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Dr. Francis: To ask the Secretary of State for Health (1) what steps she is taking to ensure that (a) voluntary sector organisations independence is not compromised in relation to their advocacy role for carers and (b) when carrying out carers assessments under contract to local authorities such arrangements do not lead to statutory carers assessments being viewed as less important by statutory service providers; 
(2) how many local authorities have put out to tender their statutory carers assessments to voluntary sector organisations; and what assessment she has made on the outcome for carers of putting such assessments out to tender; 
Mr. Ivan Lewis: The duty to carry out a carers assessment, if requested, lies with the local authority and cannot be delegated except to a national health service body as part of partnership arrangements under section 31 of the Health Act 1999.
A local authority may arrange for the actual process of carrying out the assessment to be undertaken by a voluntary organisation on their behalf. However, the authority remains responsible for ensuring that each assessment is valid, fair and comprehensive and for considering the implications of the assessment for its provision of services.
The number of local authorities who have made arrangements for voluntary sector organisations to assist them by carrying out the process of statutory carers assessments is not held centrally. We have made no assessment on the outcome for carers of involving voluntary sector organisations in this way. In addition, we have no plans to take steps to encourage local authorities to arrange for the process of assessments to be carried out by voluntary sector organisations.
Regardless of who carries out the process of an assessment, local authorities retain the statutory responsibility for those assessments. Local authorities should therefore treat the results of those assessments in precisely the same way as they would those carried out by their own staff.
Caroline Flint: The latest data available for the prevalence of overweight and obesity among children are from the Health Survey for England 2005. The data showed that in England, 15.7 per cent. of boys aged two to 15 were classed as overweight (but not obese), and 18.3 per cent. were classed as obese. Among girls aged two to 15, 12.9 per cent. were classed as overweight (but not obese), and 18.3 per cent. were classed as obese.
Health Survey for Englandupdating of trend tables to include 2005 data. The Information Centre
Tim Farron: To ask the Secretary of State for Health (1) if she will consult (a) GPs and (b) other clinicians in Cumbria and Lancashire on the transfer of clinical assessment treatment and support services to the independent sector; 
(2) if she will consult trade unions on the effect on levels of employment in the NHS in Lancashire and Cumbria of the transfer of clinical assessment treatment and support services to the independent sector. 
Andy Burnham: The six primary care trusts (PCTs) in Cumbria and Lancashire are currently carrying out public consultation on clinical assessment and treatment and support services in the two counties. The PCTs are actively engaging with health professionals who work within the national health service, their representative and those who employ them.
Mr. Ellwood: To ask the Secretary of State for Health pursuant to the answer of 18 December 2006, Official Report, column 1707W, on diamorphine, (1) how much diamorphine is held in reserve in the UK; and how much diamorphine was required by the NHS in 2006; 
Caroline Flint [holding answer 22 January 2007]: Both suppliers of diamorphine to the United Kingdom are working to their full available capacity, and are supplying the market on a regular and frequent basis. They are currently unable to produce enough to meet historic demand, although that demand may have changed due to changes in prescribing practice. We expect the situation to improve during 2007, and in the meantime we believe that through careful prescribing and use of available stocks, patient care is not being compromised. This is in part because we arranged for the increased production and availability of alternative drugs such as morphine when the problem arose in December 2004.
The amount of diamorphine held in the supply chain at any one time varies, according to a number of factors including the manufacturers' production schedules. All presentations are currently available.
The value of dispensing for 2005, the most recent year for which figures are available, shows that the net ingredient cost for community dispensing was £18.0 million and estimated hospital cost was £17.9 million.
Tim Farron: To ask the Secretary of State for Health what the evidential basis was for the statement by the primary care trusts of Lancashire and Cumbria that independent sector providers can provide clinical assessment, treatment and support services at better value for money than existing NHS trusts. 
Andy Burnham: The clinical assessment, treatment and support (CATS) services for Cumbria and Lancashire will provide clinical consultations, diagnostic tests and minor treatment on one site. Patients using CATS services are likely to attend health services on fewer occasions than under a traditional out-patient care pathway, resulting in lower costs.
Tim Farron: To ask the Secretary of State for Health if she will estimate the proportion of NHS funds provided to independent sector providers of clinical assessment, treatment and support services likely to be paid out in dividends. 
Andy Burnham: As private companies, the payment of dividends by the independent sector provider is dependent upon financial performance of the company, investment decisions and shareholders resolutions. It is not possible to link payments for the clinical assessment and treatment services (CATS) to any interim or final dividend paid out by the company.
The CATS scheme aims to deliver value for money to the local health economy by procuring cost-effective triaging of general practitioner referrals and a range of diagnostics capacity. Primary care trusts will pay national health service tariff for these services.
