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Eyesight: Testing

Mr. Jenkins: To ask the Secretary of State for Health how much the Government has spent to provide free eye tests to pensioners in each year since 1997. [132909]

Ms Rosie Winterton: An estimate of national health service expenditure on sight tests for patients aged 60 and over is set out in the following table.

NHS expenditure on sight test provision for adults aged 60+ (£ million)















Free sight tests were extended to all those aged 60 and over from 1 April 1999. Prior to that, a number of patients of pensionable age would have qualified for NHS sight tests on other grounds, such as low income or because they had been diagnosed with diabetes or glaucoma, but data collected centrally did not differentiate such groups by age.

The figures in the table are based on the number who claimed entitlement by virtue of their age. The totals are likely to include those who might otherwise have qualified for sight tests on grounds such as low income.

Expenditure on sight test provision includes expenditure on domiciliary visit fees, employers’ superannuation costs, and help given to certain patients towards the cost of private sight tests.

Folic Acid

Mr. Stewart Jackson: To ask the Secretary of State for Health what her most recent estimate is of the take-up of folic acid in women of child bearing age in socio-economic groups C2 and DE; and if she will make a statement. [134891]

Caroline Flint: The most recent information available on folate intakes is from the 2000-01 National Diet and Nutrition Survey of adults aged 19-64 years. In this survey households in receipt of income-related state benefits can be used as a broad indicator of socio-economic group. The survey shows that mean folate intake from food sources in women of child bearing age (19-49 years) living in households in which someone was in receipt of benefits was 214 micrograms/day. When the contribution of folic acid supplements was
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included mean intake in this group increased to 221 micrograms/day. This level of intake is below the recommendation for women who could become pregnant to take a 400 micrograms/folic acid supplement.

The Food Standards Agency has undertaken a survey of diet and nutrition in low income/materially deprived consumers in the United Kingdom. Results, to be published later this year, will include folate intakes.

Health Services: East Riding

Mr. Graham Stuart: To ask the Secretary of State for Health what estimate she has made of the impact on the finances of the East Riding of Yorkshire Primary Care Trust of the number of temporary residents. [132462]

Andy Burnham: Arrangements are in place to enable payment for emergency treatment for those patients who are not normally resident in the area. For English patients who are treated as emergencies, their responsible primary care trust (PCT) is invoiced for the activity directly by the national health service organisation concerned ensuring that the host PCTs are not burdened with the payment for material costs of hospital activity. This guidance also covers the payment arrangements for charge-exempt overseas visitors. This includes all those visitors who are covered under international bilateral healthcare agreements, including European Economic Area arrangements.

Health Services: Equality

Mr. Drew: To ask the Secretary of State for Health on what date the Race Equality Impact Assessment for part II of the Health and Social Care Act 2001 (Patient and Public Involvement in Health and Social Care) was prepared. [132877]

Ms Rosie Winterton: The Race Equality Impact Assessment for patient and public involvement in health and social care was published as part of the regulatory impact assessment for the Local Government and Public Involvement in Health Bill on 11 December 2006.

Heart Diseases: Staffordshire

Mr. Jenkins: To ask the Secretary of State for Health how many people in (a) Tamworth constituency, (b) the West Midlands and (c) Staffordshire have been treated for heart disease in each of the last five years. [132741]

Ms Rosie Winterton: The information is not available in the format requested.

However, information relating to finished consultant episodes (FCE) with a primary diagnosis of heart disease for the relevant organisations for 2001-02 to 2005-06 is shown in the following table.

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National health service hospitals England
Tamworth, Burntwood and Lichfield Primary Care Trust Staffordshire West Midlands





















Finished consultant episode (FCE)
An FCE is defined as a period of admitted patient care under one consultant within one healthcare provider. Please note that the figures do not represent the number of patients, as a person may have more than one episode of care within the year.
Diagnosis (primary diagnosis)
The primary diagnosis is the first of up to 14 (7 prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was in hospital.
Primary care trust (PCT) and strategic health authority (SHA) data quality
PCT and SHA data were added to historic data-years in the HES database using 2002-03 boundaries, as a one-off exercise in 2004. The quality of the data on PCT of Treatment and SHA of Treatment is poor in 1996-97, 1997-98 and 1998-99, with over a third of all finished episodes having missing values in these years. Data quality of PCT of GP practice and SHA of GP practice in 1997-98 and 1998-99 is also poor, with a high proportion missing values where practices changed or ceased to exist. There is less change in completeness of the residence-based fields over time, where the majority of unknown values are due to missing postcodes on birth episodes. Users of time series analysis including these years need to be aware of these issues in their interpretation of the data.
Data quality
Hospital Episode Statistics (HES) are compiled from data sent by over 300 NHS trusts and primary care trusts (PCTs) in England. The Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. Whilst this brings about improvement over time, some shortcomings remain.
Ungrossed data
Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).
Hospital Episode Statistics (HES), The Information Centre for health and social care.

Hospital Closures: Media Interests

Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 29 March 2007, Official Report, column 1787W, on hospital closures: media interest, what methodology was used to arrive at predictions of media interest as indicated on the heat maps released by her Department on 7 November 2006. [131875]

Andy Burnham: As was stated in the earlier answer, the Department uses a range of methods to monitor media activity. The maps were produced following routine discussions with strategic health authorities (SHAs) and gave an indication of possible future local media coverage of health issues by SHA.

Hyperactivity: Medical Treatments

Bob Spink: To ask the Secretary of State for Health what representations her Department has received on the use of diet and brain exercise to control developmental conditions such as Attention Deficit Hyperactivity Disorder. [132313]

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Mr. Ivan Lewis: No such representations have been received.

The Department is not aware of any satisfactory research into the effects of stimulatory exercises in the treatment of attention deficit hyperactivity disorder.

