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20 Feb 2008 : Column 812Wcontinued
Mr. Hancock: To ask the Secretary of State for Health when all frontline staff in mental health and learning disability services will have received Promoting Safer and Therapeutic Services training in conflict resolution. 
Ann Keen: The NHS Security Management Service organises conflict resolution training for national health service staff. Within this training programme, the Promoting Safer and Therapeutic Services syllabus has been specifically designed for staff working in mental health and learning disability settings. The aim is for all staff to have received training by 31 March 2008.
Mr. Kemp: To ask the Secretary of State for Health how many midwifery training places there were in each English region in each of the last five academic years. 
Ann Keen: A table which shows how many midwifery training places there were in each strategic health authorities in each of the last five academic years has been placed in the Library.
Andrew George: To ask the Secretary of State for Health what the cost to his Department of training student midwives was in each year since 2004-05. 
Ann Keen [holding answer 18 February 2008]: The total estimated cost of training student midwives for each year since 2004-05 is set out in the following table.
|Financial year||Total cost (£ million)|
(i) 2004-05 and 2005-06 are forecasts. No data are available for 2006-07 onwards.
(ii) Data in the above time series are not strictly comparable due to changes in the way data were collected.
(iii) Average bursary costs for nurses and midwives have been added to tuition costs from 2004-05 onwards.
Keith Vaz: To ask the Secretary of State for Health how many neurosurgeons qualified in each of the past 10 years 
Ann Keen: The Department does not hold the numbers of neurosurgeons who qualified each year because the annual national health service workforce census does not separately identify the number of consultants specialising in neurosurgery who qualify each year.
The number of consultants specialising in neurosurgery employed in the NHS in each year from 1996 to 2006 is shown in the following table.
|Hospital and Community Health Services : Medical staff showing consultants and doctors in training and equivalents working in neurosurgery: England at 30 September each year|
|All staff, of which:||C onsultants||Doctors in training and equivalents|
| Source: The Information Centre for health and social care Medical and Dental Workforce Census.|
Mr. Oaten: To ask the Secretary of State for Health what guidance he has issued on NHS trusts charging contractors for tenders. 
Mr. Bradshaw: Guidance on this matter is not issued centrally.
National health service trusts are responsible for their own good financial management. This will include looking closely at all opportunities to prevent or minimise any impact on services to patients.
Suppliers must decide for themselves whether to support a particular tender invitation after giving due consideration to the potential benefits and process savings that might be accrued from it.
Sammy Wilson: To ask the Secretary of State for Health what estimate he has made of the number of people who have experienced (a) strokes and (b) heart attacks related to their use of the drug Vioxx. 
Dawn Primarolo: Data are not available on which to base a valid estimate of the number of heart attacks, strokes and other adverse effects that may have been caused by Vioxx and other COX-2 inhibitors. The underlying medical condition of many patients treated with COX-2 inhibitors means that they are already at higher risk of heart attack and stroke than the rest of the population, and the impact of the COX-2 inhibitor on this risk is not possible to calculate.
Since Vioxx was voluntarily withdrawn by the manufacturer in 2004, the safety of other COX-2 inhibitors and traditional anti-inflammatory drugsnon-selective non-steroidal anti-inflammatory drugs (NSAIDs)has been under continual and intense assessment in the United Kingdom and Europe. The latest evidence suggests that both NSAIDs and COX-2 inhibitors might pose a small increased risk of heart attacks or strokes, although the exact level of risk may vary between medicines. The Medicines and Healthcare products Regulatory Agency has widely communicated the latest information and advice for healthcare professionals in letters and bulletins, and other publications through liaison with the British National Formulary and National Prescribing Centre. In addition, product information (including patient information leaflets) has been updated in order to support informed decision-making in relation to the choice of anti-inflammatory medicine.
Mr. Stephen O'Brien: To ask the Secretary of State for Health on what days the www.jobs.nhs.uk/terms.html webpage was updated in the last two months. 
Ann Keen: The www.job.nhs.uk/terms.html webpage was last updated on 16 January 2008 as stated on the website. The terms and conditions of the National Health Service Jobs website are reviewed once a month by NHS employers and are updated when necessary. They were previously updated in 2006 as a result of changes from Commissioning a Patient led NHS.
Mr. Gordon Prentice: To ask the Secretary of State for Health whether any categories of clinical or nursing staff are exempt from the bare below the elbow rule. 
Ann Keen: No categories of clinical or nursing staff are automatically exempt from the bare below the elbows dress code. In setting local uniform policy, national health service trusts need to take account of the Departments guidance and to decide when both clinical and nursing staff are in situations where it is applicable.
Clinical and nursing staff need to dress appropriately and professionally to enable them to carry out their duties. The new bare below the elbows dress code is a matter of patient safety, as it supports good hand cleaning practice and contributes to infection prevention and control.
Mr. Stephen O'Brien: To ask the Secretary of State for Health pursuant to the answer of 18 December 2007, Official Report, column 1396W, on nutrition, how many patients were (a) admitted to and (b) discharged from hospital with a diagnosis of (i) malnutrition, (ii) nutritional anaemia and (iii) other nutritional deficiencies in 2006-07, per 1,000 patient admissions, broken down by NHS trust. 
