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9 Jan 2006 : Column 142W—continued


Mr. Oaten: To ask the Secretary of State for Health what guidelines she has issued on the prescription of methadone in prisons; and if she will make a statement. [37324]

Ms Rosie Winterton: Prison Service Order 3550, Clinical Services for Substance Misusers" includes the provision that prisons will have evidence-based guidelines on maintenance prescribing, including methadone prescribing, in line with departmental guidelines.

Minimally-invasive Technologies

Mr. Lansley: To ask the Secretary of State for Health what steps she is taking to encourage the use of
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minimally-invasive technologies in the NHS, with particular reference to (a) the training of staff in the use of such technologies and (b) building incentives into the system of payment by results. [27545]

Mr. Byrne: The Department recognises that the use of minimally-invasive technologies can be effective in improving outcomes for patients, including through reduced length of time in hospital and reduced pain and scarring after surgery.

Setting curricula for health professional training is the responsibility of the statutory and professional bodies. The Department shares their commitment to ensure that all health professionals are trained to have the skills and knowledge they need to deliver high-quality health care to the population. This would include training in the use of minimally-invasive technologies.

Post-registration training needs for national health service staff are determined against local NHS priorities, through appraisal processes and training needs analyses informed by local delivery plans and the needs of the service. Local authorities and health service providers decide how best to provide services to meet the needs of individuals.

The Royal College of Surgeons has started a programme of work to train clinicians in minimally-invasive surgical techniques and are currently in discussions with the Department to examine the options.

The current payment by results programme takes account of the impact of the National Institute for Health and Clinical Excellence (NICE) technology appraisals when calculating an uplift on average reference costs for the national tariff. For example, the 2004–05 tariff included an uplift for the costs of implementing a NICE appraisal of drug eluting stents, which was published in October 2003. The combination of incentives under payment by results and patient choice will reward providers that attract people by responding to their needs and preferences.

Minor Illness Injury Units

Mr. Laurence Robertson: To ask the Secretary of State for Health whether patient group directions cover practices in minor illness injury units; and if she will make a statement. [38504]

Jane Kennedy [holding answer 19 December 2005]: Patient group directions can be used in any national health service service, including minor injury units.

Patient group directions may be used to supply and administer medicines to patients by certain registered health care professionals, for example, nurses, pharmacists or ambulance paramedics. They may be used in the NHS including those services which are funded by the NHS but provided by the private, voluntary or charitable sectors. They may also be used by independent hospitals, agencies and clinics registered under the Care Standards Act, prison health services, police services and the defence medical services.

Necrotising Fasciitis

Mr. Amess: To ask the Secretary of State for Health how many people in (a) Southend, (b) Essex,
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(c) Hertfordshire, (d) Greater London and (e) England have (i) contracted and (ii) died of necrotising fasciitis in each of the last 10 years. [34293]

Ms Rosie Winterton: I refer the hon. Member to the answer the Under-Secretary with responsibility for community care, my hon. Friend the Member for Birmingham, Hodge Hill (Mr. Byrne) gave the hon. Member for Ribble Valley (Mr. Evans) on 6 December 2005, Official Report, columns 1230–31W.

NHS Bursaries

Daniel Kawczynski: To ask the Secretary of State for Health what steps she is taking to reduce the amount of time student nurses wait for their NHS bursaries. [35430]

Mr. Byrne: I refer the hon. Member to the reply I gave on 6 December 2005, Official Report, column 1233W to the hon. Member for Billericay (Mr. Baron).

Tim Farron: To ask the Secretary of State for Health for what reasons eligible students who apply for NHS bursaries in advance do not receive their bursaries before their courses start. [38473]

Mr. Byrne [holding answer 19 December 2005]: The NHS Student Grants Unit does not release any funds to students until universities have confirmed that students have turned up on the first day of their course, in order to avoid fraudulent claims.

NHS Commissioning

Mr. Andrew Smith: To ask the Secretary of State for Health what the basis of payment to the provider of management services to a primary care trust will be under the reforms proposed by Commissioning a Patient-led NHS where that provider is (a) an NHS team, (b) a voluntary sector body and (c) a private sector body. [18721]

Mr. Byrne [holding answer 17 October 2005]: As part of the proposals for primary care trust (PCT) reconfiguration, one strategic health authority (SHA) proposed to procure an external management team to run one of their newly proposed PCTs. However, this proposal will not be considered during the forthcoming local consultation as it is for the new PCTs, not the current SHAs, to decide how best to manage their responsibilities after reconfiguration.

