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25 July 2006 : Column 1196W—continued
Bowel Cancer
Anne Main: To ask the Secretary of State for Health what measures she has put in place to reduce waiting times for referral to specialists for bowel cancer patients. [86679]
Ms Rosie Winterton: A maximum two-week out-patient waiting time standard was introduced in 2000 for urgent general practitioner referrals for suspected bowel cancer. In the last quarter (January to March 2006) 99.9 per cent. of urgent referrals for suspected bowel cancer were seen by a specialist within two weeks.
Cadbury Schweppes
Chris Huhne: To ask the Secretary of State for Health (1) what (a) manpower and (b) finances are being provided to (i) Birmingham city, (ii) Herefordshire and (iii) Bath and North East Somerset council by the Food Standards Agency in relation to potential legal action against Cadbury Schweppes; and if she will make a statement; [87762]
(2) when Cadbury Schweppes will introduce (a) a positive release system and (b) changes to the testing regime for its products; when it will (i) start and (ii) complete the process of (A) cleaning and (B) improving its Marlbrook plant; and if she will make a statement. [87763]
Caroline Flint: The Food Standards Agency (FSA) has offered both financial and manpower resources to support investigations by the relevant local authorities. To date Herefordshire council has requested and been provided with the services of an investigator from the FSA. Cadbury Schweppes informed the FSA on 6 July that they had introduced a positive release system and changed their testing regime with immediate effect. Cadbury Schweppes also agreed to a programme of cleaning and improvement at the Marlbrook plant starting with immediate effect. This work, monitored by Herefordshire council, is scheduled to last six months to be followed by an ongoing programme of cleaning and maintenance.
Chris Huhne: To ask the Secretary of State for Health what the criteria were by which the Food Standards Agency decided which Cadbury Schweppes products should be recalled; and if she will make a statement. [86428]
Caroline Flint: Article 14 of EC regulation 178/2002 prohibits food being placed on the market that is unsafe. Article 19 places obligations on food businesses to recall, and/or withdraw, food from the market if they have reason to believe it is not in compliance with the food safety requirements of Article 14. In deciding which Cadbury Schweppes products were unsafe and should therefore be recalled the Food Standards Agency received advice, from the Advisory Committee on the Microbiological Safety of Food, that there is no acceptable level of Salmonella in ready to eat foods.
Cancer Care
Anne Main: To ask the Secretary of State for Health what progress has been made by the group comprising officials from (a) her Department, (b) the Department for Work and Pensions and (c) Macmillan Cancer Relief since March 2005 to ensure more efficient delivery of benefits to cancer patients; and if she will make a statement. [86717]
Ms Rosie Winterton: Since March 2005, both the Department and the Department for Work and Pensions have met with Macmillan Cancer Relief to discuss steps that can be taken to ensure that cancer patients are signposted to information and advice about benefits. These discussions are continuing and in particular, through proposals announced in the White Paper “Our Health, Our Care, Our Say” to develop information prescriptions for people with long-term conditions.
Anne Main: To ask the Secretary of State for Health what progress has been made in the extending of best practice to improve support for dying patients and their families since the publication of the 19(th) report of the Committee of Public Accounts, Tackling Cancer: improving the patient journey. [86725]
Ms Rosie Winterton: The National Cancer Director and cancer action team are working with strategic health authorities (SHAs) and cancer networks on the implementation of the National Institute for Health and Clinical Excellence’s supportive and palliative care guidance. Cancer networks have been required to set out action plans with key milestones to achieve compliance with the recommendations in the guidance. Implementation is being monitored by SHAs.
Ministers have asked the National Cancer Director, Professor Mike Richards, with support from Professor Ian Philip, the National Director for Older People, to prepare a new end of life care strategy. This will include examples of good practice and will be disseminated across the health service.
Mr. Sheerman: To ask the Secretary of State for Health what steps her Department is taking to encourage hospitals to help with transportation costs for cancer patients. [82797]
Ms Rosie Winterton: Hospital travel costs scheme (HTCS) provides financial assistance to those patients, including cancer patients, who do not have a medical need for ambulance transport, but who require assistance in meeting the cost of travel to and from their care. The Department has published good practice guidance to support trusts when administering the scheme. The guidance states that information about the scheme should be displayed in all patient areas and included in all appointment or admission letters. It is for individual trusts to decide how good practice is implemented locally.
