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Chiropractors

Mr. Hancock: To ask the Secretary of State for Health pursuant to the answer of 5 June 2006, Official Report, column 353W, on chiropractic management, how many chiropractors were employed by the NHS in each of the last three years; and at what cost. [79850]

Ms Rosie Winterton: Information on the number of chiropractors and the cost to the national health service is not available as chiropractors were not separately identified in the workforce census from the rest of the non-medical work force.

Choose and Book Service

Anne Milton: To ask the Secretary of State for Health how much money has been spent on the choose and book service. [77059]

Mr. Ivan Lewis: I refer the hon. Member to the reply given to the hon. Member for St. Albans (Anne Main) on 10 March 2006, Official Report, columns 1812-13W.

Mr. Stephen O'Brien: To ask the Secretary of State for Health what percentage of patients have been unable to book an appointment on the telephone and online when they have been given a unique booking reference number by the Choose and Book system as a result of (a) human failure and (b) system error. [76380]

Mr. Ivan Lewis: The information requested is not collected centrally.

Clinical Academic Staff

Mr. Drew: To ask the Secretary of State for Health what plans she has to increase the number of clinical academic staff in (a) medical and (b) dental schools. [86364]

Andy Burnham: The Department and its partners are taking forward training schemes to implement the recommendations on clinical academic careers made last year by the academic careers sub-committee of modernising medical careers and the United Kingdom clinical research collaboration. In the first round, the clinical academic careers panel has recommended for funding:

The Higher Education Funding Council for England and the Department are also offering funding for up to 200 “new blood” senior lectureships through five annual rounds of awards.


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Clinical Assessment Services

Mr. Clappison: To ask the Secretary of State for Health what assessment she has made of the use of Clinical Assessment Services by primary care trusts; what the plans are for the introduction of a Clinical Assessment Service to deal with patients in Hertsmere; what standard of medical skills will be required of those providing that service; what other service specifications will be required; what target has been set for cost savings as a result of the introduction of the service; what the cost of the service is expected to be; what assessment she has made of the likely effect of the service on waiting times; what opportunities patients will have to have a say in the running of the service; and what consultations have been carried out with patients about the provision of a Clinical Assessment Service in Hertsmere. [86972]

Andy Burnham: Current advice is contained in a letter from the Department's director of access to primary care trust chief executives in July 2005. Referrals to community-based clinical assessment services, and other such centres, should happen only where it adds genuine clinical value for patients. A copy of the letter is available in the Library.

Information about the effects of the use of such services on referrals to secondary care is not held centrally.

Clinical Care (Peter Halley)

James Duddridge: To ask the Secretary of State for Health where within the NHS the on-call doctor at Southend Hospital with responsibility for the treatment of Peter Halley of Southend-on-Sea following admission on 7 May 2004 now works. [87947]

Andy Burnham [holding answer 24 July 2006]: The Department does not hold information on the employment of individual doctors working in the national health service. All NHS trusts who employ doctors including temporary staff have a duty to check the good standing and employment history of those doctors and to ensure that they are fit to practise and fit for purpose, this includes checking whether an alert letter has been issued. Where doctors are supplied through agencies those agencies have a similar duty. Alert letters provide a mechanism by which the NHS can urgently communicate concerns of a serious nature in relation to a healthcare practitioner.

Clostridium Difficile

Sir John Stanley: To ask the Secretary of State for Health (1) which NHS hospital trusts have reported having patients in their hospitals with clostridium difficile in 2006; [88165]

(2) what guidance has been issued to (a) NHS hospital trusts and (b) NHS primary care trusts on dealing with clostridium difficile; and if she will make a statement; [88166]

(3) which primary care trusts have reported having patients in their hospitals with clostridium difficile in 2006. [88168]


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Andy Burnham: Data on the number of “Clostridium difficile” reports for patients aged 65 and over is available for national health service acute trusts from the mandatory surveillance scheme on health care associated infections. Results for 2006 are not available but data for 2005 is available at:

Reporting of data is the responsibility of the NHS acute trust and therefore data are not available for primary care trusts.

The following guidance was sent to chief executives of NHS trusts and made available to Chief Executives of strategic health authorities and primary care trusts:

A joint professional letter from the Chief Medical Officer and the Chief Nursing Officer went out to NHS Trusts in December 2005 to remind them of the importance of this infection. This letter listed the key actions to control “Clostridium difficile” and highlighted the guidance available(1,2). The letter is at:

As part of our delivery programme “Saving lives: a delivery programme to reduce health care associated infections including MRSA” a high impact intervention which is a tool to help reduce “Clostridium difficile” infections was published in June 2006.

A simple guide to “Clostridium difficile” is also available on the Department’s website at:

Although much of the current guidance is still extant we have asked the Health Protection agency to review the national guidance. Mandatory surveillance has shown a clear need to improve NHS performance and we believe that upgrading the level of surveillance and more rapid feedback of results will help performance. Therefore, we intend to move to quarterly publication as soon as it is feasible to do so.

