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NHS West Midlands will be agreeing with Worcestershire Primary Care Trust (PCT), in the light of its service and financial plans for 2007-08 onwards (to be finalised by the end of March 2007), the continued applicability and robustness of the business case for a new community hospital in Malvern. If the
case remains strong and the PCT can demonstrate affordability and value for money, then the strategic health authority will work with the PCT to secure capital funding by whichever route is most appropriate and expeditious, including the opportunity to bid against the national £750 million community hospitals fund.
Joan Ruddock: To ask the Secretary of State for Health what progress her Department has made in achieving gender equality in public appointments to bodies which fall within her Department's responsibility since 1997. 
Ms Rosie Winterton [holding answer 5 March 2007]: The appointment of national health service trust chairs has been delegated to the Appointments Commission by the Secretary of State. I have, therefore, asked the Commission to write to my hon. Friend with the detailed information she has requested.
Ms Rosie Winterton: Healthcare providers should remain alert throughout the entire antenatal period to signs or symptoms of conditions which affect the health of the mother and fetus, including diabetes.
In November 2006, the Department produced the diabetes commissioning toolkit. The toolkit supports national health service commissioners of diabetes care at both primary care trust and practice level.
The toolkit makes clear national and locally agreed guidelines and protocols that should be implemented in the care of pregnant women with diabetes. We expect local guidelines to reflect national guidelines and that all healthcare professionals will follow these guidelines in providing maternity care.
The National Institute for Health and Clinical Excellence is currently developing guidelines on diabetes in pregnancy. The guidelines, which will cover the management of diabetes and its complications from pre-conception to the post-natal period, are expected to be published in November 2007.
Owners, or those who are responsible for the management of public buildings or other public places, may provide or make available a supply of drinking water. If they choose to do so, or are required to do so under a scheme of legislation, they may safely rely on the quality of the public drinking water supply.
Under the Workplace (Health, Safety and Welfare) Regulations 1992 employers are required to provide an adequate supply of wholesome drinking water for all people at work in the workplace. The supply should be readily accessible at suitable places, conspicuously marked by an appropriate sign where necessary for health or safety reasons. Unless the water is in a jet, employers should also provide cups.
Mr. Jamie Reed: To ask the Secretary of State for Health if she will place in the Library copies of the accounts for the (a) West Cumberland hospital, Whitehaven, and (b) the Cumberland infirmary, Carlisle, for each year since 1997. 
Mr. Jamie Reed: To ask the Secretary of State for Health how much was spent on services commissioned at the (a) West Cumberland hospital, Whitehaven, (b) Cumberland Infirmary, Carlisle, and (c) Cumberland Infirmary's predecessor in each year since 1997. 
|Income from activities (provision of healthcare services 1998-99 to 2005-06|
|West Cumbria Healthcare NHS trust||Carlisle Hospitals NHS trust||North Cumbria Acute NHS trust|
NHS trust audited summarisation schedules for the relevant trusts.
Ms Rosie Winterton: Revenue allocations were made to health authorities (HAs) between 1997-98 and to primary care trusts (PCTs) between 2003-04 and 2007-08. Table 1 shows the allocations to HAs in Cumbria. Table 2 shows the allocations to the PCTs which merged on 1 October 2006 to become Cumbria PCT.
|Table 1: Allocations to HAs in Cumbria|
|Table 2: Allocations to PCT in Cumbria|
The area covered by the former Morecambe Bay PCT is now split between Cumbria and North Lancashire PCTs
|Number of laboratory cases|
Laboratory serological tests are not able to differentiate between acute and chronic cases of hepatitis C infection. Therefore laboratory reports of hepatitis C contain both recently acquired and past infections. For this reason the data represent newly diagnosed cases of hepatitis C as opposed to newly acquired infections.
Health Protection Agency Data as at 28 February 2007. Data for 2006 are provisional.
Ms Rosie Winterton: We are revising the existing plan for a response to pandemic influenza, updating it in the light of current knowledge and expanding it to cover all relevant Government Departments. The framework has been tested recently in Exercise Winter willow and will be made available to the public shortly for discussion before a final framework is produced and published in the summer.
