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As a regulator, the Commission for Social Care Inspection (CSCI) has mandatory powers of compulsion under the CSA 2000 to ensure the compliance of care providers where a complaint indicates a breach under
the Care Homes Regulations 2001 or the associated National Minimum Standards (NMS). In such instances, CSCI will issue requirements aimed at bringing the provider into compliance, and if necessary, will issue a statutory notice where the requirement has not been observed. Non-compliance with a statutory notice is an offence that can result in a cancellation of a providers registration.
In effect, CSCI uses its powers of inspection as the regulator to undertake proportionate inquiries into all information (including complaints) brought to its attention about regulated care services. CSCI considers that its focus is correctly upon provider compliance with service specific regulations and NMS, not interpersonal conflict resolution between complainant and provider, for which it has no statutory responsibilities.
Mr. MacDougall: To ask the Secretary of State for Health what steps his Department is taking to increase the protection of elderly people living in private care homes; and if he will make a statement. 
Mr. Ivan Lewis: The Government regard the abuse of vulnerable and older people in any setting as unacceptable in all its forms and are determined to root it out. We are addressing the issue in a variety of ways.
We set out standards for care and treatment for the national health service and social care services via the National Service Frameworks for Older People and Mental Health and the White Paper, Valuing People: A New Strategy for Learning Disability.
We introduced regulations and national minimum standards for care homes, domiciliary care agencies and adult placements. These are intended to ensure vulnerable and older people can live in a safe environment, where their rights and dignity are respected, staff are properly trained and care is of the requisite quality. The regulations and national minimum standards apply equally to all providers of care, whether in the private, voluntary or public sectors.
We have created independent regulators, the Commission for Social Care Inspection (CSCI) and the Healthcare Commission, and given them the powers they need to take action against poorly performing providers or where abuse occurs. Ultimately, they have the power to close services down. All providers of care, including private care homes are legally required to register with and be inspected and regulated by CSCI.
We expect local authorities to play their part. No Secrets, published by the Department in 2000 provides a complete definition of abuse and a framework for councils to work with the police, the national health service and regulators to tackle abuse and prevent it from occurring. On June 14 this year, I also announced a review of the No Secrets guidance. The case for legislation to protect vulnerable adults will be considered as part of the review.
Local authorities have been given specific responsibilities. Statutory guidance issued in May 2006 required them to ensure that Directors of Adult Social Services maintain a clear organisational and operational focus on safeguarding vulnerable adults and that relevant statutory requirements and other national standards are met, including Protection of Vulnerable Adults (POVA) requirements. Local authorities must make sure the Director of Adult Social Services has the powers and resources necessary to encourage a culture of vigilance against the possibility of adult abuse.
We introduced the POVA Scheme in July 2004, under the provisions in Part 7 of the Care Standards Act 2000, which requires staff who provide personal care to older people in their own homes or in care homes to be subject to statutory checks, including checks of their criminal record. At the heart of the POVA scheme is the POVA list, which operates as a workforce ban and prevents dangerous or unscrupulous people from gaining access to older and vulnerable people in care homes or being cared for in their own homes. Only the employers in regulated social care services or the regulator, CSCI, can make referrals to the POVA list.
The Government support the work of Action on Elder Abuse (AEA). AEA has been awarded a Section 64 grant, totalling £360,000. This grant covers the three year period from 2007 to 2009 and is to help fund central administrative costs, which will include their freephone helpline for anyone concerned in any way about the abuse of older people.
We are introducing a new centralised vetting and barring scheme for people working with children and vulnerable people. This scheme, as set out in the Safeguarding Vulnerable Groups Act 2006, will extend the coverage of existing barring schemes, such as POVA and draw on wider sources of information to provide a more comprehensive and consistent measure of protection for vulnerable groups across a wide range of settings, including the whole of social care and the NHS. The new scheme will make it far more difficult for abusers to gain access to some of the most vulnerable groups in society and will be a significant step forward.
Barbara Keeley: To ask the Secretary of State for Health what (a) publicity and (b) other activities his Department is planning in order to increase the number of eligible carers being offered influenza vaccinations in 2007-08. 
Dawn Primarolo: Details of those eligible to receive their free flu vaccination this year was made available to all health professionals via the chief medical officer letter dated 30 March 2007 and also as part of the If you knew about Flu campaign leaflet. 2 million of these leaflets have been distributed as part of this years campaign.
Barbara Keeley: To ask the Secretary of State for Health how many carers in England will be eligible for routinely-offered influenza vaccinations in accordance with the Chief Medical Officers guidance letter. 
Dawn Primarolo: Flu vaccine is given to carers at the discretion of their general practitioner (GP). Based on results from the national flu vaccine uptake survey, it is estimated that around 200,000 primary carers have so far been identified by GP practices in England.
Mr. Spring: To ask the Secretary of State for Health how many cases of clostridium difficile there were in (a) Addenbrookes Hospital, (b) West Suffolk Hospital and (c) Ipswich Hospital in (i) 2005, (ii) 2006 and (iii) 2007 to date. 
Ann Keen: The mandatory surveillance system operated run by the Health Protection Agency (HPA) provides data on the number of reports of clostridium difficile (C. difficile) associated disease. All acute national health service trusts in England are obliged to report all cases of blood stream infections processed by their laboratories and the system does not record when or how the infection was acquired. The current HPA C. difficile associated disease data are therefore published at trust level.
