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5 Jun 2007 : Column 437W—continued

General Practitioners

Mr. Lancaster: To ask the Secretary of State for Health what estimate she has made of the percentage of patients in each (a) strategic health authority and (b) primary care trust who are satisfied with the GP out-of-hours service. [138615]

Andy Burnham: This information is not collected centrally. Primary care trusts have a responsibility to ensure they provide, or secure provision of a high quality, sustainable service for their local population.

Health Hazards: Noise

Bob Russell: To ask the Secretary of State for Health (1) whether she plans to introduce an upper or overall noise exposure limit for members of the public attending (a) indoor and (b) outdoor venues where loud music is played; and if she will make a statement; [139162]

(2) what research she has undertaken on the use of regulations in other countries to set upper and overall noise exposure limits for members of the public attending (a) indoor and (b) outdoor venues where loud music is played; and if she will make a statement. [139166]

Mr. Bradshaw: I have been asked to reply.

The Government are planning to introduce a ‘permitted level’ for night noise (11 pm to 7 am) from licensed premises, through the Clean Neighbourhoods
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and Environment Act 2005, later this year. This power will enable local authorities to take action once a warning notice has been served, with the option to offer the opportunity to discharge the offence through payment of a fixed penalty notice of £500. This will be a power for local authorities, not a duty. In addition, local authorities have a duty to deal with statutory noise nuisance from premises under Part 3 of the Environmental Protection Act 1990.

No research has been undertaken specifically on the use of similar legislation in other countries in this area. However, the World Health Organisation recommends that a general outdoor daytime limit of 55 decibels (A) Leq is desirable to prevent any significant community annoyance. The WHO also recommends that, for good sleep, the sound-level should not exceed 30 decibels (A) for continuous background noise, and individual noises events exceeding 45 decibels (A) should be avoided.

The code of practice on environmental noise control at concerts recommends that music noise levels should not exceed guidelines at one metre from the fa├žade of any noise sensitive premises or events held between the hours of 9 am and 11 pm. These guidelines are set out in the following table.

Concert days per calendar year, per venue Venue category Guideline

One to three

Urban stadiums or arenas

The MNL should not exceed 75dB(A) over a 15 minute period.

One to three

Other urban and rural venues

The MNL should not exceed 65dB(A) over a 15 minute period.

Four to 12

All venues

The MNL should not exceed the background noise level by more than 15dB(A) over a 15 minute period.

Health Services: Barnsley

Mr. Illsley: To ask the Secretary of State for Health (1) what the total allocation of funding to (a) Barnsley health authority and (b) Barnsley primary care trust for orthodontic services was for each year between 2000 and 2006; [138732]

(2) what the total allocation of funding for orthodontic services for (a) Barnsley, (b) Doncaster, (c) Rotherham and (d) St. Helens was in each year between 1997 and 2006. [138733]

Ms Rosie Winterton: Most national health service orthodontic care in the primary sector is provided by dental practitioners working as independent contractors. Prior to April 2006, most orthodontic services were provided under general dental services arrangements. These were demand-led services where the pattern of dental expenditure was largely determined by where dentists chose to practice, and how much NHS work they chose to undertake. Primary care trusts were not awarded fixed funding allocations for GDS.

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PCTs only assumed full responsibility for local commissioning of primary care dentistry and received devolved budgets with effect from 1 April 2006. A table listing the primary dental service resource allocations for 2006-07 for all PCTs in England as at 31 July 2006 is available in the Library. Those allocations reflected the most current data on levels of expenditure on general and orthodontic services by dental contractors in each area. Subject to offering contracts to all serving contractors, PCTs were free to vary the balance of resources committed to either general or orthodontic care, or to supplement provision from within their total NHS resources, if they considered this an appropriate local priority.

Latex: Allergies

Jo Swinson: To ask the Secretary of State for Health (1) how much the Government spent on promoting awareness of latex allergies in each of the last five years; [140531]

(2) what assistance her Department provides to those with latex allergies; [140532]

(3) how many people in England have latex allergies. [140533]

Mr. Ivan Lewis [holding answer s 4 June 2007]: The number of people in England living with latex allergy is not collected.