In the event of a PCT in future wishing to outsource some aspect of their management services they would need to use recognised contracting processes and ensure proper value for money irrespective of the source of those services. They would not be able to outsource or delegate the public accountability for the financial responsibility placed on them as a statutory body.

Mr. Gordon Prentice: To ask the Secretary of State for Health what discussions she has had with Mr. Roy Lilley on opportunities for the independent and voluntary sector arising from the proposals set out in SirNigel Crisp's paper on commissioning a patient-led NHS. [19150]

Mr. Byrne: My right hon. Friend the Secretary of State has had no discussions with Mr. Roy Lilley on this issue.
9 Jan 2006 : Column 145W

NHS Direct

Clive Efford: To ask the Secretary of State for Health what discussions she has had with representatives of NHS Direct staff on regrading of staff due to restructuring of the service. [31650]

Mr. Byrne: The Department has had no such discussions with representatives of NHS Direct staff. NHS Direct special health authority is responsible for staffing matters and will be able to provide information on their consultative process with staff.

Mr. Andrew Smith: To ask the Secretary of State for Health how many people have used NHS Direct in each year since its introduction, broken down by region. [36868]

Mr. Byrne: Information is not collected centrally on the number of people who have used NHS Direct in each region.

Information from 1998–99 onwards on the number of calls received nationally and the number of visits to NHS Direct Online are available in the statistical supplement to the chief executive's report to the national health service, which is available at

NHS Finance

Mr. Lansley: To ask the Secretary of State for Health what assessment she has made of whether there is a correlation between NHS organisations' deficits and the number of agency staff they employ. [36348]

Mr. Byrne: We do analyse agency spend and deficits, but deficits are usually due to poor performance across a range of areas leading to inefficiency rather than one single factor.

Mr. Lansley: To ask the Secretary of State for Health how the NHS net financial deficit in 2004–05 was financed, broken down by area of her Department's activity from which funds were diverted to meet that deficit. [36427]

Mr. Byrne: The NHS Litigation Authority declared reductions to provisions for clinical negligence during 2004–05. These central savings were used to offset the national health service deficit.

Mr. Lansley: To ask the Secretary of State for Health what the level of NHS income from charges was in 2004–05; and how much was accounted for by income from (a) fees and charges from health authorities, (b) fees and charges from district health authorities, (c) road traffic accident income, (d) fees and charges from NHS trusts, (e) NHS Supplies Authority fees, (f) dental charges, (g) prescription charges, (h) nursing home inspection fees, (i) subsidised dried milk, (j) Medicines Control Agency licences and
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inspections, (k) youth treatment service income, (l) NHS Pension Agency fees, (m) Medical Devices Agency fees, (n) Human Fertilisation and Embryology Authority licence fees, (o) English National Board for Nursing registration fees and (p) other charges. [36431]

Mr. Byrne: National health service income figures from fees and charges are shown in the table. The table includes fees and charges to bodies outside the NHS, charges to private and overseas patients and charges to NHS patients.

The only charges to NHS patients are those for dental and prescription charges.
Breakdown of NHS income from charges by charge type 2004–05

Charges£ million
(a) Strategic health authority—fees and charges33.7
(b) District health authorities(31)
(c) Road traffic accident income110.3
(d) NHS trusts—fees and charges669.4
(e) NHS Logistics fees1.0
(f) Dental charges451.8
(g) Prescription charges424.6
(h) Nursing home inspection fees
(i) Subsidised dried milk
(j) Medicines Control Agency—licences and inspections(31)
(k) Youth treatment service income(31)
(l) NHS Pensions Agency fees0.6
(m) Medical Devices Agency fees(31)
(n) Human Fertilisation and Embryology Authority—licence fees
(o) English National Board for Nursing—registration fees(31)
(p) Other316.1

(31)Organisations no longer exist.
(a)Health authorities became strategic health authorities in 2002–03. Figures include fees and charges for primary care trusts.
(e)Previously the NHS Supplies Authority.
(h)From April 2002, the National Care Standards Commission regulated nursing homes. Health authorities no longer collect the fee income.
(i)Not collected after 2002–03 (following a review with the NAO to eliminate non-material items).
(p)Information relating to charges for private patients and overseas visitors has been provided for NHS trusts and primary care trusts.
Information on fees and charges has been provided from the audited accounts of the relevant NHS bodies.

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