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We have shared the emerging findings from the EOLC Strategy with strategic health authorities, which have been asked to develop local strategic visions for end of life care, to be completed in the New Year, to inform the Next Stage Review. We will then take account of this local work in the development of the national EOLC Strategy.
Bob Spink: To ask the Secretary of State for Health when he plans to publish his Departments response to the independent review of childrens palliative care services; and if he will make a statement. 
Mr. Ivan Lewis: We are developing a national strategy for childrens palliative care and will endeavour to cover as many as possible of the reports recommendations in this work. We aim to have the strategy ready by the end of the year.
It is, however, essential that we align as much of this work as possible with the work arising from the conclusions contained in the parallel HM Treasury/Department for Children, Schools and Families reviewAiming High for Disabled Children. The two reviews offer an important opportunity to advance the agenda for these very vulnerable children and that is why we are taking them forward together.
Ann Keen: On 26 May 2005 the National Patient Safety Agency (NPSA) issued to all national health service organisations in England and Wales, via their safety alert broadcast system, the guidance Protecting People with Allergy Associated with Latex, which recommended that a comprehensive working policy on the use and purchasing of latex products be developed.
substitute, control or eliminate latex where appropriate and possible;
ensure staff are aware of, and have access to, safe and effective latex-free alternatives;
identify and protect sensitised patients; and
raise awareness about latex sensitivity among patients and staff.
They further recommended that this policy should be backed up by efficient management arrangements, and the policies audited and reviewed to check compliance. A deadline of January 2006 was given for all these actions to be completed.
In addition, a website-based toolkit has been developed by the Health and Safety Executive, in partnership with the Department, the NPSA, the Latex Allergy Support Group, the National Association of Theatre Nurses, the Medicines and Healthcare products Regulatory Agency, the healthcare industry and other relevant bodies. This toolkit includes example policies and materials to help local NHS organisations raise awareness of latex allergy with both staff and patients.
John Battle: To ask the Secretary of State for Health what his latest estimate is of the average cost per week of (a) keeping a person in hospital and (b) keeping a person in a nursing home in Leeds. 
Ann Keen: Accurate information on the average cost per week for hospital inpatient treatment is not available. However, the average gross total cost per week in 2005-06 for supporting an adult (aged 18 and over) in nursing care in Leeds was £718.
Source: Information Centre for health and social care.
Mr. Meacher: To ask the Secretary of State for Health who recommended Rose Gibb, the former Chief Executive of Maidstone and Tunbridge Wells NHS Trust, for the post of Chief Executive at Pennine Acute Trust in February. 
Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 11 January 2007, Official Report, column 700W, on the Small Change, Big Difference campaign, what the expenditure on the campaign has been since April 2006, broken down by major item of expenditure. 
In June 2007, we also published Partnerships for Better Health, Small Change, Big Difference: healthier choices for life a series of case studies highlighting partnership working and the lessons derived from them in support of the Small Change, Big Difference initiative.
Mr. Gale: To ask the Secretary of State for Health what the cost to the public purse was of preparing and distributing his Department's package of information on the smoking ban sent to private individuals and businesses after the ban came into effect. 
David Taylor: To ask the Secretary of State for Health what his Department's budget is for mass media anti-smoking campaigns in the 2007-08 financial year; and what the budget will be in each of the financial years to 2011-12. 
Dawn Primarolo: The Departments campaign advertising budget for smoking campaigns for 2007-08 financial year is £11.39 million. This figure does not include campaign advertising expenditure to support the introduction of smokefree legislation or the increase of the age of sale of tobacco products this year.
Sarah Teather: To ask the Secretary of State for Health whether his Department has allocated funds for the Speaking For Yourself programme for (a) 2007-08, (b) 2008-09 and (c) 2009-10; and what plans he has for future funding for this programme. 
Mr. Ivan Lewis: We have not allocated any funds to this programme and we do not have any plans for future funding. The Prime Minister announced in September 2007, that the hon. Member for Buckingham (John Bercow), will be leading a review of services for children and young people with speech, language and communication needs. The Bercow Review will be supported by officials from the Department for Children, Schools and Families and also from the Department of Health.
Ann Keen: Between 1996-97 and 2007-08, spending on the NHS has increased from £33 billion to just over £90 billion, representing an average annual increase in real terms of 6 per cent. The improvements seen in stroke services have undoubtedly benefited from these increases over the last 10 years.
The National Service Framework (NSF) for long-term conditions was published in 2004 to improve the quality of life and independence for people with long-term neurological conditions. It set out general guidelines for a range of conditions, including stroke, to establish faster diagnosis, more rapid treatment and a comprehensive package of care based around individual patient needs.
