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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. 
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
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).
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 mainstreamingthe 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.
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. 
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.
|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|
Data are provisional
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