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Mr. Walker: To ask the Secretary of State for Health in what year the 40p per mile payment was introduced for NHS clinical staff who use their own cars for patient visits; and if he will increase this payment. 
A letter from the Chief Nursing Officer and Director General of National Health Service Finance, Performance and Operations was sent to the NHS on 1 November giving instructions on the various measures targeting healthcare-associated infections, including deep cleaning.
Each trust's deep-clean plan will vary according to local need. Trusts will agree costed deep-clean plans with their lead commissioners and SHA, who will monitor performance against this plan, as per normal performance management arrangements. Foundation trusts will also be invited to agree plans and funding for additional deep cleaning with local commissioners, together with local arrangements for checking the agreed work has been carried out. SHAs will take an overview as to progress across their area and will report to the Department.
|Average amount spent per patient main meal (£)|
In-patients are expected to receive three main meals per day. The spend includes the cost of provisions and staff costs. The data are collected from the national health service. Since 2004-05 the data provided has not been collected on a mandatory basis and therefore will not be complete.
Mike Penning: To ask the Secretary of State for Health what assessment he has made of the likely effect of compulsory ward inspections on (a) hygiene standards and (b) infection rates in hospitals. 
Ann Keen: The Healthcare Commission is currently carrying out spot checks of 120 trusts and, from next year, the commission will be undertaking annual specialist inspections of all acute trusts. It will be for the Healthcare Commission to decide how detailed an inspection is required in any individual case and inspections are likely to vary in depth, with the greatest focus being on those trusts giving rise to the greatest concern.
The Healthcare Commission has the power to issue improvement notices where it finds material failures to comply with the statutory code of practice for the prevention and control of healthcare-associated infections, in order to ensure that such failings are remedied.
Mike Penning: To ask the Secretary of State for Health how many cases of (a) methicillin-resistant staphylococcus aureus, (b) vancomycin-intermediate staphylococcus aureus, (c) clostridium difficile- associated diarrhoea, (d) vancomycin-resistant staphylococcus aureus and (e) glycopeptide-resistant enterococci were recorded in each hospital in England in each of the last five years; and if he will make a statement. 
Ann Keen: From April 2001 all national health service acute trusts in England were required to report all cases of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections under the mandatory surveillance scheme run by the Health Protection Agency (HPA). The latest data for each trust for the quarter from April to June 2007 and for each 12 month period from April 2001 to March 2007 are available (table 3 and table 5 respectively) at
Data are not collected for vancomycin-intermediates Staphylococcus aureus or vancomycin-resistant Staphylococcus aureus under the mandatory surveillance scheme. However, the Staphylococcal Reference and Antibiotic Resistance Monitoring Laboratory (ARMRL), the national reference laboratory responsible for the detection and investigation of antibiotic resistance, has screened over 50,000 MRSA isolates for resistance to vancomycin in the past 10 years. Of these, the ARMRL has confirmed two isolates of vancomycin-intermediate Staphylococcus aureus. The ARMRL has not confirmed any isolates of vancomycin-resistant Staphylococcus aureus.
Information is also available by acute NHS trust for England for Clostridium difficile infection under the mandatory surveillance scheme from January 2004 in people aged 65 years and over. The latest data for the first two quarters of 2007 and data for 2004, 2005 and 2006 are available at (table 1 and table 2 respectively)
The HPA also collects acute trust data on Glycopeptide-resistant enterococci blood stream infections in England from October 2003. Data for each 12 month period from October 2003 to September 2006 were published in July 2007 at:
Ms Abbott: To ask the Secretary of State for Health what assessment he has made of the effect on the level of hospital-acquired infections of the widespread introduction of subcontracting in hospital cleaning; and if he will make a statement. 
Ann Keen: Mandatory surveillance of health care associated infections was not introduced until 2001 but prevalence surveys of health care associated infections were undertaken in 1980, 1993 and 2006. There has been little change in the prevalence of hospital acquired infections overall over the last 20 years.
The Conservative Government introduced compulsory competitive tendering in 1983, requiring the national health service to market-test domestic cleaning, catering, and linen and laundry services on a regular basis. This Government lifted that requirement in 2000, and trusts must now benchmark their services before deciding whether to market-test.
Current guidance on contracting for cleaning makes it clear that quality must be considered alongside cost in decisions on how to provide cleaning services. Recent information suggests that there is currently no difference between in-house and outsourced cleaning in terms of standards and outcomes.
