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Mr. Stephen O'Brien: To ask the Secretary of State for Health in what circumstances health trusts are required to offer reconfiguration plans for public consultation; who is responsible for deciding the circumstances; and to whom that person is accountable. 
Andy Burnham: For all proposals concerning substantial changes to general service delivery, there is a duty to involve and consult' patients and the public conferred on national health service organisations by section 11 of the Health and Social Care Act 2001. It is the responsibility of the relevant health organisation to decide which proposals should be consulted on and the strategic health authority to oversee the formal consultation process.
The local authority's Overview and Scrutiny Committee (OSC) considers the proposals as part of the formal consultation process and has the power to refer any proposal to the Secretary of State if it believes the proposal is not in the interests of the health service or the local community or if the consultation with the OSC has been inadequate. The Secretary of State can refer the matter to the independent reconfiguration panel for advice, require further consultation or endorse the decision of the local NHS organisations responsible for them.
Ms Rosie Winterton: Funding is not ring-fenced within the revenue allocations to primary care trusts (PCTs). It is PCTs responsibility to decide how to use the funding allocated to them to meet the health needs of their local populations.
It is recommended that all children should be screened for visual impairment between four and five years of age. Once this programme is in place, the school entry vision screening programme aimed at seven-year-olds should cease.
Although most cases of hearing impairment should be identified before school entry, there will be some cases that are missed, and the UK National Screening Committee has recommended that screening for hearing loss at the time of school entry should continue while further research is undertaken.
Andrew George: To ask the Secretary of State for Health pursuant to her Department's report of 5 December 2006 on the clinical case for reconfiguration in the context of heart disease and stroke services, what extra spending would be required to improve available services in accident and emergency departments to bring the required number of hospitals up to the proposed level of emergency treatment capacity. 
For treatment of heart attack, the key facility required is a catheterisation laboratory. The Department and the new opportunities fund have provided funding of £125 million to build 90 new or replacement catheterisation laboratories in England, increasing the capacity previously available by more than 50 per cent. The emerging findings from our national study of primary angioplasty show that the best times are achieved by ambulance paramedic triage and taking patients direct to the catheterisation laboratory without going via the A and E department.
It is more appropriate for stroke victims to be taken directly to a stroke unit rather than to an A and E unit. Early analysis of best evidence provides an estimate that to provide immediate scanning for all stroke patients and increase uptake of thrombolysis to 4 per cent., currently being achieved by the centre with the highest thrombolysis rate in England, will cost £6.7 million to £8.7 million. To increase uptake to 10 per cent. (currently being achieved by leading centres around the world) the estimated cost is £10.9 million to £12.9 million. However, analysis also demonstrates that this investment will result in considerable long-term savings, and allow a significant number of stroke patients not only to survive, but to live fully independent lives.
Andrew George: To ask the Secretary of State for Health pursuant to her Department's report of 5 December on the clinical case for reconfiguration in the context of heart disease and stroke services, what the proposed maximum pain to treatment time is for (a) heart attack and (b) stroke patients. 
Ms Rosie Winterton:
The national service framework for coronary heart disease set a target that thrombolysis, treatment with clot-busting drugs, should be given to heart attack patients within 60 minutes of calling for professional help. Good progress has been made with meeting this target but there has been less progress in reducing the time from
pain to call. Public awareness of symptoms is a key issue here. The Department is supporting the British Heart Foundation's recently launched campaign to raise awareness of heart attack symptoms. Primary angioplasty is most effective when delivered within three hours of onset of symptoms but will provide some benefit up to 12 hours after they have developed.
Thrombolysis for stroke patients must be delivered within three hours of onset of stroke. The licence for the thrombolytic drug for stroke is only for delivery within three hours. It must be noted that a stroke may not involve pain so increasing awareness of the symptoms of stroke is an important part of delivering thrombolysis. The Department is currently supporting the Stroke Association FAST campaign which provides a clear and simple test to identify a stroke.
Mr. Lansley: To ask the Secretary of State for Health what methodology was used to arrive at predictions for media interest (a) now, (b) in the summer, (c) in the autumn and (d) in the future as indicated on the heat maps released by her Department on 7 November; which organisations carried out the research which was used to draw up the predictions for media interest; how much these organisations were paid; for what reasons her Department analysed media interest surrounding potential hospital closures; whether her Department has any plans to conduct further research into the media interest surrounding hospital closures; and if she will make a statement. 
Andy Burnham: The Department produced a set of maps following discussions with strategic health authorities (SHAs). These gave an indication of local media coverage of health service issues by SHA. The maps have not been updated.