Community Hospitals

Mr. Davey: To ask the Secretary of State for Health how many community hospitals in (a) South West London, (b) Surrey, (c) Middlesex, (d) Greater London and (e) England are having their closure discussed; and in how many such cases the possible closure is a result of NHS trust budget deficits. [58919]

Andy Burnham: Making decisions on local healthcare provision, including the closure of community hospitals, is a matter for primary care trusts (PCTs) and strategic health authorities (SHAs) in consultation with the local population. Therefore,
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the Department does not centrally collect information on the number of community hospitals that are having their closure discussed.

In paragraph 6.42 of the recently published Health White Paper ‘Our health, our care, our say: a new direction for community services’ it was made clear to national health service organisations that community hospital facilities should not be lost in response to short-term budgetary pressures that are not related to the viability of the community facility itself.

Therefore, no community hospitals should be closed solely as a result of NHS primary care trust budget deficits. Therefore, there is a commitment that PCTs taking decisions about the future of community hospitals are required to demonstrate to their SHA that they have consulted locally and have considered options such as developing new pathways, new partnerships and new ownership possibilities. In relation to this commitment, the Department has recently written to SHAs to clarify how it might operate in practice.

The Department has announced a £750 million capital investment programme and recently published a document that sets out how to take forward the agenda on community hospitals and community-based services and facilities. The document also includes case study examples of those areas that are already making the most of their community hospital, and highlights new developments that fit with the vision that the White Paper put forward. The document can be found on the Department’s website at:

Mr. Davey: To ask the Secretary of State for Health what (a) information and (b) support she has made available to hon. Members with community hospitals threatened with closure in their constituency. [58920]

Andy Burnham: The recently published Health White Paper “Our health, our care, our say: a new direction for community services” sets out how the Department intends to fulfil the Government’s manifesto commitment to develop a new generation of modern national health service community hospitals. The Department will keep Parliament updated with progress against this commitment.

However, making decisions on local health care provision, including the closure of community hospitals, is a matter for primary care trusts and strategic health authorities in consultation with the local population. Therefore, the onus is on local NHS organisations to consult with local stakeholders, such as local hon. Members, and to make relevant information available as appropriate.

The Department has announced a £750 million capital investment programme and recently published a document that sets out how to take forward the agenda on community hospitals and community-based services and facilities. The document also includes case study examples of those areas that are already making the most of their community hospital, and highlights new developments that fit with the vision that the White Paper put forward. The document can be found on the Department’s website at www.dh.gov.uk.


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Mr. Davey: To ask the Secretary of State for Health what assessment she has made of the impact of the closure of community hospitals on the elderly; and what steps she is taking to lessen that impact. [58922]

Andy Burnham: This Government have invested heavily on developing alternatives to in-patient stays in hospitals, including more intensive support to enable people to stay in their own homes wherever that is safe and what the individual wants. We set out in the White Paper “Our Health, Our Care, Our Say: a new direction for community services” that community hospitals can play an invaluable role in delivering services that patients need, and want close to home. We have stressed that short-term budgetary pressures are insufficient reason to close viable community hospitals that local people want and that they should only be closed after extensive consultation locally and when any proposals have been tested against the principles set out in the White Paper.

The Department has announced a £750 million capital investment programme and recently published a document that sets out how to take forward the agenda on community hospitals and community-based services and facilities. The document also includes case study examples of those areas that are already making the most of their community hospital, and highlights new developments that fit with the vision that the White Paper put forward. The document can be found on the Department’s website at www.dh.gov.uk.

Mr. Moss: To ask the Secretary of State for Health pursuant to her oral Statement of 5 July 2006, Official Report, column 819W, on community hospitals, how many community hospitals in Norfolk, Suffolk and Cambridgeshire strategic health authority area she assesses as being based in Victorian workhouse facilities. [85963]

Ms Rosie Winterton: Suffolk West Primary Care Trust (PCT) currently provides services at Walnutree Hospital and Cambridge City and South Cambridgeshire PCTs provide services on part of the Brookfields site (Davison House), all of which were workhouses originally.

Mr. Moss: To ask the Secretary of State for Health whether her Department has made an assessment of the likely demand for community hospital beds in East Cambridgeshire and Fenland primary care trust area over the next five to 10 years. [85965]

Ms Rosie Winterton: It is for primary care trust to assess and commission services to meet the needs of the populations that they serve.

Mr. Moss: To ask the Secretary of State for Health how many community hospital beds there were in the East Cambridgeshire and Fenland primary care trust area in each year since 1997. [85980]

Ms Rosie Winterton: The information requested is not held centrally.

Anne Milton: To ask the Secretary of State for Health whether her Department has made an assessment of the likely demand for community
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hospital beds in (a) Guildford and Waverley primary care trust area and (b) Surrey over the next (i) five and (ii) 10 years. [87915]

Andy Burnham: It is for local primary care trusts in conjunction with strategic health authorities to make assessments relating to local health service provision.