Mr. Redwood: To ask the Secretary of State for Health pursuant to the Prime Minister's answer of 14 November 2007, Official Report, columns 657-8, on the immigration status of employees, what steps his Department has taken to establish the immigration status of its employees since the Security Industry Authority wrote to employers in August on security checks. 
Mr. Bradshaw: We apply the baseline security checks, which include a nationality check, to all employees on entry to this Department; this forms part of our standard recruitment process and is applied to permanent, fixed-term and casual employees.
Mr. Allen: To ask the Secretary of State for Health when the Under-Secretary of State for Health, the hon. Member for Brentford and Isleworth (Ann Keen) will meet the hon. Member for Nottingham North to discuss the issues relating to incontinence arising from the Westminster Hall debate on 24th October 2007, Official Report, columns 93-100WH. 
Sarah Teather: To ask the Secretary of State for Health what quantity of influenza vaccine the Government's scientific advisers have recommended should be stockpiled; and what quantity of influenza vaccine has been stockpiled. 
Dawn Primarolo: The Government have already stockpiled 3.3 million doses of H5N1 vaccine. The science underpinning the further development and potential use of pre-pandemic vaccine, including the range of options for the size of any future stockpile, has been reviewed by United Kingdom and other international experts. Their conclusions are available on the Department's website at
Mr. Stephen O'Brien:
To ask the Secretary of State for Health what proportion of finished episodes of care with a primary diagnosis of (a) coronary heart disease, (b) stroke and transient ischaemic attack, (c) diabetes, (d) chronic obstructive pulmonary disorder, (e) cancer, (f) dementia, (g) depression and (h) chronic
kidney disease had a secondary diagnosis of malnutrition or nutritional anaemias in each year since 1997-98. 
The following table shows a count of finished consultant episodes where the primary diagnosis was either coronary heart disease, stroke and
ischaemic attack, diabetes, chronic obstructive pulmonary disorder, cancer, dementia, depression or chronic kidney disease and the proportion of these which also had a secondary diagnosis of malnutrition or nutritional anaemia, in each year since 1997-98 to 2005-06 (the latest data available).
|NHS hospitals, England|
|Finished consultant episodes where the primary diagnosis is either coronary heart disease, stroke and ischaemic attack, diabetes, chronic obstructive pulmonary disorder, cancer, dementia, depression or chronic kidney disease.||Finished consultant episodes where the primary diagnosis is either coronary heart disease, stroke and ischaemic attack, diabetes, chronic obstructive pulmonary disorder, cancer, dementia, depression or chronic kidney disease and the secondary diagnosis is malnutrition or nutritional anaemia.||Percentage of finished consultant episodes where the primary diagnosis is either coronary heart disease, stroke and ischaemic attack, diabetes, chronic obstructive pulmonary disorder, cancer, dementia, depression or chronic kidney disease, that had a secondary diagnosis of either malnutrition or nutritional anaemia.|
1. Diagnosis (Primary Diagnosis)
The primary diagnosis is the first of up to 14 (seven prior to 2002-03) diagnosis fields in the HES data set and provides the main reason why the patient was in hospital.
2. Secondary Diagnoses
As well as the primary diagnosis, there are up to 13 (six prior to 2002-03) secondary diagnosis fields in HES that show other diagnoses relevant to the episode of care.
3. Finished Consultant Episode (FCE)
A FCE is defined as a period of admitted patient care under one consultant within one health care provider. The figures do not represent the number of patients, as a person may have more than one episode of care within the year.
4. Ungrossed Data
Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).
5. Assessing growth through time
HES figures are available from 1989-90 onwards. During the years that these records have been collected by the national health service there have been ongoing improvements in quality and coverage. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series. Changes in NHS practice also need to be borne in mind when analysing time series. For example a number of procedures may now be undertaken in outpatient settings and may no longer be accounted in the HES data. This may account for any reductions in activity over time.
Hospital Episode Statistics (HES), The Information Centre for health and social care.
Mr. Ivan Lewis [holding answer 13 November 2007]: Information on the total number of in-patient deaths in national health service mental health accommodation in England from 2001-02 to 2005-06 is shown in the following table.
|Total number of in - patient deaths in NHS acute hospitals and other NHS accommodation in England from 2001-02 to 2005-06|
1. Data refer to all male and female deaths, for all age groups and from all causes.
2. Ungrossed data: the figures have not been adjusted for shortfalls in data.
Hospital Episode Statistics, the Information Centre for health and social care
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