentists may have an open GDS or PDS contract in more than one SHA and therefore have been counted more than once. Therefore the England figure is not a sum of SHA totals.
2.Prison contracts have been excluded.
3.The areas have been defined using practice postcodes within the specified areas.
Dental Practice Board.

Steve Webb: To ask the Secretary of State for Healthwhich primary care trusts do not comply with (a) clinical and (b) distance standards for providing full access to NHS dentistry. [9375]

Ms Rosie Winterton: Primary care trusts (PCTs) are responsible for setting local distance standards for access to dentistry, and for monitoring these standards. Information on each PCTs performance against its own local standards is not collected centrally.
21 Jul 2005 : Column 2158W

There are currently no clinical standards for national health service dentistry that PCTs are monitored against.

Sandra Gidley: To ask the Secretary of State for Health what guidelines have been provided to NHS dentists regarding the cost of dentures. [10076]

Ms Rosie Winterton: The statement of dental remuneration issued under the NHS General Dental Services regulations 1992 provides for the following payments shown in the table.

Type of denture

Synthetic resin
Chrome cobalt or stainless steel
Dentists fee158.10279.60
Patient charge(53)126.48222.88
Total received by dentist284.58502.48

(53)Where the patient is exempt from dental charges the dentists receives the full amount from national health service funds.

Mr. Laws: To ask the Secretary of State for Health what proportion of children (a) under the age of five years and (b) under the age of 10 years have experienced (i) tooth decay and (ii) one or more fillings in each year since 1985–86; and if she will make a statement. [12087]

Ms Rosie Winterton [holding answer 18 July 2005]: The available information, which is shown in the following tables, compares the results of the decennial child dental health surveys carried out in 1983, 1993 and 2003 and shows a very encouraging improvement in the oral health of children.
Table 1: Proportion of children with obvious decay experience in primary teeth by age (United Kingdom, 1983, 1993, 2003)
Percentage of children

Tooth conditionFiveEight
Decay into dentine
Filled (otherwise sound)
Obvious decay experience
Filled teeth as a percentage of obvious decay experience

(54)Criteria used for 2003 survey: d3cv mft (decayed, missing, or filled teeth) includes visual caries.
(55)Criteria used for 1993 survey:d 3 c mft does not include visual caries.

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Table 2: Proportion of children with obvious decay experience in permanent teeth by age (United Kingdom, 1983, 1993, 2003)
Percentage of children

Tooth conditionEight1215
Decay into dentine
Filled (otherwise sound)
Missing due to decay
Obvious decay experience
Filled teeth as a percentage of obvious decay experience

(56)Criteria used for 2003 survey: D3cv MFT (decayed, missing or filled teeth) includes visual caries.
(57)Criteria used for 1993 survey: D 3 c MFT excludes visual caries.

Anne Main: To ask the Secretary of State for Health how many complaints her Department has received regarding access to dental care since 1997. [10847]

Ms Rosie Winterton: The Department's correspondence system does not separate complaints from other forms of correspondence. Since the present record system began in December 2001, we have received 4,309 pieces of correspondence on access to dentistry. This number represents 1.75 per cent, of all correspondence received by the Department in that period.

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