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16 Apr 2007 : Column 325W—continued

Cancer: Urinary System

Mr. Clelland: To ask the Secretary of State for Health (1) what assessment she has made of the progress of cancer networks in implementing the Improving Outcomes guidance for urological cancers; [128525]

(2) what mechanisms she has put in place to ensure that service providers commissioned by her Department are meeting the Improving Outcomes guidance for urological cancers in relation to (a) multi-disciplinary team working and (a) access to specialist nurses. [128660]

Ms Rosie Winterton: Strategic health authorities were asked to submit action plans to demonstrate how they will implement the guidance on Improving Outcomes in urological cancers. Progress against these action plans is monitored by the Department and the Healthcare Commission. The majority of cancer networks reported at December 2006 that the guidance would be fully implemented by December 2007.

The guidance has also been translated into a series of measures for inclusion in the Manual of Cancer Services 2004. All cancer networks in England have now been peer reviewed against these measures, which include measures about urological cancer multi-disciplinary teams including urology nurse specialists. Reports of the local peer review visits for each cancer network can be found on the Cancer Quality Improvement Network System (CQuINS) database at A national summary will also be produced and is expected to be available in the summer.

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Care Homes

Greg Mulholland: To ask the Secretary of State for Health how many people in the UK aged 75 years or over are living in (a) public sector residential care homes and (b) private sector residential care homes. [130279]

Ms Rosie Winterton [holding answer 27 March 2007]: The information requested is not collected centrally.

Mr. Clegg: To ask the Secretary of State for Health how many approved care homes for the (a) elderly and (b) other vulnerable people there are in England. [129160]

Andy Burnham: The Commission for Social Care Inspection (CSCI), as the official regulator of social care provision, registers and inspects all care homes in England. It is important to note that care homes are not approved by CSCI. Registration with and inspection by CSCI simply signifies that a home is permitted to operate.

I am informed by the chair of CSCI that care homes are not registered as homes for older people (those aged over 65) or for younger adults (those aged 18-64). Many take in a mix of client groups. The following table shows the number of homes in England which have been regulated by CSCI against the national minimum standards (NMS) for care homes for older people and the NMS for care homes for younger adults.


Total number of homes


Care homes regulated against NMS for care homes for older people


Care homes regulated against NMS for care homes for younger adults


(1) This total is greater than the sum of the two categories of home due to the fact that some homes (such as new homes) had not been regulated against the NMS by 1 April 2006.
CSCI report The State of Social Care in England2005-06. Figures at 31 March 2006

Care Homes: Fees and Charges

Mr. Stephen O'Brien: To ask the Secretary of State for Health why Torbay Primary Care Trust (PCT) reimbursed care home fees to Mr. Mike Pearce; what precedent has been set by the PCT’s decision; what estimate she has made of the liabilities of the NHS for future repayments of denied continuing care funding; what framework Torbay used to re-assess the case; and what the total NHS expenditure was in England in 2005-06 on (a) care homes and (b) care home places for those with Alzheimer’s disease. [119803]

Caroline Flint: Following the Health Service Ombudsman’s report “NHS Funding for Long Term Care of Older and Disabled People”, the national health service has carried out retrospective reviews of over 12,000 cases where fully funded NHS care was denied, dating back to 1996. The case of Mr. Pearce’s mother was one of these retrospective reviews of her
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eligibility for continuing care. This retrospective review found that Mrs. Pearce was wrongly denied NHS funding for her care, and so Torbay Care Trust reimbursed care home fees for the period of time when they considered they should have been paying for her care.

The care trust will continue to take the same approach to any other retrospective reviews they have to conduct, but no national precedent has been set.

In 2004, primary care trusts (PCTs) estimated that they would pay approximately £180 million in repayment as a consequence of the retrospective reviews of cases following the Ombudsman’s report.

Torbay Care Trust used the strategic health authority’s (SHA) eligibility criteria, which have been reviewed in accordance with guidance issued by the Department since the Coughlan and Grogan judgments. In their consideration of Mrs. Pearce’s case, they used the draft decision support tool, published as part of the Department’s consultation in 2006 , to help them gather information about Mrs. Pearce’s needs. This information was then tested against the criteria already in place in the SHA.

