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6 July 2006 : Column 1245W—continued
GP Referrals
Mr. Lansley: To ask the Secretary of State for Health what research she has commissioned on the clinical effectiveness of adopting a maximum 18-week waiting time target for all GP referrals. [78012]
Andy Burnham:
Research specifically into the clinical effectiveness of introducing a maximum 18-week waiting time was not commissioned. However, there was extensive clinical input to the plans for delivering the 18-weeks commitment, which was published in “Tackling hospital waiting: the 18-week patient pathway” on 10 May 2006. The vision is to provide patients with fast and convenient access to hospital care, enhancing clinical outcomes wherever
appropriate. As now, those with conditions requiring urgent attention will be treated much faster than the average and most waiting times from referral to treatment will be much shorter than 18 weeks.
Herceptin
Martin Horwood: To ask the Secretary of State for Health whether Herceptin will be available on the NHS in Gloucestershire in 2006. [80774]
Caroline Flint: There is no restriction on the national health service to prescribe drugs, within their licensed indications, while the National Institute for Health and Clinical Excellence (NICE) is developing guidance.
On 9 June, NICE published its draft guidance on Herceptin. These recommendations are subject to an appeal period which closed on 28 June 2006. The final guidance is expected to be issued at the beginning of July 2006, assuming there are no appeals.
Once finalised, the recommendations will mean that all eligible patients with early stage HER2-positive breast cancer should receive Herceptin on the NHS within three months of NICE issuing final guidance. Although the recommendations are subject to appeal, there are no national restrictions on the NHS using Herceptin.
Health Care (Shropshire)
Mr. Dunne: To ask the Secretary of State for Health what the (a) Down’s syndrome birth rate and (b) birth defect rate was for each electoral ward in Shropshire, in each year from 2000 to 2005. [82401]
John Healey: I have been asked to reply.
The information requested falls within the responsibility of the National Statistician who has been asked to reply.
Letter from Karen Dunnell, dated 6 July 2006:
As National Statistician I have been asked to reply to your recent Parliamentary Question asking what the (a) Down’s Syndrome birth rate and (b) birth defect rate was for each electoral ward in Shropshire in each year from 2000 to 2005. (82401)
The Office for National Statistics (ONS) is responsible for maintaining the National Congenital Anomaly System (NCAS) notifications in England and Wales. These notifications are collected only for live and stillbirths (e.g. terminations are excluded) and are provided by NHS Trusts on a voluntary basis either directly to ONS on form SD56 or via local congenital anomaly registers that exchange data with ONS. Information on congenital anomalies is routinely published for strategic health authorities. Figures cannot be provided by electoral ward because of the risk of disclosing individual’s information due to very small number of events.
Notifications of congenital anomalies, numbers and rates, in Shropshire County from 2000 to 2004 (the most recent year for which figures are available) are given in the table below.
| Congenital anomaly notifications - Down Syndrome, All babies: number and rates for Shropshire county, 2000-04 | ||||||
| 2000 | 2001 | 2002 | 2003 | 2004 | 2000-04 | |
| * Numbers smaller than 5 and rates based on these numbers have been suppressed to protect confidentiality of individuals. | ||||||
Information Technology
Mr. Lansley: To ask the Secretary of State for Health how much was spent on information technology by (a) NHS trusts and (b) primary care trusts in (i) 2002-03, (ii) 2003-04, (iii) 2004-05 and (iv) 2005-06. [74060]
Caroline Flint: The information requested is shown in the table.
| £ millions | |||
| 2002-03 | 2003-04 | 2004-05 | |
These figures, rounded to the nearest whole million pounds, comprise revenue expenditure reported through a national survey of information technology investment by national health service organisations; and capital expenditure, including information technology additions and software licences, identified in NHS accounts. They do not include expenditure by strategic health authorities, special health authorities, or central expenditure funded by the Department.
For each year in the table, revenue expenditure is understated because a small percentage of NHS organisations, averaging four per cent. per year, failed to complete returns.
Information for 2005-06 is not yet available.