Prior to this the NSF for Older People, published in 2001, included a chapter on stroke services. It set out a range of measures to reduce the incidence of stroke and improve stroke treatment, which have led to a widespread development of services: the Royal College of Physicians (RCP) shows that all trusts caring for people who have had a stroke now have a specialist stroke service and 97 per cent. of hospitals in England now have a stroke unit; these were uncommon a decade ago. The audit also shows that in 2006, around two thirds of stroke patients were treated on a stroke unit. This is a significant improvement since 2004 when the figure was less than half. Length of stay in hospital for stroke patients is falling from 34 days in 2001 to 28 days in 2004. The results of the RCP audit also show that the proportion of trusts with a stroke unit meeting five or six of the audit's criteria has increased from 33 per cent. to 41 per cent. between 2004 and 2006.
Stroke mortality is falling. For people under 65, the three year average death rate from stroke has fallen by 23 per cent. over the period from 1993-95 to 2002-04. For people aged 65-75 the death rate has dropped by 30 per cent. over the same period. We have made greater progress in reducing premature deaths from coronary heart disease than from stroke. This is because we have begun by focusing on coronary heart disease, the biggest killer in the country. However, because of the
significant progress we have made in this area we are now able to redouble our efforts in addressing the challenge of stroke. This is why the Department launched a stroke strategy document for consultation on 9 July 2007. It followed an 18-month programme of work, setting out the views of six expert working groups who represented a wide range of key stakeholders. The strategy aims to accelerate the emergency response to stroke, by setting out a framework for care of stroke patients, and raising awareness about stroke symptoms and risk factors. It is due for publication by the end of 2007.
In addition to developing the strategy, in 2006 the Department published Mending hearts and brains, a report by Professor Roger Boyle, the National Director for Heart and Stroke. The report makes the clinical case for reconfiguring stroke services. In particular, it emphasises the need to treat stroke as an emergency, including the delivery of thrombolysis at specialist centres and a possible 'hub and spoke' model for stroke services.
Last year the Department also launched ASSET (Action on stroke services: an evaluation toolkit) to help health care providers compare their performance with others. It considers four aspects of acute treatment setting out how these mean fewer people experiencing death or disability, and more efficient hospital services with people able to return home faster. An additional version, ASSET 2, for commissioners has also been introduced which uses analytical modelling to advise hospitals and primary care trusts of what the impact of making specific changes to their services would be. We have also published a guide for commissioners, setting out key questions they need to consider and a series of best practice case studies.
(2) what research his Department has undertaken on the relationship between levels of uptake of smoking amongst under 18 year olds and the availability and accessibility of tobacco vending machines. 
Dawn Primarolo: It is illegal for tobacco products to be sold to young people under 18 from vending machines, and the code produced by the National Association of Cigarette Machine Operators states that machines should be sited and monitored in supervised areas so that staff can be sure of preventing their use by those under 18.
The Department has not undertaken specific research between the levels of smoking among under 18-year-olds and the availability and accessibility of tobacco vending machines, but relies on the annual
Smoking Drinking And Drug Use among Young People survey and on reports from trading standards departments.
Ann Keen: The use of the multi-professional education and training money is monitored through strategic health authority quarterly performance monitoring reports to the Department, which are not published. The last reports were received in May 2007 for the 2006-07 financial year. Returns for the period April to September 2007 are in the process of being collected.
Ben Chapman: To ask the Secretary of State for Health (1) what assessment he has made of the availability of nail cutting services in Wirral Primary Care Trust; and if he will make a statement; 
The NHS North West Strategic Health Authority reports that chiropody provision in Eastham has been relocated to the Treetops Surgery in Bromborough, and the capacity in Parkfield Medical Centre has been doubled in the new premises. From October 2007, the eligibility criteria for treatment in the former Bebington and West Wirral PCT area have been extended to include more vulnerable and elderly patients which has resulted in additional investment. This includes the recruitment of an additional podiatry
post which has been funded and created to facilitate this and the Wirral Primary Care Trust is currently actively recruiting to this post. No chiropody clinics in the Wirral Primary Care Trust have closed within the last five years.
Helen Southworth: To ask the Secretary of State for Health what guidelines his Department has issued in relation to provision of child and adolescent mental health services, with particular reference to (a) 24 hour emergency access to services and (b) the emergency provision of a place of safety for young persons under the age of 16. 
Mr. Ivan Lewis: The Department's vision for Child and Adolescent Mental Health Services (CAMHS) was set out in the National Service Framework for Children, Young People and Maternity, published in 2004.
The Department has a Public Service Agreement (PSA) Standard to ensure that CAMHS are available to all children and young people who need them. Achievement of the standard is measured by the attainment of three proxy targets, one of which is the commissioning by primary care trusts (PCTs) of twenty-four hour, emergency CAMHS assessment. The latest information, which relates to June 2007, shows that approximately 99 per cent. of PCTs are commissioning this element of service, and it is expected that coverage will be universal by the end of 2007.
In June 2007, the Department wrote to Chief Executives of Strategic Health Authorities (SHAs) to give advice on the use of adult psychiatric wards for children under 16 years of age. The letter advised that, in the exceptional case where a child of 16 or under is placed on an adult psychiatric ward, SHAs should use the Serious Untoward Incident protocol to notify the Department, setting out how the child will be moved to appropriate accommodation within 48 hours and how the ward and staffing have been made appropriate for the childs needs.