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Pre-registration Nursing Courses

Justine Greening: To ask the Secretary of State for Health how many people are enrolled on pre-registration nursing courses; how many were enrolled in each of the previous four years; and if she will make a statement. [72748]

Andy Burnham: Information on the number of people enrolled on pre-registration nurse training courses is shown in the following table:

	Number
2002-03	58,900
2003-04	64,995
2004-05	70,210
2005-06	72,930
2006-07 Forecast	73,670

Primary Care Trusts

Mr. Jeremy Browne: To ask the Secretary of State for Health how much funding was allocated to each primary care trust in England in each year since 2001. [64306]

Andy Burnham: Revenue allocations were first made to primary care trusts (PCTs) in 2003-04. Prior to this, funding was allocated to health authorities (HAs). The funding allocated to each HA for 2001-02 and 2002-03 and to each PCT for 2003-04 to 2007-08 in England has been placed in the Library.

Mrs. Maria Miller: To ask the Secretary of State for Health what criteria were used to determine the size of the reorganised primary care trusts announced on 16 May. [72490]

Andy Burnham: Proposals for primary care trust (PCT) reconfiguration were assessed against eight criteria.

secure high quality, safe services;

improve health and reduce inequalities;

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improve the engagement of GPs and roll-out of Practice Based Commissioning with demonstrable practice support;

improve public involvement;

improve commissioning and effective use of resources;

manage financial balance and risk;

improve co-ordination with social services through greater congruence of PCT and local government boundaries; and

deliver at least 15 per cent. reduction in management and administrative costs.

These criteria were set out by the Department in July 2005 in ‘Commissioning a patient led NHS’. Strategic health authorities consulted widely with stakeholders on reconfiguration. Options for PCTs and Ministers considered carefully the views expressed in making final decisions that balanced views expressed and the criteria.

School Nurses

Dr. Murrison: To ask the Secretary of State for Health how many primary care trusts have at least one full-time, year round qualified school nurse for each cluster or group of primary schools and related secondary school; if she will list the primary care trusts which do not have such provision; and if she will make a statement. [67412]

Mr. Ivan Lewis: The September 2005 census showed that there were 2,887 (1,913 full-time equivalent (fte)) qualified nurses working in the school nursing service, an increase of 478 (19.8 per cent.) since 2004.

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Of these 943 (665 fte) have a post registration school nursing qualification, an increase of 87 (10 per cent.) since 2004.

Data on the number of full-time qualified school nurses by primary care trust have been placed in the Library.

Sexual Health

Dr. Kumar: To ask the Secretary of State for Health what estimate the Department has made of the number of people in each region in England with undiagnosed (a) HIV/AIDS, (b) Chlamydia, (c) gonorrhoea, (d) hepatitis B and (e) syphilis. [67189]

Caroline Flint: Data on the estimated number of undiagnosed HIV infections for all adults in the United Kingdom is shown in the following table.

Results from screening asymptomatic sexually active young people, aged less than 25 years, through the national Chlamydia screening programme indicate that up to one in 10 of the target population are infected with Chlamydia. This indicates a high level of undetected genital Chlamydia infection in young sexually active people.

There are no estimates of the number of cases of undiagnosed gonorrhoea in England. It is thought that while the majority of infections among men are symptomatic, a significant proportion are asymptomatic and therefore more likely to remain undiagnosed. The proportion of asymptomatic infections is higher among women.

There are no estimates on undiagnosed cases of hepatitis B in England.

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Estimates( 1) of prevalent HIV infections among adults aged 15 to 59, United Kingdom 2004
Exposure category	Number diagnosed( 2,3)	Number undiagnosed	Total
Sex between men	17,400	9,100	26,500
	(16,900, 17,900)	(6,600, 13,300)	(23,900, 30,700)
Injecting drug use	1,300	600	2,000
	(1,300, 1,400)	(500, 800)	(1,800, 2,100)
Heterosexuals	19,900	9,800	29,700
	(19,300, 20,600)	(7,600, 13,000)	(27,600, 32,900)
Men	7,400	4,700	12,000
	(7,100, 7,600)	(3,600, 6,700)	(10,900, 14,100)
African born	4,600	1,600	6,200
	(4,400, 4,700)	(1,000, 2,700)	(5,600, 7,300)
Non-African born	2,800	3,000	5,900
	(2,700, 2,900)	(2,300, 4,200)	(5,100, 7,000)
Women	12,500	5,100	17,700
	(12,100, 13,000)	(3,900, 6,700)	(16,500, 19,200)
African born	9,300	2,400	11,700
	(8,900, 9,600)	(1,700, 3,400)	(10,900, 12,700)
Non-African born	3,300	2,700	6,000
	(3,100, 3,400)	(2,100, 3,500)	(5,400, 6,800)
Grand total	38,600	19,700	58,300
	(37,500, 39,800)	(16,100, 24,800)	(54,700, 63,400)
(1) Numbers diagnosed and undiagnosed (rounded to the nearest 100) were estimated using multi- parameter evidence synthesis, in an extension of the method described in Goubar A et al Bayesian multi-parameter synthesis of HIV surveillance data in England and Wales, 2001, 2005 submitted. (2 )Numbers diagnosed exclude individuals aged 15 to 59 with unknown area of residence (570 in 2004). (3) Numbers diagnosed exclude individuals aged 15 to 59 infected through blood or blood products or tissue (410 in 2004) or through mother-to-child transmission (120 in 2004). Source: SOPHID; CD4 monitoring; reports of deaths in HIV-infected individuals; Natsal 2000; unlinked anonymous prevalence monitoring; national study of HIV in pregnancy and childhood (NSHPC)