There is some limited evidence for the value of elimination diets that seek to exclude foods to which intolerance exists, but an elimination diet will only help a minority of children and can be difficult to apply. A study on the impact of food supplements on the incidence of aggressive behaviour among young people in custody has demonstrated positive results but further research is required and the study was not specifically focused on attention deficit hyperactivity disorder.

Maternity Services

Mr. Baron: To ask the Secretary of State for Health what estimates she has made of the cost of (a) increasing medical research into preventing premature birth and (b) caring for babies who are born prematurely. [132259]

Mr. Ivan Lewis: None. The National Perinatal Epidemiology Unit at the University of Oxford, set up and supported by the Department, is however undertaking a study on the long-term economic costs of pre-term birth financed by an award from the charity Tommy’s.

Medical Equipment: VAT

Peter Bottomley: To ask the Secretary of State for Health if she will extend the range of reduced rate reliefs for VAT on goods and services normally intended to relieve or treat disability for the exclusive personal use of people with disabilities under the sixth EC Directive. [134429]

John Healey: I have been asked to reply.

There is a wide range of goods and services supplied to disabled people for their personal use on which VAT is not chargeable. This includes certain building alterations to a disabled person’s home, wheelchairs and mobility scooters, and equipment designed solely for use by a disabled person.

Under the VAT agreements with our European partners, signed by successive Governments, we can retain our existing VAT zero rates, but we may not extend them or introduce new ones. It is therefore not possible to remove VAT from additional goods and services purchased for the exclusive personal use of a disabled person

More generally, the Government are carefully considering evidence presented in the recent Low Incomes Tax Reform Group’s report ‘VAT and disabled people’ - the changes, including new reduced rates, would be consistent with our European VAT agreements and well-targeted and cost-effective when compared with the range of support already provided for people with disabilities.

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Members: Correspondence

Sir Michael Spicer: To ask the Secretary of State for Health when the Minister of State, Department of Health, the hon. Member for Don Valley (Caroline Flint) expects to reply to the letter from the hon. Member for West Worcestershire of 27 February 2007, on GP prescriptions and labelling by pharmacists. [134603]

Caroline Flint [holding answer 27 April 2007]: I regret the letter was not received by the Department. The hon. Member has now forwarded a copy. I will arrange for it to be dealt with urgently.

Mental Health Services

Mr. Lansley: To ask the Secretary of State for Health (1) what recent assessment she has made of the use by the NHS of the computerised cognitive behavioural therapies (a) Beating the Blues, (b) COPE, (c) Overcoming Depression, (d) FearFighter and (e) OCFighter; and whether the packages are supplied to the NHS through the NHS Purchasing and Supply Agency in each case; [131866]

(2) what estimate she has made of the number of referrals for computerised cognitive behavioural therapies in the NHS in the latest period for which figures are available. [131867]

Ms Rosie Winterton: These computerised cognitive behavioural therapies (cCBT) packages were reviewed by the National Institute for Health and Clinical Excellence (NICE), in Technology Appraisal 097 in February 2006. NICE recommended the use of Beating the Blues in the management of mild to moderate depression and FearFighter as an option for delivering cognitive behavioural therapy in managing panic and phobia.

NICE decided that there was insufficient evidence for it to recommend the use of COPE and Overcoming Depression as clinically or cost-effective options for managing depression, except as part of ongoing or new clinical trials that are designed to generate robust, relevant data on the clinical effectiveness of these specific cCBT packages.

OCFighter (previously known as BTSteps) was not recommended for delivering cognitive behavioural therapy in managing obsessive compulsive disorder. Where people are currently using OCFighter, whether as routine therapy or as part of a clinical trial, they should be allowed to choose to continue this therapy until the patient, general practitioner and/or specialist, consider it appropriate to stop. NICE will consider reviewing this guidance in September 2008.

We have worked with suppliers and the National Health Service Purchasing and Supplies Agency in negotiating a framework agreement and tariff to ensure that the NHS can provide Beating the Blues and FearFighter in a cost effective and value for money way.

Information on the number of referrals made for cCBT is not collected centrally. However, as part of the implementation guidance which we launched on 28 March, a demand estimate tool has been developed which helps commissioners to establish the likely
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demand for cCBT in their local areas. This calculates the number of people who are likely to have mental heath conditions which will respond to cCBT, like depression or phobias and also estimates the number who might want to use this technology.

Mr. Dai Davies: To ask the Secretary of State for Health what recent assessment she has made of the adequacy of the delivery of mental health in-patient and day care in the NHS. [133627]

Ms Rosie Winterton: Since the publication of the “National Service Framework for Mental Health” in 1999, mental health services in England have seen significant improvements, particularly in access to specialist community-based services that aim to reduce unnecessary hospital admissions and the length of in-patient stays. However, in-patient services remain a key element of mental health service provision and a national acute in-patient mental health programme, which is hosted by the Care Services Improvement Partnership and supported by its regional infrastructure, is helping local services in implementing the Department’s policy implementation guidance published in 2002. The Department has also announced that over 2006-07 and 2007-08, £130 million of extra capital investment would be targeted to upgrade the mental health estate, particularly in improving psychiatric intensive care units and places of safety for assessment under the Mental Health Act 1983 and enhancing the sexual safety of women.

In recognition of the important role they play in promoting and facilitating social inclusion, the Department published a good practice guidance on commissioning of day services in 2006. The aim of this guidance is to improve access to mainstream opportunities for people with mental health problems in closer partnership with other agencies and organisations including the voluntary and community sector. The national social inclusion programme, also hosted by the Care Services Improvement Partnership and supported by its regional infrastructure, is helping local services in implementing this guidance in line with their assessment of local need.

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