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Mr. Walker: To ask the Secretary of State for Health what contracts his Department has with external consultants; what the total value, including all VAT and disbursements, of these contracts are for the current financial year; how long each contract lasts; and what the forecast total value is of each contract. 
Mr. Bradshaw [holding answer 12 November 2007]: The criteria for determining performance pay and bonuses for senior civil servants will be set out in the Department's pay strategy. The pay strategy is prepared following the publication of the Review Body on Senior Salaries (SSRB), whose terms of reference include the remuneration of senior civil servants, and the Government's response to it. The SSRB is usually published in February each year. The Director General of the Commercial Directorate will become eligible to be considered for a bonus for the first time in April 2008 under criteria set in the 2008 pay strategy.
Mr. Cox: To ask the Secretary of State for Health what recommendations have been made by his Department on (a) the use of digoxin in the treatment of heart conditions and (b) the monitoring of patients for whom it is prescribed. 
Digoxin is most often used in the treatment of heart failure or atrial fibrillation. The National Institute for Health and Clinical Excellence (NICE) issued guidelines on Chronic Heart Failure
(CG5, July 2003) and the Management of Atrial Fibrillation (CG36, June 2006) which included advice on the use and monitoring of this medicine.
Mr. Lansley: To ask the Secretary of State for Health if he will place in the Library a copy of table 18, referred to in his Departments evidence to the review body on doctors and dentists remuneration. 
Mr. Lansley: To ask the Secretary of State for Health if he will break down table 2.3 on page 16 of his Departments evidence to the review body on doctors and dentists remuneration by expenditure on each type of pressure in each financial year by programme; and how the 3 per cent. efficiency savings were calculated. 
Mr. Bradshaw: Revenue allocations are made directly to primary care trusts (PCTs), as it is for PCTs to determine how to use the funding to commission services to meet the healthcare needs of their local populations. Table 2.3 in the Departments evidence to the review body on doctors and dentists remuneration provides a central estimate of national health service cost pressures. The cost of individual programmes will depend on local decisions on the implementation of NHS priorities.
The Department needs to ensure that the best value is secured for the investment in the NHS. The requirement to make 3 per cent. year on year efficiency savings enables the Government to build on the Spending Review 2004 efficiency programme, and was considered to be achievable based on the value for money delivery plans that all Departments were required to submit as part of the current Comprehensive Spending Review.
Mr. Spring: To ask the Secretary of State for Health how many and what percentage of patients treated on the NHS for drug addiction in (a) the East of England and (b) Suffolk emerged free of addiction after treatment in each of the last three years. 
Norman Lamb: To ask the Secretary of State for Health what estimate he has made of the cost of amending the NHS (Charges to Overseas Visitors) Charging Regulations 1989 to extend the period of absence disregarded when establishing residence from less than three months in the 12 months immediately preceding treatment to less than six months in the 12 months immediately preceding treatment. 
Mr. Burns: To ask the Secretary of State for Health what the average waiting time was for hearing aid assessments in (a) Mid Essex and (b) England in the last period for which figures are available. 
Mr. Ivan Lewis: The average median waiting time for a diagnostic audiology assessment, including hearing assessment, is one week for the Mid Essex Primary Care NHS Trust. The average for England is 16 weeks.
Mr. Spring: To ask the Secretary of State for Health how many and what percentage of pensioners in Suffolk received a free influenza vaccination in (a) the East of England and (b) Suffolk in each of the last five years. 
Dawn Primarolo: Flu vaccine uptake data were collected for the first time on those aged 65 and over from 2000. The percentage of those aged 65 and over who received a flu vaccine in each London primary care trust from 2000 is available in the Library.
Deaths of patients who were detained under the Mental Health Act 1983 should be referred to Her Majesty's Coroner (HMC). HMC will hold an inquest where the medical cause of death remains in doubt after a post-mortem examination, or if the cause of death is violent or unnatural or where a death has occurred in such a place as to require an inquest under section 8 (1) of the Coroner's Act 1988.
