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8 Jan 2007 : Column 60W—continued
Public Health Directors
Tim Loughton: To ask the Secretary of State for Health (1) how many public health directors are employed by primary care trusts; and what the total cost was of the employment of such directors in 2005-06; [105648]
(2) how many public health directors were employed by primary care trusts in 2005-06; and what the cost was. [105649]
Ms Rosie Winterton: This information is not collected centrally.
Residential Care
Anne Main: To ask the Secretary of State for Health pursuant to the answer of 7 December 2006, Official Report, column 688W, on residential care/sheltered housing, which local authorities still consider cases including spousal liability for (a) residential care in care homes and (b) sheltered housing. [109859]
Mr. Ivan Lewis: Sections 42 and 43 of the National Assistance Act 1948 the liable relatives rule give local authorities discretionary powers to ask the person's liable relatives, in effect their spouse, to make payments towards the costs incurred by the state of a person's care in a care home. The liable relatives rule does not apply to sheltered housing.
Information about whether local authorities are seeking liable relatives payments is not collected centrally.
Resource Accounting
Mr. Lansley: To ask the Secretary of State for Health what plans she has to review the way the system of resource accounting and budgeting is applied to NHS trusts. [109630]
Andy Burnham: We recognise the rationale behind the Audit Commission’s recommendation to reverse the impact of past resource accounting and budgeting deductions made to national health service trust income and to create a central buffer to absorb the impact.
We will look again at the case for reversing the impact of past resource accounting and budgeting reductions on delivery of financial balance in 2006-07.
Resource Allocation
Mr. Lansley: To ask the Secretary of State for Health what each change which has been made to the system of resource allocation since May 1997 was; when the decision to make each change was made; and in what financial year each change was first implemented. [101725]
Andy Burnham: National health service resource allocation is based on the principle of weighted-capitation, whereby resources are distributed between areas on the basis of the relative needs of their populations.
The weighted-capitation formula is continuously overseen by the Advisory Committee on Resource Allocation (ACRA). ACRA’s role is to ensure equity in resource allocation. ACRA is an independent body which has NHS management, general practitioner, and academic members. Prior to each allocations round, ACRA agrees a work programme to support the revenue allocations to primary care trusts (PCTs). On completion of the work programme, ACRA makes recommendations to Ministers on possible changes to the weighted-capitation formula. Decisions on changes to the weighted-capitation formula are made prior to each allocations round.
Since 1997 the following changes have been made to the weighted capitation formula:
1997-98 changes to the weighted capitation formula
In 1997-98 two changes were made to hospital and community health services allocations:
community health services were weighted for additional need;
the staff market forces factor (MFF) was revised.
1998-99 changes to the weighted capitation formula
In 1998-99 two changes were made to hospital and community health services allocations:
all services were weighted for additional need; and
the emergency ambulance cost adjustment (EACA) was introduced.
One change was made to prescribing allocations, with the introduction of new age/sex weights.
1999-2000 changes to the weighted-capitation formula
Prior to 1999-2000, there were separate funding streams for HCHS, prescribing and general practice infrastructure (GMSCL). In 1999-2000 these became a single unified allocation.
In addition, an English language difficulties adjustment (ELDA) was introduced as a supplement to the formula, for the extra costs of interpretation, advocacy and translation services.
2001-02 changes to the weighted-capitation formula
In 2001-02 an interim health inequalities adjustment (HIA) was introduced.
2002-03 changes to the weighted-capitation formula
Four main changes were made to the weighted-capitation formula in 2002-03:
a new general medical services non-cash limited (GMSNCL) component was introduced;
the additional need adjustment in the new GMSNCL component replaced the existing additional need adjustment in the general medical services cash limited (GMSCL) component;
the staff MFF was revised; and
the HIV/AIDS special allocations became part of the unified allocation.