The national health service provides a range of health and social care services for people suffering from latex allergy, based on an individual assessment of need.

The Department and the NHS promotes awareness of latex allergies in many ways to health professionals, the public and other stakeholders. This includes the provision of information through NHS Direct, and through the publication of clinical knowledge summaries, formerly known as prodigy guidance, on the NHS Library website at:

A breakdown of the specific expenditure on latex allergy awareness is not held centrally.

Learning Disability

Mr. Stephen O'Brien: To ask the Secretary of State for Health when the national audit of services for people with learning disabilities commenced; and when she expects it to report. [139006]

Mr. Ivan Lewis: The Healthcare Commission is carrying out the national audit of services for people with learning disabilities which commenced on 10 January 2007.

The Healthcare Commission will be reporting the results in the autumn.

Maternity Services: Barnet Hospital

Mr. Clappison: To ask the Secretary of State for Health what recent reports she has received on the service provided by the Barnet hospital maternity unit; what assessment she has made of the impact of the transfer of maternity services from Chase Farm
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hospital to Barnet hospital on the services provided; and if she will make a statement. [138856]

Andy Burnham [holding answer 23 April 2007]: It is for the local national health service to decide upon the best way to provide health services to the community it serves.

Mental Health Services: Sexual Offences

Bob Russell: To ask the Secretary of State for Health pursuant to the answer of 1 May 2007, Official Report, column 1607W, on mental health services: sexual offences, what steps she has taken to ensure that patients making allegations of rape or sexual assault receive counselling and support; and if she will make a statement. [137871]

Ms Rosie Winterton: As set out in the Department’s guidance entitled “Safety, privacy and dignity in mental health units”, national health service trust boards are responsible for putting in place policies and procedures to address patient safety, privacy and dignity including those for preventing and dealing with all forms of harassment and abuse. This responsibility is enshrined in “Standards for Better Health” thus, is a crucial part of the performance assessment framework of NHS trusts.

In line with the standard care planning process, and indeed with good professional practice, mental health service users’ clinical needs should be regularly assessed and their care plans updated accordingly. Service users should then be offered effective treatments, including psychological interventions, to meet those needs.

NHS: Finance

Mr. Bone: To ask the Secretary of State for Health how much has been allocated to the NHS in 2007-08; how much was spent, in equivalent terms, on the NHS in 1996-97; and if she will make a statement. [139992]

Andy Burnham: The following table shows expected net expenditure in the national health service for 2007-08 and net expenditure in 1996-97 in actual and equivalent terms.

NHS net expenditure: England
£ billion
Actual 2007-08 Prices







Notes: 1. Expenditure pre 1999-2000 is on a cash basis. 2. Expenditure figures from 1999-2000 to 2002-03 are based on a Stage 1 Resource Budgeting. 3. Expenditure figures from 2003-04 to 2007-08 are based on Stage 2 Resource Budgeting. 4. Figures are not consistent over the period due to technical adjustments. 5. Expenditure is net of non-trust depreciation. 6. Calculations based on GDP deflator as at 28 March 2007.

NHS: Private Finance Initiative

Mr. Stewart Jackson: To ask the Secretary of State for Health in how many private finance initiative projects in the National Health Service have leases
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for land and property been granted to commercial organisations which exceed the length of the project; and if she will make a statement. [140615]

Andy Burnham: There are five major private finance initiative schemes which have leases for the land on which the hospital is constructed that exceed the length of the contract.

Scheme Contract length (break options exist where over 30 years) Length of lease

North Cumbria Acute Hospitals National Health Service Trust



Dartford and Gravesham NHS Trust



Queen Elizabeth Hospitals NHS Trust



Hereford NHS Trust



County Durham and Darlington Acute Hospitals NHS Trust



In the case of County Durham and Dartford and Gravesham, the leases terminate either on expiry of the contract period or on an earlier termination at a break point. In any event, the excess lease period is of insufficient length to be of any commercial value. While the trusts have the right to abandon the site at the end of the contract period to the private sector, at present the only situation in which it is envisaged that the trust would want to abandon the site was if the land and buildings had a negative value and there was no health care use.

