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Dr. Cable: To ask the Secretary of State for Health whether any changes are planned in the provision of stoma nurses. 
Mr. Byrne [holding answer 18 January 2006]: The Department is currently undertaking a consultation about the possible changes to improve the arrangements for the provision of dressings, incontinence appliances, stoma appliances, chemical reagents and other appliances to primary and secondary care. Part of this consultation will review the sponsorship of nurses and manufacturers.
The consultation closes on 23 January and we are not in a position at present to comment on the outcome.
Mr. Maude: To ask the Secretary of State for Health what the cost per patient treated in hospital was for each strategic health authority in England in each of the last 10 years. 
Mr. Byrne: There is no data collected centrally at individual patient level. Data are collected on a finished consultant episode basis and at national health service trust level, within which one or more hospitals will operate.
Lynne Featherstone: To ask the Secretary of State for Health (1) what research her Department has undertaken into thiomersal; and if she will make a statement; 
(2) which paediatric vaccines contain mercury; and if she will make a statement. 
As with all medicinal products, vaccine safety is continually monitored by the Medicines and Healthcare products Regulatory Agency (MHRA) with advice from independent experts. The United Kingdom's Committee on Safety of Medicines (CSM) and its expert working group on vaccine safety have thoroughly reviewed the safety of thiomersal-containing vaccines, including alleged links with neurodevelopmental disorders, and kept this under close review.
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In 2001, the CSM, now the Commission for Human Medicines, conducted a major review of the available evidence and has since then considered new data on a number of occasions as it has emerged. Following concerns in the United States of America (USA) about the possible toxicity of thiomersal-containing vaccines, the Department funded a study using the UK's general practice research database to investigate whether there is a relationship between the amount of thiomersal that an infant receives through vaccination at a young age and subsequent neurological disorders. Data from a study involving over a 100,000 UK children were considered by CSM in 2003. Further studies from Denmark involving almost half a million children and a study from the USA have also specifically investigated the suggested link between mercury-containing vaccines and autism. None of these studies have found any evidence of a causal association with subsequent neurodevelopment disorders, including autism.
The advice of CSM stands that there is no evidence of harm from the very small quantities of thiomersal contained in some vaccines, with the exception of possible allergic reactions, typically skin rashes or local swelling at the site of injection. This view concurs with that of the World Health Organisation, the USA's Institute of Medicine and the European Medicines Agency. The balance of benefits and risks of thiomersal-containing vaccines remains overwhelmingly positive.
None of the vaccines that are currently part of the recommended childhood immunisation programme contain mercury.
John Smith: To ask the Secretary of State for Health (1) what discussions she had on raising thrombosis as a patient safety issue during the UK presidency of the European Union; 
(2) whether the prevention of venous thromboembolism was raised at the Patient Safety Summit held in London on 28 to 30 November 2005. 
Jane Kennedy: The prevention of venous thromboembolism was not raised as a specific patient safety issue during the 2005 UK presidency of the European Union.
However, in response to the Health Committee report on The prevention of the Venous Thromboembolism (VTE) in Hospitalised Patients" published last year, the Government have established an independent expert working group to help develop a comprehensive strategy for both treatment and prevention of VTE.
The VTE expert group has been asked to report to Chief Medical Officer by summer 2006.
Mr. Burstow: To ask the Secretary of State for Health what national targets for tooth decay her Department has set in the last five years; and what the performance against each target has been of each (a) primary care trust and (b) strategic health authority. 
Ms Rosie Winterton: The last national targets were set in 1994 and were for the period 19982003. Within this framework, it was for local NHS organisations to decide whether to set individual targets for their locality.
For adults, the target was to reduce the percentage of dentate adults with at least one deep periodontal pocket (greater than 6 millimetres) from 17 per cent. to 10 per cent. The National Adult Dental Health Survey conducted in 1998 showed that 6 per cent. of people aged 45 to 64 had pockets over 6 mm in depth.
For children, the targets were that 12-year-olds should have no more than an average of 1.0 teeth with decay experience, 70 per cent. of five-year-olds should have no decay experience and that five-year-olds should have no more than an average of 1.0 teeth with decay experience. The National Child Health Survey conducted in 2003 found that 12-year-olds in England had an average of 0.7 teeth with obvious decay experience, 59 per cent. of five-year-olds in England had no primary teeth with obvious decay experience and the average number of primary teeth with obvious decay in five-year-olds was 1.5 per cent.
Peter Viggers: To ask the Secretary of State for Health what recent changes there have been to Government policy on the vaccination of children against tuberculosis; and what the present policy is. 
Caroline Flint [holding answer 9 January 2006]: The changes to the bacille calmette guerin vaccination policy were given in the Chief Medical Officer letter to the health profession dated 6 July 2005. A copy of which is available in the Library.
Mr. Lansley: To ask the Secretary of State for Health pursuant to her statement on the Dimbleby programme that her Department is examining its budget to ensure value for money is achieved, if she will list the programme budgets which are under review. 
Mr. Byrne: It is usual practice to keep all central budgets under review as the financial year progresses as part of prudent financial management.
Dr. Gibson: To ask the Secretary of State for Health (1) what assessment she has made of the optimum age at which breastfed babies will benefit from vitamin D drops; and which variety of vitamin D the Department recommends; 
(2) if she will seek advice from the Food Standards Agency on the levels of vitamin D in various foods for infants and issue appropriate guidance. 
The Committee on Medical Aspects of Food Policy (COMA) recommends that breastfed infants under six months do not need vitamin supplements provided the mother had an adequate vitamin status during pregnancy. From age six months, infants receiving breast milk as their main drink should be given supplements of vitamins A and D. Between the ages of one to five years, vitamins A and D supplements
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should be given unless adequate vitamin status can be assured from a diverse diet containing vitamins A and D rich foods and from moderate exposure to sunlight.
The Department provides free vitamin supplements to children aged under five under the welfare food scheme, and this supplement provides seven micrograms of vitamin D3 per day. COMA also recommends a supplement for pregnant and breastfeeding mothers of 10 mcg per day which we expect to provide under the healthy start scheme.
The levels of vitamin D in various foods for infants are controlled by the Processed Cereal-based Foods and Baby Food for Infants and Young Children (England) Regulations 2004. These regulations set minimum and maximum levels for the vitamin D content of processed cereal-based foods for infants (0.25 to 0.75 per 100 kilojoules or 1 to 3 per 100 kilocalories).
Greg Clark: To ask the Secretary of State for Health what the (a) maximum, (b) average and (c) target waiting times were for (i) inpatient and (ii) first outpatient appointments for each strategic health authority in England in each quarter of the last eight years. 
Mr. Byrne: The Department collects waiting time data by time bands, that is, the number of patients who waited zero to four weeks; four to 13 weeks; 13 to 17 weeks; 17 to 21 weeks; 21 to 26 weeks; and over 26 weeks. It is not possible from those data to calculate precisely the longest any patient had to wait in any given quarter.
Information on average waiting times for first outpatient appointment treatment since 200203, when strategic health authority were established, has been placed in the Library.
Target maximum waiting times are shown in the table.
|Year end||Maximum inpatient waiting time in months||Maximum waiting time for a first outpatient appointment in months (weeks)|
|1 April 2002||15||6 (26)|
|1 April 2003||12||5 (21)|
|1 April 2004||9||4 (17)|
|End 2005||6||3 (13)|
|End 2008||18 weeks for general practitioner referral to|
start of treatment
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