2003-04 changes to the weighted-capitation formula
In November 1998, Ministers announced a wide- ranging review of the weighted-capitation formula. The main objective for this review was “to contribute to the reduction in avoidable health inequalities”. The review
was carried out under the auspices of ACRA. The new formula replaced both the existing formula and the HIA, and has been used for the 2003-04 to 2005-06 and the 2006-07 and 2007-08 allocations rounds.
Three main changes were made to the weighted-capitation formula for the 2003-04 to the 2005-06 allocations round:
populations were based on the 2001 census;
new need adjustments were introduced in the HCHS and prescribing components; and
the staff MFF was revised.
In 2003-04 revenue allocations were made to primary care trusts for the first time, covering three years. Prior to 2003-04 revenue allocations were made to health authorities on an annual basis.
2006-07 changes to the weighted-capitation formula
The following changes were made to the weighted-capitation formula for the 2006-07 and 2007-08 revenue allocations:
Office for National Statistics (ONS) population projections provided the population base;
a primary medical services component was introduced into the formula following the devolution of this funding to PCTs in 2004-05, replacing the GMSCL and GMSNCL components;
the HCHS MFF was reviewed to support the implementation of Payment by Results.
The main resulting change was an increase in the number of zones in the staff MFF from 119 to 303 to match the geography of PCTs:
the rough sleepers adjustment was dropped; and
a growth area adjustment was introduced in support of the Department for Communities and Local Government sustainable communities initiative.
Responsible Drinking
Lynda Waltho: To ask the Secretary of State for Health what steps the Government are taking to promote responsible drinking; and if she will make a statement. [110009]
Caroline Flint: The Government are serious about tackling alcohol misuse and reducing alcohol-related harms. The Know Your Limits campaign focuses on young people who are binge drinkers, because research shows that 18 to 24-year-olds are most likely to drink irresponsibly and cause harm to themselves and others. It aims to ensure that sufficient information exists to help everyone to become more aware of the risks to individual health and personal safety that alcohol misuse can bring, and to make informed choices on the basis of that information.
The campaign is designed also to reach a secondary audience of hazardous, harmful, dependent, and pregnant drinkers. These groups are being targeted through public relations and stakeholder work. Literature advising people how to drink sensibly has been produced by the Department, which targets these audiences.
We have seen a fall in the proportion of men drinking more than the daily benchmarks on at least one day in the previous week, from 39 per cent. in 2004 to 35 per cent. in 2005.
I am also pleased that the Drinkaware Trust has appointed as its new chair Debra Shipley, whom I very much look forward to working with as she takes the trust forward over the coming months.
Ritalin
Mr. Sheerman: To ask the Secretary of State for Health what assessment her Department has made of the effectiveness of the drug Ritalin in the treatment of attention deficit hyperactivity disorder. [112648]
Andy Burnham: The Department has made no assessment but has asked the National Institute for Health and Clinical Excellence (NICE) to develop a clinical guideline on attention deficit hyperactivity disorder. This will include an assessment of the clinical and cost-effectiveness of the drug Ritalin. NICE currently expects to publish guidance in February 2008.
Mr. Sheerman: To ask the Secretary of State for Health what the cost to her Department of the prescribing of the drug Ritalin was in the last year for which figures are available; and what her most recent estimate is of the number of patients who are prescribed the drug. [112650]
Andy Burnham: Ritalin is a formulation of methylphenidate hydrochloride. In 2005 the net ingredient cost of prescriptions dispensed in the community in England was £834,500. This figure does not include drugs dispensed in hospitals, including mental health trusts, or private prescriptions.
The Department does not hold data on the number of patients who are prescribed the drug Ritalin.
Mr. Sheerman: To ask the Secretary of State for Health (1) what her estimate is of the number of children with attention deficit hyperactivity disorder being prescribed the drug Ritalin; [112651]
(2) what assessment she has made of the extent of the inappropriate prescribing of Ritalin to young people. [112652]
Mr. Ivan Lewis: Information on the number of children prescribed Ritalin (methylphenidate) is not collected.