Given that this is highly unlikely, the trust will almost inevitably exercise its right to take the site back into public ownership, thus automatically terminating the lease.

In the case of Hereford, on termination at the end of the contract period the trust has four options, three of which result in it retaining the land at no cost and one where the private sector retain their long lease. The only scenario where the head lease would continue in the private sector's hands is if the trust itself wants to let it continue. Given that the trust has the option to terminate and use the land as it wishes, it is again difficult to envisage why the trust would ever want to exercise this option.

The position at North Cumbria and Greenwich is less straightforward. At Carlisle, if the contracts continue for the full 45-year term, the head lease falls away at the end of term. If, however, the trust terminates the contract at the 30-year break point, the trust must either compensate the special purpose vehicle (SPV) for the residual value of the contract (essentially any profits foregone and any unrecovered costs that would have been covered if the lease had run its full term), or it could simply vacate the site and the SPV could then retain the lease for the remainder of the 125-year period.

It is not possible to determine what decisions the trust would make at the 30-year point, but it will be primarily dependent on operational need as if the hospital was still required, renewing the lease for
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15 years would result in its full term being served. If there was no operational need for the hospital or the site, the relative costs and benefits of the termination payment would be compared to those of surrendering of the lease, and the most beneficial option for the taxpayer selected. However, given the remote location of the hospital, it is unlikely that there will be no need for the hospital in 20 years' time (30 years from 1997).

The contract at Greenwich (Queen Elizabeth hospitals) has a base term of 60 years, with a head lease of 125 years. If the contracts run for the full 60-year term, the trust has the option to cancel the head lease provided there is a healthcare purpose either for the land or for the cash proceeds from any sale. It is impossible to see how the trust would not exercise this option.

At the breakpoint of 30 and 45 years, the trust can terminate the private finance initiative (PFI) contract, but the SPV would have the right to retain the head lease for the land for the remainder of the 125-year period. However, at the 30 and 45-year point, the availability payments fall away and the trust will make no building related payments. At the same time all domestic and support services are re-tendered and the trust need only pay for what it specifies at that point.

Again, it is not possible to predict with certainty what will happen in many years time. If there was a health care need the contract would be renewed after the re-tendering. However, if there was no health care need, in the area, decisions would be taken on the basis of best value for money for the taxpayer.

In all cases, the freehold of the land remains with the NHS, unless it resolves to sell or vacate it.

These variations arose because, in the early days of PFI, each trust developed its own contract, and there were differences in the way leases were managed. In all contracts after these five, contracts and head leases are coterminous and the head lease automatically falls away with the contract.

NHS: Uniforms

Norman Lamb: To ask the Secretary of State for Health (1) for what reasons the measurable standards of laundering for workwear worn by workers in NHS hospital kitchens and workwear worn by nurses on NHS hospital wards dealing direct with patients are not comparable; [138649]

(2) what guidance is given to NHS trusts on the standards of laundering for (a) nurses' workwear and (b) kitchen staff workwear; and if she will make a statement; [138650]

(3) when she intends to publish the conclusions of the uniform and laundry review group on the code of practice for prevention and control of healthcare-associated infections. [138651]

Ms Rosie Winterton: Setting standards for the laundering of staff clothing is a matter for local determination and the Department has not issued any standards in this area. However, duty 4(h) of the Health Act 2006 code of practice requires that clothing worn by staff when carrying out their duties (including uniforms) is clean and fit for purpose.

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A uniform and laundry review group has been deliberating this issue, and will shortly publish evidence-based good practice statements to help trusts develop local policies. Additionally, health service guideline HSG(95)18 sets out the procedures to be applied when dealing with used and infected linen; this guideline is currently under review.

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