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Medical Equipment: Incontinence

Mr. Stephen O'Brien: To ask the Secretary of State for Health what account was taken of tax revenues paid by appliance manufacturers in estimating the effect of price reductions for incontinence and stoma appliances proposed by his Department. [170552]

Mr. Bradshaw: The Department is not privy to company tax information. No account has been taken of manufacturers' tax revenues, and it is unclear as to where they may be domiciled for tax purposes.

Dr. Richard Taylor: To ask the Secretary of State for Health what discussions he has had with ministerial colleagues on the possible effect on UK manufacturing jobs of the price reductions for incontinence and stoma appliances proposed by his Department. [171200]

Mr. Bradshaw: One of the stated aims of consultation on the “Arrangements under Part IX of the Drug tariff for the provision of stoma and incontinence appliances—and related services—to primary care” is to work in partnership to deliver fair prices for the national health service and reasonable returns for suppliers and contractors.

Departmental officials have had constructive dialogue with trade associations, individual companies,
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and patient and user groups in relation to what is proposed and is carefully listening to what they have to say.

To date no specific representations have been made to my officials with detailed consequences on United Kingdom manufacturing activities including jobs.

Medical Professions: Surveys

Mr. Hoban: To ask the Secretary of State for Health whether his Department conducts (a) focus groups and (b) other qualitative or quantitative opinion research of (i) doctors and (ii) nurses. [173366]

Mr. Bradshaw: The Department is committed to consulting and involving the public, national health service staff and our stakeholders to help inform both policy formulation and the delivery of better quality public services. Responsive public services are an important part of the Modernising Government initiative.

The Department regularly commissions research among NHS staff.

Medical Records: Databases

Jeremy Wright: To ask the Secretary of State for Health if he will introduce legislation to provide that he shall not be a data controller in relation to personal data processed on a detailed care record. [169024]

Mr. Bradshaw: The Government have no current plans to do so in relation to patient records within the National Health Service Care Records Service, but will keep the position under review as the new service is implemented. Some key data controller responsibilities such as overall network and technical system security are managed through the Department’s contracts and it would not be appropriate for the Secretary of State to avoid these responsibilities. This does not, however, permit the Department’s staff to access confidential patient information unless expressly authorised by the patient concerned.

Medical Services: Finance

Mr. Lansley: To ask the Secretary of State for Health what plans he has to extend the scope of practice-based commissioning to include real budgets for (a) elective acute care, (b) unscheduled care and (c) other types of care; and what plans he has to phase out the use of indicative budgets in relation to practice-based commissioning. [166390]

Mr. Bradshaw: There are no plans to introduce real budgets for practice-based commissioning or phase out the existing indicative budget arrangements. The Department considers that such an approach would not offer additional flexibility or benefits for practice-based commissioners.

Mental Health Services

Anne Milton: To ask the Secretary of State for Health with reference to the answer of 29 October 2007, Official Report, column 1037W, on mental health services, what estimate he has made of the average cost
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to the NHS of a course of cognitive behavioural therapy (CBT); what representations he has received on the availability and future use of CBT in the last 12 months; and what discussions (a) he, (b) his Ministers and (c) his Departmental officials have had with those who have made such representations. [174041]

Mr. Ivan Lewis: While National Institute for Health and Clinical Excellence have calculated that the average cost of delivering a course of cognitive behavioural therapy (CBT) is £750, the cost calculation for delivering CBT and other evidence-based psychological therapies, used in implementing the Improving Access to Psychological Therapies (IAPT) programme, is lower. This is because the IAPT model of care includes a range of evidence-based therapeutic approaches and delivery methods.

Over the last year a significant number of representations have been made about the availability and future use of CBT, and discussions have taken place with a wide range of interests which include third sector organisations, senior academics, providers of CBT training courses and other forms of therapy and the private sector, in particular manufacturers of computerised CBT products.

Milton Keynes Hospital: Midwives

Mr. Lancaster: To ask the Secretary of State for Health how many midwives should be employed at Milton Keynes hospital to deal with the number of births there each year. [174579]

Mr. Ivan Lewis: This is a matter for the Chair of Milton Keynes Hospital NHS Foundation Trust, as it is the Foundation Trust’s responsibility to ensure that staffing levels are sufficient to ensure that patient safety is not compromised.

NHS Foundation Trusts: Infectious Diseases

Patrick Mercer: To ask the Secretary of State for Health how many hospitals with above average levels of infection of (a) MRSA and (b) clostridium difficile have (i) gained and (ii) retained foundation status. [171913]

Ann Keen: We only support applications for national health service foundation trust status if we are satisfied that the NHS trust is a high performing organisation both in terms of service quality and financial rigour. Once NHS trusts become NHS foundation trusts they must continue to deliver high quality services and should they fall short of national standards then they will be subject to intervention by Monitor, the independent regulator of NHS foundation trusts. Monitor has a range of interventions available, from increased reporting through to direct managerial change.

All acute NHS trusts are obliged to report all methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections and clostridium diff i cile infection (CDI) diagnosed in their laboratory.

In 2006-07, 69 trusts had MRSA rates above the national rate of 1.67 cases per 10,000 bed-days, and of these 15 were NHS foundation trusts.


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However, it is misleading to compare trusts on their reported CDI surveillance data. This is because the calculation used attributes all cases of CDI to the trust whose laboratory detects and reports the infection. This is inappropriate for those trusts that test samples from other hospitals, general practitioner practices etc. because the rate produced is higher than the actual infection rate in trust patients.

