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1 Nov 2005 : Column 973W—continued

Myasthenia Gravis

Kelvin Hopkins: To ask the Secretary of State for Health if she will make a statement on hospital waiting times for patients diagnosed with myasthenia gravis. [20822]

Mr. Byrne: Waiting time data are not available for specific conditions.

By the end of 2005, the maximum waiting time for first out-patient appointment with a consultant will fall to 13 weeks and the maximum waiting time for in-patient treatment will fall to six months.

NHS Terms of Service

Mr. Lansley: To ask the Secretary of State for Health whether the NHS terms of service require doctors to prescribe treatments whenever they consider a medicine to be necessary. [18344]

Jane Kennedy: It is a requirement of their contract with primary care trusts that primary medical services contractors in providing essential services to registered patients should offer consultation and where appropriate physical examination for the purpose of identifying the need, if any, for treatment or further investigation. They should also make available such treatment or further investigation as is necessary and appropriate, including the referral of a patient for other services under the National Health Service Act 1977 and liaison with other health care professionals involved in the patient's treatment and care.

Whether or not any treatment includes the prescribing of medicines or drugs is a matter of clinical judgment.
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NICE (Drug Approvals)

Dr. Richard Taylor: To ask the Secretary of State for Health how many new drugs are (a) under appraisal and (b) awaiting appraisal by the National Institute for Health and Clinical Excellence for the treatment of (i) malignant disease and (ii) other diseases. [20355]

Jane Kennedy: I understand from the National Institute for Health and Clinical Excellence that they have 63 appraisals in progress, and 19 of these are for cancer drugs. In addition, there are two cancer drugs awaiting appraisal.

Mr. Paterson: To ask the Secretary of State for Health how many drugs approved by the EU Committee for Medicinal Products for Human Use are being assessed by the Department prior to referral to the National Institute for Health and Clinical Excellence. [19893]

Jane Kennedy: The Department does not assess drugs.

However, the Department is considering referring to the National Institute for Health and Clinical Excellence a number of drugs approved by the European Union committee for medicinal products for human use so that their clinical and cost effectiveness may be determined.

Pensioner Health Services

Mr. Laws: To ask the Secretary of State for Health what recent estimate she has made of the average annual cost of providing NHS health services to someone over state pension age; and if she will make a statement. [19925]

Mr. Byrne: Around 43 per cent. of the national health service hospital and community health services expenditure in 2003–04 was on people over the age of 65. This totalled around £16.5 billion.
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A breakdown of the same data by age group shows the following:

Perinatal Deaths

Mr. Amess: To ask the Secretary of State for Health how many perinatal deaths there were in each of the last 15 years for which figures are available; what are the most common causes of perinatal deaths; and what steps she is taking to reduce the number of perinatal deaths. [20609]

Mr. Byrne: Perinatal deaths include stillbirths and deaths under one week. These data are shown in the table.
Perinatal deaths (stillbirths and deaths within the first week of life) 1990–2004: England and Wales

Number of stillbirths(36)
Number of deaths under one week (early neonatal)

(36) On 1 October 1992 the legal definition of a stillbirth was changed from a baby born dead after 28 or more weeks completed gestation to one born dead after 24 or more weeks completed gestation. This means that perinatal and stillbirth data for 2004 can be compared with data only from 1993 onwards.
Office for National Statistics.

Causes of stillbirths and early neonatal deaths differ significantly. Causes in stillbirths during 2003 are attributed as follows: 48 per cent. were of uncertain cause, 28 per cent. due to asphyxia, anoxia or trauma (antepartum), 14 per cent. were due to congenital anomalies. The remainder were due to antepartum infections, asphyxia, anoxia or trauma (intrapartum) or other specific conditions. Of the early neonatal deaths, 62 per cent. were due to immaturity related conditions, 23 per cent. were due to congenital anomalies, 10 per cent. due to asphyxia, anoxia or trauma (intrapartum) and the remainder due to antepartum infections or other specific causes.

We are committed to reducing, by 2010, the gap in infant mortality between routine and manual groups—as defined in national statistics socio-economic classification—and the population as a whole, by at least 10 per cent.
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Comprehensive maternity services are key to providing best outcome. The Government signalled their commitment to maternity services by introducing the maternity standard of the national service framework (NSF) for children, young people and maternity services in September 2004 and by bringing forward to 2009 the NSF's target to give all women choice in where and how they have their baby and what pain relief to use, and to have the support of a named midwife. An implementation advisory group of key stakeholders has been established to help take this forward.

The decline in early neonatal deaths is associated with advances in technology and the capability of the neonatal services to improve outcomes for the smallest, sickest babies. We have invested £20 million additional capital and £20 million recurrent revenue funding to further improve access to, and the capability of neonatal services.

The confidential inquiry into maternal and child health, which collects information on deaths from 22 weeks gestation to 28 days of life, will publish annual reports on perinatal mortality. In addition, hospitals will receive individualised reports to enable them to compare their own mortality rates over time.

Rehabilitation Services

Mr. Baron: To ask the Secretary of State for Health (1) what steps she is taking to increase the number of fully qualified rehabilitation workers for visually impaired people; [20423]

(2) what steps she is taking to increase consistency in rehabilitation services provided for visually impaired people living in different parts of England. [20460]

Mr. Byrne [holding answers 21 October 2005]: Rehabilitation services for blind and partially sighted people are provided by local health and social care bodies. It is for those organisations to commission appropriate services based on local need. This would include the number, training and composition of teams available to provide rehabilitation for blind and partially sighted people.

Risk Sharing Scheme

Mr. Burstow: To ask the Secretary of State for Health what evaluation she plans to carry out of the results of the risk sharing scheme for beta interferon and glatiramer acetate treatments. [20732]

Mr. Byrne: Ongoing evaluation has been an integral part of the scheme from its inception. The first evaluation is due around summer 2007.

School Nurses

Mr. Drew: To ask the Secretary of State for Health what steps she is taking to recruit school nurses. [19236]

Mr. Byrne: The Department is committed to providing new funding so that by 2010, every primary care trust, working with children's trusts and local
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authorities, will be resourced to have at least one full-time, year-round, qualified school nurse working with each cluster or group of primary schools and the related secondary school.

The Department understands that school nurses have an important and central role to play in tackling health issues among children and younger people, such as obesity, exercise, smoking prevention and cessation and sexual and emotional health.

The Chief Nursing Officer is leading the development and promotion of a new modern role for school nurses and many school nurses are already modernising their roles and playing a key role in initiatives such as Healthy Schools" and preventing teenage pregnancy. The NHS improvement plan and the nursing strategy, Making a Difference", also point towards an expanded role for school nurses, and a three-year school nurse development programme is currently being updated to ensure school nurses remain a dynamic workforce who are able to contribute to good outcomes for children and young people.

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