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Mental Health Services

Paul Rowen: To ask the Secretary of State for Health what assessment he has made of the level of demand for NHS services for dual-diagnosis patients who abuse substances and have a mental illness; what assessment he has made of whether that demand is being met; and what plans he has for future provision of services. [179175]

Dawn Primarolo: The Department has undertaken a substantial programme of work to ensure that the needs of this group are met. The implementation of this has been supported by substantial increases in funding across the NHS over the past 10 years and
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specific funding increases for substance misuse services through the introduction of the pooled drug treatment budget, which has tripled in size since it was introduced in 2001 (£129 million to £398 million in 2007-08).

Examples of work undertaken to support improvements in this area include:

In the “Mental Health Policy Implementation Guide: Dual Diagnosis Good Practice Guide” (Department of Health, 2002) it was made clear that people who have both drugs misuse and mental health problems need high quality, patient focused and integrated care, which should be delivered within mental health services. It charged local implementation teams in partnership with drug action teams with implementing the policy requirements.

The 2002 Good Practice guide alongside guidance published in 2006, “Dual diagnosis in inpatient and day hospital settings” represents a summary of current Government policy on this issue. The key message is the need for mainstreaming—the recognition that substance misuse is usual rather than exceptional among people with mental health problems, and that the relationship between the two is complex.

The updated “Drug Misuse and dependence - UK guidelines on clinical management” (the ‘clinical guidelines’), published in September 2007 identifies that patients in drug treatment services with common mental illness problems additional to their drug misuse are often treated in drug treatment services, although clarity on competencies and shared care models is important. For all those with mental health problems, it is important that competent practitioners make adequate assessment and appropriate treatment be organised.

Proper assessment is the key to establishing a comprehensive care plan for dual diagnosis. Adequate risk assessment of mental health should be undertaken at initiation of treatment and at appropriate times during management. Specific psychological management in line with appropriate guidance, such as National Institute for Health and Clinical Excellence and other psychiatric and drug misuse guidelines can then be provided.

MRSA: Greater London

Mr. Boris Johnson: To ask the Secretary of State for Health how many cases of (a) MRSA and (b) clostridium difficile have (i) been reported and (ii) resulted in death, (A) in total, (B) of those under the age of one, (C) of those under the age of five and (D) of those aged over 65 years at each hospital in Greater London in each year since 2000. [178059]

Ann Keen [holding answer 14 January 2008]: The requested data are not available and the best source is the mandatory surveillance system. Surveillance of methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections (bacteraemia) started in April 2001 and surveillance for Clostridium difficile infection began in January 2004. Data for individual trusts in the London region are shown in the following tables.

Figures on deaths involving MRSA or C. difficile in individual hospitals are not currently available

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The total of MRSA bacteraemia reported in each trust for all age groups in the London region:

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	MRSA bacteraemia reports
Name of NHS trust	April 2001-March 2002	April 2002-March 2003	April 2003-March 2004	April 2004-March 2005	April 2005-March 2006	April 2006-March 2007
Barking, Havering and Redbridge Hospitals	92	77	116	98	69	71
Barnet and Chase Farm Hospitals	62	94	94	102	78	62
Barts and the London	62	74	62	64	67	50
Bromley Hospitals	37	32	18	16	25	27
Chelsea and Westminster Hospital	36	32	38	47	28	23
Ealing Hospital	40	38	36	26	39	22
Epsom and St. Helier University Hospitals	84	72	88	58	45	62
Great Ormond Street Hospital for Children	7	13	4	7	6	5
Guy’s and St. Thomas’	124	155	165	102	80	72
Hammersmith Hospitals	89	115	125	81	69	62
Homerton University Hospital	14	19	15	5	20	17
King’s College Hospital	92	108	107	64	99	70
Kingston Hospital	55	59	47	52	57	32
Mayday Healthcare	39	48	56	40	48	43
Moorfields Eye Hospital	0	0	0	0	0	0
Newham University Hospital	25	33	24	17	18	25
North Middlesex University Hospital	46	48	53	29	39	35
North West London Hospitals	59	44	55	54	56	51
Queen Elizabeth Hospital	19	35	32	41	23	22
Queen Mary’s Sidcup	30	32	28	41	23	18
Royal Brompton and Harefield	9	9	5	7	4	4
Royal Free Hampstead	122	101	98	69	93	75
Royal National Orthopaedic Hospital	2	6	1	5	3	2
St. George’s Healthcare	115	75	93	63	62	85
St. Mary’s	64	72	59	48	67	44
The Hillingdon Hospital	33	36	24	30	24	38
The Lewisham Hospital	54	45	49	60	31	23
The Royal Marsden	6	7	4	1	2	11
The Whittington Hospital	27	30	29	24	35	32
University College London Hospitals	95	114	86	63	68	56
West Middlesex University Hospital	32	41	34	30	27	38
Whipps Cross University Hospital	45	43	37	48	16	29
Note: Data are provisional

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