Jeremy Corbyn: To ask the Secretary of State for Health what guidance he has issued to mental health trusts on (a) procedures to be followed and (b) inquiries to be made following deaths of patients held under mental health legislation. 
Mr. Ivan Lewis [holding answer 13 November 2007]: The Department issued guidance in 1994 Health Service Guidance (94) 27: Guidance on the discharge of mentally disordered people and their continued care in the community which details action to be taken following mental health in-patient deaths. This was followed by further guidance in 2005, Independent investigation of adverse events in mental health services, which updated part of the 1994 guidance.
This guidance requires strategic health authorities to commission independent investigations. This involves appointing the investigation team, agreeing terms of reference, publishing and distributing the results and agreeing a local action plan following a homicide committed by a person in touch with mental health services.
The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH) collects data on suicide and sudden unexpected deaths of in-patients and homicides committed by persons in touch with mental health services. NCISH is funded by the National Patient Safety Agency and published its latest report, Avoidable Deaths, in December 2006. This reviews homicides in England and Wales between April 1999 and December 2003 and suicides from April 2000 to December 2004.
The Mental Health Act Commission (MHAC) collects data on all detained patient deaths and publishes data on those from non-natural causes in its biennial report. MHAC, under its general remit to keep under review the operation of the Mental Health Act 1983, asks providers to notify it of all deaths of detained patients within three working days.
MHAC reviews the deaths of patients who have died from non-natural causes to establish whether good practice, as defined in the Mental Health Act 1983 Code of Practice, has been followed and whether lessons for future practice and policy need to be learned. This review may include sending a Commissioner to the inquest which considers the circumstances of the death or arranging a visit to the hospital to consider the issues arising.
Students may be entitled to other payments such as allowances for dependant children and the cost of national health service employees seconded on to midwifery training programmes will include a proportion of their salary costs.
Mr. Ivan Lewis: The Department is currently establishing five demonstration sites in England for innovative delivery of health and work services to private employers, in particular focusing on small and medium-sized businesses, by providing a £10 million capital fund. A further £10 million capital fund is available for an additional tranche of demonstration sites to enrich the developing good practice in this area. This will both bring benefits to the private sector in the areas in which the demonstration sites are located, and establish good practice from which others can learn.
Mr. Lansley: To ask the Secretary of State for Health which trusts are part of his Departments turnaround programme for organisations in particular financial difficulties; and how much funding has been allocated to pay for turnaround teams in 2007-08. 
Mr. Bradshaw: There is no central turnaround programme in 2007-08. The Department, in conjunction with strategic health authorities, continues to apply best practice learnt from the turnaround programme in recent years and applies this through the usual performance management functions. No central funding has been set aside to pay for turnaround teams.
Mr. Lansley: To ask the Secretary of State for Health how much of the multi-professional education and training levy allocated to strategic health authorities in 2006-07 was not spent on workforce development in (a) cash terms and (b) as a percentage of overall strategic health authority budgets, broken down by strategic health authority. 
Ann Keen: The amounts of the multi-professional education and training (MPET) levy allocated to strategic health authorities (SHAs) in 2006-07 that was not spent on workforce development in cash terms and as a percentage of overall strategic health authority budgets, broken down by strategic health authority, are shown in the following table.
|SHAs||MPET Budget not spent on workforce in cash terms (£000)||MPET Budget not spent on workforce as a percentage of overall SNA resource budget|
Mr. Lansley: To ask the Secretary of State for Health how much of the NHS surplus in 2006-07 was accounted for by lower than expected expenditure on items classed as non-cash or capital; and how much of the surplus was used to cover pay costs. 
Mr. Bradshaw: The Department did not expect the national health service to plan or manage its expenditure on a separate near cash and non-cash basis in 2006-07. Instead, the NHS was expected to live within overall expenditure limits and at least achieve financial balance. The net surplus of £515 million recorded in the audited accounts for 2006-07 represents a revenue surplus only, and is reported after full account was taken by the NHS for pay costs.
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