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Mr. Stephen O'Brien: To ask the Secretary of State for Health what discussions his Department has had with the independent care home sector over the past 12 months on financial measures to reward high-quality care. 
However, responsibility for commissioning social care services rests with local councils. The Department allocates funding to councils for social care services. Councils are responsible for using these resources ina way which best meets the needs of their local populations. Contracting arrangements between councils and independent-sector providers of care are a matter for local decision. The Department does not set or recommend rates at which councils contract with nursing and residential homes, nor does it set quality standards. It is important that councils are able to tailor contracts as necessary to suit specific local circumstances. Many councils do pay financial premiums for high-quality services.
There have been substantial increases in the level of funding provided for social services. Between 1996-97 and 2002-03, the overall level of funding for social services increased by 20 per cent., an average real-terms annual increase of around 3 per cent. Funding to councils for personal social services has increased by an annual average of 6 per cent. In real terms from 2003-04 to 2005-06; councils can and do use this money to increase the fees they pay to care homes.
Mr. Baron: To ask the Secretary of State for Health pursuant to the answer of 2 March 2006, Official Report, column 919W, on insulin, whether data pertaining to accidental insulin overdoses includes the type of insulin being used. 
Anne Main: To ask the Secretary of State for Health (1) how many deaths have occurred in the UK where the insulins (a) Hypurin Porcine isophane, (b) Human Insulatard and (c) Lantus were suspected to be a cause or contributory factor since 2002 as show on Yellow Card Adverse Reaction Reports; and if she will make a statement; 
Andy Burnham: The human insulin analogue Lantus (insulin glargine) was granted a marketing authorisation valid throughout the European Union by the European Commission in June 2000. Clinical trials submitted at the time of licensing examined the safety and efficacy of insulin glargine in diabetic patients treated for up to 12 months. Generally, the side effects observed with insulin glargine were similar to those seen with other human insulins, with the most commonly observed side effects being hypoglycaemia, visual disturbance and injection site reactions. A European public assessment report, which details the basis for the decision to license insulin glargine and all subsequent changes to the license, is available on the website of the European Medicines Agency (EMEA) at www.emea.eu.int.
The safety of all insulins in routine clinical practice in the United Kingdom (UK) is closely monitored by the Medicines and Healthcare products Regulatory Agency (MHRA). Any possible new safety issue to emerge is evaluated and any new prescribing advice is issued to health professionals and patients, following discussion with other European regulatory agencies and EMEA as appropriate. The patient information leaflet for insulin glargine contains suitable advice on use of the product and warnings about possible adverse effects.
The MHRA receives reports of suspected adverse drug reactions (ADRs) via the UK yellow card scheme. A total of 373 reports of suspected ADRs have been received in association with insulin glargine since January 2002 and of these 15 had a fatal outcome. Where cause of death was reported there is no particular pattern. There have been a total of five reports of a suspected adverse reaction with Human Insulatard in this time period, of which one had a fatal outcome. There has been one report of a suspected adverse reaction to Hypurin Porcine Isophane in this time-period; this did not have a fatal outcome. These figures reflect only those reports where the products Human Insulatard or Hypurin Porcine Isophane have been specified by the reporter.
The reporting of a suspected adverse reaction does not necessarily mean it was caused by the drug. The suspected reaction may relate to other factors such as underlying illness or other medicines taken concurrently. It is not valid to compare the number of reports of suspected adverse reactions between products as a number of different factors affect the level of reporting of adverse reactions including the level of usage of the product, how long the product has been on the market and any publicity surrounding the product.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what research she has commissioned into healthcare information technology programmes in other countries, with particular reference to system interoperability. 
Caroline Flint: The national programme for information technology has been designed and developed, and is being implemented, in accordance with international and European Union-wide standards. These standards have also been adopted by the United Kingdom e-Government Interoperability Framework. The Department's NHS Connecting for Health agency, which is responsible for delivering the programme, works closely with the World Health Organisation and with European and international standards bodies to ensure interoperability subject to adherence to standards and strict security and confidentiality safeguards. The interoperability standards are regularly updated and are made readily available to suppliers of information technology systems. Departmental officials have regular contact and dialogue with healthcare organisations across the world. The national health service is taking a leadership role in the promotion of SNOMED CT, a terminology system that has now been adopted by several other jurisdictions.
Mr. Stephen O'Brien: To ask the Secretary of State for Health, pursuant to the answer of 28 March 2006, Official Report, column 926W, on local improvement finance trust (LIFT) schemes, what progress she has made towards the targets set for LIFT. 
