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Matthew Taylor: To ask the Secretary of State for Health what percentage of accident and emergency patients in Cornwall had a trolley wait of over four hours in the latest period for which figures are available. 
Mr. Bradshaw: Information on the percentage of patients not placed in a bed, in a ward, within four hours of a decision to admit (commonly referred to as a trolley wait) is reported by National Health Service Hospital Trusts.
This is published quarterly as part of the Departments Quarterly Monthly Accident and Emergency (A and E) Services Central Return (QMAE) dataset. Information is collected at trust level, and Royal Cornwall Hospitals NHS Trust reports that 0.2 per cent. of patients were in this position for the period July to September 2007. This is the latest period for which figures are available.
Mr. Bradshaw: Information relating to the number of ambulances operating in Lancashire, including those in Chorley, as well as the number of paramedics who might be based in Chorley, is not held centrally. These data can instead be obtained direct from the North West Ambulance Service NHS Trust.
Tony Baldry: To ask the Secretary of State for Health how many people have been diagnosed with (a) aphasia, (b) dyspraxia and (c) dysproxia, broken down by (i) strategic health authority area, (ii) primary care trust and (iii) constituency in each of the last three years. 
Mr. Mullin: To ask the Secretary of State for Health what recent representations he has received on establishment of a national strategy on autism and Asperger's syndrome; and if he will make a statement. 
However, I recently attended the launch of the National Autistic Society's I Exist campaign which calls on the Government to demonstrate national leadership by encouraging implementation of good practice at a regional and local level.
Better Services for people with an autistic spectrum disorder: A note clarifying current Government policy and describing good practice was published on 16 November 2006. It clarifies the nature and intent of existing Government policy as it relates to adults with an autistic spectrum disorder (ASD). A copy of this document is available in the Library.
Tim Loughton: To ask the Secretary of State for Health how much was paid out in financial support schemes or discount schemes by hospitals for family costs incurred while babies needed care in a neonatal unit last year; and how many families used this service. 
Mr. Baron: To ask the Secretary of State for Health pursuant to the answer of 4 February 2008, Official Report, columns 870-72W, on Basildon Hospital: clostridium, when information for January to December 2007 will be made available. 
Ann Keen: The Health Protection Agency publishes these data on their website and final figures for the year January to December 2007 for all NHS acute trusts in England, including Basildon and Thurrock University Hospitals Foundation Trust, will be available in July 2008. Once this information is available, a copy will also be placed in the Library.
Mr. Baron: To ask the Secretary of State for Health what steps he is taking to ensure that the Eastern regional bowel cancer screening hub (a) catches up and (b) keeps pace with other regional hubs in terms of (i) invitations sent, (ii) kits sent and (iii) kits returned. 
Ann Keen: The pace of rollout in each screening hub is governed by a strategy agreed with the local strategic health authorities which reflect local circumstances. The roll-out of bowel cancer screening is administered from the Eastern Regional Bowel Cancer Screening Hub.
Mr. Baron: To ask the Secretary of State for Health further to the publication of the Cancer Reform Strategy, by what means he plans to measure the extent to which (a) primary care trusts and (b) cancer networks give high priority to raising public awareness of cancer risk factors; and what sanctions there will be for (i) primary care trusts and (ii) cancer networks which do not do this. 
Primary care trusts (PCTs) are funded to meet the healthcare needs of their populations, which will include the provision of cancer services. PCTs are expected to plan for and commission services, and to monitor delivery of those services against local agreements. PCT and cancer networks are jointly responsible for making local decisions about the services needed, and
are expected to use local information to assess the need for local awareness initiatives. PCTs are responsible for driving and managing change locally.
Mr. Baron: To ask the Secretary of State for Health further to the publication of the Cancer Reform Strategy, what the timetable is for ensuring that GPs and primary care professionals have fast access to relevant diagnostic tests for cancer; and how he plans to measure progress towards this objective. 
Ann Keen: It is the responsibility of primary care trusts to ensure that general practitioner and primary care professionals have appropriate and timely direct access to diagnostic tests, and to determine whether these diagnostic facilities should be provided in acute general hospitals or in community settings, on the basis of local circumstances and the needs of their local populations.
Mr. Lansley: To ask the Secretary of State for Health pursuant to the Answer of 14 January 2008, Official Report, column 992W, on cancer, whether the information on projected cancer in-patient costs placed in the Library expresses costs in real or cash terms. 
Anne Milton: To ask the Secretary of State for Health whether the National Cancer Director's forthcoming review of cancer drugs will evaluate geographical variations in the use of cancer drugs (a) approved by and (b) awaiting appraisal by the National Institute for Health and Clinical Excellence. 
Ann Keen: The National Cancer Director's forthcoming review of cancer drugs will evaluate the usage of National Institute of Health and Clinical Excellence (NICE)-approved cancer drugs. It will not evaluate the usage of cancer drugs awaiting appraisal by NICE.
