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6 Nov 2006 : Column 761W—continued
Consanguinity
Mr. Gordon Prentice: To ask the Secretary of State for Health what guidance she gives to general practitioners on the advice they offer to patients who are in an at risk category on the issue of consanguinity. [94280]
Andy Burnham: None. In general, guidance on issues of practice is a matter for the appropriate professional or regulatory bodies. In addition, local national health service organisations may decide to issue guidance to help practitioners deal with issues which are of particular relevance to their local population.
The Human Genetics Commission supports the need for proper provision of education and information about marriage within a kin-ship group. This should entail access to counselling and support, preferably in the individual’s or couple’s preferred language, and a no-blame approach that enables at-risk couples to come forward for testing. Those wanting specific advice on their individual risk should consult a clinical geneticist or genetic counsellor in their local NHS regional genetics centre.
From next year the curriculum for trainee general practitioners will include learning objectives to equip them to refer patients at risk of genetic conditions appropriately and to appreciate the importance of considering a patient’s cultural and religious background and beliefs concerning inheritance in providing care. These have been developed by the Royal College of General Practitioners in partnership with the NHS national genetics education and development centre, an initiative funded by the Department to identify health care practitioners’ genetics educational needs and encourage the integration of genetics into pre- and post- registration courses and continuing professional development.
Continuing Care
Mr. Lansley: To ask the Secretary of State for Health (1) pursuant to the answer of 25 July 2006, Official Report, column 1209W, on continuing care, when she expects to publish (a) her Department's response to the consultation on the draft national framework for continuing care and (b) the final national framework for continuing care; [98620]
(2) whether all patients in receipt of NHS continuing care in those strategic health authorities which are operating multiple eligibility criteria will continue to be eligible for NHS continuing care after the SHA in which they are resident has amalgamated the criteria. [98632]
Mr. Ivan Lewis:
All strategic health authorities have recently reviewed their criteria to ensure their legal compliance. Therefore, where a SHA is operating multiple eligibility criteria the existing legal basis for the provision of NHS continuing health care will
remain the same regardless of which criteria is used. We would not anticipate a change in an individual's eligibility following the merger of the SHAs as long as their assessed health care needs have not changed.
The public consultation on the national framework for NHS continuing health care closed on 22 September. We have had a large number of responses to the consultation which we are currently collating and analysing. We will publish our response as soon as this process is complete, and it will set out the timetable for implementation of the framework.
Convention on Human Rights and Biomedicine
Mr. Drew: To ask the Secretary of State for Health what plans she has to sign the 1997 Council of Europe Convention on Human Rights and Biomedicine. [97611]
Ms Rosie Winterton: The UK has not yet signedthe European Convention on Human Rights and Biomedicine. The UK supported the development of the convention, but domestic policy on many of the issues in the convention has been developing rapidly since the convention was opened for signature in 1997 and it covers a wide range of complex ethical and legal issues where domestic policy is still to be resolved. These matters will need to be concluded before the Government are in a position to consider signing and ratifying the convention.
Dentistry
Daniel Kawczynski: To ask the Secretary of State for Health how many dental practices in the Shropshire Primary Care Trust area have (a) signed, (b) disputed and (c) refused to sign the new dental contracts. [95551]
Ms Rosie Winterton: Management information on the number of contracts signed, signed in dispute and rejected in Shropshire PCT area by 1 April 2006 shows that of the contracts offered, 64 were signed and eight rejected. Of the 64 contracts signed, 55 were signed in dispute. Three of these disputed contracts are now settled and discussions continue on the remaining contract. The information on disputes is updated through monthly reports and is available on the Department’s website on www.performance.doh.gov.uk/dental_contracts.
For Shropshire PCT, rejected contracts represent 11,256 units of dental activity. This was 2.6 per cent. of the total UDAs associated with all the contracts the PCT offered in April. The latest information shows that as at the end of August, the PCT had re-commissioned a total of 11,411 UDAs.