Dawn Primarolo: The information is not available in the exact format requested.
Tables showing the rates of finished in year admission episodes for malnutrition/nutrition anaemias and other nutritional deficiencies per 1,000 hospital admission episodes and the rate of in year discharge episodes for the specified diagnosis per 1,000 hospital discharge episodes, have been placed in the Library. This does not represent how many patients were admitted or discharged with these specified diagnosis as a person may have more than one admission/discharge episode within the year for a particular diagnosis. The figures are by per 1,000 hospital admission episodes rather than per 1,000 patient admissions.
Also, it is not possible to add the number of admission/discharge episodes in each of the three diagnosis categories (malnutrition, nutritional anaemia and other nutritional deficiencies) to obtain the total number of episodes with these diagnoses because it is possible that a patient could have more than one of the diagnoses recorded in their episode which means the same episode could appear in all three categories.
Mr. Stephen O'Brien: To ask the Secretary of State for Health pursuant to the answer of 18 December 2007, Official Report, column 1396W, on nutrition, what assessment he has made of the reasons for the trend in the diagnoses of (a) malnutrition, (b) nutritional anaemias and (c) other nutritional deficiencies since 1997-98. 
The trend of a greater number of discharge episodes than admission episodes does not imply that patients are becoming malnourished or developing nutritional anaemia/other nutritional deficiencies
during their time in hospital. It is not possible to compare admissions and discharges in this way because there are a number of reasons why we would expect there to be more discharge episodes than admission episodes with these diagnoses.
For example, a patient showing signs/symptoms of malnutrition etc. would often undergo various tests to establish the cause of the symptoms; it may not be until later (e.g. the patients last episode in a particular hospitaltheir discharge episode) that the results come back and a formal diagnosis of malnutrition can be made. Hence, waiting for test results could result in more diagnoses being recorded in the discharge episode.
Also, a diagnosis in the discharge episode will be the last diagnosis that a particular patient was being treated for. This does not mean that patients who have a discharge episode with a diagnosis of malnutrition/nutritional anaemia/other nutritional deficiencies were actually discharged from hospital still malnourished or with nutritional anaemia or other nutritional deficiencies.
It is not possible to add the number of admission/discharge episodes in each of the three diagnosis categories (malnutrition, nutritional anaemia and other nutritional deficiencies) to obtain the total number of episodes because it is possible that a patient could have more than one of the diagnoses recorded. This means the same episode could appear in all three categories.
The increase trend in finished in year admission and discharge episodes over time, is in part due to factors such as the improvements in quality/coverage of Hospital Episode Statistics data and clinical coding since 1997. These improvements in information submitted by the national health service have been particularly marked in the earlier years and need to be borne in mind when analysing time series.
Mr. Don Foster: To ask the Secretary of State for Health (1) how many children aged 11 to 16 years were considered (a) obese and (b) overweight in each year since 1997; 
(2) how many children under the age of 11 years were considered (a) obese and (b) overweight in each year since 1997. 
Dawn Primarolo: The information is not available in the exact format requested.
Data on the prevalence of overweight and obesity among children aged two to 10 and aged 11 to 15 years, since 1995, can be found in the Health Survey for England 2006 latest trends, published 31 January 2008. The data are presented in table 4 (obesity) of the Childrens trend tables 2006. A copy of the report and tables has been placed in the Library.
Mr. Jenkins: To ask the Secretary of State for Health when the last suicide prevention campaign aimed at school students was launched; and how much his Department has spent on suicide prevention in schools in each of the last five years. 
Jim Knight: I have been asked to reply.
The Government are committed to improving safeguards for children. That is why they have introduced new legislation, new guidance, new structures and new policy initiatives to make children safer and to ensure that there is a proper focus on children at the very heart of Government. A national suicide prevention strategy for England was launched by the Department of Health in September 2002 with the aim of supporting the target to substantially reduce the mortality rate from suicide and undetermined injury by at least 20 per cent. by 2010.
We are currently working with Papyrus on the prevention of young suicide and funding the expansion of their helpline called Hopeline UK. We are also putting £30 million into the NSPCC to expand and improve their services so that more children can be given advice and help. Action to tackle this complex problem also includes raising awareness of the potential dangers of suicide websites/chat rooms and working with Internet Service Providers to discourage them from hosting sites which may encourage suicide. The independent Byron review is looking into helping children and young people get the most from the internet whilst protecting them from inappropriate and potentially harmful material.
The Department does not collect data on how much schools spend on suicide prevention. However grant funding to local authorities for implementing the ten year programme of improvements for child and adolescent mental health services (CAMHS) set out in the National Framework for Children and Young People and Maternity Services (NSF) has increased from £10 million in 1999-2000 to £91 million in each financial year from 2003-04 to 2007-08. The Social and Emotional Aspects of Learning (SEAL) programme was created to develop all children and young people's social and emotional skills at school, which help to underpin emotional wellbeing. SEAL will be supported by an extra £13.7 million over four years, on top of the £7 million a year already confirmed, and the aim is that by 2010-11 SEAL will be available to all schools nationally. In addition from April we will invest an additional £60 million over three years to support schools to work with mental health practitioners and strengthen the provision of targeted mental health services for children and adolescents. We also announced plans in 2007 for an independent review of CAMHS.
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