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15 May 2006 : Column 751W—continued

Medical Practitioners

Steve Webb: To ask the Secretary of State for Health what estimate she has made of the annual suicide rate of medical practitioners in each year since 1998 in England; and if she will make a statement. [51904]

Ms Rosie Winterton: Information is not available in the format requested. Information on the number of deaths and proportional mortality ratios for suicide and undetermined injury in medical practitioners (persons aged 20 to 74) in England and Wales in each year since 1998 is shown in the table.

Proportional mortality ratios( 1) for suicide and undetermined injury( 2) in medical practitioners( 3) persons aged 20-74, England and Wales, 1998-2004( 4)
95 per cent. confidence interval
Proportional mortality ratio Lower confidence interval Upper confidence interval Number of deaths




290) *





317) *





443) *





357) *





305) *





322) *





328) *


* Statistically significant (95 per cent. confidence intervals not overlapping 100).
(1) All deaths from suicide = 100.
(2) Data selected using the international classification of diseases ninth revision (ICD-9) codes for deaths from 1998 to 2000 and international classification of diseases tenth revision (ICD-10) codes for death from 2001 onwards. The codes used are as follows: ICD-9—E950-E959, E980-E989 excluding E988.8 ICD-10— X60-X84, Y10-Y34 excluding Y33.9 where the verdict was pending. (3) Occupations selected using the standard occupational classification (1990) for the years 1998 to 2000 and the standard occupational classification (2000) for the years 2001 to 2004. The codes used are as follows: Standard Occupational Classification (1990)—220 medical practitioners Standard Occupational Classification (2000)—2,211 medical practitioners. (4) Data are for occurrences of deaths in each calendar year. Source: Office for National Statistics.

Medicines Review Processes

Mr. Austin Mitchell: To ask the Secretary of State for Health what assessment has been made of the potential effect on costs of ensuring patient compliance with dosing regimens and effective medicine review processes. [69579]

Andy Burnham: No specific overall assessment has been made of the potential effect on costs of ensuring patient compliance with dosing regimes and effective medicine review processes. However, evidence shows that up to 50 per cent. of prescription medicines for long-term conditions are not being taken as intended, and that adverse reactions to medicines are implicated in 5 to 7 per cent. of hospital admissions.

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A number of factors would need to be taken into account in making such an assessment. Through improved compliance, patients may benefit more from their treatment, both in terms of length and quality of life. More medicines may be prescribed, but those that are prescribed would be less likely to be wasted. Better management of a patient's condition may reduce the need for more specialist care, including admission to hospital. The provision of effective medication review processes would also have costs in terms of service delivery, for example through payments under the quality and outcomes framework for general medical services or fees to community pharmacists for medicine usage reviews.

Mental Health Services

Tim Loughton: To ask the Secretary of State for Health how many (a) early intervention teams and (b) assertive outreach teams have been (i) closed and (ii) reduced due to financial deficits in mental health services in the last 12 months. [69437]

Ms Rosie Winterton: The Department does not routinely collect information about local service reconfigurations or the reasons for them. Such decisions are for primary care trusts to make in consultation with local health partners and in accordance with assessment of the needs of the local population.

Data on mental health teams are collated through the Durham adult mental health service mapping. The January 2006 data will be available at the end of May.

National Blood Service

Steve Webb: To ask the Secretary of State for Health (1) to what use the National Blood Service premises in the Midlands will be put after services provided there are moved to Bristol; and what the estimated cost is of converting the building for new use; [69628]

(2) what measures she has put in place to ensure that provision of blood to patients in the Midlands is not adversely affected by the closure of National Blood Services in Birmingham; and if she will make a statement. [69629]

Ms Rosie Winterton: A key factor in the successful delivery of NHS Blood and Transplant's (NHSBT) activities is implementation of its estate strategy. As part of its estate strategy the National Blood Service (NBS), an operating division of NHSBT, has proposed the development of a new site at Filton, Bristol.