Mrs. Riordan: To ask the Secretary of State for Health, pursuant to her oral statement of 5 July 2006, Official Report, column 816-32, on community hospitals, whether the new community hospitals will have midwife-led maternity services. [85284]

Andy Burnham: As stated in the publication ‘Our Health, Our Care, Our Community: investing in the future of community hospitals and services’ the clinical possibilities of community hospitals and their range of services are considerable. Annex A of that publication, outlines some of the possibilities, which include maternity services.

However, decision making on specific local healthcare provision, including midwife led maternity services, is a matter for primary care trusts and strategic health authorities in consultation with the local population.

Mr. Gray: To ask the Secretary of State for Health what estimate her Department has made of the number of community hospital beds which will be needed in the next 10 years. [85494]

Andy Burnham: It is for local primary care trusts in conjunction with strategic health authorities to make assessments relating to local health service provision.

Contestability Process

Mr. Godsiff: To ask the Secretary of State for Health which operational areas of her Department’s work are being reviewed under the contestability process. [62680]

Mr. Ivan Lewis: The Department is not reviewing new areas for contesting departmental functions although some services continue to be contracted out such as information technology maintenance, catering, occupational health and photocopying.

Continuing Care

Mr. Lansley: To ask the Secretary of State for Health pursuant to her answer of 13 July 2006, Official Report, column 2042W, on continuing care, if she will make it her policy that no-one currently in receipt of continuing care will lose their entitlement to it with the introduction of the national framework for continuing care. [87693]

Mr. Ivan Lewis: We are consulting on a draft national framework until 22 September 2006, and it would be inappropriate to enter into specific commitments until all consultees have had an opportunity to comment and for those comments to be considered.

However, the national framework will not change the existing legal basis for the provision of NHS Continuing Healthcare, by which fully funded NHS Continuing Healthcare is provided for all those individuals whose
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primary need is a health need. This is based on an assessment of need and if individuals’ needs have not changed there is no reason to expect them to lose their entitlement to NHS Continuing Healthcare. Equally, continuing entitlement to an individual whose needs change cannot be guaranteed.

Contract Notice 2006/05 114-121806

John Hemming: To ask the Secretary of State for Health (1) which organisations her Department consulted on the contract notice 2006-05 114-121806; [86110]

(2) why the contract notice 2006-05 114-121806 published in the Official Journal of the European Union was withdrawn; and whether she intends to submit a revised contract notice. [86111]

Andy Burnham: The advertisement in the Official Journal of the European Union (OJEU) was withdrawn and a revised advertisement submitted on 13 July to make it clear that clinical provision was explicitly excluded from the scope of the procurement. In other words, that we were advertising for a range of management functions to support primary care trusts (PCTs) commissioning role. We have used the opportunity of the reissue of the advertisement to emphasise that even if PCTs choose to use such services they remain accountable to the public for the resources spent on health care in their locality.

The procurement framework will allow successful companies to offer a range of commissioning skills and services to PCTs who can chose whether or not to use the services offered. This is part of a range of measures to support PCTs and practices in developing effective commissioning as described in “Health reform in England: update and commissioning framework”. PCTs are and will remain public, statutory bodies responsible for using their growing budgets to commission the best possible services for local people. They can never outsource this responsibility, or ask others to make these decisions for them.

We did not consult with external organisations prior to issuing the OJEU because one of the main purposes of such an advertisement is to elicit responses from interested organisations.

Counterfeit Medicines

Dr. Iddon: To ask the Secretary of State for Health what measures are in place to control the sale of counterfeit medicines online. [79001]

Andy Burnham: Medicines law in the United Kingdom (UK) (Medicines Act 1968 and related regulations) imposes strict controls on the sale, supply and advertising of medicines and these controls apply without distinction to medicines offered for sale via the internet and by mail order. Internet pharmacies must be registered with the Royal Pharmaceutical Society of Great Britain and any manufacturing or distribution activities are required to be licensed by the Medicines and Healthcare products Regulatory Agency.

Problems arise when online sites are based in another territory, outside of the UK’s legal jurisdiction. Regulatory requirements can vary from country to country, particularly
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outside the European Community, where the products may be classified differently and the laws may be entirely different. In such cases, details of the websites are referred to counterparts in the host country with a request to take action as appropriate to prevent sale to UK citizens.

Dentistry

Mr. Hancock: To ask the Secretary of State for Health which groups representing those working in dental laboratories she has met in the last 12 months. [86281]

Ms Rosie Winterton: I met with the Dental Laboratories Association (DLA) in December 2005. The DLA is represented on the implementation review group, which has been set up to review the impact of the national health service dentistry reforms and identify any issues that need to be addressed. I attended the first meeting of the review group in April.

Mr. Hancock: To ask the Secretary of State for Health what research she has (a) initiated and (b) evaluated on the reasons for the change in the level of dentists providing NHS dental repairs since the implementation of the new dental contracts; and if she will make a statement. [86283]

Ms Rosie Winterton: It is for individual dentists working under general dental services contracts or personal dental services agreements to use their clinical judgment to examine a patient and determine what treatment including any dental repairs is necessary. The Department does not collect routine information on the quantity or type of dental repairs being carried out.

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