As part of the ‘Our health, our care, our say’ White Paper commitment to expand the HTCS to include referrals by health care professionals, we will be consulting on the impact of this as well as other issues, such as alternative ways to raise awareness of the scheme.
Mr. Lansley: To ask the Secretary of State for Health what plans she has to alter the role of primary care trusts in the (a) commissioning and (b) contracting of (i) out-patient and (ii) in-patient cancer services; whether she expects elements of the (A) commissioning and (B) contracting process will be undertaken by organisations outside the public sector; and if she will make a statement. [88301]
Ms Rosie Winterton: Commissioning is the process which determines how the health and health care budget is issued. The process must result in a good deal both for taxpayers and for patients, whether this is for cancer or other services.
Commissioning will not be the responsibility of a single organisation in a patient-led national health service. Rather it will be a partnership between primary care trusts (PCTs), general practice and local government.
Practices will play a central role in the future health system as the integrator of services for each patient. With indicative budgets for almost all primary and secondary care services, practice based commissioners (PBC) will be discussing and shaping with specialist and other health professionals the best patterns of care in their area, ensuring that their patients have available to them health services that best suit their needs. PCTs will also act as the agent of their practices, securing and holding contracts on behalf of practices.
The proposed new local involvement networks (LINKS) will have a key role to play in helping commissioners use people's knowledge and experience to improve services they use.
PCT commissioning, PBC and joint commissioning are not alternatives. They are each essential components of an effective commissioning process.
Different aspects of cancer care will need to be planned and commissioned at different levels, according to the rarity of the disease or intervention. The important thing is that commissioning is co-ordinated within the context of the local cancer network.
The Health Reforms support health care organisations to provide responsive services closer to home, making NHS providers stronger with greater freedom to innovate and creating more opportunities for voluntary sector, social enterprise and independent sector where local people and commissioners see the need.
The great majority of health services will always be publicly owned. The exact mix locally will be for patients, through choice, and general practitioners and PCTs, using the commissioning process, to decide.
We have launched a national procurement of commissioning expertise, using a framework agreement and call-off contract. Accredited providers will be made available to the NHS locally to support PCTs in their commissioning functions, should they need such expertise or support. This would form part of the Department’s programme to strengthen NHS commissioning by providing PCTs with world class commissioning expertise from the private sector.
The revised Official Journal of the European Union advert makes it clear that no PCT can hand over to the private sector their public accountability for commissioning decisions.
There is scope for a number of diagnostic and treatment services related to cancer to be provided by the independent sector. However, it will be important to ensure that any such services are provided within the context of the local cancer network and that standards of care/treatment are the same as in the NHS.
Cannabis
Tim Loughton: To ask the Secretary of State for Health how much was spent by her Department on treatment for cannabis dependence in the last period for which figures are available. [88014]
Caroline Flint:
Funding for drug treatment is not allocated according to drug type. The pooled treatment budget (PTB) for drug treatment is given to drug action teams across the country which spend this allocation based on the need of the local community. The PTB for 2006-07 is £375 million. In addition, £20 million capital
is being made available to help support the expansion of residential rehabilitation and in-patient detoxification and other treatment services.
Carcase Deboning
Mr. Roger Williams: To ask the Secretary of State for Health for what reason the deboning of carcases in butchers’ shops is restricted in the UK to bovine animals under 24 months.[R] [87003]
Caroline Flint [holding answer 20 July 2006]: The deboning of carcases in butchers’ shops is not restricted just to bovine animals under 24 months. In line with the Community TSE Regulation, any butcher in the United Kingdom wishing to remove vertebral column from bovines between 24 to 30 months of age, is able to do so providing they obtain an authorisation from their local authority.
Cardioverter Defibrillation
Dr. Desmond Turner: To ask the Secretary of State for Health what percentage of patients with relevant conditions use implantable cardioverter defibrillation; and what financial savings have been identified from their use. [86359]
Ms Rosie Winterton: This information is not collected centrally.