Suicidality

Tim Loughton: To ask the Secretary of State for Health if she will publish the research undertaken by Government agencies on the effects of certain drugs on suicidality. [69942]

Andy Burnham: The Medicines and Healthcare products Regulatory Agency (MHRA) has published research into the effect of selective serotonin reuptake inhibitors (SSRIs) on suicidal thoughts and behaviour. The report of the committee on safety of medicines expert working group on the safety of SSRIs was published on 6 December 2004 and is available on the MHRA’s website at www.mhra.gov.uk. A copy is available in the Library. The MHRA is committed to publishing the research which underpins its decisions on safety of medicines.

Tuberculosis

Dr. Murrison: To ask the Secretary of State for Health (1) what plans the Government have to change screening arrangements for tuberculosis at United Kingdom (a) ports and (b) airports; and if she will make a statement; [67429]

(2) how many X-ray machines for tuberculosis screening are located at each United Kingdom (a) port and (b) airport; and if she will make a statement; [67430]

(3) how many immigrants were (a) screened for and (b) found to have tuberculosis in each of the last 12 months for which figures are available; and if she will make a statement; [67431]

(4) how many follow-up health checks were conducted on immigrants to the United Kingdom in each year since 1997; and if she will make a statement; [67432]

(5) what action she plans to take in response to the Health Protection Agency’s report on screening arrangements for tuberculosis at United Kingdom points of entry; and if she will make a statement. [67435]

Caroline Flint: The Immigration Act 1971 gives immigration officers the power to refer people who are subject to immigration control and who are seeking entry to the United Kingdom to a medical inspector for a medical examination. The immigration officer may take the findings of the medical examination into account when deciding whether to admit the person to the UK.

The long-standing policy of successive Governments are that people who come from a country with a high annual incidence rate of tuberculosis (over 40 cases of TB per 100,000 population) and who are seeking leave to enter the UK for more than six months and port asylum claimants should routinely be referred for medical examination. In addition, immigration officers should refer for medical examination anyone who appears ill, or who mentions health or illness as a reason for coming to the UK. Because of the large numbers of travellers passing through Heathrow and Gatwick airports, there are three x-ray machines at Heathrow and one at Gatwick for taking chest x-rays.

The time pressures at points of entry mean that it is not possible, even where x-ray machines are available, to carry out there all the tests that would be desirable, or to make firm diagnoses of TB. That is why long-standing policy is that checks carried out at points of entry should be followed up by the national health service. This was reinforced by the “NICE TB Clinical Guidelines” published on the 22 March 2006, which make clear recommendations to the NHS to identify new entrants for TB screening from port of arrival reports (that is, information from medical inspectors), new registrations with primary care, entry to education (including universities) and links with statutory and voluntary groups working with new entrants. The National Institute for Health and Clinical Excellence also have provided screening protocols and toolkits for the NHS for new entrant screening. The Department does not routinely collect figures from points of entry on the numbers of immigrants screened for TB. Follow up health checks on immigrants may take a variety of forms, in a variety of settings, and are not identified as such in statistics about NHS activity.

As announced in February 2005, in the Home Office’s five-year asylum and immigration strategy “Controlling our Borders” (Cm 6742), the Government plan to increase the number of routine TB checks that are done abroad. Checks overseas can be more thorough than those that can be made under pressure of time at points of entry, and those found to have infectious TB are required to complete treatment before entry clearance to the UK is granted. Phase one of this overseas programme began in autumn 2005 has been operational in six countries (Bangladesh, Cambodia, Laos, Sudan, Tanzania and Thailand) since spring 2006. Phase two is planned to start later in 2006.

The Department and the Home Office commissioned a review of the operational arrangements made at points of entry in England both for medical examinations under the Immigration Act and for discharging responsibilities under the Public Health (Aircraft), (Ships) and (International Trains) Regulations with a view to strengthening those arrangements. (Responsibility for the health input into operational arrangements at points of entry in Scotland, Wales and Northern Ireland rests with the Scottish Ministers, National Assembly for Wales, and Department of Health, Social Services and Public Safety in Northern
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Ireland). The review was carried out by a project team led by the Health Protection Agency (HPA) and with Home Office representation. Their report is on the Agency's website at www.hpa.org.uk/porthealth/default.htm. Specific actions relevant to medical examinations under the Immigration Act 1971 that are being taken in the light of the review are that:

the Department will continue, as already planned, with an evaluation of the effectiveness of routine TB checks, both overseas and at points of entry;

the HPA will take the overall operational lead at points of entry in England to ensure that there are appropriate operational arrangements for medical examinations under the Immigration Act 1971, ensuring that this and appropriate supporting actions are reflected in its business plan;

the Home Office will take forward with appropriate consultation a proposal that the accommodation needed for medical examinations under the Immigration Act should be provided free of charge; update the relevant Immigration Directorate Instructions; and survey the impact that advice from those who carry out medical examinations has on the entry decisions taken by immigration officers; and

the Department and the Home Office will seek an opportunity to modernise the legislation on medical examinations under the Immigration Act, giving the responsibility for carrying out examinations to a body with health functions (such as the HPA) rather than to individually appointed medical inspectors.

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