Mr. Hayes: To ask the Secretary of State for Health what assessment she has made of the gravity of the incidents referred to in paragraph 5.108 of her Departments 2006 annual report relating to infusion devices; what the reasons were for the time taken to rectify the fault; and what the reason is for the range of possible savings given. 
Mr. Ivan Lewis: In 2002, the Medicines and Healthcare products Regulatory Agency (MHRA) identified a number of infusion device incidents associated with user error. The National Patient Safety Agency (NPSA), as soon as it had been set up, decided that this was a priority area to look into. It therefore conducted a six-month pilot study from May to November 2003 to identify baseline rates of error in the use of infusion devices. During the study 321 safety incidents were identified.
On the basis of the pilot study the NPSA concluded that the national health service required further advice on the use of infusion devices. In May 2004, the NPSA issued a safer practice notice on improving infusion device safety to trusts in England and Wales. The intervening period was used to identify an effective solution and to develop the safer practice notice, which took into account the pilot study and other relevant research.
The range of possible savings was taken from research carried out by a health economist. The reason for the wide range of savings made by the different trusts is due to the existing varying levels of implementation of the notice. There were indications that savings have been made in a number of different areas such as reduced stock maintenance costs, more efficient use of nursing time and reduced costs as a result of infusion errors. These savings would be maximised in trusts that prior to the issue of the safer practice notice had been less effective at managing their stock of infusion devices. On the other hand where trusts were already making effective use of their stock of infusion devices, the savings would be minimised. The extreme range of the savings is emphasised by year on year long-term effect of better stock management procedures.
Mr. Hollobone: To ask the Secretary of State for Health (1) for what reasons she proposes to increase Medicines and Healthcare products Regulatory Agency fees above inflation; and what account was taken of the April 2006 increase in fees in making such proposals; 
(3) what discussions Ministers have had with (a) pharmaceutical companies and (b) representative bodies on the Medicines and Healthcare products Regulatory Agencys proposals to increase fees in April 2007. 
Caroline Flint: The Medicines and Healthcare products Regulatory Agency (MHRA) is required, as a trading fund, to recover the costs of its medicines regulatory functions through fee income. The agency is required to assess cost pressures to ensure that fee income can fully recover costs. Fees levels were subject to significant increases in April 2006 following new legislation that expanded the agencys responsibilities in order more effectively to protect public health. In recognition of this, the agencys aim has been to keep fees increases for the coming year to the lowest possible level. The proposals set out in the agencys consultation document (MLX 335) include some fees where no increase is proposedfor instance, for wholesale dealers, and for companies who adopt the new international standard for electronic licence applications, which will have speed and efficiency benefits for both the agency and pharmaceutical companies. The average rate of the proposed increases, across the agencys business, is 4.9 per cent. The income from these increases will cover pay and other cost increases, but will in particular be focused on supporting the agencys ability to deliver further improvements in the service it provides to companiessomething the industry has said it would wish to see. The consultation paper, and its supporting draft regulatory impact assessment, covers these issues in further detail.
Representatives from MHRA have held extensive discussions with industry associations both before the start of the consultation period and after its publication. These discussions included the Association of the British Pharmaceutical Industry, the Proprietary Association of Great Britain, the British Generic Manufacturers Association, the BioIndustry Association and the Ethical Medicines Industry Group. A further meeting with all these associations will take place on 30 January. Ministers have met pharmaceutical industry representatives on a number of occasions in recent months. The issue of MHRA fees has not been raised in those discussions.
Mr. Hollobone: To ask the Secretary of State for Health what assessment her Department has made of the impact that the time taken by the Medicines and Healthcare products Regulatory Agency to process applications has had on when pharmaceutical products reach the market. 
Caroline Flint: The time taken by the Medicines and Healthcare products Regulatory Agency (MHRA) for the assessment and determination of applications for licensing of medicinal products, and for their subsequent variation, lengthened for most product types during 2006. This was as a result of a number of operational difficulties primarily related to the introduction of a new electronic data and document management system.
The MHRA has introduced a number of steps to improve its performance in this respect and these changes are now beginning to take effect. Following discussion with representatives of the medicines trade associations a number of new performance measures have been agreed and these are soon to be published on the MHRA's website,
During this difficult period the MHRA has tried to ensure that any delays in its work did not prevent the placing on the market of essential medicines. Where necessary product licence applications and variations for such medicines were prioritised and then processed as rapidly as possible.
Tim Loughton: To ask the Secretary of State for Health which hospitals located in constituencies represented by Conservative hon. Members (a) she and (b) other Ministers in her Department have visited since May 2005; and on which dates such visits took place. 
Mr. Ivan Lewis [holding answer 22 January 2007]: Information on which hospitals the Secretary of State for Heath and Ministers in the Department have visited which are located in constituencies represented by Conservative hon. Members and the date of the visits are shown in the table.
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