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20 Jun 2007 : Column 1916W—continued
Hospitals: Waiting Lists
Mr. Burstow: To ask the Secretary of State for Health pursuant to the Answer to the hon. Member for South Cambridgeshire of 8 May 2007, Official Report, column 149-50, on hospitals: waiting lists, in which month she expects to publish the requirements which will apply to the target date of December. [144133]
Andy Burnham: At the latest, the requirements for December 2008 will be published in December 2007.
Hyperactivity: Medical Treatments
Mr. Sheerman: To ask the Secretary of State for Health (1) what assessment has been made of the effectiveness of treating attention deficit hyperactivity disorder by means of medication alone; [144244]
(2) what clinical guidelines she has issued on the use of Ritalin to treat attention deficit hyperactivity disorder prior to the publication of the National Institute for Health and Clinical Excellence guidelines. [144245]
Mr. Ivan Lewis: Prior to the National Institute for Health and Clinical Excellence (NICE) issuing its original guideline on the use of methylphenidate (Ritalin) in October 2000 no clinical guidance had been issued, other than the prescribing guidance that comes with a licensed medicinal product.
In March 2006, NICE reviewed its earlier advice on methylphenidate and included in their guideline other drugs used to treat attention deficit hyperactivity disorder (ADHD)—atomoxetine and dexamphetamine. NICE has estimated that around 5 per cent. of school-aged children meet the diagnostic criteria for ADHD, equivalent to 366,000 children and adolescents in England and Wales, but not all these children will require medication.
Drug therapy should only be part of a comprehensive treatment programme that includes a range of social, psychological and behavioural interventions. These are mainly aimed at the child, but sometimes involve the parents and/or teachers. NICE has recommended that drug treatment for ADHD should only be initiated by an appropriately qualified healthcare professional with expertise in ADHD and should be based on a comprehensive assessment and diagnosis. Continued prescribing and monitoring of drug treatment may be performed by general practitioners, under shared care arrangements.
NICE is currently developing a clinical guideline on both the pharmacological and psychological interventions to treat ADHD. Publication of the guideline is expected in July 2008.
Independent Reconfiguration Panel
Mr. Hancock: To ask the Secretary of State for Health (1) whether she plans to make rulings of the Independent Reconfiguration Panel binding; [144044]
(2) if she will make it her policy to allow local overview and scrutiny committees to refer plans to reconfigure local NHS services directly to the Independent Reconfiguration Panel. [144045]
Andy Burnham: The Independent Reconfiguration Panel (IRP) is an advisory non-departmental public body. The panel provides advice to Ministers on proposals for national health service change in England that have been referred to the Secretary of State by overview and scrutiny committees (OSCs).
The Government’s response to the recent Health Select Committee report on patient and public involvement in the NHS states:
“it is for the Secretary of State to determine when she wishes to seek independent advice from the Independent Reconfiguration Panel (IRP)”.
The IRP is also available to provide informal advice to organisations involved in developing proposals for NHS service change and is contacted each year by a number of NHS organisations, OSCs and other interested parties. In its informal role, the panel supports organisations in developing proposals for NHS service change and implementing good practice, thereby avoiding cases being contested and referred formally to the Secretary of State at a later date.
There are no plans to change the arrangements for handling referrals to the Secretary of State, nor the role of the IRP.
Infant Foods: Labelling
Lynne Jones: To ask the Secretary of State for Health what action she is taking to encourage relevant authorities to prosecute companies that continue to make claims on infant formula labels and promotional material for baby milk which are non-compliant with current legislation. [143720]
Caroline Flint: The local authorities coordinators of regulatory services issued updated guidance in late 2006 to clarify the types of claims about infant formula that are prohibited. All local authority enforcement offices have been made aware of the new guidance and encouraged to enforce the United Kingdom legislation to ensure companies comply with the rules on claims.