Mr. Jim Cunningham: To ask the Secretary of State for Health what steps the Government have taken to reduce the incidence of death from cardiovascular disease among people under 75 since 1997. 
Ann Keen: The national service framework (NSF) for coronary heart disease (CHD) published in March 2000 sets a 10-year framework for action to prevent disease, tackle inequalities, save more lives, and improve the quality of life for people with heart disease.
The target set out in Saving Lives: Our Healthier Nation to reduce deaths from cardiovascular disease (CHD and stroke and related diseases) by 40 per cent. in people under 75 by 2010 has been met five years early. The mortality rate fell by 40.3 per cent. between 2004 and 2006 over the 1995-97 baseline. This means that we are now saving nearly 31,000 lives per year from cardiovascular disease.
Mr. Baron: To ask the Secretary of State for Health further to the publication of the Cancer Reform Strategy, what (a) target and (b) timetable he has for reducing the variation of cervical cancer screening coverage between primary care trusts; when he plans to measure the performance of this policy; and by what means. 
Ann Keen: It is for primary care trusts (PCTs) working in partnership with their strategic health authorities, local screening services and local stakeholders to provide appropriate cervical screening services for their local populations, which includes increasing coverage. Participation can be improved by engaging with potential users at a community level.
To incentivise services to encourage higher coverage, we will explore moving to an activity-based system for funding screening services. We are at the early stages of this exploration, and are focusing on how cancer screening can fit within the existing payment by results system. National health service cancer screening programmes will also encourage the sharing of best practice in improving accessibility for all groups. There is a need to ensure that health inequalities are tackled with targeted programmes that increase the uptake of screening in poor communities and in black and ethnic-minority communities. Commissioners in PCTs with low coverage will wish to develop these programmes.
We will continue to monitor levels of cervical screening coverage through the Office for National Statistics/Information Centre for health and social care annual Cervical Screening Statistical bulletin.
Mr. Baron: To ask the Secretary of State for Health further to the publication of the Cancer Reform Strategy, on what date he expects all women to be informed of the result of their cervical screening test within two weeks of its being taken. 
Mr. Baron: To ask the Secretary of State for Health further to the publication of the Cancer Reform Strategy what (a) target and (b) timetable he has set for tackling the falling participation of women aged 25 to 35 in cervical cancer screening. 
Ann Keen: It is for primary care trusts (PCTs) working in partnership with their strategic health authorities (SHAs), local screening services and local stakeholders to provide appropriate cervical screening services for their local populations, which includes tackling the falling participation in women aged 25 to 35.
In order to tackle the fall in coverage among younger women, national health service cancer screening programmes have commissioned the Improvement Foundation to undertake work at a local level targeting this age group. The lessons learned from this work, due to be completed in 2009, will be shared with SHAs and local screening programmes to develop best practice. The NHS cancer screening programmes press office is developing an information pack to be issued to all local screening programmes and is also developing a public relations strategy, including articles in appropriate media publications and posters. In addition, Cancer Research UK has commissioned research on this issue, which we will monitor closely. We will share the findings.
Continued local action in this area is also essential, and we will continue to monitor levels of cervical screening coverage through the Office for National Statistics/Information Centre for health and social annual Cervical Screening Statistical bulletin.
Ian Stewart: To ask the Secretary of State for Health on what evidential basis changes were made in 2005-06 to the NHS Direct Health Encyclopaedia in relation to possible causes of chronic fatigue syndrome, to remove references to altered immune response due possibly to infections such as glandular fever or hepatitis neurotoxins and to immunisation; and what medical references were taken into consideration. 
Mr. Stephen O'Brien: To ask the Secretary of State for Health how many patients were infected with (a) clostridium difficile and (b) MRSA as recorded by the mandatory surveillance system, broken down by NHS trust in 2006-07; and what those figures are per 1,000 admissions of patients aged over 65 years. 
Ann Keen: The mandatory surveillance system operated for the Department by the Health Protection Agency (HPA) provides data on the number of reports of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections and Clostridium difficile ( C. difficile) infection. All acute national health service trusts in England are obliged to report all cases of MRSA bloodstream infections and C. difficile infection processed by their laboratories and the data are published at trust level.
Mandatory surveillance of MRSA bloodstream infections was introduced in April 2001 and in 2004 for C. difficile for patients aged 65 and over, and has been extended to all patients aged two and over from April 2007.
Rates per 1,000 bed days are available for those aged 65 years and over for C. difficile in the above table for C. difficile. Rates for the over-65 age group are not available for MRSA. However, the MRSA enhanced surveillance scheme introduced in 2005 provides limited data. An analysis of data(1) for cases diagnosed between April 2006 and March 2007 where age was provided showed that 69 per cent. of cases occurred in people aged 65 years and over.
(1) SourcesHealth Protection Agency. Surveillance of healthcare associated infections report 2007
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