Andy Burnham: The national health service local improvement finance trust, along with other existing primary care procurement routes, is a mechanism to support the delivery of the following targets set out in the NHS Plan:
Up to £1 billion investment in primary care facilities;
Up to 3,000 family doctors premises substantially refurbished or replaced by 2004; and
500 one stop primary centres delivered by 2004, which has been extended by delivering
the NHS Plan to 750 by 2008.
Over £1 billion additional investment is supporting the development of primary care facilities;
2,848 family doctors premises were substantially refurbished or replaced by the end of 2004; and
510 one stop primary care centres were delivered by the end of 2004, with the latest figure being 566 centres delivered by December 2005.
Mr. Ivan Lewis: The National Institute for Health and Clinical Excellence (NICE) produced guidelines Antenatal Care: Routine Care for the Healthy Pregnant Woman which recommend an early ultrasound scan between 10 to 13 weeks for gestational age assessment.
The benefits of the whole-scale 12-week scans are well documented. Early detection and appropriate care management is important for women with multiple pregnancies and will produce a healthier outcome for both the mother and baby. The benefits of early screening also extend to screening for other conditions such as sickle cell anaemia and Thalassaemia, so that screening and the follow on diagnosis can take place at the correct time.
The early scan will also detect some serious abnormalities such as neural tube defects. In relation to national screening programmes, an early dating scan is a set standard agreed by an expert working group who recommend that all women prior to Downs syndrome screening must have a dating scan to ensure the quality of the screening test. Guidance for health professionals on more accurate tests for Downs syndrome screening was published by the Department in November 2003. This guidance, based on advice from the national screening committee, which advises Ministers on all aspects of screening, complements and supports national health service implementation of the NICE guideline.
Ms Rosie Winterton: The Department has not made a direct assessment of perinatal mental health provision in Northamptonshire or England. The National Institute for Health and Clinical Excellence has been commissioned to produce guidelines on routine postnatal care, which is due for publication in June 2006, and antenatal and postnatal mental health, which is due in February 2007.
Tim Loughton: To ask the Secretary of State for Health (1) how many prescriptions for anti-depressants have been given to children in the last 12 months; and if she will list the drugs prescribed; 
We do not collect information on the number of children in respect of which these prescriptions were issued, nor whether the prescriber was a general
practitioner or consultant. Not all the prescriptions will have been treating depression as these drugs are also used to treat disorders such as nocturnal enuresis, anxiety, obsessive compulsive disorders and phobic states.
|Total number of anti-depressant items (000's) dispensed to children in the community in England for 2005. Source PCA.|
|Number of items||Drug name||2005|
| Notes: PCA Data Prescription information are taken from the Prescription Cost Analysis (PCA) system, supplied by the Prescription Pricing Authority (PPA), and is based on a full analysis of all prescriptions dispensed in the community i.e. by community pharmacists and appliance contractors, dispensing doctors, and prescriptions submitted by prescribing doctors for items personally administered in England. Also included are prescriptions written in Wales, Scotland, Northern Ireland and the Isle of Man but dispensed in England. The data do not cover drugs dispensed in hospitals, including mental health trusts, or private prescriptions. Prescription Items Prescriptions are written on a prescription form. Each single item written on the form is counted as a prescription item. Exemption Category Estimates The exemption data is identified from the box ticked on the back of the prescription form and relies on the form being completed correctly which may not always be the case. Information for categories that are not required to pay a charge (e.g. children) is based on a 1 in 20 sample of all exempt prescriptions dispensed by community pharmacists, appliance contractors and dispensing doctors. The information we have is therefore an estimate and subject to sampling errors. To reflect this we have rounded the exemption figures appropriately-figures less than 1,000 are shown as "*"; figures between 1,000 and 100,000 have been rounded to the nearest 1,000 and figures between 100,000 and 1 million have been rounded to the nearest 10,000. Data for total of all ages has not been rounded since it is not exemption data. Due to rounding, the sum of the components may not equal the totals. Children are defined as 0-15 year olds, and as 16-18 year olds in full time education. Dispensing Doctors Data up to 2000 are not strictly comparable with data from later years. Up until September 2000 only patients having their prescriptions dispensed by the community pharmacists and appliance contractors were required to complete the back of the prescription form, but from October 2000 this requirement was extended to patients of dispensing doctors. Therefore data prior to October 2000 do not include prescriptions dispensed by dispensing doctors.|
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