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Norman Lamb: To ask the Secretary of State for Health (1) what guidance her Department has issued to local service providers on delivering the integrated NHS national programme for IT; and what requirements have been placed on such providers; 
Caroline Flint: The role of national programme local service providers (LSPs) is to deliver information technology systems and services across the national health service within clusters of strategic health authorities, in London (BT), the south (Fujitsu), and the north, midlands and east (CSC). LSPs ensure the integration of existing local systems and, where necessary, implement new systems so that the national applications can be delivered locally, while maintaining common standards. All LSPs have contracted to develop and deliver a fully integrated NHS care record solution, and are in the process of doing so.
Like all contracts, those between the Department and the LSPs provide for obligations and undertakings on either party. Among the key requirements which the contracts place on the LSPs are that functions and services are shown to work before they are bought. If providers do not deliver to their contractual obligations they are not paid. In this way the cost of non-delivery rests with the supplier, not the taxpayer. So, for example, we have retained extensive rights under the contracts to defer payments, receive compensation for missed milestones and, if necessary, terminate contracts, for failure to achieve required performance or deployment activity. We also reserve the right to consent to the appointment of key personnel of the prime contractor and material subcontractors, and have an interventionist approach to assurance including step-in rights or the appointment of a third party in certain critical circumstances if necessary.
These arrangements have been devised to secure an optimum balance between cost, risk, incentive and quality of outcome for the provision of the systems and services that we have specified for the benefit of patients, the NHS and taxpayers.
Norman Lamb: To ask the Secretary of State for Health what criteria her Department is employing to determine whether the NHS national programme for IT is successful; and if she will make a statement. 
Caroline Flint: The successes of the national programme are visible every day of the week in hospitals, general practices and pharmacies across the national health service, and the benefits are being experienced by doctors, nurses and, most importantly, patients. On any typical day the national programme currently enables over 100,000 prescriptions to be transmitted electronically, reducing errors and inefficiencies; 16,000 choose and book electronic bookings to be made, putting patients in charge of their care and reducing significantly the numbers not attending outpatient appointments; almost 1.5 million queries to be processed on the patient demographic system, ensuring receipt of around three-quarters of a million letters a year that would otherwise be posted to the wrong address and enabling patient information to be handled more efficiently; over 100,000 NHSmail users, each of whom has an email address for life, to send 1 million secure emails, one third of which contain confidential patient information; 20 new secure broadband connections to be installed; and 33,000 general practitioners (GPs) to use the quality management analysis system (QMAS) to deliver better care to patients under the new GP contract.
Meanwhile, we are developing plans to respond to a recommendation, made by the National Audit Office in its June 2006 report on the national programme, for the publication of an annual statement quantifying the benefits delivered by all aspects of the programme, set against the costs incurred. The aim is for the first statement, to include information for 2006-07, to be available in summer 2007.
Mr. Havard: To ask the Secretary of State for Health (1) what mechanisms her Department has available to hold DHL, as holder of the contract to manage supply chain and procurement services for the NHS, to account should the national procurement savings target not be met; 
DHL has a significant incentive to maximise sales volume by lowering selling prices, investing in increasing capacity, and improving product quality and service performance. There are significant contractual constraints on the maximum remuneration payable including a profit cap. Therefore savings flow through to national health service trusts, which in turn ensures benefit to NHS patients by reducing the overall cost of patient care.
Andy Burnham: The general practitioner patient survey is expected to cost no more than £11 million. The total cost of the hospital choice element of the survey will depend on the number of responses received by Ipsos MORI from patients, but is likely to be in the region of £2.5 million.
Helen Jones: To ask the Secretary of State for Health what discussions she has had with (a) the Department for Education and Skills and (b) the Learning and Skills Council on ways to reduce the number of health care staff without a level 2 qualification. 
The Department is working closely with the Department for Education and Skills, the sectors skills councils for health and social care, employers and other key stakeholders to consider the implications of the Leitch review of skills for the health and social care work force.
Mr. Lansley: To ask the Secretary of State for Health how many out-patient did-not-attends there were in each quarter since the quarter ending June 1997 (a) in England and (b) broken down by NHS organisation; and what proportion this represented in each quarter. 
Andy Burnham: Information on the number and percentage of did-not-attends (DNAs) for first, follow-up and total consultant-led out-patient attendances has been placed in the Library. Data have been supplied for 1996-07 to the second quarter of 2006-07. However, the data for 1996-07 to 1999-2000 are at England level only and on annual basis only; and the data for 2000-01 are on an annual basis only.