To build this new centre in the most cost-effective way, NBS proposes to consolidate some services into the new Filton site from centres in Birmingham, Southampton and Plymouth. These services are those which do not need to be close to the patient, such as blood processing and testing. The NBS will ensure that this has no adverse effect on patients across the Birmingham and South West area.

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The NBS does not propose to close any centres, including the Birmingham centre. It will continue to provide critical services from Birmingham. For example, the centre will continue to have a local blood bank to meet orders for blood. This will ensure that there is no adverse impact on patients around Birmingham.

The NBS centre in Birmingham will require development, even after these changes, to ensure that those services which remain in Birmingham are provided from buildings which are fit for purpose. A number of options are being considered.

NHS Dispensing Contractors

Sandra Gidley: To ask the Secretary of State for Health when the Government will publish their response to the consultation paper ‘Proposals to simplify the reimbursement arrangements for NHS dispensing contractors' and if she will make a statement. [65512]

Andy Burnham: Due to the large number and technical nature of the proposals consulted on in this paper, it is intended to proceed with the issues raised in the consultation individually. The first announcement, covering changes to the zero discount arrangements, was published on the Department's website on25 April. Decisions and announcements covering further proposals will be made in due course.

A summary of the responses received to this consultation document is also available on the Department's website at

NHS Finance

Mr. Maude: To ask the Secretary of State for Health what financial penalties are applied to (a) NHS trusts and (b) strategic health authorities for (i) running continuing deficits and (ii) overspending in a single financial year; and what assessment she has made of the impact of such penalties on patient care. [68133]

Andy Burnham: Under the cross-Government resource accounting and budgeting (RAB) regime, national health service organisations carry forward their year-end level of over or under-spending. The carry-forward is based on the total deficit or surplus at the end of the year, which will reflect overspending in-year as well as spending in previous years.

For 2005-06, the NHS Bank has developed an incentive scheme whereby the level of overspending carry-forward into 2006-07 is subject to an uplift of 10 per cent. The carry-forward regime and the NHS Bank incentive scheme are operated at strategic health authority (SHA) level. SHAs have discretion over how they apply it to their organisations.

The level of carry-forward and the NHS Bank incentive scheme will be factored into the financial planning for 2006-07. The plans for 2006-07 have not yet been agreed by the Department.

All areas of the country will continue to see improvements in patient care in 2006-07.

15 May 2006 : Column 754W

Ms Abbott: To ask the Secretary of State for Health when the financial recovery plan for health trusts in London will be in place; and what measures have been adopted to ensure that it will be fair and transparent. [69533]

Andy Burnham: The five strategic health authorities (SHAs) in London are responsible for ensuring that those trusts that need financial recovery plans have produced plans that are fair and transparent. From 1 July 2006, the new London SHA will take over this responsibility.

The Department is working with the SHAs to finalise the financial plan for the national health service for 2006-07.

To support the work of the SHAs in their work with specific trusts and primary care trusts, the Secretary of State announced the establishment of turnaround teams in a written ministerial statement on 1 December 2005, Official Report, column 37WS. The teams comprise experts with a mix of commercial and NHS turnaround skills.

Local turnaround teams are agreeing a tailored package of support with the organisations facing the largest challenges and with their SHA. This will help them to achieve financial balance and provide services more efficiently. The teams will support the chief executive of the organisation. The chief executive remains accountable for the financial performance, establishing financial recovery plans and measures to ensure they are fair and transparent..

Ms Abbott: To ask the Secretary of State for Health what the timetable is for the NHS financial recovery plan; and whether those organisations which have been asked to reduce spending will receive a clear indication of how funding levels will be restored over an agreed period. [69534]

Andy Burnham: The Department is working with the strategic health authorities (SHA) to finalise the financial plan for the national health service for 2006-07. The plan will deliver financial balance across the NHS in 2006-07. SHAs are supporting trusts and primary care trusts in producing robust local plans which will have locally agreed timetables.

