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Clostridium Difficile

Mr. Lidington: To ask the Secretary of State for Health what action she has taken since the publication of the Interim Report of the Healthcare Commission and the Health Protection Agency in December 2005 to encourage NHS hospital trusts routinely to isolate cases of clostridium difficile infection. [89866]

Andy Burnham: We are actively working with the national health service to improve control of this infection.

In December 2005, the Chief Medical Officer and Chief Nursing Officer reminded the NHS of the importance of this infection, listed the key actions for its control and highlighted the guidance available. This included clear recommendations that cases of clostridium difficile associated diarrhoea should be isolated in single rooms or in cohort wards. We have commissioned the Health Protection Agency to review and update the national guidance and have added a new high impact intervention protocol on clostridium difficile disease to “Saving lives: a delivery programme to reduce health care associated infections including MRSA”.

Andrew Rosindell: To ask the Secretary of State for Health what procedures are in place for the storing of samples of those infected with clostridium difficile (a) pre- and (b) post mortem. [89957]

Andy Burnham: Policy on storing samples is a local issue but faecal samples containing “clostridium difficile” are generally stored in a rigid container. These are refrigerated or frozen until disposed of by incineration according to local protocols. Samples are not normally taken post mortem but the procedures would not differ.

Andrew Rosindell: To ask the Secretary of State for Health if she will establish a public inquiry into cases of clostridium difficile in the Oldchurch hospital. [89958]

Andy Burnham: A public inquiry under the Inquiries Act 2005 is not appropriate.

Andrew Rosindell: To ask the Secretary of State for Health what assessment she has made of the change in the number of cases of clostridium difficile over the last seven years; and if she will make a statement. [89959]

Andy Burnham: The Health Protection Agency receives reports from microbiology laboratories of cases in all age groups through voluntary surveillance.

Data for England and Wales from 1999 to 2005 is shown in the table. It is not clear how much of the increase in the number of reports is due to improved reporting of cases, an increase in ascertainment, or an actual rise in “Clostridium difficile” disease incidence. It was to help establish a baseline that we introduced mandatory surveillance in 2004.

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Voluntary laboratory reports of clostridium difficile England and Wales 1999 to 2005
	England	Wales
1999	17,279	1,438
2000	18,812	1,744
2001	20,064	1,599
2002	26,357	1,710
2003	33,201	1,587
2004	40,401	2,114
2005(1)	46,501	1,939
(1 )Provisional totals. Source: www.hpa.org.uk/infections/topics_az/clostridium_difficile/c_diff_reports_isolated_faecal_specimens_england.W.

Andrew Rosindell: To ask the Secretary of State for Health how many cases of clostridium difficile have been reported at Oldchurch Hospital in each of the last seven years. [89962]

Andy Burnham: This information is not available. However, since January 2004, acute national health service trusts in England have been required to report all cases of clostridium difficile-associated disease in people aged over 65 years under the mandatory surveillance scheme. This is operated by the Health Protection Agency on behalf of the Department.

Oldchurch hospital provides services for Barking, Havering and Redbridge Hospitals NHS Trust.

The total numbers of cases of clostridium difficile- associated disease in patients aged 65 years and over reported by the Barking, Havering and Redbridge Hospitals NHS Trust were 648 in 2004, and 927 in 2005.

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Community Hospital Beds

Mr. Amess: To ask the Secretary of State for Health whether her Department has made an assessment of the likely demand for community hospital beds in (a) Southend Primary Care Trust area and (b) Essex over the next (i) five, (ii) 10, (iii) 15 and (iv) 20 years. [89680]

Andy Burnham: It is the responsibility of primary care trusts and strategic health authorities to analyse their local situation and develop plans, in liaison with their local national health service trusts and primary care providers, to deliver high quality NHS services and take action to recruit the appropriate staff required to deliver these services.

Complaints against Doctors

Mr. Salmond: To ask the Secretary of State for Health how many formal complaints were recorded against doctors in each year since 1999. [89347]

Andy Burnham: The table gives numbers of complaints made between April 1999 and the end of March 2005, which is the latest available audited data. There is one table for hospital and community health service complaints with details of complaints by profession. Family health service complaints are not broken down by profession.

The source of this data reflects complaints made through the NHS complaints procedure and does not include complaints made to the General Medical Council (GMC) or to other professional bodies, such as the General Dental Council or the National Midwifery Council.

