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21 Mar 2007 : Column 1013W—continued


In Vitro Fertilisation

Mr. Cameron: To ask the Secretary of State for Health what guidance her Department gives to primary care trusts on the implementation of National Institute for Health and Clinical Excellence guidelines in relation to the number of IVF cycles that should be made available and funded through the NHS. [128434]

Caroline Flint: The primary responsibility for the provision of fertility services rests with the national health service at the local level. In welcoming the clinical guideline published by the National Institute for Health and Clinical Excellence in 2004, we advised that the Department would be looking to primary care trusts (PCTs) who provide no in vitro fertilisation (IVF) treatment to provide a minimum national level of provision of one cycle of IVF by April 2005, and to make progress to the full implementation of the guideline in the longer term. We are funding the patient support organisation Infertility Network UK to help PCTs share best practice in the provision of fertility services and engage with fertility patients in the planning and prioritisation of services.

Insulin

Mr. Sanders: To ask the Secretary of State for Health when she expects to submit a request to the National Institute for Health and Clinical Excellence to undertake a comparison of the different types of insulin in its future work programme. [122679]

Caroline Flint: The National Institute for Health and Clinical Excellence (NICE) has issued technology appraisals of inhaled insulin, insulin pump therapy and long acting insulin analogues in the management of diabetes. NICE has also published a clinical guideline on the management of type 1 diabetes and a guideline on the management of type 2 diabetes—blood glucose. These guidelines include advice on the role of insulin in managing those conditions, NICE is currently reviewing its published clinical guidelines on type 2 diabetes and expects to publish a revised guideline in early 2008.

We have no plans at this time to ask NICE to undertake a comparison of different types of insulin, but the need for further NICE guidance on aspects of the management of diabetes will be kept under review.

Local Government Targets

Tom Brake: To ask the Secretary of State for Health what targets her Department sets for local authorities. [104907]


21 Mar 2007 : Column 1014W

Mr. Ivan Lewis: “National Standards, Local Action; Health and Social Care Standards and Planning Framework 2005-06 to 2007-08”, published in July 2004, set out a standard-based planning framework for health and social care and standards for national health service health care to be used in planning, commissioning and delivering services.

The standards set out are focused on the provision of NHS health care, but recognise the need to develop services in a co-ordinated way, taking full account of the responsibilities of other agencies in providing comprehensive care. In particular the statutory duties of partnership on all NHS bodies and local authorities established under the Health Act 1999 and the Health and Social Care (Community Health and Standards) Act 2003. This introduced requirements on both the NHS and local authorities to work together to achieve the co-operation needed to bring about improvements in health care.

The following specific targets for 2005 to 2008 were set for local authority social services and social services in partnership with the NHS:

and although measured through NHS indicators, social services provide a major contribution to

Maternity Services

Mr. Baron: To ask the Secretary of State for Health (1) how many episodes of maternity care there were in (a) consultant-led units with more than 3,000 live births per year, (b) consultant-led units with fewer than 3,000 live births per year, (c) midwife-led units in acute hospital settings and (d) midwife-led units in community settings in each of the last three years; [126388]

(2) how many deaths of women in the care of NHS maternity services there were in each of the last three years; and how many occurred in (a) consultant-led units with more than 3,000 live births per year, (b) consultant-led units with fewer than 3,000 live births per year, (c) midwife-led units in acute hospital settings and (d) midwife-led units in community settings. [126390]

Mr. Ivan Lewis [holding answer 9 March 2007]: This information is not collected centrally in the form requested. Data from the Office of National Statistics shows that in 2002, the last year for which information
21 Mar 2007 : Column 1015W
is available, there were 596,122 live births, of which 582,569 took place in hospital, 12,684 took place at home and 869 took place elsewhere.

Confidential enquiry into maternal and child health (CEMACH)’s report on maternal death for the three year period 2000 to 2002 showed that there were 106 direct maternal deaths in that period, representing 5.3 deaths per thousand of the two million births. It is not possible to break these figures down by place of delivery.

Medical Records: Databases

Mr. Stephen O'Brien: To ask the Secretary of State for Health how many electronic patient records she expects there to be; and how many she expects to have (a) sealed and (b) sealed and locked data on them. [119873]

Caroline Flint: In the future, each person using the national health service will have an electronic NHS care record which will be made up of detailed care records, held locally by the NHS body that provides care to the patient, and a summary care record. At the local level detailed care records will be built up over time into a comprehensive health and care history.

The objective of sealing, and sealing and locking information is to reduce the number of people who might otherwise feel the need to opt-out completely of having a summary care record because of their concern about only a small amount of sensitive information in their record. It will be open to any patient to ask to limit access to such information, including to request that specific sensitive information is accessible only with their consent. The sealed envelopes approach has the confidence of the professions in being able to provide appropriate controls for the support of patient confidentiality.