IVF
Mr. Stewart Jackson: To ask the Secretary of State for Health (1) what guidance she has issued to primary care trusts on the provision of at least one cycle of IVF treatment in the case of individuals who meet the appropriate criteria for treatment; and if she will make a statement; [142437]
(2) what work has been undertaken between her Department and the Infertility Network UK to improve the extent of IVF treatment provision in the last 12 months; and if she will make a statement; [142438]
(3) whether she intends to review the operation of the social access criteria in the provision of IVF treatment by primary care trusts; and if she will make a statement; [142439]
(4) how many primary care trusts in England will provide (a) one, (b) more than one and (c) no cycle of IVF treatment to patients meeting the criteria for treatment; and if she will make a statement; [142440]
(5) what recent estimate has been made of the effect of primary care trust deficits on the local provision of IVF treatment to eligible patients; and if she will make a statement; [142441]
(6) whether she plans to publish a written response to the recent findings of the Infertility Network UK questionnaire to primary care trusts; and if she will make a statement. [142597]
Caroline Flint:
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 provided no in-vitro fertilisation (IVF) treatment to meet a minimum level 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 (I N UK) to help primary care trusts share best practice and engage with fertility patients in the planning and prioritisation of fertility services. The questionnaire issued to PCTs by I N UK will help to inform that work and we are discussing the findings with them. The primary responsibility for the provision of fertility services, including the application of social access criteria, rests with the national health service at local level and we have not collected data centrally. The need to restore financial balance has meant that a small
number of primary care trusts have suspended the provision of IVF, and the reinstatement of the service is a matter for them, taking account of local circumstances.
Joint Committee on Vaccination and Immunisation
Sandra Gidley: To ask the Secretary of State for Health (1) if she will publish the minutes of the Joint Committee on Vaccination and Immunisation Human Papillomavirus sub-group held on 28 February; [143326]
(2) if she will publish the minutes of the meeting of the Joint Committee on Vaccination and Immunisation held on 14 February. [143327]
Caroline Flint: Copies will be placed in the Library when they have been agreed.
Junior Doctors: Pay
Mr. McGovern: To ask the Secretary of State for Health whether she plans to make available financial support to compensate junior doctors put at a financial disadvantage by the problems with the modernising the medical careers scheme. [143613]
Ms Rosie Winterton [holding answer 18 June 2007]: The Secretary of State has given a commitment to support doctors whose contracts come to an end during round two recruitment by ensuring that all applicants in substantive NHS employment will continue to have employment while they progress through the next round. Strategic health authorities have been asked to work with trusts and draw up plans to deliver this commitment.
Learning Disabilities: Life Expectancy
Martin Horwood: To ask the Secretary of State for Health what estimate she has made of the cost of a confidential inquiry into mortality of people with learning disabilities as suggested in “Valuing People” in 2001; and what assessment she has made of the merits of an inquiry into understanding and addressing health outcomes for people with a learning disability. [143303]
Mr. Ivan Lewis: “Valuing People” included a commitment to explore the feasibility of establishing a confidential inquiry into mortality among people with a learning disability.
The National Patient Safety Agency (NPSA) was commissioned by the Department to carry out this scoping study and did so during 2005-06. The NPSA presented the Department with a number of scenarios for carrying out a confidential inquiry, with estimated costs ranging between £2 million and £5 million over a three-year period.
Since that work was carried out, the Department has established an independent inquiry into the deaths of the six people named in Mencap’s report, “Death by Indifference”. In addition to the six cases, the independent inquiry will be identifying the action required to ensure that people with learning disabilities receive appropriate health care. The findings and recommendations of that inquiry will be used to
inform a decision on whether to take forward a full confidential inquiry into mortality.
Macular Degeneration: Drugs
Martin Salter: To ask the Secretary of State for Health if she will overrule the draft National Institute for Health and Clinical Excellence guidelines approving the use of the drug Lucentis for only a limited proportion of the patients who suffer from wet age-related macular degeneration; and if she will make a statement. [143825]
Caroline Flint: The National Institute for Health and Clinical Excellence (NICE) is an independent body, established to issue evidence-based advice to the national health service on the clinical and cost-effectiveness of new and existing treatments. NICE has published for consultation its preliminary recommendations on the use of Macugen and Lucentis for the treatment of wet age-related macular degeneration. Stakeholders have until 5 July to submit comments to NICE, following which NICE’s Appraisal Committee will formulate its final advice for the NHS.
The Department is a stakeholder in the guidance development process and will be submitting a response to NICE’s consultation, but it would not be appropriate for Ministers to intervene in the conduct of a NICE appraisal.
Pending final guidance from NICE, NHS bodies should continue to make local decisions on the use of Lucentis and Macugen, taking account of the available evidence.
Maternity Services
Mr. Hancock: To ask the Secretary of State for Health by what date each primary care trust must have produced their local strategy for meeting the guarantees made in maternity matters; if her Department will require that these local strategies are (a) placed on the internet and (b) otherwise made available to the public; and what assessment her Department plans to make of these strategies. [143626]
Mr. Ivan Lewis: In maternity matters, we state that primary care trust (PCT) prospectuses would be published in autumn 2007. These prospectuses should include the PCT proposals for increasing choice and improving maternity services. It is for strategic health authorities (SHAs) to ensure that PCTs complete their prospectuses and publish them. Although the documents will be readily accessible to the public there is no requirement to publish on the internet. However, we understand that a number of PCTs plan to do so.