A contract may be for an individual dentist or a practice.
Daniel Kawczynski: To ask the Secretary of State for Health how many (a) adults and (b) children have been registered as NHS patients with dental practices in the Shropshire primary care trust area in each year since 1996. [95552]
Ms Rosie Winterton: The number of adults and children using general dental services and personal dental services registered within Shropshire County PCT during the period 31 March 1997 to 31 March 2006 is shown in the table.
| Shropshire county PCT | |||
| Adults | Children | Total | |
| Notes: 1. The postcode of the dental practice was used to allocate dentists to specific geographic areas. PCT and strategic health authority areas have been defined using the Office for National Statistics all fields postcode directory. 2. The data in this report are based on NHS dentists on PCT lists. These details were passed on to the Business Services Authority who paid dentists based on activity undertaken. A dentist can provide as little or as much NHS treatment as he or she chooses or has agreed with the PCT. In some cases, a NHS dentist may appear on a PCT list but not perform any NHS work in that period. Most NHS dentists do some private work. The data do not take into account the proportion of NHS work undertaken by dentists. 3. PDS schemes had varying registration periods. To ensure comparability with corresponding GDS data, PDS registrations are estimated using “proxy registrations”, namely the number of patients seen by PDS practices in the previous 15 months. PDS proxy registrations were not estimated for periods before September 2003—actual registrations were used before this date. 4. Data for 2003 and earlier do not include those PDS schemes that do not have any registrations, for example dental access centres, and is therefore not directly comparable with later data. 5. The boundaries used are as at 31 March 2006. 6. The latest information available for registration data covering the time series 31 March 1997 to 31 March 2006 has been published by The Information Centre for health and social care. “NHS Dental Activity and Workforce Report England: 31 March 2006” ISBN 1-84636-073-0. Sources: The Information Centre for health and social care NHS Business Services Authority. | |||
The previous system of patient registration does not operate under the new regulations. Information will be available in due course via the NHS BSA on the numbers of patients who receive care or treatment from national health service primary care dentists on one or more occasions within a given period of time. This will provide a measure that is broadly similar to that of patient registration under the former system of GDS. We expect the first information to be available later in the year.
Ben Chapman: To ask the Secretary of State for Health (1) what mechanisms are in place for action against dentists who encourage patients to switch to private dental health insurance schemes without informing them of their entitlement to NHS treatment; [98334]
(2) what steps she is taking to ensure that patients are kept informed about their entitlement to treatment by an NHS dentist; [98335]
(3) if she will monitor the number of patients switching from NHS dentists to private dental health
insurance schemes; and if she will ensure that those who do so are aware of their entitlement to NHS treatment. [98336]
Ms Rosie Winterton: If a dentist holds a national health service contract, misleading a patient about the range of treatments available is a breach of that contract. Where primary care trusts have evidence that a dentist has misled patients in this way there are a range of possible actions culminating potentially in termination of the dentist's NHS contract.
The General Dental Council's guidance “Maintaining Standards” requires dentists, whether providing NHS services or not, to make clear to patients the nature of the contract and in particular whether the patient is being accepted for private or NHS treatment. Non-compliance with these standards potentially puts a dentist's GDC registration at risk.
Information for patients about NHS treatment and eligibility is widely available. Local information is held by each PCT. Many also run help lines dedicated to advising callers on how to access NHS dental services locally. At national level, NHS Direct can give callers information on their nearest dental practice offering NHS treatment. Patients can also access this information on line at NHS.UK.
There are no plans to monitor the numbers of patients using private dental care. As with private medical care, this is a matter for the individual. However, access to NHS dental treatment is monitored. The first information following the reforms on the number of people accessing NHS dental services is expected to be available later this year.
Mr. Lansley: To ask the Secretary of State for Health which primary care trusts have refused to allow dentists operating under (a) the new general dental services contract and (b) the new personal dental services agreement to maintain children-only lists. [98639]
Ms Rosie Winterton: This information is not held centrally.