Further clarification for PCTs about redress, in cases where it has been found that NHS funding was wrongly withheld, was contained in guidance published by the Department in response to the publication of the joint report by the Parliamentary Commissioner for Administration (Parliamentary Ombudsman) and the Health Service Ombudsman for England, Retrospective continuing care funding and redress, on 14 March 2007.

The information requested on NHS expenditure on care home and care home places is not held centrally.

Care Homes: Manpower

Mr. Laurence Robertson: To ask the Secretary of State for Health what regulations determine the ratio of nursing staff to patients in (a) nursing and (b) residential homes; what those ratios are; and if she will make a statement. [130725]

Ms Rosie Winterton: Regulation 18 of the Care Homes Regulations 2001, which apply to both nursing and residential homes, requires that the registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users, ensure that at all times suitably qualified, competent and experienced persons are working in the care home in such numbers as are appropriate for the health and welfare of service users.

Specific ratios are not laid down, either in the Regulations or the national minimum standards, which the regulator, the Commission for Social Care Inspection, must have regard to when inspecting care homes to establish compliance with the regulations.

Staffing ratios must be determined according to service users’ health and care needs; these may vary from home to home and from day to day. It is a provider’s obligation in law to ensure that their establishment is appropriately staffed on a day to day basis.

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Carers: Peterborough

Mr. Stewart Jackson: To ask the Secretary of State for Health (1) what proportion of the funding made available to local authorities for respite care for carers in the recent New Deal for Carers statement will be allocated to Peterborough City Council; and if she will make a statement; [123830]

(2) what estimate she has made of the number of carers in the Peterborough City Council area for the purposes of the allocation of funding to assist with respite care are under the New Deal for Carers. [123831]

Tony Baldry: To ask the Secretary of State for Health pursuant to her written statement of 21 February 2007, Official Report, column 49WS, on the New Deal for Carers, how much of the additional £25 million available to local authorities in England for the provision of short term home-based respite care she expects to be allocated to Oxfordshire County Council. [124263]

Andy Burnham: There were 670 carers who received an assessment or a review in Peterborough council during the year 2005-06, of which 200 carers received a break and or carers specific services.

In 2007-08 Peterborough city council will receive £1.959 million for carers, of which £233,000 will support the provision of emergency respite care.

During the same period Oxfordshire county council will receive £0.686 million for carers, of which £82,000 will support the provision of emergency respite care.

A table detailing the amounts each council will be allocated has been placed in the Library.

Cataracts: Surgery

Miss McIntosh: To ask the Secretary of State for Health what the average waiting time was for cataract operations in (a) North Yorkshire, (b) County Durham and (c) England in the latest period for which figures are available; and how many cataract operations were cancelled and re-arranged following an initial date for the operation being given in the same period. [129489]

Ms Rosie Winterton: The average waiting times for cataract operations in the former strategic health authorities for County Durham and Tees Valley and North and East Yorkshire and Northern Lincolnshire in 2005-06 are given in the following table.

Strategic health authority Median time waited (days)

County Durham and Tees Valley


North and East Yorkshire and Northern Lincolnshire




1. Data are for finished admission episodes, i.e. the first period of in-patient care under one consultant with one Healthcare provider.
2. Time waited is the difference between the admission and decision to admit dates.
Hospital Episodes Statistics (HES), The Information Centre for health and social care.

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The Department does not collect data on numbers of cancelled operations for individual procedures such as cataract operations.

