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Departmental Advice

Mr. Baron: To ask the Secretary of State for Health what advice her Department issued to (a) strategic health authorities and (b) primary care trusts between July and October 2005 on the differences between managerial or administrative changes and changes which impact on the planning, design and delivery of health services. [50824]

Mr. Byrne [holding answer 13 February 2006]: In September 2005, the office of strategic health authorities (SHAs) wrote to SHA chief executives with advice about the basis for consultation on primary care trust (PCT) and SHA reconfiguration. The letter made clear that this is not a consultation about services; and that, in so far as these administrative changes may lead to changes in the pattern of service provision, there will be subsequent and separate consultations about these.

Diabetes

Mr. Dunne: To ask the Secretary of State for Health how many fatalities of diabetes patients there have been since January 2004 where the long-acting insulin analogue, Lantus, has been suspected to be a cause or contributory factor; and what steps have been taken to assess its safety. [56921]

 
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Jane Kennedy: Clinical trials submitted at the time of licensing have examined the safety and efficacy of the Lantus (insulin glargine) in diabetic patients treated for up to 12 months. Generally, the side effects observed with Lantus were similar to those seen with human insulins, with the most commonly observed side effects being hypoglycaemia, visual disturbance and injection site reactions.

The Medicines and Healthcare products Regulatory Agency (MHRA) receives reports of suspected adverse drug reactions (ADRs) via the United Kingdom yellow card scheme. A total of 229 reports of suspected ADRs have been received in association with Lantus since January 2004 and of these, 12 had a fatal outcome. Where cause of death was reported there is no particular pattern. It is important to appreciate that the reporting of a reaction does not necessarily mean it was caused by the drug and may relate to other factors such as underlying illnesses or other medicines taken concurrently.

The longer term safety of the use of human insulin analogues, including Lantus, in routine clinical practice is closely monitored by the MHRA. Any possible new safety issue to emerge is evaluated and, if necessary appropriate action will be taken and the product information for prescribers and patients updated.

Mr. Lancaster: To ask the Secretary of State for Health what steps she is taking to ensure that there are adequate numbers of diabetic nurses. [54878]

Mr. Byrne: The national service framework for diabetes: delivery strategy states "diabetes services need to ensure that there are enough staff with appropriate skills who are well-led, supported, and deliver high-quality care". Workforce guidance assists the national health service locally in delivering improved services.

Emergency Treatment

Mrs. Dorries: To ask the Secretary of State for Health how many patients were referred by general practitioners to accident and emergency, casualty and minor injuries clinics in the (a) Bedfordshire Heartlands, (b) Luton and (c) Bedford Primary Care Trust (PCT) with (i) eye trauma, (ii) suspected fractures, (iii) acute chest pain, (iv) suspected meningitis, (v) acute abdominal pain, (vi) suspected deep vein thrombosis, (vii) suspected pneumonia, (viii) acute chest pain, (ix) acute asthma and (x) acute bronchitis in each year since the PCT was established; how many were admitted to hospital; how many were discharged with (A) advice and (B) treatment; and if she will make a statement. [55286]

Ms Rosie Winterton: This information is not held centrally by the Department.

Equal Pay

Lynne Featherstone: To ask the Secretary of State for Health what estimate of the total cost of liability to the NHS to settle possible future equal pay claims has been made following the recent equal pay settlement for women working in Cumbrian NHS hospitals; and if she will make a statement. [54834]

 
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Mr. Byrne: The NHS Litigation Authority is currently assessing the risks to the national health service from existing claims. It is not possible to estimate the cost to the NHS of settlement of possible future equal pay claims that have not been made.

European Working Time Directive

Mr. Hands: To ask the Secretary of State for Health what assessment she has made of the effect of the European working time directive on recruitment in the NHS; and if she will make a statement. [38503]

Mr. Byrne: Implementation of the working time directive (WTD) is the responsibility of local national health service trusts and strategic health authorities were required to draw up affordable plans to meet WTD 2004.

The Government agreed to implement the European working time directive as United Kingdom legislation to improve the health and safety and working lives of all employees in this country. The vast majority of staff groups have been covered by the 48-hour week since 1998. The Government negotiated an extension to the WTD for doctors in training to enable phased implementation from August 2004.

Mr. Lansley: To ask the Secretary of State for Health what discussions she has had with (a) members of the European Commission and (b) representatives of other member states of the European Union regarding the introduction of definitions of on-call time and inactive on-call time into the European working time directive; and if she will make a statement. [46403]

Mr. Byrne: Following a series of bi-laterals with other member states, the United Kingdom presidency put forward amended proposals for the European working time directive relating to the definitions of on-call time, workplace and inactive part of on-call time which offered a realistic chance for agreement at the Employment Council on 8 December 2005. Although member states came close to agreement, and despite considerable efforts from the UK presidency no deal was reached.

Together with many member states, we continue to press for changes to the working time directive to address the difficulties from the SiMAP and Jaeger judgments. Both the retention of the individual opt out and a solution for the problems caused by the SiMAP/Jaeger judgments remain key priorities for the UK, and we will continue to try to secure an acceptable agreement with member states and the European Commission.

Health Action Zones

Frank Dobson: To ask the Secretary of State for Health (1) what additional funding was made available to the east end of London during the existence of the health action zone covering that area; [50334]

(2) when health action zones ceased to receive additional funding. [50335]

Jane Kennedy [holding answers 13 February 2006]: Table 1 shows the targeted funding for health action zones (HAZs) made to the former East London and the City health authority within their revenue allocations
 
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between 1999–2000 and 2002–03. In 2002–03, its HAZ funding was supplemented by a health inequalities adjustment (HIA) distributed to the health authorities which ranked highest on a years of life lost index.
Table 1

	Additional funding (£ million)
1999–2000	1.6
2000–01	3.2
2001–02	3.2
2002–03	6.1

From 2003–04, HAZs were aligned with primary care trusts (PCTs) in the HAZ localities. A revised needs adjustment within the weighted capitation formula replaced both the existing needs adjustment and the HIA. The revised needs adjustment has been used for the allocations up to and including allocations for 2007–08. To protect those PCTs which benefited from the HIA, the 2002–03 HIA was added to those PCTs' 2003–04 baselines. Table 2 shows the distribution of the HIA to PCTs in the former East London and the City health authority.
Table 2

PCT	Share of HIA in 2003–04 baseline (£ million)
City and Hackney	1.3
Newham	2.7
Tower Hamlets	2.0

Health White Paper

Mr. Lansley: To ask the Secretary of State for Health what assessment she has made of the effect of permitting unregistered patients to attend general practitioners as described in paragraph 3.34, of the White Paper, "Our Health, Our Care, Our Say", on the demand for NHS services from those ineligible for NHS care. [49517]

Mr. Byrne: This is one of the matters that will be taken into account in the review announced in paragraph 3.34 of the Health White Paper, "Our Health, Our Care, Our Say: a new direction for community services".

Mr. Lansley: To ask the Secretary of State for Health who is expected to make arrangements for standardising practice patient surveys as described on paragraph 3.57 of the White Paper, Our Health, Our Care, Our Say, Cm 6737; which organisation will conduct the practice patient surveys; and if she will make a statement. [49556]

Mr. Byrne: The Department is currently developing plans to deliver the commitment in paragraph 3.57 of the White Paper, "Our Health, Our Care, Our Say". This will include ensuring provision for the conduct of a new patient survey at practice level.

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