All organisations need to fulfil their statutory financial duties which include ensuring that income and expenditure is in balance. Where there are local agreements to create a financial reserve fund, the SHA will also ensure these agreements are fair.

Ms Abbott: To ask the Secretary of State for Health whether guidance has been issued to London health organisations seeking financial support under the financial recovery plan on (a) the actions they must take and (b) the consequences of not complying. [69535]

Andy Burnham: The planning framework for the national health service is set out in National Standards Local Action which was issued in July 2004 and covers the period 2005-06 to 2007-08. The Department has issued specific guidance for 2006-07 called “The Operating Framework for 2006-07” and a follow up letter from the Acting Chief Executive of the NHS was issued on 10 May. There has been no specific guidance to organisations in London from the Department.

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Palliative Care

Steve Webb: To ask the Secretary of State for Health if she will make a statement on the future of palliative care services at the Frenchay site of North Bristol NHS Trust. [70985]

Caroline Flint: Avon, Gloucestershire and Wiltshire strategic health authority reports that the plans for the redevelopment of the Frenchay site as a community hospital include the retention of the present unit for palliative care.

Primary care trusts are responsible for commissioning and funding services for their resident population, including palliative care. We have set out in “Our health, our care, our say” a programme of action that will deliver increased choice to all patients at the end of life about where they are cared for. We will be working with key stakeholders in taking this forward.

Patient Packs

Mr. Todd: To ask the Secretary of State for Health what steps she has taken to establish a means of standardising patient packs; and if she will make a statement. [68040]

Andy Burnham: We are not convinced that it is for the Government to tell manufacturers what pack sizes they should produce. Further, any European Community law implications of such a measure would need to be considered. In any event, standardisation of sizes of packs manufactured in the United Kingdom would not solve the problem of pack size variety, as packs imported from other European Union countries could be of any size.

A consultation on simplification of reimbursement arrangements for national health service dispensing contractors was issued last year. This included measures designed to further promote patient pack dispensing. We are currently considering responses to this consultation.

Pharmacy Contracts

Mr. Hancock: To ask the Secretary of State for Health what (a) support and (b) guidance she has issued to pharmacists in Portsmouth to develop medicine utilisation reviews under the new pharmacy contract; and if she will make a statement. [68472]

Andy Burnham: This is a matter for determination by the local primary care trust (PCT) and I am advised there are a number of local initiatives under way or being developed.

The Department has issued national guidance to all PCTs on medicines use reviews (MURs), which PCTs may use in assisting pharmacists in the development of a successful MUR service. A patient information leaflet about the service has been made available to pharmacies, which will assist pharmacists in explaining the service to their patients.

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Premature Births

Mr. Amess: To ask the Secretary of State for Health how much her Department has spent on research into premature births in each year since 1996; and how much she plans to spend in each of the next five years. [62886]

Andy Burnham: The main agency through which the Government support medical and clinical research is the Medical Research Council (MRC). The MRC is an independent body funded by the Department of Trade and Industry via the Office of Science and Innovation.

The Department funds research to support policy and to provide the evidence needed to underpin quality improvement and service development in the national health service. The policy research programme in particular supports the national perinatal epidemiology unit. Much of the unit's work on the compromised foetus and baby focuses on or is linked to preterm birth.

Spend by the MRC on projects related to premature birth and by the Department's national research programmes is shown in the table.

£ million
MRC Department of Health































(1)Not available.
1. The full cost of several large cohort studies where the premature birth component of the study is relatively small is included in these figures. 2. Total national perinatal epidemiology unit funding and the part (2005-06) cost of one health technology assessment programme project.

In addition, the MRC supports a large portfolio of reproductive tract research and underpinning reproductive medicine and paediatric research.

Over 75 per cent. of the Department's total expenditure on health research is currently devolved to and managed by national health service organisations. Details of individual projects including a number concerned with premature birth are available on the national research register at

The MRC and the Department plan to continue to invest in this area of research.

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