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When the shortage of diamorphine first arose in December 2004, the remaining supplier immediately increased its production, and the Department took steps to ensure that adequate supplies of alternative painkillers were available. In addition, the Department issued an alert to the national health service via the chief medical officers cascade system, warning health care professionals about the shortage and advising them to avoid wastage, and to consider alternative painkillers wherever possible and reserve diamorphine supplies for those patients whose need was greatest. Both suppliers are now fully in production. The supply situation improved during 2007, and is expected to continue doing so during 2008.
Tom Brake: To ask the Secretary of State for Health how much funding his Department provided for people with disabilities to assist them with learning to use computers in each year since 2001. 
The Department has not collected separate statistics on how much funding it provides for specific groups to assist them with learning to use computers since 2001. The information requested can be provided only at disproportionate cost.
As part of the overall funding of the Governments e-learning strategy, funding was used to create infrastructure and was aimed at sectors such as further education and institutions such as colleges. The main thrust was to put technology in place, to develop the content of e-learning materials, including adaptations to enable ease of access by disabled people, and to develop staff to use technology with different groups. This has led to projects designed to support the effective use of computers by vulnerable groups such as disabled people.
For example, between 2004 and 2006 the Learning and Skills Council and the Joint Information Systems Committee provided £250,000 supporting 27 projects in specialist colleges designed to increase confidence and motivation among disabled learners and create innovative technical solutions to meet individual needs, including learners with complex disabilities.
Until 2005 the then Department for Education and Skills partly funded two national Aids to Communication in Education centres supporting learners with learning disabilities with grants of approximately £400,000 per year. These centres still exist and are self-financing.
My Department does recognise how important it is for disabled people to use computers effectively, and a number of projects have been established to improve usage and give disabled people the confidence and skills to use all forms of information and computer technology (ICT) effectively. As part of its responsibilities under the Disability Discrimination Act 1995, my Department ensures that its delivery partners are working to eliminate discrimination and this includes ensuring access to technology.
Mr. Jenkins: To ask the Secretary of State for Health what estimate he has made of the number of calls to the national drugs helpline which have been unanswered as a consequence of staff shortages in each year since the helpline's inception. 
The Central Office of Information (COI) advises that FRANK has received 2,114,533 telephone calls since its inception as at 31 December 2007. A total of 1,818,497 of those telephone calls were answered.
COI advise that overall there are no problems regarding staff shortages. Calls which are unanswered are as a consequence of callers who may hang up before speaking to a live adviser or who are routed to an interactive voice response system.
Anticipated demand can be exceeded owing to unknown media activitysomething relating to drugs appears on television or in the national daily press and the FRANK helpline number is quoted. In these instances, staffing levels are increased to cope with the peak according to their availability. However, despite this, there may be occasions when response performance varies.
Mr. Lansley: To ask the Secretary of State for Health on what dates representatives from his Department have met representatives of general practitioners to discuss changes to the quality and outcomes framework in the last six months. 
Mr. Bradshaw: NHS Employers conduct negotiations on the General Medical Services Contract with the General Practitioners Committee (GPC) of the British Medical Association. Officials from the Department are not normally present. Within the last six months, an official from the Department of Health attended only one meeting of the Quality and Outcomes Framework (QOF) Negotiating Sub Group, on 23 August 2007 as an observer. Wider meetings between Department officials and representatives of the GPC do also take place regularly but not specifically to discuss changes to the QOF.
Mr. Bradshaw: Regulations allow a practice to accept a person living outside its boundary on to its list of national health service patients if it wishes to do so. In accepting a patient, a practice has obligations to provide certain services such as home visits. If the practice is unable to fulfil this obligation, it is a reasonable ground to refuse a person living outside a practice area.
Mr. Walker: To ask the Secretary of State for Health what estimate he has made of the number of hours per week GPs spent on practice-based commissioning in the most recent period for which figures are available. 
Mr. Bradshaw: Primary care trusts will only grant a general practitioner practice closed list-status once both parties have made reasonable endeavours to keep the list open and the conclusion is that this is not possible.
The Department is currently exploring, as part of the Next Stages Review being undertaken by the Parliamentary Under-Secretary of State (Lord Darzi), whether further action is needed to better ensure patients have more choice of practices with which to register.
Mr. Walker: To ask the Secretary of State for Health what assessment he has made of the likely financial impact on GP surgeries of the removal of funding for choice and booking and access to directed enhanced services; and if he will provide financial support for surgeries which are adversely affected. 
Mr. Bradshaw: In each of the last two years, primary care trusts have invested £158 million, equating to an average £19,000 per practice, to fund the Access and Choice Directed Enhanced Services. It was always intended that these schemes would end on 31 March 2008. This money will be available to support PCTs and practices in agreeing improvement in patient access to their general practice.
