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14 May 2007 : Column 596W—continued
Medical Equipment
Mark Tami: To ask the Secretary of State for Health (1) what percentage of hospitals have allocated (a) part and (b) all of the additional funding provided to them under the Capital Challenge Fund scheme for the funding of medical devices; [133383]
(2) what percentage of the total Capital Challenge Fund has been allocated for (a) medical devices, (b) single bay creation and (c) service modification. [133386]
Mr. Ivan Lewis: This information is not available centrally. Trusts applying for an allocation from the Capital Challenge Fund were required to allocate the funds to combating healthcare acquired infections, but were not required to give a breakdown of the details of the proposed expenditure.
Medical Records
Mr. Burrowes: To ask the Secretary of State for Health what guidelines or procedures are used by (a) hospital and (b) general practitioners' staff to ensure that patient records are handled correctly. [134881]
Caroline Flint: The NHS Confidentiality Code of Practice, published in November 2003, provides guidance on required practice for those who work within or under contract to national health service organisations about the safeguarding of confidentiality, and patients' consent to the use of their health records. The guidance includes an explanation of the main relevant legal requirements, and examples of appropriate information disclosure decisions in practice. The guidance applies equally to clinicians, managers, and all other staff in both primary and secondary care settings whose work involves access to personal information and, where appropriate, includes staff in the private and voluntary sectors.
A full version of the code can be downloaded from the Department's website at www.dh.gov.uk/assetRoot/04/06/92/54/04069254.pdf, a copy has been placed in the Library. The code has been endorsed by the Information. Commissioner, the General Medical Council, and the British Medical Association.
Strong disincentives exist which protect against abuse of patient confidentiality. NHS organisations are responsible, as employers, for the actions taken on their behalf by their employees, and for disciplining their staff when they behave inappropriately. Accessing personal information without a legitimate reason constitutes a breach of the code. Staff who breach patient confidentiality are subject to professional disciplinary measures. Offending doctors and nurses will be reported to their professional regulatory bodies and may face additional disciplinary action, including losing their licence to practice. Separate legal penalties for individuals and organisations misusing personal health and other information are provided for under Section 60 of the Data Protection Act.
Medical Records: Disclosure of Information
Lynne Jones: To ask the Secretary of State for Health what rights of personal compensation or redress will be available to the patients concerned in respect of commitments made in the NHS care record guarantee in the event of any failure of information governance which results in improper use of disclosure of information from patient records in breach of the guarantee. [132553]
Caroline Flint:
Responsibility for meeting information governance standards rests with local national health service organisations and their staff. NHS Connecting for Health has introduced a requirement for NHS organisations to sign a statement of compliance, indicating that they meet all appropriate standards and the Department has made information governance standards a key element of performance management within the NHS for the coming year. Organisations will be held accountable for any failings, and in extreme cases will be denied access to the NHS information technology infrastructure
until problems are rectified. Where staff knowingly misuse systems we would expect their employing organisation to invoke appropriate disciplinary proceedings.
Where a failure to meet standards also results in a breach of confidentiality or of data protection requirements, the individual patients concerned have recourse to NHS complaints procedures, the Information Commissioner, and the courts. Health professionals may also be reported to their regulatory bodies if they are in breach of professional standards.
Lynne Jones: To ask the Secretary of State for Health when NHS patient records are made available to health service providers in the private sector, what steps are (a) required of the private sector entity (b) taken by the NHS to ensure (i) separation of NHS and private sector database systems and (ii) responsible use and disposition of data by the private sector entity; and what (A) resources and (B) arrangements are in place for technical audit and inspection of IT systems operated by private providers. [134130]
Caroline Flint: Personal health information may only be made available to private sector providers providing services to national health service patients with the consent of the individual patient concerned, and under a contract that sets out the requirement that the appropriate information governance standards required of NHS bodies covering confidentiality, security and record retention are complied with in full.
Data used in the treatment of NHS patients are not required to be held in a separate database. However, the data handling and management systems to be used must pass a technical and information governance compliance process which includes an assessment that they conform with the requirements of the care record guarantee.