Mandatory surveillance of C. difficile was introduced in 2004 for patients aged 65 and over to help assess the scale of the problem and concentrate attention on this infection. This has been extended to all patients aged two and over from April this year.
The figures for patients aged 65 and over for the trusts covering Addenbrookes hospital (Cambridge University Hospitals NHS Foundation Trust), West Suffolk hospital (West Suffolk Hospital NHS Trust) and Ipswich hospital (Ipswich Hospital NHS Trust) are shown in the following table.
|NHS Trust||Figures for C . difficile associated disease|
|2005||2006||January to June 2007|
| Source: HPA data.|
Mr. Walter: To ask the Secretary of State for Health how many NHS dentists there were in North Dorset in each year since 1997; and how many of them (a) admitted new adult patients to their list and (b) treated NHS patients between the ages of 18 and 65 years in each of those years. 
Ann Keen [holding answer 20 November 2007]: Numbers of national health service dentists at primary care trust (PCT) and strategic health authority (SHA) level as at 31 March 1997 to 2006 are available in annex E of the NHS Dental Activity and Workforce Report England: 31 March 2006. Information at parliamentary constituency level is available in annex G.
Numbers of adult patients (aged 18 and over) registered with an NHS dentist at PCT and SHA level as at 31 March 1997 to 2006 are available in annex A of the aforementioned report. Information at parliamentary constituency level is available in annex C.
The number of NHS dentists at PCT and SHA level as at 30 June, 30 September, 31 December 2006 and 31 March 2007 are available in table E1 of annex 3 of the NHS Dental Statistics for England: 2006-07 report. This information is based on the new dental contractual arrangements, introduced on 1 April 2006.
The inclusion of dentists on trust-led contracts in the data collection following the 2006 reforms means that data collected since April 2006 cannot be directly compared with data collected under the previous system.
In both reports, the work force numbers quoted are headcounts and do not differentiate between full and part-time dentists, nor do they account for the fact that some dentists may do more NHS work than others.
Since April 2006, patients no longer have to be registered with a dental practice to receive NHS care and treatment. The closest equivalent current measure is the number of patients receiving NHS dental services (patients seen) in a given area over a 24-month period, for that area. However, this is not directly comparable to the registration data for earlier years.
The number of adult patients (aged 18 and over) seen in the 24-month periods ending 31 March 2006 and 31 March 2007 are available in table C1 of annex 3 of the NHS Dental Statistics for England 2006-07 report. Information is available at PCT and SHA area in England.
Ann Keen [holding answer 20 November 2007]: The number of adult and child patients registered with a national health service dentist are available in annex A of the NHS Dental Activity and Workforce Report, England: 31 March 2006. This report is available in the Library.
The closest equivalent measure to registration is the number of patients receiving NHS dental services (patients seen) in a given area over a 24-month period, for that area. However, this is not directly comparable to the registration data for earlier years.
The number of adult and child patients seen in the 24-month periods ending 31 March 2006 and 31 March 2007 are available in table C1 of annex 3 of the NHS Dental Statistics for England 2006-07 report. This report is available in the Library. Information is available for SHA and PCT areas in England.
Dr. Iddon: To ask the Secretary of State for Health which classes of prescription and over-the-counter products are classified by the Medicines and Healthcare products Regulatory Agency as having the greatest potential for patients to become physically dependent on or addicted to them. 
Dawn Primarolo: Medicines which are known to have significant potential for physical dependence and addiction, and which may be abused or diverted, are designated as controlled drugs and come within the scope of the Misuse of Drugs Act 1971 and the Misuse of Drugs Regulations 2001.
The Medicines and Healthcare products Regulatory Agency (MHRA) continuously monitors the safety of all medicines in the United Kingdom, including concerns about dependence and addiction, and, where necessary, takes suitable action to safeguard public health. The MHRA does not classify medicines by their potential for causing physical dependence or addiction.
As new evidence comes to light, the MHRA seeks advice on safety issues from its independent scientific advisory groupthe Commission on Human Medicines. If action is needed, following an assessment of the risks and benefits of the medicine, then a number of regulatory options are available, including: withdrawal of a product from the market; and, amending the labelling and patient information leaflet.
John Mann: To ask the Secretary of State for Health what the average age of patients is in his Departments three-centre pilot into the use of diamorphine to treat heroin addiction; what the (a) shortest, (b) longest and (c) average length of their heroin addiction was; what total length of time each had spent in prison before the programme began; what the average length of their sentences had been; how many court appearances each had had; on how many occasions each member of the pilot group had been admitted to hospital for (i) overdose through accident and emergency and (ii) for patient stays linked to their drug use; and what the estimated number of acquisitive crimes committed by this group was (A) in total and (B) on average before the pilot. 
Dawn Primarolo: The National Addiction Centre is currently undertaking the Randomised Injectable Opiate Treatment Trial, which is examining injectable diamorphine, injectable methadone and oral methadone treatments in a randomised controlled trial.
The trial, although supported by the Government, is an independent study following strict research governance protocols. The information requested will not therefore be available prior to the publication of the research findings.
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