Under proposals put to the General Practitioner Committee this money would be used by PCTs to pay general practices for providing extended opening of 30 minutes per week for every 1,000 patients on their list size. There would be no compulsion placed on practices to do this, but should an average GP practice of 6,000 patients take it up and provide the expected minimum three extended hours per week, it could expect to receive £19,000 per year. When practices choose not to provide such services to their patients, this money will not be available to them.
Mr. Lansley: To ask the Secretary of State for Health if he will estimate the overall cost to the public purse in (a) 2005-06, (b) 2006-07 and (c) 2007-08 of reviewing the quality and outcomes framework. 
Mr. Bradshaw: NHS Employers are funded by the Department to take forward negotiations with the General Practitioners Committee of the British Medical Association on changes to the General Medical Services Contract. Funding is not identified separately for the review of the Quality and Outcomes Framework (QOF) except for a contract for a period of three years starting from April 2006 to commission an independent expert panel to advise on the review of the QOF. The total value of the contract for the three-year period is £799,364 (excluding VAT).
Mr. Kidney: To ask the Secretary of State for Health what mechanisms his Department has to ensure the continuity of health and social care services provided for children with autism and Asperger's syndrome as they make the transition to adulthood. 
Mr. Ivan Lewis: The Department for Children, Schools and Families (DCSF) is the lead Department on transition from children's to adult services, and on social care for children. However, the Department of Health launched good practice guidance at a conference in March 2006, Transition: getting it right for young people, a copy of which is available in the Library. The same good practice guidance as applies to children with autistic spectrum disorders applies to those with any other condition. The 2007 report, Aiming High for Disabled Children proposed a transition support programme for 14 to 19-year-olds and DCSF has allocated £19 million to pilot arrangements.
Dawn Primarolo: We are aware of the considerable work my hon. Friend has done with Cuba through his chairmanship of the all-Party Parliamentary Group. However, owing to other commitments, Ministers have no plans to visit Cuba at the present time.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what plans he has to promote the involvement and consultation of patients and the public who receive NHS services through the third sector and the independent sector. 
Under section 242 of the National Health Service Act 2006, all NHS organisations are required to involve service users in the planning, development and
operation of health services. This duty does not apply directly to third-sector and independent-sector organisations.
NHS organisations which commission services from the third and independent sector must specify in their contractual arrangements that service users shall be systematically involved in the planning, development and operation of services, and that such involvement shall be evidenced and reported as part of contract performance.
The involvement of users in services provided by third-sector and independent-sector organisations shall be developed and promoted in the forthcoming statutory guidance for section 242 to be published in the summer of 2008.
Helen Southworth: To ask the Secretary of State for Health what steps his Department has taken to improve outcomes in coronary health care in (a) Warrington and (b) Cheshire in the last five years; and if he will make a statement. 
Ann Keen: The National Service Framework for Coronary Heart Disease, published in March 2000, set out 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. An estimated 178,000 lives have been saved since 1996.
The target set out in Our Healthier Nation (OHN) to reduce deaths from cardiovascular disease (coronary heart disease and stroke and related diseases) by 40 per cent. in people under 75 by 2010 has been met five years early. The mortality rate has fallen by 40.3 per cent. between 2004-06 over the 1995-97 baseline.
Inequalities in the death rate from heart disease, stroke and related diseases among the under-75s have been narrowing for the past eight years, and we are on track to meet a 40 per cent. reduction target in the gap by 2010. The death rate has reduced by 32 per cent. since 1995-97.
In addition, a £600 million programme of hospital building is continuing to provide new or expanded cardiac facilities in the places where they are most needed. There has been a £125 million investment in improved diagnostic and treatment facilities (combined departmental and national lottery fund money) which has supported the building and equipping of 90 new or replacement catheterisation laboratories in England, increasing the capacity previously available by more than 50 per cent.
More locally, a new cardiac catheter laboratory was opened at the Warrington general hospital in January 2006. The hospital also has a dedicated eight-bed coronary care unit providing monitoring and urgent treatment for patients with acute coronary conditions.
Mr. Greg Knight: To ask the Secretary of State for Health what research his Department has (a) commissioned and (b) evaluated on links between cardiac arrest survival rates and the time taken for the patient to reach a hospital. 
The national service framework for coronary heart disease and other guidance in this area is based on the best available evidence, and departmental policy recognises the importance of ensuring that an emergency ambulance response reaches the patient as quickly as possible. The ambulance response time target for calls to people with potentially life-threatening illnesses and conditions (which includes cardiac arrest) is for 75 per cent. of cases to be responded to within eight minutes irrespective of location.
For heart attack (blockage of a coronary artery by a blood clot which may lead to a cardiac arrest if not treated quickly), the Department has not commissioned research, but research results have been taken into account in the formulation of policy on heart attack treatment. There is accumulating evidence that angioplasty leads to better longer-term outcomes than clot-busting drugs even if it takes longer to deliver.
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