Sir Gerald Kaufman: To ask the Secretary of State for Health how many (a) hospitals, (b) hospital doctors, (c) nurses and (d) other hospital staff working with patients there were on (i) 2 May 1997 and (ii) the most recent date for which figures are available. 
There is no specific definition of a hospital. An estimate of the current number of hospitals has been made using information from the National Administration Codes Services (from Connecting for Health) by extracting sites which have hospital or infirmary in their title. The total number of hospital sites, on this basis, is in the order of 1,200.
|Hospital and community health services (HCHS): medical and dental and non-medical staff by grade and yearEngland at 30 September each year|
| Note: Data include acute, elderly and general care, paediatric nursing, maternity services, psychiatric, and learning disabilities nurses. Community nursing staff are excluded. Source: The Information Centre for health and social care Medical and Dental Workforce Census. The Information Centre for health and social care Non-Medical Workforce Census.|
Andy Burnham: The main agency through which the Government support biomedical research is the Medical Research Council (MRC). The MRC is an independent body funded by the Department of Trade and Industry via the Office of Science and Innovation.
The MRC funds a considerable programme of research that underpins scientific understanding of hospital-acquired infections including methicillin-resistant staphylococcus aureus (MRSA), clostridium difficile and other antibiotic resistant pathogens. A summary of the financial support given as part of that programme specifically to research on MRSA is shown in the table.
The Department has recognised the public health importance of rising antimicrobial resistance for many years. During the first half of 2003 the Department commissioned a £2.5 million strategic programme of research aimed at improving scientific understanding of antimicrobial resistance. £590,000 of that total sum was spent between 2004 and 2006 supporting three research projects specifically dealing with MRSA.
The publication of the Department's report Winning Waysworking together to reduce healthcare associated infection in England in December 2003 was accompanied by the announcement that £3 million would be allocated to fund a new research programme on healthcare associated infections.
a study of the efficacy and cost-effectiveness of MRSA screening and monitoring on surgical wards using a new molecular test; and
a randomised crossover trial of a new, rapid method of MRSA detection compared with conventional screening, looking at efficacy and the effect upon hospital MRSA infection rates, transmission rates and the use of hospital resources.
The Department is also supporting a £90,000 study related to improving understanding of possible community-acquired MRSA; has funded a national confidential study of suspected deaths from healthcare-associated infection at a cost of £254,000; and a £216,000 study of bacteraemia in children caused by MRSA.
Andy Burnham: Tackling MRSA is a priority for Government and the national health service. We have set a target to halve the number of MRSA bloodstream infections by 2008 and each acute trust has its own target. The Department and its partner organisations have developed a range of mutually reinforcing activities that ensure combating the spread of MRSA is embedded in everyday procedures and policies, in particular:
all acute trusts are signed-up to the Saving Lives package of best practice which, if implemented in full, should combat MRSA spread in the acute sector. It is supplemented by the Essential Steps initiative, designed for non-acute care settings;
mandatory MRSA surveillance, which continues to be developed/enhanced;
the first ever national hand hygiene programme for hospital staff cleanyourhands, has progressed to its second year;
a root cause analysis tool was published in September 2006 to help trusts investigate and better understand how and why MRSA bloodstream infections occur and hence where they should focus their action to prevent them;
a statutory code of practice which requires NHS bodies to have appropriate management and clinical governance systems in place to deliver effective infection control came into force on 1 October;
enhanced advice on screening patients at risk was published on 16 November; and
acute trusts have been invited to apply for additional capital resources to help tackle healthcare associated infections, with £50 million set aside for this purpose.
Additionally, tailored support is available for those trusts in the most challenging positions. Improvement teams will during 2006-07, work with about 50 trusts, so as to help identify those issues that prevent reduction in infections at the local level, and help them develop action plans to speed up and sustain progress.
Steve Webb: To ask the Secretary of State for Health how much was spent by social services departments in each local authority on provision for (a) adults and (b) children who have no recourse to public funds because of their immigration status in 2005-06; how many adults and children were receiving such services; and if she will make a statement. 
Mrs. Dean: To ask the Secretary of State for Health what the utilisation of each of the independent sector treatment centres was as a percentage of contracted value in 2005-06; and what it has been so far in 2006-07. 
Caroline Flint: The percentage values for individual independent sector treatment centres (ISTCs) are commercially sensitive and release at this time would adversely affect the Departments ability to achieve best value from these contracts. An average across the programme was nearly 80 per cent. in 2005-06.
The Department procured independent sector capacity on the basis of capacity planning exercises conducted through strategic health authorities where the additional capacity in elective treatment and diagnostics required to meet key public service agreement waiting times targets was estimated. Where the estimates of demand have not been met so far in a contract the Department is working with the national health service and independent providers to ensure contracts deliver best value over the life of the contract.
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