We have no plan to make any assessment other than to ensure that, via SHAs, the strategic needs assessments are completed.
Mr. Hoban: To ask the Secretary of State for Health pursuant to the answer of 6 June 2007, Official Report, column 584W, on mothers: home help, how many hours per week of support the intensive nurse-led home visiting programme provides for each family. [144491]
Mr. Ivan Lewis:
Nurses in the family nurse partnership intervention pilot project visit each client
during pregnancy and until the child’s second birthday. Prenatal visits occur once a week for the first four weeks after enrolment, usually between 16 and 28 weeks into the pregnancy, then every other week for the rest of the pregnancy. After the baby is born, visits are increased again to once a week for the first six weeks, then level out at every other week until the child is 21 months old. Visits then continue once a month until the child’s second birthday. Each visit is expected to last from one to one and a half hours.
Mr. Hoban: To ask the Secretary of State for Health pursuant to the answer of 6 June 2007, Official Report, column 584W, on mothers: home help, on what date her Department (a) first announced and (b) first started testing the intensive nurse-led home visiting programme. [144492]
Mr. Ivan Lewis: In “Reaching Out: An Action Plan on Social Exclusion” (September 2006) the Government announced a proposal to establish 10 pilot projects to test a specific model of intensive home visiting for vulnerable first time young mothers. The 10 sites began testing this model of intervention from April 2007.
Maternity Services: Banbury
Tony Baldry: To ask the Secretary of State for Health whether her Department expects the Oxford Radcliffe Hospitals NHS Trust to issue guidance to GPs in Banbury on which hospitals to refer expectant mothers. [144084]
Mr. Ivan Lewis: “Maternity Matters: Choice Access and Continuity of Care in a safe environment” has introduced a new national choice guarantee for women. This means that by 2009 all women will have choice in where and how they have their baby, and what pain relief to use, depending on their individual circumstances.
I understand Oxford Radcliffe Hospitals National Health Service Trust will work in accordance with the guidelines of “Maternity Matters” to ensure there is a clear understanding of the choice of local midwifery and obstetric services.
Maternity Services: St. Mary’s Hospital
Gregory Barker: To ask the Secretary of State for Health (1) what extra funding has been allocated for the Recurrent Miscarriage Unit at St. Mary’s Hospital over the next 10 years; [143259]
(2) if she will make a statement on the future of the Recurrent Miscarriage Unit at Paddington Hospital. [143260]
Mr. Ivan Lewis: This information requested is not held centrally. It is for primary care trusts to commission services to meet the needs of the communities that they serve.
The miscarriage unit at St. Mary’s Hospital NHS Trust continues to provide this vital service.
Medical Treatments: British Nationality
Sarah Teather:
To ask the Secretary of State for Health what entitlement British citizens who have
recently returned from overseas have to treatment at GP surgeries. [144638]
Andy Burnham: The national health service is intended first and foremost for the benefit of people living in the United Kingdom. General practices have discretion over whom they register as a patient but people who are living lawfully in the UK and for a settled purpose, are entitled to register with a practice. This includes British citizens who have recently returned from overseas and who intend to settle here.
In addition, anyone, whether they are a UK resident or from overseas, who requires treatment which, in the clinical opinion of a general practitioner or health care professional, is an emergency or immediately necessary is entitled to receive that treatment free of charge irrespective of whether the person is registered with that practice.
Medicine: Training
Dr. Gibson: To ask the Secretary of State for Health what assessment she has made of the effectiveness of the Medical Training and Application Service’s website in facilitating the application process for ST1-4 positions. [124741]
Mr. Andrew Smith: To ask the Secretary of State for Health what recent assessment she has made of the operation of the Medical Training Application System; and if she will make a statement. [125093]
Ms Rosie Winterton [holding answer 7 March 2007]: On the 7 March we announced that a review of the recruitment processes into specialty training and the Medical Training Application Service (MTAS) would be undertaken by Professor Neil Douglas, Vice President of the Academy of Royal Colleges. Members of the review group included representatives of the Royal Colleges, the British Medical Association, the four United Kingdom Health Departments and NHS Employers.
In March we also conducted a high level review of the functionality of the MTAS system and whether it was delivering what it was designed to deliver. The conclusion was that the system met its specification, was stable, performed acceptably and contained the necessary functionality to be fit for the purpose for which it was designed.
The Review Group made a number of recommendations about the 2007 recruitment process after listening to concerns from doctors and in the light of its own work. These have been implemented including:
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