Written complaints about hospital and community services by profession
England
	1999-2000	2000-01	2001-02	2002-03	2003-04	2004-05
Number of written complaints by profession	86,536	95,734	93,020	91,023	90,156	90,066
Medical (including surgical)	38,261	43,892	42,994	40,819	40,094	40,762
Dental (including surgical)	711	726	723	893	853	762
Professions supplementary to medicine	4,546	4,969	5,248	5,015	4,833	4,514
Nursing, midwifery and health visiting	17,966	18,892	17,908	18,062	19,379	19,308
Scientific, technical and professional	1,258	1,502	1,544	1,609	1,612	1,670
Ambulance crews (including paramedics)	3,212	3,243	3,063	2,658	2,548	2,201
Maintenance and ancillary staff	1,923	2,295	1,910	2,078	1,678	1,925
PCT administrative staff/members (exc FHS admin)	880	1,081	1,015	822	1,086	1,196
Trust administrative staff/members	7,729	8,925	8,319	8,668	7,778	7,619
Other	10,050	10,209	10,296	10,399	10,295	10,108
Notes: 1. Number of complaints may differ to the figures shown in other tables as one complaint can cover more than one professional area. 2. The rows marked ‘medical (including surgical)’ and ‘dental (including surgical)’ do not represent complaints concerning doctors in their entirety, as there will be complaints that are not about a single profession (for example where a complainant is unhappy with their treatment by a doctor and a nurse). 3. Data as at 1 April to 31 March. Source: The Information Centre for health and social care KO41a dataset

Dentists

Sir Paul Beresford: To ask the Secretary of State for Health how many dentists who signed the new NHS dental contract who are (a) in dispute and (b) not in dispute had (i) withdrawn and (ii) given notice of their intention to withdraw from the contract by 1 October. [91833]

Ms Rosie Winterton: As at 31 August 2006, 11 out of the 2,773 cases where contracts were originally signed
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in dispute had ended with the contractor deciding not to continue with the contract. A contract may be for either a practice or an individual dentist. Information on disputed contracts is collected by contract.

Statistics on the resolution of contract disputes are published monthly at www.performance.doh.gov.uk/dental_contracts.

Information is not collected on the number of contracts signed without dispute where the contractor later withdrew from the contract. As for other professional groups, the dental workforce is always subject to some degree of regular turnover.

Emergency Readmissions

Mr. Lansley: To ask the Secretary of State for Health how many emergency readmissions to hospitals there were within 28 days of discharge in each year since 1997, broken down by NHS trust, expressed in terms of the percentage of all live discharges. [90302]

Andy Burnham: Robust information for each year since 1997 is not available in the form requested. The Healthcare Commission has published information broken down by trust as part of annual star ratings assessments, this is available on the website at:

2002-03 ratings values, covering the calendar year 2002:

www.chi.nhs.uk/Ratings/Trust/results/indicatorResults.asp?indicatorId=1026Drafting

2004 ratings values, covering the calendar year 2003:

ratings2004.healthcarecommission.org.uk/Trust/results/indicatorResults.asp?indicatorId=1403

2005 ratings values, covering the calendar year 2004:

ratings2005.healthcarecommission.org.uk/Trust/results/indicatorResults.asp?indicatorId=1403

The National Centre for Health Outcomes Development will publish data on trust readmission rates over the past seven years on their website at www.nchod.nhs.uk early in 2007.

Flu Pandemic

Mr. Lansley: To ask the Secretary of State for Health what role she expects NHS Direct to perform in the event of an influenza pandemic. [92104]

Ms Rosie Winterton: Telephone contact will be an essential part of the service provided during a pandemic and we are currently considering the role of NHS Direct in providing this.

Hospital Infection Data

Mr. Lansley: To ask the Secretary of State for Health for what reasons Barts and The London NHS Trust and Newham Healthcare NHS Trust were missing data for one quarter of 2005 in their mandatory statistical collections of clostridium difficile-associated disease. [90301]

Andy Burnham: Barts and The London NHS Trust and Newham Healthcare Trust did not provide information because the laboratory information system used in early 2005 could not identify clostridium difficile results. The problem was resolved with the
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introduction of a new pathology laboratory information system in early 2005.

Mental Health

Mr. Marsden: To ask the Secretary of State for Health what assessment she has made of the comprehensiveness of the National Institute of Health and Clinical Excellence’s consideration of current prescribing practice in assessing drug and monitoring costs for the prescription of Alzheimer’s disease drugs. [91992]

Andy Burnham: My right hon. Friend has made no specific assessment of this issue. The National Institute for Health and Clinical Excellence is an independent body and its appraisal of drugs for the treatment of Alzheimer’s disease has involved two public consultations.

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