CCBRT
Anne Milton: To ask the Secretary of State for Health pursuant to the Answer of 14 June 2006, Official Report, column 1278W, on Consultant Contract Benefit Realisation Team (CCBRT), what the cost was of the CCBRT; how the effectiveness of CCBRT was measured; and what results CCBRT produced during the time it was operational. [84042]
Andy Burnham: The Consultant Contract Benefits Realisation Team (CCBRT) was set up in March 2005 and the 2005-06 total allocation of funding was £595,000. The effectiveness of the team's work was assessed against its objectives to:
examine the implementation of the consultant contract;
assess the value of the consultant job planning toolkit;
identify how clinical leads have been developed to undertake job planning; and
identify benefits gained and disseminate good practice.
The team produced a final report to the strategic health authority in May 2006 the lesson from which are still under discussion.
Chest Diseases
Mr. Amess: To ask the Secretary of State for Health what the estimated cost was to the national health service of the treatment of chest diseases in each year since 1995. [85161]
Mr. Ivan Lewis: We do not have data before 2002-03. Since then, the Department’s resource accounts have included details of expenditure by programme budget categories. Gross national health service expenditure on respiratory problems is shown in the following table.
| Gross expenditure £000 | |
| Source: Department of Health Resource Accounts 2002-03 (HC 191), 2003-04 (HC 150), 2004-05 (HC668). | |
Child Health Interim Application
Mr. Stephen O'Brien: To ask the Secretary of State for Health what recent assessment she has made of the impact on children in London of the failure of the child health interim application. [85633]
Caroline Flint: Affected primary care trusts (PCTs), departmental colleagues, Connecting For Health (CfH) and the Health Protection Agency (HPA) are currently carrying out an assessment review of the COVER statistics that have been produced by the HPA. The assessment is not yet complete but it appears that in some areas uptake of immunisation differs from what may have been expected. It is not yet clear whether the data received is complete, or if there is a drop in uptake, whether or not the problem is related to the child health interim application (CHIA) and/or other factors. Once the outcome of the review is complete, an action plan will be determined by the team to address the matter.
In addition, CfH, the Department's immunisation team, HPA and the strategic health authority (SHA) have been working with the contractor (BT) to ensure that current problems with CHIA are managed effectively to provide child health teams with a more reliable system for the immediate future. An options appraisal has also been commissioned to consider the relative merits of either continuing work on the current system, or introducing an alternative system. This appraisal will be completed by September 2006. In the meantime, BT is continuing to provide support to PCTs to try to improve the present situation.
Mr. Stephen O'Brien: To ask the Secretary of State for Health if she will make a statement on problems with the child health interim application. [85637]
Caroline Flint: The problems with the child health interim application (CHIA) have been addressed by a number of press releases from Connecting for Health (CfH). Colleagues from the Department and CfH are taking an expedient and pragmatic approach with the primary care trusts, strategic health authority and suppliers to resolve these issues in the short term and to review the options available for ensuring that a full and robust system is employed in the longer term.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what estimate she has made of the cost of identifying and vaccinating children affected by the disruption to child health services through problems with the Child Health Interim Application. [85638]
Caroline Flint:
It appears from the COVER reports that the number of children being immunised in some areas may not be as expected; however, as the returns received may be incomplete, we cannot at this stage
draw any conclusions. An assessment review to determine the scope of the problem is being taken forward by colleagues at the Department, Connecting for Health, primary care trusts and strategic health authority and the suppliers (BT) who are working together to move the child health interim application forward as quickly as possible, as well as implement a more robust solution in the longer term.
Once these issues have been resolved an investigation will commence to identify children who do not appear to have had due immunisations. There will then be a catch-up operation to ensure that these children are protected as soon as possible. At this stage, it is not possible to identify the cost of these exercises.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what action she plans to take in relation to the primary care trusts using the child health interim application which have not filed data with the Health Protection Agency in this quarter. [85920]
Caroline Flint: The provision of primary care trust (PCT) immunisation reports to the Health Protection Agency (HPA) forms the basis of the HPA COVER reports, which are an important resource for measuring immunisation uptake across the country. It is in everyone’s interests to ensure that all child health systems are able to facilitate this operation by producing statistics that can be used for the national COVER report. Whilst it is true that child health interim application (CHIA) has not been able to produce reports, colleagues at Connecting for Health and the strategic health authority have been working with the to try and produce reports from the raw data within CHIA for the last quarterly and annual returns.
The provision of a permanent solution to provide COVER reports for the PCTs is currently the highest priority objective for the next software release of CHIA.
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