It is not possible to predict with any certainty how many people may in future choose to exercise this option as this will be the first time such an approach has ever been used. However, there is ample evidence to suggest that only a small minority would have concerns about the content of their medical records that would lead to their choosing to seal information. In response to a Consumer Association Survey (October 2002) question on this subject 60 per cent. of respondents said that they would remove nothing, around a quarter (24 per cent.) said they would remove a little, and around four per cent, said they would remove “a lot” or “all”.

This is paralleled by the available evidence about the likelihood of people to opt out of having a summary care record at all. The Scottish emergency care summary, which extracts data from general practitioners’ records and hospital notes, currently contains records for nearly 4.93 million patients and less than 500 have opted out. Similarly, in the course of a consultation on establishing an electronic health record in the Wirral, of patients invited to opt out if they had concerns, only 25 opted out whilst 350,000 records were uploaded. And of the 1.3 million patients likely to be affected by a similar proposal in Hampshire and the Isle of Wight, only some 1,150 decided not to have their records included in the data repository.


21 Mar 2007 : Column 1016W

Midwives: Training

Ms Keeble: To ask the Secretary of State for Health how many training places there were for midwives in each health region in England in each of the last three years. [124384]

Ms Rosie Winterton: This information has been placed in the Library.

Missing Persons

Helen Southworth: To ask the Secretary of State for Health pursuant to the answer of 14 March 2007, Official Report, column 428W, on missing persons, what bilateral contact her Department has had with other stakeholders represented on the missing persons strategic oversight group in the last two years; on what dates these contacts took place; and with whom they took place. [128783]

Ms Rosie Winterton [holding answer 20 March 2007]: Departmental officials have met with representatives of the police, the Home Office and the National Missing Persons Helpline a number of times over the past year. Most recently, officials met with representatives of the National Missing Persons Helpline on 22 November 2006. Details of other meetings are not centrally available.

MRSA

Natascha Engel: To ask the Secretary of State for Health if she will place in the Library information she has on the incidence rates of MRSA in other (a) EU and (b) World Health Organisation member states; and what comparative assessment she has made of rates in those countries and in the UK. [126514]

Caroline Flint: The best European data are from the European antimicrobial resistance surveillance system (EARSS) database. This provides information only as a proportion of Staphylococcus aureus bloodstream infections that are resistant to meticillin.

A copy of the 2005 EARSS annual report has been placed in the Library and is available at:

It is difficult to compare different European countries as health services and surveillance systems differ. There is no overall trend but increases have been seen in some member states. However, our figures show that we need to reduce meticillin resistant Staphylococcus aureus (MRSA) cases and tackling MRSA and other healthcare associated infections (HCAIs), continues to be a priority. We have introduced a number of interventions to help the national health service. Between April 2003 and March 2004 and October 2005 to September 2006, there has been a 10.2 per cent. reduction in the 12-month rolling total. This shows that our actions are having a significant effect.

The World Health Organisation does not compile information on MRSA.


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MRSA: Lancashire

Mr. Hoyle: To ask the Secretary of State for Health how many people contracted MRSA in hospitals in Lancashire in each of the last five years. [125168]

Caroline Flint: The information is not available as requested

The best available information is from the mandatory methicillin resistant Staphytococcus aureus
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(MRSA) blood stream infections surveillance that began in April 2001 and covers acute trusts in England.

The number of reported MRSA blood stream infections for national health service acute trusts within Lancashire is shown in the following table. The surveillance protocol requires all trusts to report MRSA positive blood cultures detected in their laboratories, whether acquired in the trust or elsewhere and these should include samples sent to the trust from other NHS run healthcare facilities. The cases recorded in the tables may not therefore have all been contracted in hospitals in Lancashire.

Number of reported blood stream infections (bacteraemias)
Trust April 2001-March 2002 April 2002-March 2003 April 2003-March 2004 April 2004-March 2005 April 2005-March 2006

Blackpool, Fylde and Wyre

44

40

64

62

55

East Lancashire Hospitals

57

66

63

69

53

Lancashire Teaching Hospitals

76

58

56

74

54

Southport and Ormskirk Hospital

4

11

10

13

14

University Hospitals of Morecambe Bay

33

24

30

30

33

Source:
Health Protection Agency

Multiple Sclerosis: AIDS

Sir Nicholas Winterton: To ask the Secretary of State for Health what her Department's budget was for research into (a) multiple sclerosis and (b) AIDS in each of the last 10 years for which figures are available. [126085]

Caroline Flint: The information requested is shown in the tables.

Expenditure on multiple sclerosis research
£ million
Department Medical Research Council

1997-98

0.04

n/a

1998-99

0.6

n/a

1999-2000

0.5

n/a

2000-01

0.5

1.5

2001-02

0.6

2.1

2002-03

0.1

1.8

2003-04

0.1

1.1

2004-05

0.1

1.4

2005-06

0.8

n/a

n/a = not available

Expenditure on HIV/AIDS research
£ million
Department Medical Research Council

1997-98

1.1

n/a

1998-99

1

n/a

1999-2000

1

13

2000-01

1.3

15

2001-02

0.8

14

2002-03

1

11

2003-04

1

11

2004-05

1

11

2005-06

1

n/a

n/a = not available

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