In March 2006, the National Institute for Health and Clinical Excellence (NICE) published guidance on the use of drugs to treat Attention Deficit Hyperactivity Disorder (ADHD). NICE has estimated that around 5 per cent. of school-aged children meet the diagnostic criteria for ADHD, equivalent to 366,000 children and adolescents in England and Wales, but not all these children will require medication. In the year to 31 August 2006, 384,000 prescriptions for methylphenidate were dispensed in England to children aged 0 to 15 years and those aged 16 to 18 years in full time education.
We have no evidence to suggest that inappropriate prescribing of methylphenidate is widespread. NICE has recommended that drug treatment for ADHD should only be initiated by an appropriately qualified healthcare professional with expertise in ADHD and should be based on a comprehensive assessment and diagnosis. Continued prescribing and monitoring of drug treatment may be performed by general practitioners, under shared care arrangements.
Methylphenidate is classified under the Misuse of Drugs Regulations 2001 as a schedule 2 controlled drug. As such, it is subject to additional restrictions in its use, for example it must be kept in a secure place that meets the requirements of the Safe Custody Regulations 1973. Amendments to the Misuse of Drugs Regulations in July 2006 brought in a standard prescription form for private prescribing of schedule two and three controlled drugs. Thus, the national data will now cover both national health service and private prescribing of methylphenidate by prescriber but not by patient.
Royal Shrewsbury Hospital
Daniel Kawczynski: To ask the Secretary of State for Health how many nurses were employed by Royal Shrewsbury hospital in (a) 2004 and (b) 2005. [101891]
Ms Rosie Winterton: The information is not available in the format requested. However, information for the Shrewsbury and Telford Hospital NHS Trust has been set out in the table.
| Qualified nursing, midwifery and health visiting staff in the Shrewsbury and Telford Hospital NHS Trust as at 30 September each specified year | |
| Headcount | |
| Source: The Information Centre for Health and Social Care non-medical workforce census | |
School Nurses
Tim Loughton: To ask the Secretary of State for Health how many school nurses and school health assistants were employed by Coventry Teaching Primary Care Trust in each of the last five years. [105645]
Mr. Ivan Lewis: The information is not available in the format requested. The following table shows the number of nursing staff in the school nursing area of work in Coventry Teaching Primary Care Trust by level as at 30 September 2005.
Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 6 December 2006, Official Report, column 568W, on school nurses, when the decision was made that the Choosing Health commitment would require the majority of school nurses to have a school nursing qualification by 2010. [109701]
Ms Rosie Winterton: A recommendation was made as part of the chief nursing officer’s review of the nursing, midwifery and health visiting contribution to vulnerable children and young people published in August 2004, and subsequently taken forward in “Choosing Health” in November 2004. Through “Choosing Health” we are providing new funding so that by 2010 every primary care trust, working with children’s trusts and local authorities, will be resourced to have at least one, full-time, qualified school nurse working with each cluster or group of primary schools and its related secondary school, taking account of health needs and school populations.
Mr. Lansley: To ask the Secretary of State for Health how many NHS hospital and community health services qualified nursing and midwifery staff, excluding agency staff, working in the school nursing area of work were working in England in each year since 1988 by (a) headcount and (b) full-time equivalent, using the same methodology as was used in the answer to the hon. Member for the City of York (Hugh Bayley), of 21 May 1996, Official Report, columns 87-88, on school doctors and nurses. [107392]
Ms Rosie Winterton: Information on the number of school nurses was not collected centrally between 1995 and 2003.
Collections done between 1988 and 1994 were collected by pay scale, while the current methodology collects staff numbers by occupation code. Therefore, the two collections are not directly comparable.
The role of nurses in schools has changed since 1994 and the introduction of other health care professionals, such as assistant practitioners and counsellors, into schools has allowed school nurses to concentrate on their modern role.
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