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3 Nov 2005 : Column 1345W—continued

Private Finance Initiative

Mr. Austin Mitchell: To ask the Secretary of State for Health how many NHS trusts are in deficit; and how many of these deficits are due to annual private finance initiative charges. [17865]

Mr. Byrne: Data from the summarised final accounts for 2004–05 show that of the 66 national health service trusts that had a financial deficit, only nine have an operational private finance initiative scheme.

Psychiatric Trainees

Mr. Burstow: To ask the Secretary of State for Health what estimate she has made of the number of psychiatric trainees undergoing psychotherapy training in each of the last five years; and if she will make a statement. [20666]

Mr. Byrne: The information requested for England at 30 September each year is shown in the following table.
Full-time equivalents

	Doctors in training
	Psychiatry group total	Psychotherapy
2000	2,824	42
2001	2,801	42
2002	2,918	45
2003	3,017	36
2004	3,470	47

Source:
National health service Health and Social Care Information Centre medical and dental work force census.

In order to obtain a psychiatry group specialist registrar post, all candidates must have undertaken some training in psychotherapy.

As at March 2005, the number of consultant psychotherapists was 112 and as at September 2004, the number of other qualified psychotherapy staff was 723.
 
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Residential Care

Mr. Burstow: To ask the Secretary of State for Health how frequently the needs of residents in (a) residential and (b) nursing homes are assessed; and how such assessments are triggered. [22267]

Mr. Byrne: The Care Homes Regulations 2001, Section 14 (2) of the regulations, requires the registered provider to ensure that assessment needs of residents in residential and nursing homes are kept under review and revised at any time when it is necessary to do so, having regard to any change in circumstances.

Self-funded Care

Mr. Burstow: To ask the Secretary of State for Health how a person who is self-funding their care is able to obtain (a) a care plan and (b) regular reviews of their (i) health and (ii) social care needs. [22266]

Mr. Byrne: An individual's financial circumstances should have no bearing on whether or not a council carries out an assessment of their need for community care services. Once an individual's care needs have been assessed and a decision made about the care, if any, to be provided, an assessment of their ability to pay charges up to the full cost of that care should be carried out.

Where a local authority is providing care services, whether paid for or not, guidance requires the person's need for those services to be kept under review.

Where a person has made their own arrangements to be in a care home or receive personal care from a domiciliary care agency regulations require the person registered in respect of the care home or agency to prepare a written plan of the service user's needs and to keep it under review.

National health service nursing care is provided free in all settings.

Smoking

Mrs. Gillan: To ask the Secretary of State for Health whether she plans to prohibit smoking in secure mental health units; and if she will make a statement. [24093]

Caroline Flint: The Health Bill was published on Thursday 27 October 2005 and contains proposals for smoke free enclosed public places and workplaces. Smoking will end in enclosed public places and workplaces from the summer of 2007 with some exemptions which would include some mental health establishments.

This is in line with the commitment in the Choosing Health White Paper for the national health service to be completely smoke free by the end of 2006 in which we recognise that in some cases, such as mental hospitals where for some patients the hospital may be their main place of residence and therefore their home, this may not be achievable.
 
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Strokes

Helen Jones: To ask the Secretary of State for Health what steps she is taking to ensure that national effective protocols and training are in place for (a) ambulance staff and (b) staff in accident and emergency departments to ensure that they can identify patients who have had a stroke and refer them for the most effective treatment. [21497]

Mr. Byrne: Standard five of the national service framework for older people provides a programme of action to ensure that those who have had a stroke have prompt access to integrated stroke care services. As part of this, it sets out the importance of making a rapid diagnosis in improving patient outcomes.

All United Kingdom ambulance services currently use National clinical guidelines developed by the joint Royal Colleges ambulance liaison committee (JRCALC), that include the recognition, assessment and management of stroke /cerebral bleeds.

Many PCTs have agreed local arrangements with ambulance services, which ensure that once an ambulance crew has made the diagnosis of stroke, the patient is transferred directly into an acute stroke unit. The joint ASA/JRCALC clinical effectiveness committee published the ACT NOW" expert report on 'joined-up' stroke services in June 2004. The report shares best practice in acute stroke management within emergency medical services and relevant hospital departments and gives examples of pathways to optimise co-ordination between disciplines. The Department's stroke strategy group will be looking at ways to share best practice guidance to encourage more trusts to adopt this approach where appropriate.

Helen Jones: To ask the Secretary of State for Health if she will make it her policy that anyone suffering a transient ischaemic attack should see a stroke specialist within seven days. [21498]

Mr. Byrne: Standard five of the national service framework (NSF) for older people, published in March 2001, provides a programme of actions to reduce the incidence of transient ischaemic attack (TIA) and stroke in the population and ensure that those who have had a TIA or stroke have prompt access to integrated stroke care services. More patients are being seen by stroke specialists and stroke mortality is declining.

The quality and outcomes framework incentivises general practitioners through their contract payments to refer patients with a suspected TIA or stroke for a computed tomography or magnetic resonance imaging scan.

Helen Jones: To ask the Secretary of State for Health what steps she is taking to ensure that all stroke patients receive a brain scan within 48 hours of having a stroke. [21499]

Mr. Byrne: Standard five of the national service framework (NSF) for older people, published in March 2001, provides a programme of actions to reduce the incidence of stroke in the population and ensure that those who have had a stroke have prompt access to integrated stroke care services. More patients are being seen by stroke specialists and stroke mortality is declining.
 
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Included within standard five is a guideline stating that,

immediate management to improve chances of survival and minimise the risk of complications should include a brain scan within 48 hours".

The Department is currently working up a framework to ensure scanning services can be deployed quickly and appropriately.

Suicide

Dr. Kumar: To ask the Secretary of State for Health (1) what steps she is taking to reduce the rate of suicide amongst people over the age of 75; [22319]

(2) what funding was allocated to work aimed at prevention of suicide in older people in the last year for which figures are available. [22320]

Mr. Byrne: The 2004 suicide prevention strategy annual report of progress sets out the actions that are underway to reduce the number of suicides in the general population, including older people. Although there are no specific actions targeting people 75-years or over, many of the measures in place will help prevent suicides amongst all age groups. Consequently, it is not possible to specify the amount of funding allocated to the prevention of suicide in older people.

The our healthier nation target is to reduce the overall death rate from suicide and undetermined injury from a baseline rate of 9.2 deaths per 100,000 population in 1995–97 to 7.3 deaths per 100,000 population in 2009–11. The latest available data for the three years 2002–4 show a rate of 8.6 deaths per 100,000 population; a reduction of 6.6 percent., from the baseline. The latest data for older people, 65 and over, show that this rate has fallen from a baseline rate of 10.0 deaths per 100,000 population to 9.0 deaths, a fall of 9.7 percent., over the period. For the 75 and over age group, the rate has fallen from a baseline rate of 11.5 deaths per 100,000 population to 10.3 deaths, a fall of 11.2 percent., over the period.

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