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30 Jan 2008 : Column 456W—continued

Mrs. Gillan: To ask the Secretary of State for Health what public funding has been made available for extending the 31-day standard target to all cancer patients; and what the expected total cost is of such an extension. [181194]

Ann Keen: An impact assessment was published at the same time as the new Cancer Reform Strategy (CRS) on 3 December 2007. A copy of the CRS Impact Assessment is available at

and is also available in the Library.

A breakdown of estimated additional costs associated with the extension of the 31-day standard is detailed in the following table.

Cost of 31-day standard for all cancer treatments
Financial year Estimate for annual costs (£ million)





















Funding for the extension of the 31-day standard is not separately identified in allocations to the national health service. Primary care trusts are funded to meet the health care needs of their populations, which will include the provision of cancer services.

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Carbon Monoxide

Tom Levitt: To ask the Secretary of State for Health if he will take steps to raise awareness of medical practitioners of the risks to health of carbon monoxide and the symptoms, diagnosis and consequences of carbon monoxide poisoning. [182673]

Dawn Primarolo: The Department is committed to helping to prevent deaths and injuries caused by carbon monoxide (CO) poisoning and raise awareness of the dangers of CO poisoning among the public and medical profession. A range of specific actions to achieve this have been and continue to be taken, many of which are specific to medical practitioners.

In his winter update issued in November 2007, which is sent to all doctors registered with the General Medical Council in England, the chief medical officer (CMO), Liam Donaldson, provides a range of advice on diagnosis of CO poisoning, including the use of neurological examination.

This builds on two previous publications, the advice of which is still current: the CMO winter 2005 update and the CMO and chief nursing officer (CNO) joint letter issued in 2002. The CMO’s update includes recognition of the symptoms of CO poisoning, key questions to ask in diagnosis, appropriate tests and treatment. The CMO/CNO letter, distributed to community nurses, midwives, health visitors and general practitioners, provides detailed advice on recognising the symptoms of CO poisoning and specific advice about investigations and testing techniques.

In addition, the Department has recently called for research to investigate the incidence of CO poisoning, health outcomes and patients’ experience following exposure, which will help inform the development of appropriate policy.

The Department also provides funding for leading national voluntary organisations through the Section 64 General Scheme of Grants, which helps in their work in raising awareness about the dangers of CO with both the public and health professionals and in supporting victims and providing information on how to prevent poisoning.

In collaboration with key stakeholders, the Department is currently looking at options for new awareness-raising initiatives as well as reviewing activities in which it is already engaged.

Community Nurses

Anne Milton: To ask the Secretary of State for Health pursuant to the answer of 14 January 2007, Official Report, column 1003W, on community nurses, how
30 Jan 2008 : Column 458W
many more community matrons the local intelligence suggests there are; and what revised estimate he has made of total numbers. [181015]

Ann Keen: Strategic health authorities have suggested that the actual figure for community matrons may be higher than the official figure shown in the national health service work force census. The latest official figure still stands at 366 (351 full-time equivalent) as shown in the 2006 NHS work force census. The 2007 census is due to be published in mid-March 2008, and will provide a more up to date figure.

Departmental Public Expenditure

Mr. Lansley: To ask the Secretary of State for Health pursuant to paragraph 5.5 of his Department's resource accounts for 2006-07, what the value of resources released for frontline activity as a result of the streamlining of NHS leadership was, broken down by strategic health authority. [178269]

Mr. Bradshaw: The information requested is provided in the following table. This gives a total figure in 2006-07 by strategic health authority (SHA) economy for each SHA and its primary care trusts.

2006-07 Commissioning a patient led national health service savings

North East SHA


North West SHA


Yorkshire and The Humber SHA


East Midlands SHA


West Midlands SHA


East of England SHA


London SHA


South East Coast SHA


South Central SHA


South West SHA




Source: Department of Health financial returns

Mr. Lansley: To ask the Secretary of State for Health pursuant to paragraph 6.4 of his Department's resource accounts for 2006-07, if he will break down his Department's £128 million revenue underspend on central programmes by programme; and what the reasons were for the underspend on each programme. [178273]

Mr. Bradshaw: The following table gives a breakdown of the Department's £128 million revenue underspend as stated in paragraph 6.4 of the 2006-07 Resource Accounts.

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Budget £ million £ million Reasons for under/(over)spend

Demand Led

European Economic Area (health costs of United Kingdom citizens abroad)


Welfare Foods


Family Health Services Dentistry




Total Demand Led budgets


Demand led budgets—difficult to accurately predict volume of activity/cost


2005-06 Accounting Adjustments


As part of the year end review of balance sheet codes a number of adjustments were made. These included the reduction to zero of some creditors no longer required in respect of Deposits and Advances, £3.6 million, and health authority impairments £10.9 million. In addition following a review of Partnership for Health published accounts a credit of £5.750 million was made to expenditure in respect of an investment in Partnerships for Health charged incorrectly to operating expenditure in 2005-06.

Skipton Fund (Hepatitis C compensation claims)


Level of provisions dependent upon expected level of claims, which was lower than forecast.

Ex-Regional Health Authority Retirements


Review of methodology and assumptions for calculating provisions resulted in an underspend against budget.

National Specialist Commissioning Advisory Group


Review of accounting methodology to bring treatment in line with National Health Service resulted in an underspend against budget.

English National Board provisions


Review of methodology and assumptions for calculating provisions resulted in an underspend against budget.

Injury Benefits


Review of methodology and assumptions for calculating provisions resulted in an overspend against budget.


Other Underspends

Arms Length Bodies


Underspend due to, in the main, revision of NHS Blood and Transplant corporate strategy, and lower than expected

requirements for transition costs funding.

Payment by Results


Personal Social Services (PSS) Regulation


£2.5 million due to delays in expansion of domiciliary workers and £2.5 million on various other social care budgets.

Healthy Choices


Replanning of website development activity.



Value for money achieved through cheaper advertising.

Individual Budget Pilots


Replanning of new PSS Grant in year.

Other underspends


Several small variances on many small budgets including £1.5 million arising from exchange rate movements on World Health Organisation budget, £1 million on PSS Grants budgets (dependent upon receipt of valid invoices).


Total Central Programme Underspend


Departmental Recruitment

Mr. Hoban: To ask the Secretary of State for Health whether the policy of British jobs for British workers will affect his Department's recruitment policy for junior doctors. [179915]

Ann Keen: The choice facing us and the medical profession is whether we accept international medical graduates displacing large numbers of United Kingdom graduates, preventing them from obtaining postgraduate training, or whether we maximise the opportunities for UK medical graduates and the taxpayers' investment in them.

Our preference is to give priority to UK and European economic area medical graduates. We were disappointed with the Court of Appeal judgment which ruled that the Department's guidance which had this effect was unlawful.

We have been given expedited leave to appeal to the House of Lords against the Appeal Court judgment. The House of Lords will hear our appeal on 28 February and we continue to examine ways to prioritise specialty training places for UK graduates.


Mr. Bruce George: To ask the Secretary of State for Health what information his Department holds on trends in prevalence of skin disease and skin-related illnesses, excluding skin cancer. [181292]

Ann Keen: The Department has no specific information on trends in the prevalence of skin disease and skin-related illnesses.

Mr. Bruce George: To ask the Secretary of State for Health what steps his Department has taken to quantify the annual productivity losses associated with members of the workforce suffering from skin-related illnesses in the latest year for which figures are available. [181294]

Ann Keen: The Department has made no assessment of the annual productivity losses associated with those members of the workforce living with skin-related illnesses.

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