As part of the initial information governance compliance process documentary evidence, including external audits, are required to be provided by the private sector providers. These are reviewed annually through evidence provided by the provider through the Information Governance Toolkit. Under the most recent private sector provider contracts this has been extended to compliance with IS027001, the new international information security management standard. The Department’s NHS Connecting for Health agency retains the right to undertake a direct audit of any private sector provider should they feel that is required.
Medical Records: Pharmacy
Mr. Todd: To ask the Secretary of State for Health (1) whether pharmacists will be included among the health professionals authorised to access a patient’s care record through the NHS Care Records Service; and if she will make a statement; [128829]
(2) what assessment she has made of the merits of enabling pharmacists access to patients’ care records through the NHS Care Records Service. [128830]
Caroline Flint:
The role of community pharmacists is evolving to enable them to play a full part in meeting the demands of 21st century healthcare, and we believe
that in order to be able to carry out these wider roles safely and effectively community pharmacists will need appropriate access to healthcare records. However, we also recognise, from talking with stakeholders, that there are concerns about how patient consent and confidentiality will be managed in a community pharmacy setting. Information governance standards will need to be strictly adhered to, and appropriate assurance mechanisms put in place before community pharmacists will be permitted access to the national health service care records service. We are committed to public consultation on these issues.
Medical Treatments: Testing
Dr. Gibson: To ask the Secretary of State for Health which academic referral centres are contracted to assess (a) drugs for the National Institute of Health and Clinical Excellence and (b) other medical technologies; and what plans she has to standardise the clinical models in different centres assessing new technologies. [134120]
Caroline Flint: The Department has contracts with seven technology assessment review teams to undertake reviews including reviews for National Institute of Health and Clinical Excellence (NICE). The teams are based at the following universities:
Aberdeen;
York;
Liverpool;
Sheffield;
Birmingham;
Southampton; and
Peninsula.
Each has a set of core methodological skills that mean any one team could be allocated any one topic (drugs or other medical technologies), although teams are encouraged to specialise. All teams follow the NICE methods guide in terms of methodological approach to ensure standardisation. The guide is available on the NICE website at:
guidance.nice.org.uk
Mental Health Services: Finance
Mr. Brady: To ask the Secretary of State for Health what the evidential basis is for her Department’s practice of relating levels of funding for severe and enduring mental health problems to levels of social deprivation. [135666]
Ms Rosie Winterton [holding answer 3 May 2007]: Mental health needs are accounted for in the needs element of the weighted-capitation formula. The needs adjustment was examined as part of a major review of the formula prior to the 2003-04 to 2005-06 revenue allocations to primary care trusts. The review was overseen by the Advisory Committee on Resource Allocation, and the results were published in the Allocation of Resources to English Areas (AREA) report. A copy of the AREA report has been placed in the Library and is also available at:
Mental Health Services: Moseley Hall Hospital
Lynne Jones: To ask the Secretary of State for Health what estimate she has made of the cost to the NHS of delays in the approval process for the construction of the new mental health facilities for elderly people at Moseley Hall Hospital since the planning application was first approved in principle; and if she will make a statement. [135769]
Ms Rosie Winterton: The Department has not made an estimate of the cost to the national health service of delays in the approval process for the construction of the new mental health facilities for elderly people at Moseley Hall hospital as this is a matter for the NHS locally.
The older peoples service developments planned for the Moseley Hall hospital site form an essential part of the Birmingham New Hospitals project. Birmingham and Solihull Mental Health NHS Trust, the University Hospital Birmingham NHS Foundation Trust and Consort Healthcare are working together to take this project forward.
Mental Health Services: Northern Region
John Cummings: To ask the Secretary of State for Health how many acute mental health beds there were in the Northern Region in the last three years; and in which hospitals they were located. [135860]
Ms Rosie Winterton: The information requested is not collected centrally.