Malnutrition
Mr. Burstow: To ask the Secretary of State for Health how many and what percentage of people (a) admitted to and (b) discharged from hospital were malnourished in the last year in which figures are available, broken down by age; and if she will make a statement. [81699]
Caroline Flint: Information on the numbers admitted and discharged is shown in the following table.
| Count of finished in-year admission episodes and in-year discharges where the patient’s main diagnosis was malnutrition, national health service hospitals in England, 2004-05 | ||||||
| Age | Malnutrition admissions | All admissions | Malnutrition admissions per 100,000 | Malnutrition discharges | All discharges | Malnutrition discharges per 100,000 |
Mental Health
Chris Ruane: To ask the Secretary of State for Health if she will seek to amend the rules governing confidentiality of personal information for those with severe mental health problems to ensure that specified family members may be given full disclosure of medication and treatment. [77114]
Caroline Flint: The rules governing confidentiality of personal information distinguish between individuals who lack the capacity to meaningfully consent to, or dissent from, information being shared, and those who have this capacity. Where capacity is judged to be absent, a health professional is expected to share information with those who need to know, including family members where appropriate, where this is in the patient's best interest or where the public interest in sharing outweighs the obligation of confidentiality.
Where an individual has the capacity to consent but refuses to do so, a health professional may still disclose information where the public interest served by doing so outweighs the obligation of confidentiality. This may include, where the risk is sufficient to warrant it, the protection of the individual's health or to safeguard others.
Where a patient is being cared for under the provisions of the Mental Health Act 1983, their nearest relative has certain statutory rights in relation to their detention and guardianship.
The Department will be revising its confidentiality guidelines during the course of this year and the importance of keeping family members informed will be given appropriate emphasis.
NHS Care Records Service
Mr. Lansley: To ask the Secretary of State for Health for what reasons she has delayed the introduction of the NHS Care Records Service (CRS); where she expects the pilot sites to test the NHS CRS will be established; and what information will be uploaded onto the national system (a) under the NHS CRS pilots and (b) when the NHS CRS is fully enabled. [75440]
Caroline Flint: The NHS Care Records Service (NHS CRS) is the key component of the new systems and services being delivered through the national programme for information technology. It has a number of applications, including:
personal demographics service (PDS), which holds nationally demographic information for every patient covered by the national health service in England, accessible through local systems, and is currently processing message transactions at a rate of over 9 million per month;
spine directory services, which holds reference data such as users and locations. Over 260,000 users are now registered, around 50,000 currently access the system on any given day;
access control framework, which registers and authenticates users, including patients, and provides a single log-in and a record of each professional accessing a NHS care record; and
transaction messaging system, which processes and routes data messages, for example from a GP to a hospital or from one general practitioner to another.
Introduction of the NHS CRS has not been delayed. These four elements went live on time and to budget in July 2004 to support choose and book. Among other planned applications, the first stage of the secondary uses service went live in June 2005 to support payment by results. Other core modules are scheduled for release over the course of 2006 and 2007. However, ambitious initial targets were set to drive the programme, and some individual components have been delayed.
In general implementation is being achieved in carefully managed stages, via incremental rollout both geographically, and by increasing functionality over time to build the care record. The programme is about patient and clinician benefit and improved safety. We believe it is best to get things right in the long term rather than to push on regardless against a rigid
timetable and risk getting things wrong in the short term. In the context of a 10-year programme the impact of this is limited.
When fully deployed, the NHS CRS will be made up of records of individual clinicians recording episodes of care, key aspects of which will be placed in the detailed care record for sharing with others as their roles allow within local health communities, and a summary care record. The national programme’s national clinical leads, working with NHS Connecting for Health, have undertaken work with a wide range of groups including the British Medical Association and the royal colleges to consider the best way of populating and launching the summary care record.
As a result, a limited amount of clinical information will be automatically uploaded, such as prescriptions and allergies. More detailed information would then be added on a case by case basis. This approach is supported by the BMA on the basis that as it takes full account of the views of patients.
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