NHS Trusts: Finance

Mr. Stephen O'Brien: To ask the Secretary of State for Health which trusts are in the financially challenged trust regime; and if he will publish the reports relating to them. [172903]

Mr. Bradshaw: The following list shows the 17 financially challenged national health service trusts. These trusts have been subject to a rigorous review of their financial and operational positions, to identify long-term solutions that best deliver value for money, while maintaining standards of patient care to the community they serve. The results of the review process for these trusts are currently under discussion with the strategic health authorities and solutions are being prepared in the context of the Department's operating framework for 2008-09.

NHS: Billing

Mr. Stephen O'Brien: To ask the Secretary of State for Health which primary care trusts (a) paid and (b) did not pay 95 per cent. of undisputed invoices within (i) contract terms or (ii) 30 days in cases where no terms were agreed, in (A) 2005-06 and (B) 2006-07; and what the total value was of those invoices in each case. [164602]

Mr. Bradshaw: This information has been placed in the Library.

NHS: Bureaucracy

Mr. Lansley: To ask the Secretary of State for Health what estimate his Department has made of the number of hours per week spent on paperwork by (a) nurses, (b) midwives, (c) consultants and (d) general practitioners in the latest period for which figures are available. [167876]


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Mr. Bradshaw: No estimates have been made centrally.

Some paperwork is essential to safe and effective patient care. The Department is committed to reducing the unnecessary burden placed on staff in the national health service wherever it can and to ensure frontline staff are able to spend more time doing what they do best—treat patients.

NHS: Complaints

Mr. Jim Cunningham: To ask the Secretary of State for Health what steps the Government has taken to improve the NHS complaints procedure since 1997. [172938]

Ann Keen: The national health service complaints procedure is continually being reviewed in the light of changes to the way the NHS works and how patients receive their treatment. In addition, there are other external drivers for change, such as the White Paper “Our health, our care, our say”, setting the strategic direction for a new NHS through world class commissioning and a new regulatory regime.

A number of changes have been introduced since 1997 aimed at improving complaints procedures and overall responsiveness to complaints. While the detail to processes have been changed the objectives have consistently aimed to deliver a system which:

Information has been placed in the Library which sets out in detail the specific changes that have been introduced to NHS complaints arrangements from 1997, and the key elements of the current proposals in the consultation “Making Experiences Count”, which ran from June to October this year.

NHS: Data Protection

Mr. Lansley: To ask the Secretary of State for Health how many staff in the NHS have been subject to disciplinary proceedings for mishandling patient data in each of the past five years. [170179]

Mr. Bradshaw: Information relating to the information governance responsibilities of individual national health service trusts, primary care trusts and general practitioner practices is not held centrally, and could be obtained only at disproportionate cost.

For the future, tools are provided by NHS Connecting for Health to enable NHS organisations to control access to patient data held in the new systems and services deployed under the national programme for information technology. System audit trails will enable organisations to monitor access, and the Department has made it clear that misuse must not be tolerated. The Department will monitor how well NHS organisations adhere to standards rather than the details of access.


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NHS: DHL

Mr. Stephen O'Brien: To ask the Secretary of State for Health by what means the DHL contract for supply and delivery of medical supplies and equipment to the NHS is being evaluated; and if he will make a statement. [172919]

Mr. Bradshaw: DHL is contracted to run the business operation now known as NHS Supply Chain and has committed to key performance indicators (KPIs), including service delivery and financial targets.

While the contractual high level KPIs are used for performance and penalty reporting, lower level KPIs are used predicatively and diagnostically to forecast and understand performance.

KPI information is produced for the lifetime of the contract in the form of standard reports, which are monitored and evaluated by the supply chain management division (SCMD) of the NHS Business Services Authority which has been set up to manage DHL performance.

Along with KPI measurement, rigorous process evaluation and Gateway reviews, the SCMD are audited to ensure processes and procedures for managing the contract are robust.

NHS: Expenditure

Mr. Lansley: To ask the Secretary of State for Health what net NHS expenditure was on (a) the unintended consequences of treatment, (b) health care arising from violent incidents, (c) coronary heart disease, (d) diabetes and (e) cerebrovascular disease (i) for England and (ii) in each primary care trust area, expressed (A) as a total, (B) as a percentage of total net NHS expenditure and (C) per head of population in the same format as that provided in table 8b of his Department’s memorandum to the Health Select Committee on Public Expenditure on Health and Personal Social Services 2006, HC(2006-07)-26-i [174881]

Mr. Bradshaw: This information has been placed in the Library.

NHS: Finance

Mr. Stephen O'Brien: To ask the Secretary of State for Health what rating is used when assessing (a) the creditworthiness of organisations receiving (i) public dividend capital and (ii) loans and (b) the risk of default by organisations on the repayment of (i) public dividend capital and (ii) loans; and pursuant to the answer of 5 December 2007, Official Report, column 1320W, to the hon. Member for South Cambridgeshire (Mr. Lansley), on NHS finance, what rating is applied to each (A) organisation, (B) public dividend capital sum and (C) loan. [174389]

Mr. Bradshaw: Loans are issued to national health service trusts where there is a reasonable expectation that they will be serviced and repaid on the agreed schedule. This is in line with rules on public sector loans set out by HM Treasury. This was assessed
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through an assurance process carried out on a case-by-case basis by strategic health authorities and the Department.

Public Dividend Capital is a different form of financing provided to NHS trusts. Unlike loans, it is not serviced at a constant rate. However, NHS trusts in receipt of public dividend capital are expected to deliver the required rate of return.


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