Sandra Gidley: To ask the Secretary of State for Health how many missed dental appointments there were in (a) England and (b) each primary care trust area in each year since 1997. [98664]
Ms Rosie Winterton: This information is not held centrally.
Mr. Stewart Jackson: To ask the Secretary of State for Health how many NHS dental patients were admitted under band 4 urgent treatment in each dental surgery in the greater Peterborough primary care partnership area in the 12 months prior to April 2006; how many have been so admitted since April 2006 in each case; and if she will make a statement. [99708]
Ms Rosie Winterton:
The separate band for urgent courses of treatment is a feature of the new NHS dental contracts introduced on 1 April 2006 and data are therefore only available for the current financial year. Data are available at primary care trust
level. The numbers of urgent courses of treatment so far reported and processed for the two Peterborough PCTs are shown in the following table.
| Courses of treatment processed by treatment band, as at April to June 2006 | ||
| Number | ||
| Notes: 1. The postcode data of the dental practice division was used to allocate dentists to specific geographic areas. PCT areas have been defined using the Office for National Statistics all fields postcode directory. 2. The data in this report are based on NHS dentists listed on a contract between a PCT and provider. These details were passed on to the BSA who paid dentists based on activity undertaken. A dentist can provide as little or as much NHS treatment as he or she chooses or has agreed with the PCT. Most NHS dentists do some private work. Sources: The Information Centre for health and social care. NHS Business Services Authority. | ||
Mr. Letwin: To ask the Secretary of State for Health what her policy is on NHS dentists advising patients that a clinically necessary treatment is not available under the NHS with a view to obtaining the agreement of a patient to have private treatment. [98289]
Ms Rosie Winterton: If a dentist holds a national health service contract, misleading a patient about the range of treatments available is a breach of that contract. Where primary care trusts have evidence that a dentist has misled patients in this way, there are a range of possible actions culminating potentially in termination of the dentist’s NHS contract.
The General Dental Council’s guidance “Maintaining Standards” requires dentists, whether providing NHS services or not, to make clear to patients the nature of the contract and in particular whether the patient is being accepted for private or NHS treatment. Non-compliance with these standards potentially puts a dentist’s GDC registration at risk.
Diabetes
Mr. Skinner: To ask the Secretary of State for Health how many (a) adults and (b) children have been (i) diagnosed with and (ii) treated for diabetes in the last five years. [97041]
Ms Rosie Winterton: Information on the number of children and adults with diabetes is not available in the exact form requested. The following information is available for diagnosed diabetes.
Estimates of the number of people aged 16 and over with doctor-diagnosed diabetes is available from the annual health survey for england. The most reliable estimates are for 1998 and 2003 when the survey concentrated on cardiovascular disease and these are as follows:
| People aged 16 and over with doctor-diagnosed diabetes in England | |
| Number | |
The health survey for England estimated that in 2003, around 90 per cent. of those with doctor-diagnosed diabetes had type two diabetes(1).
The number of patients diagnosed with diabetes identified by general practitioner practices in England in 2004-05 was 1.76 million people(2). This is the first year of data from this source. Figures are not available for type one and type two diabetes separately.
The number of patients diagnosed with diabetes identified by GP practices in England in 2005-06 was 1.89 million people(3). Figures are not available for type one and type two diabetes separately.
Information on all diagnoses count of finished consultant episodes for diabetes in national health service hospitals, England 1997-98 to 2004-05 is provided in the following table. It is difficult to accurately quantify hospital activity that is directly related to diabetes as all persons admitted with diabetes have it recorded in their diagnoses, irrespective of whether that was the reason for their admission. Conversely, a significant number of hospital admission may result from diabetes co-morbidity but never be recorded as diabetes related.
Sources:
(1) Self-reported prevalence estimates published in 2003 health survey for England.
(2) 2004-05 quality and outcomes framework data published by the information centre for health and social care.
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