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Andy Burnham: The most recent estimate of the burden of adverse drug reactions (ADRs) in the United Kingdom (UK) comes from a study published in the British Medical Journal in July 2004. The study conducted in two large hospitals in Merseyside, suggested that ADRs account for one in 16 hospital admissions. This is a similar estimate to a number of studies worldwide, including figures from the United States of America.
This study highlights the importance of effective systems for monitoring and responding to issues relating to the safety of medicines, a process called pharmacovigilance. This study, which was funded by the Medicines and Healthcare products Regulatory Agency (MHRA), underlines their commitment to improving the evidence base for pharmacovigilance in the UK.
This study also highlights the vital importance of safety information which meets the needs of prescribers and patients. The MHRA committee on safety of medicines publication Always read the leaflet proposed actions to improve risk communication, including development of a leaflet for patients published by the MHRA. The commission on human medicines has established a working group to examine ways to improve the provision of safety information accompanying medicines.
Changes to medicines legislation introduced in 2005 were also designed to enhance the capability of regulation to reduce the burden of adverse drug reaction, for example in the requirement on marketing authorisation holders to develop risk management plans for newly licensed medicines.
Lynda Waltho: To ask the Secretary of State for Health what steps she is taking to increase (a) access to and (b) capacity of specialist alcohol treatment services; and what plans she has (i) to respond to and (ii) to implement recommendations arising out of the departmental alcohol needs assessment research project. 
Commissioning of specialist alcohol treatment services is the responsibility of primary care
trusts (PCTs). The Department has issued to PCTs Alcohol Misuse Interventions: Guidance on Developing a Local Programme of Improvement. It provides practical steps on improving interventions and services for problem drinkers based on local need. It will be supported by the soon to be published Models of Care for Alcohol Misuse (MoCAM), which will provide commissioners with a framework against which to commission effective, quality services. MoCAM is informed by an extensive effectiveness review, which will be published as a companion document.
Caroline Flint: There are no centrally held records on the general use of complementary and alternative medicines within the national health service. The Government considers that decision making on individual clinical interventions, using either complementary or alternative medicines or more orthodox medicines, is a matter for local NHS service providers and practitioners. However, when making any clinical decisions, clinicians are expected to consider the safety and effectiveness of treatments whether complementary, alternative or orthodox medicines.
Mr. Ivan Lewis: The existing national framework agreement for the provision of adult hearing services to the national health service is operational until September 2006. Since October 2003, there have been over 52,000 patient journeys provided to the NHS through this agreement. A separate procurement is currently being undertaken by the commercial directorate of the Department to support improvements to diagnostic capacity in the NHS. This procurement includes the potential for approximately 42,000 patient journeys per annum to be provided to the NHS for adult hearing services.
The guidance recently published by the Department around implementing the 18-week patient pathway, whilst not including direct access adult hearing services, made reference to the development of a national action plan. The Department is considering a number of options to improve services and to provide sustainable solutions.
Mr. Stewart Jackson: To ask the Secretary of State for Health what the waiting time is for the fitting of digital hearing aids in the Greater Peterborough Primary Care Partnership area; and if she will make a statement. 
Mr. Willis: To ask the Secretary of State for Health what the total cost is of the research being conducted by York Health Economics Consortium and the School of Health and Related Research at Sheffield University into the costs and benefits of current services for bowel cancer. 
Mr. Baron: To ask the Secretary of State for Health what information cancer networks have been asked to submit to her Department as part of the follow-up to the report by the National Cancer Director on variations in the usage of cancer drugs approved by the National Institute for Health and Clinical Excellence; and when she expects to publish the results of the follow-up. 
Ms Rosie Winterton: As in the first review, each cancer network was provided with centrally held information on its usage of the 16 National Institute for Health and Clinical Excellence (NICE) appraised cancer drugs and four cancer drugs which have not been appraised by NICE. The information covered the period from January to June 2005.
Mr. Baron: To ask the Secretary of State for Health what estimate she has made of the number of specialist cancer nurses working in the NHS in each of the last five years; and what steps she is taking to increase this number. 
Work force planning is the responsibility of local national health service employers and strategic health authorities, who must ensure that they have sufficient staff, with the right skills to meet local service needs.
The Department's capital investment plans are set out in chapter four of the Departmental Report 2006 published in May of this year. This states that the public capital resources available to the national health service will increase by a further £950 million in
2006-07, a real terms increase of 21 per cent., and outlines the priorities for this funding during 2006-07. As in previous years, there will also be further investment through the private finance initiative and NHS local improvement finance trust, the public-private partnership vehicle for transforming primary care premises.
Lynne Jones: To ask the Secretary of State for Health what services for children who have been sexually abused are funded by her Department; and what mechanisms are in place to provide liaison between services funded by her Department and those provided by other funding streams. 
Mr. Ivan Lewis: Specialist services including treatment for sexually transmitted infections, termination of pregnancy and mental health services are available for those children who need them as a result of sexual abuse. For children with less severe mental health problems, it is more appropriate for universal services to provide the psychological support they need than for them to be referred to specialist child and adolescent mental health services.
It is important that child and adolescent mental health services (CAMHS) are developed in a way that is responsive to the needs of the populations they serve. The CAMHS standard of the children's national service framework (NSF) sets out the requirement for an assessment of the needs of particular groups of children in the locality who are vulnerable or at risk. The NSF also states the commissioners and services should be able to demonstrate multi-agency partnership working in the following areas: the provision of services to children and young people who may or may not have been harmed, as set out in Working Together to Safeguard Children; contributing to the assessment of complex child abuse cases; the assessment and provision of post-abuse therapeutic services; and services for looked-after and adopted children.