The cost of the choose and book computer system will be £64.5 million for system development and related service charges under a core contract with Atos Origin spanning five years. This core contract covered release 1 of the software, delivered
on time and to budget on 2 July 2004, a disaster recovery service to ensure resilience and continuity of the service, a helpdesk service to answer user inquiries, and a programme to keep the underlying technologies up to date over the lifetime of the contract. At the end of January 2007, expenditure against this contract was £34.6 million, up from £26.4 million at April 2006.
A further £39.7 million has been spent on the additional functionality and services that the original business case, approved by HM Treasury in October 2003, envisaged were likely to be required as the system rolls out. These costs are expected to total £79.5 million over the five-year period. To date expenditure has covered releases 2 and 3 of the software, a number of minor enhancements increasing the breadth of functionality in response to user comments and changing policy requirements, the delivery and support of a demonstration environment to facilitate clinical engagement, and an additional test environment to ensure that the new software performs as required. An additional £36 million has been spent on supporting the technical configuration of 109,000 local desktop computers and infrastructure to make them compatible with choose and book and with subsequent national programmes for information technology systems. Training has also been provided to trainers and 50,000 end users. These items were also included in the original business case.
Andrew George: To ask the Secretary of State for Health what mechanisms she has put in place to measure the change in the overall administrative burden of managing referrals referred to in the answer of 13 June 2006, Official Report, column 1152W, on the choose and book system. 
Andy Burnham: None. The choose and book system should reduce the overall administrative burden of managing referrals. For example, it eliminates the need for hospitals to correspond with patients over possible appointment times, and absolves practice staff and patients from the need to chase responses to referrals.
Mr. Amess: To ask the Secretary of State for Health how many (a) women, broken down by age group, and (b) babies in England died from pre-eclampsia in each of the last five years for which figures are available; what recent research she has (i) commissioned and (ii) evaluated on this condition; what recent discussions she has had with members of the medical profession on pre-eclampsia; and if she will make a statement. 
Mr. Ivan Lewis: Data on the number of stillbirths and maternal deaths where pre-eclampsia and eclampsia was identified as the cause of death are shown in the following tables. The number of maternal deaths are also broken down by age group.
Babies do not die from pre-eclampsia, but from the effects of it. They mainly die from prematurity associated with early delivery. More rarely, death occurs following eclampsia in the mother where, for example, the oxygen to the baby is interrupted or from antepartum haemorrhage associated with severe pre-eclampsia. Mothers who have experienced chronic pre-eclampsia may have babies who are small for gestational age and they are also at risk.
The Department funds research to support policy and to provide the evidence needed to underpin quality improvement and service development in the national health service, and through its health technology assessment programme is undertaking a systematic review of the methods of prediction and prevention of pre-eclampsia. The results of the review will be published early next year.
|Stillbirths where pre-eclampsia was identified as the maternal condition|
Confidential Enquiry into Maternal and Child Health.
|Maternal deaths certified as due to pre-eclampsia, eclampsia and other related conditions, England and Wales, 2001 to 2005|
Office for National Statistics.
|Deaths by age group, 2001 to 2005|
Office for National Statistics.
Mr. Lansley: To ask the Secretary of State for Health how many primary care trusts operate referral management schemes; what assessment she has made of the effectiveness of such schemes; what safeguards she has put in place to ensure that referral management schemes operated by the independent sector do not compromise the care offered to patients; whether referral management schemes have the statutory authority to override GP referrals; and if she will make a statement. 
Information on how many primary care trusts operate referral management centres is not held centrally. Primary care trusts with their partners, including the independent sector, have been advised that it is good practice to review and where necessary develop existing referral management centres to make sure that they create tangible benefits for patients, and uphold the principles set out in Care and resource
utilisation: ensuring appropriateness of care, published on 14 December 2006. This is available in the Library and at:
Mr. Peter Ainsworth: To ask the Secretary of State for Health how many shipments containing US long grain rice have been rejected at UK ports of entry for failing to comply with emergency EU legislation on GM Rice (LL601) since August 2005; and what the volume was of each shipment. 
Caroline Flint: Commission Decision 578/2006 came into force in August 2006 and required all imports of United States (US) long grain rice into the European Union to be certified free from the unauthorised genetically modified (GM) rice LL601. This Decision was replaced in September by Decision 601/2006, which was amended in November to require such imports to be subject to additional re-testing at the point of import. Two shipments of US long grain rice arriving in the United Kingdom have been rejected, as they arrived in September 2006 without the necessary certificate, and testing at the port indicated the presence of the unauthorised GM rice. These shipments were of 183 and 22 tonnes.
Mr. Lansley: To ask the Secretary of State for Health how many cases of (a) HIV, (b) chlamydia, (c) gonorrhoea, (d) syphilis, (e) genital warts and (f) genital herpes there have been in England since 1997, (i) in total and (ii) broken down by (A) strategic health authority area and (B) primary care trust area. 
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