Bowel Cancer Screening

Mr. Baron: To ask the Secretary of State for Health (1) how many (a) newly trained non-medical endoscopists and (b) medical endoscopists were delivered by the national endoscopy training programme in each year since its creation; [129628]

(2) what estimate she has made of the number of additional endoscopists required to support a fully-implemented national bowel cancer screening programme. [129629]

Ms Rosie Winterton [holding answer 23 March 2007]: Training in endoscopy (bowel scoping) is vital to the diagnosis of bowel cancer. To prepare for the bowel cancer screening programme, we have built on the training established as part of the national health service cancer plan. A national training programme has been established, with three national and seven regional centres, to train medical staff, general practitioners, nurses and other health professionals to carry out vital procedures for diagnosing bowel cancer. The options appraisal analysis for the introduction of the bowel cancer screening programme estimated that an additional 61,274 endoscopies would be required equating to 14 additional endoscopy units staffed by four trained nurse endoscopists and 1.4 whole-time equivalent gastroenterologists. It is for cancer networks to work in partnership with strategic health authorities and postgraduate deaneries to put in place a sustainable process to assess, plan and review their workforce needs and the education and training of all staff linked to local and national priorities for cancer.

Based on current trends and definitions the training programme is projected to deliver the following training courses by the end of 2006-07.

National endoscopy training programme courses
2004-05 2005-06 2006-07 Total

Medical endoscopists





Non medical endoscopists










Mr. Baron: To ask the Secretary of State for Health (1) further to her Department’s press release on the bowel cancer screening programme of 2 August 2005, how the figure of £37.5 million of expenditure will be broken down over the first two years of the programme’s implementation; [130553]

(2) pursuant to the answer of 23 March 2007, Official Report, column 1190W, on bowel cancer screening, what funding earmarked for the programme has been included in the Strategic Health Authority bundle for 2007-08. [130595]

Ms Rosie Winterton [holding answer 29 March 2007]: Funding for the national health service bowel cancer screening programme is included in the strategic health authority (SHA) bundle, that incorporates a number of budgets formally managed directly by the Department.

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Around £10 million was made available for wave one of the programme in 2006-07. The value of the SHA bundle for 2007-08 is £6,945.78 million, and was announced in the NHS operating framework that was published on 11 December 2006 to the NHS. £27.5 million was included in the SHA bundle for the bowel screening programme. Allocations are made direct to SHAs, and they manage the distribution of funds among the different programmes, including the bowel cancer screening programme, taking account of local circumstances.

This is an ambitious project and the Government are committed to ensuring that the necessary funding is available to ensure the full implementation of the bowel cancer screening programme.

Mr. Baron: To ask the Secretary of State for Health further to her Department's press release on the bowel cancer screening programme of 2 August 2005, what steps she will take to assess whether the target for 25 per cent. coverage of England by the end of 2006-07 has been met; and what estimate she has made of the proportion of England currently covered by the programme. [130554]

Ms Rosie Winterton [holding answer 29 March 2007]: We started the roll-out of the programme slightly later than originally intended. However, we took all the practical steps possible to prepare for the roll-out and to minimise the delay. All five programme hubs in England are now operational, and 15 of the eventual 90 to 100 local screening centres opened in 2006-07. These cover 49 out of 152 primary care trusts in England, covering a population of 13 million, around 26 per cent. of the English population. It is for strategic health authorities working in partnership with their primary care trusts and local stakeholders to organise and deliver services for their local populations. We expect around half of the local screening centres to be operational by March 2008, with full overage in England by December 2009.

The bowel cancer screening programme is an ambitious project, and one of the first of its kind in Europe. When fully implemented, it will screen around 2 million men and women and detect around 3,000 bowel cancers every year. We are committed to implementing this important programme.

Dr. Gibson: To ask the Secretary of State for Health if her Department will extend the national bowel cancer screening programme to those aged (a) 70 and over and (b) between 50 and 60. [130800]

Ms Rosie Winterton: The bowel cancer screening programme is beginning by inviting men and women aged 60 to 69 to be screened as the risk of bowel cancer increases with age, with over 80 per cent. of bowel cancers arising in people who are 60 or over.

The successful national health service pilot study also showed that men and women in their 60s were more likely to take up their invitations for screening than men and women in their 50s.

Within the programme, men and women aged 70 and over are able to self-refer for screening every two years.

When we have rolled out the programme to the whole of England, we will make an assessment of whatever next steps may be required, including looking at the age range.

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