The Department has been working closely with the Home Office to develop sexual assault referral centres (SARCs). A SARC is a one-stop location where victims of rape and sexual assault can receive medical care and counselling, and have the opportunity to report to the police and undergo a forensic examination. The joint Department of Health and Home Office National Service Guidelines for Developing Sexual Assault Referral Centres (SARCs) was published in October 2005.
Since 2003, £1.27 million from the Home Office's Victims Fund has been spent on new and existing SARCs. The Department has an important role in allocating these resources as departmental officials are on the committee that make grant assessments. SARCs currently operate in 14 locations in England and Wales and there are six more due to open in the forthcoming year.
The Department and the Home Office are supporting the development of appropriate services for children within existing or new SARCs. St. Mary's SARC in Manchester has established a service for children. In London, Project Amethyst was piloted in 2005-06 jointly by local police and health to provide services for children in association with the three London SARCs (the Havens
in Camberwell, Whitechapel and Paddington). A number of the new SARCs scheduled to open will be providing services for children.
Bob Spink: To ask the Secretary of State for Health what plans she has to meet the Association of Children's Hospices to commence formal discussions on a sustainable long-term funding arrangement for delivery of palliative care to children and respite to their families; and if she will make a statement. 
Mr. Ivan Lewis: Departmental officials have already held a preliminary meeting with the Association of Children's Hospices and will have further discussions with them and other stakeholders about the forthcoming review of children's hospice services and their long-term funding.
Mr. Jenkin: To ask the Secretary of State for Health what the average waiting time was in Colchester primary care trust (PCT) for chiropody/podiatry treatment in the past 12 months; what the average waiting time for such treatment was in other primary care trusts of equivalent size, demographic character and spending patterns; whether all the funding allocated by Colchester PCT for employing clinical staff in chiropody/podiatry in that period was used; whether there are fewer clinical staff applying for jobs in chiropody/podiatry than vacant posts in that area; and if she will make a statement. 
Andy Burnham: This information is not held centrally by the Department. Primary care trusts are responsible for assessing the needs of their local community. They have the resources to commission services, and to identify the number of professional and non-professional staff they need to deliver those services. This process provides the means for addressing local needs within the health community, including the provision of chiropody and podiatry services.
Bob Russell: To ask the Secretary of State for Health (1) whether there is a requirement for the costs incurred by the private sector partner in preparing the abandoned private finance initiative expansion at Colchester General Hospital to be repaid to the partner; what estimate she has made of the costs; and if she will make a statement; 
(2) what estimate she has made of the costs incurred by (a) Essex Rivers Healthcare Trust and (b) the national health service centrally in preparing the abandoned private finance initiative expansion at Colchester General Hospital; and if she will make a statement. 
Andy Burnham: The Government's policy is that whenever a procuring authority such as Essex Rivers Healthcare Trust abandons a viable, affordable project, reasonable compensation should be paid for costs incurred by bidders.
To date, no discussions have been held with either the trust or their private sector partner to determine if the Government's policy applies to the circumstances under which this project was abandoned nor of the likely costs.
Mr. Graham Stuart: To ask the Secretary of State for Health (1) how much of the £100 million capital investment to build, rebuild or refurbish at least 50 community hospitals identified by her Department has been earmarked for new projects; how much has been spent; and if she will make a statement; 
Andy Burnham: Configuration of local service provision facilities, including the building of new community hospitals, is a matter for primary care trusts (PCTs). Therefore, the Department has not historically monitored the number of new community hospitals that have been built and it is not possible to provide the data requested in relation to this.
As confirmed in the White Paper Our health, our care, our say: a new direction for community services, the Government fully intends to fulfil its manifesto commitment to develop a new generation of modern national health service community hospitals over the next five years.
The Department will shortly be publishing further guidance, which will outline the next steps that PCTs and strategic health authorities need to take to access central capital to invest in community hospitals and services. Capital will be available but has not currently been earmarked for specific projects.
Mr. Graham Stuart: To ask the Secretary of State for Health whether her Department plans to assess the effect on the number of community hospitals of primary care trust deficits; and if she will make a statement. 
Andy Burnham: There are no plans to assess the effects of primary care trust (PCT) deficits on the provision of services in community hospitals. Commissioning decisions are of course for local determination. However, the White Paper Our health, our care, our say makes it clear that community facilities, including community hospitals, should not be lost in response to short-term budgetary pressures in PCTs that are not related to the viability of the community facility itself. Therefore, no community hospitals should be closed solely as a result of national health service PCT budget deficits.
A letter was sent to strategic health authorities (SHAs) on 16 February, which concerned the commitment relating to community hospitals, made in paragraphs 6.42 and 6.43 of the aforementioned White Paper. This letter provided instruction on how SHAs should go about ensuring and testing that PCTs comply with the commitment made. A copy of this letter is available in the Library.
Sandra Gidley: To ask the Secretary of State for Health (1) what arrangements health authorities are required to put in place for the provision of independent advice for NHS patients' consideration of signing up for continuing care; 
Mr. Ivan Lewis: Following a rigorous procurement exercise, the Department has recently awarded contracts to three organisations who will deliver a new and improved independent complaints advocacy service (ICAS) from 1 April 2006 across England. The ICAS provides an advocacy for all national health service services, including NHS continuing care. The Carers Federation, South East Advocacy Projects and POhWER have been delivering ICAS under contract to the Department since 1 September 2003, bringing a wealth of experience and expertise in general and specialist advocacy service delivery.
The consultation on an improved national framework for continuing care was launched on 19 June 2006. We cannot anticipate what the new framework will be until the consultation is completed, and we have considered all responses.
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