Mental Illness
Mr. Laws: To ask the Secretary of State for Health what proportion of expenditure on commissioned secondary mental illness services went to (a) NHS trusts and (b) non-NHS providers in each of the last 10 years. [129898]
Ms Rosie Winterton: Information on the proportion of expenditure commissioned by secondary mental illness services by national health service trusts and non-NHS trusts providers is not available. Mental health strategies collects information on behalf of the Department on adult mental health planned expenditure in England. The following table shows the proportion of adult MH planned expenditure by NHS trust and non-NHS trusts providers from 2001-02 to 2005-06.
| Adult mental health planned expenditure from 2001-02 to 2005-06 and percentage split by provider type | |||
| All NHS organisation (Percentage) | Non-NHS organisation (Percentage) | Total investment (£000) | |
| Notes: 1. Percentage split by commissioner type exclude unreported investment. 2. Total investment include reported and unreported investment. 3. Non-NHS providers include social services, voluntary and the independent sectors. Source: Mental Health Strategies survey. | |||
Methylamphetamine
Mr. Todd: To ask the Secretary of State for Health what evidence she gathered of the effectiveness of measures designed to restrict opportunities to manufacture methylamphetamine from pseudephedrine and ephedrine used in other countries prior to consulting on changing the legal status of medicines containing these substances to prescription-only in the UK. [128934]
Caroline Flint: Although the prevalence of misuse of methylamphetamine is believed to be currently low in the United Kingdom (UK), the Association of Chief Police Officers is receiving increasing levels of intelligence about the prevalence of methylamphetamine. If methylamphetamine did secure a hold in the UK, the consequences would undoubtedly be very serious. The international experience shows that misuse can spread rapidly when certain conditions prevail and the advice of UK enforcement authorities is that most of these conditions now prevail in the UK.
The experience of comparator countries such as the United States of America (USA), Australia and New Zealand is that once a small number of illicit domestic laboratories become established, a sharper rise in prevalence in these countries has followed. A police force in America reported that if the USA had made ephedrine and pseudoephedrine based products prescription only at a much earlier stage, they would have prevented to a large extent the massive growth in small home made laboratories. The regulatory action taken by the Food and Drug Administration has contributed to a sharp decrease in domestic methylamphetamine production.
The Commission on Human Medicines (CHM) also considered non-statutory options to restrict the availability of pseudoephedrine and ephedrine, such as rigorous supervision of pharmacy sales of single packs, and concluded that these measures alone would not be sufficient to protect public health. In order to protect public health in the UK, the CHM concluded that a consultation exercise should be conducted on changing the legal status of these medicines, together with restricting the pack size. Ministers accepted this advice and a full public consultation exercise commenced on 7 March 2007 and can be accessed via the Medicines and Healthcare products Regulatory Agency’s (MHRA) website at www.mhra.gov.uk. The MHRA would welcome views on the merits of all the consultation proposals and is hosting a meeting with key stakeholders next month.
Minimally Conscious State
Mr. Amess: To ask the Secretary of State for Health what research has been (a) commissioned and (b) evaluated by her Department on persons in a minimally conscious state; and if she will make a statement. [129523]
The Medical Research Council (MRC) is one of the main agencies through which the Government support biomedical research. The MRC is an independent body funded by the Department of Trade and Industry via the Office of Science and Innovation.
The MRC has funded the following studies of relevance to the hon. Gentleman’s question:
Dr. Adrian Owen’s work at the MRC Cognition and Brain Sciences Unit in Cambridge which has demonstrated that it is possible to detect awareness in patients suffering from persistent vegetative state;
the CRASH trial—a large simple placebo-controlled trial, among adults with head injury and impaired consciousness, of the effects of corticosteroids on death and disability—led by a team at the London School of Hygiene and Tropical Medicine; and
a university of Southampton study seeking to develop of a clinically relevant in vitro model of traumatic brain injury.
Mite Allergens
Alan Simpson: To ask the Secretary of State for Health what research she has (a) conducted and (b) supported into mite allergens; and whether this research indicates potential risks to human health. [128139]
Caroline Flint: The Department is currently funding a research programme at a cost of £2.5 million over five years at the Social Medicine and Health Services Research Unit at Imperial College, London on respiratory epidemiology. Part of this programme includes research on allergens, including house dust mites.
The unit is the coordinating centre for the second European Community Respiratory Health Survey. The survey has sought among other things to determine the risk attributable to chronic exposure to environmental risk factors including mite allergens for the incidence and prognosis of allergy, allergic disease and low lung function. Results will be published in due course.
The Medical Research Council, one of the main agencies through which the United Kingdom Government support medical and clinical research, is currently funding a large volume of underpinning work on allergic mechanisms and on asthma, although none specifically on mite allergens at present.
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