Mr. Spellar: To ask the Secretary of State for Health pursuant to the answer of 19 February 2007, Official Report, column 49W, on influenza: disease control, whether the World Health Organisation was involved in Operation Winter Willow. 
Ms Rosie Winterton: The World Health Organisation participated in the Exercise Winter Willow that was conducted to test the United Kingdom's response to an outbreak of pandemic influenza at local, regional and national levels.
Chris Huhne: To ask the Secretary of State for Health what arrangements her Department has made to retain pharmaceutical production facilities in (a) the UK and (b) elsewhere to make a post-pandemic influenza virus vaccine; how many doses would be provided under such arrangements; what the timescale is for providing the vaccine following the identification of the virus; and if she will make a statement. 
Ms Rosie Winterton: We are working closely with other countries, the World Health Organization, and the European Commission and are in regular dialogue with manufacturers to ensure that a vaccine can be developed as quickly as possible for the whole population once a pandemic influenza strain emerges.
The chief medical officer has invited manufacturers to tender for a contract to supply the UK with pandemic flu vaccine. This proposal, to purchase in advance the capacity needed to make pandemic flu vaccine, will make sure that an effective vaccine is available for use in the UK as quickly as possible after a flu pandemic starts. Tenders received are currently being evaluated.
Mr. Lansley: To ask the Secretary of State for Health what the evidential basis was of the statement made by the Minister of State with responsibility for delivery and quality on 14 December 2006, Official Report, column 357WH, that the burden of disease is higher in areas with the lowest life expectancy than it is in areas with the longest life expectancy; and what definition of the burden of disease she uses. 
Andy Burnham: The evidential basis for my statement is four indicators: premature mortality rates in under 75s from cancer and coronary heart disease; and in under 65s from stroke, and the prevalence of diabetes in people of all ages, as a proxy for the burden of disease.
The following table shows that the 5 per cent. of primary care trusts (PCTs) with the longest life expectancy have a lower average burden of disease for
each of the four indicators than the 5 per cent. of PCTs with the shortest life expectancy.
|Averages for the five per cent of PCOs with the||Averages for the five per cent of PCOs with the|
|Shortest life expectancy||Longest life expectancy||Shortest life expectancy||Longest life expectancy|
1. The aggregate figures are population weighted averages (using populations rounded to the nearest 100 for the life expectancy and mortality data). For the life expectancy and directly age-standardised mortality rates, using a population-weighted average is only an approximation to the actual figures for the aggregate of areas.
2. The 5 per cent. of primary care organisations with the shortest/longest life expectancy values have been selected by ranking all PCOs by life expectancy (for males and females separately). Around the cut off point, if two or more PCOs have the same life expectancy, all PCOs with that figure for life expectancy are included in the longest or shortest 5 per cent. grouping.
3. Life expectancy at birthdata for PCOs for 2001-03.
Primary care organisations (boundaries as of April 2003)
4. Mortality rates are directly age-standardised rates (DSR) per 100,000 European Standard population
Data years 2002-04 (pooled)
Causes of death are based on the International Classification of Diseases version 10
Mortality from all cancers (ICD10 C00-C97)
Mortality from coronary heart disease (ICD10 120-125)
Mortality from stroke (ICD10 160-169)
Data are based on the original underlying cause of death.
Data are based on the latest revisions of ONS population estimates for the respective years, current as at 20 December 2005.
5. Diabetesunadjusted prevalenceaggregate figures for PCT not accounting for age-sex distribution of the PCT population
Unadjusted prevalence = (number on disease register/list size) *100
Data for financial year 2005-06
1. For life expectancy and mortality rate data: Health and Social Care Information Centre. Compendium of Clinical and Health Indicators/Clinical and Health Outcomes Knowledge Base (www.nchod.nhs.uk or nww.nchold.nhs.uk)
2. For diabetes prevalence: Health and Social Care Information Centre, Quality and Outcomes Framework (QOF)
QMAS database2005-06 data as at end of June 2006
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