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Ann Keen: Information about the effectiveness of individual urology multi-disciplinary teams (MDTs) can be found within local cancer network peer review reports. These are in the public domain and can be accessed on the Cancer Quality Improvement Networks System website at:
Mr. Lansley: To ask the Secretary of State for Health what estimate he has made of the post-operative mortality rate for radical prostatectomy (a) in total and (b) broken down by strategic health authority area. 
Mr. Lansley: To ask the Secretary of State for Health how many representations his Department has received from (a) patients and (b) clinicians on treating prostate cancer on the NHS in the last six months; what the content of these representations was; and if he will make a statement. 
Ann Keen: The main forum through which patients and clinicians make representations to the Department of Health is the Prostate Cancer Advisory Group (PCAG). As part of our commitment to working in partnership, the Government welcomed the establishment of the Prostate Cancer Charter for Action in January 2003 and acted upon its call to establish the PCAG, chaired by Professor Mike Richards, the National Cancer Director. The overall remit of the PCAG is to facilitate collaboration between the Department, the voluntary sector and patient and professional groups to advise Ministers, the National Cancer Director and the Department on the development of policy on prostate cancer.
progress on the Cancer Reform Strategy (CRS);
the National Institute for Health and Clinical Excellence (NICE) clinical guideline on prostate cancer: diagnosis and treatment;
the pilot multi-disciplinary team training programme;
implementation of the NICE improving outcomes guidance (IOG) on urological cancers and
NICE cancer drug appraisals.
I met representatives of the Prostate Cancer Charter for Action on 7 November 2007, and treatment issues discussed were the important role of cancer nurse specialists, patient experience, the Career Research Society and clinical outcomes data.
In addition, since 1 August 2007, the Department has received 57 items of correspondence from patients and clinicians on a wide variety of subjects relating to prostate cancer. Since 6 November 2007, the Department has received 26 parliamentary questions on prostate cancer.
There are 1,556 extra cancer consultants since 1997 (a 49.3 per cent. increase) and 3,341 (65.7 per cent.) extra consultants in other specialties who spend a significant amount of their time caring for cancer patients.
Mr. Lansley: To ask the Secretary of State for Health what proportion of prostate cancer patients had prostate cancer diagnosed at (a) clinical stage I or II, (b) clinical stage III and (c) clinical stage IV in the latest period for which figures are available; and what assessment he has made of the way in which these proportions have changed over time. 
Ann Keen: The Department does not publish statistics on the stages at which prostate cancer is diagnosed. The Cancer Reform Strategy, published last December, highlights the need to collect and use high quality data on clinical outcomes with adjustments for stage of disease. Part of the new National Cancer Intelligence Networks work will be, in due course, to co-ordinate the collection and analysis of this data.
Mr. Lansley: To ask the Secretary of State for Health how many cancer networks have a (a) lead clinician, (b) nurse director and (c) service improvement lead for the Improving Outcomes Guidance for urological cancers. 
Ann Keen: In terms of the Improving Outcomes in Urological Cancers guidance, posts would be at multidisciplinary team (MDT) rather than cancer network level. The most recent round of peer review (2004-07) found that for urological cancer:
100 per cent. and 99 per cent. of local and specialist urological cancer MDTs had a lead clinician respectively;
96 per cent. and 100 per cent. of local and specialist urological cancer MDTs had a clinical nurse specialist respectively; and
92 per cent. and 96 per cent. of local and specialist urological cancer MDTs had service improvement leads respectively.
Mr. Lancaster: To ask the Secretary of State for Health (1) how many (a) operational and (b) non-operational posts are vacant in the Buckinghamshire division of South Central Ambulance NHS Trust; 
Ann Keen [holding answer 21 February 2008]: The requested information on the number of staff on sick leave, and the number of staff who have resigned is not collected centrally. These are matters for South Central Ambulance Service National Health Service Trust, and the hon. Member may wish to approach the Chief Executive of the Trust for this information.
Information on number of staff in post, and number of vacant posts is not available in the requested format. Information is held at NHS trust level, and is provided in the following tables, for all categories of staff at South Central Ambulance Service NHS Trust. Latest available information is for September 2006 and March 2007.
|Staff in the South Central Ambulance Service NHS Trust by main staff group and level as at 30 September 2006|
|South Central Ambulance Service NHS Trust||headcount|
| Source: The Information Centre for health and social care Non-Medical Workforce Census.|
|NHS three month vacancies in South Central Ambulance Service NHS Trust as at March 2007|
| Notes: 1. Vacancy data is from the Vacancies Survey 2007. 2. Three month vacancy information is as at 31 March 2007. 3. Three month vacancies are vacancies which trusts are actively trying to fill, which had lasted for three months or more (full time equivalents). 4. Vacancy numbers are rounded to the nearest whole number. Source: The Information Centre for health and social care Non-Medical Workforce Census.|
Tony Baldry: To ask the Secretary of State for Health what steps he is taking to improve access to speech and language therapy for people with communication difficulties following strokes; and if he will make a statement. 
Ann Keen: The National Stroke Strategy published last December sets out the vision for modernising services and delivering the newest treatments for stroke. The strategy makes clear that people who have had strokes should be able to access high-quality rehabilitation and receive support from stroke-skilled services as soon as possible after they have had a stroke, available in hospital, immediately after transfer from hospital and for as long as they need it. Stroke care networks are being developed to provide support for service providers and commissioners locally to improve the services they offer.
The national health service has the resources to fund these changes to stroke services, having seen record levels of investment and a period of significant expansion in the workforce. There has been a 36 per cent. increase in the number of speech and language therapists (SLTs) working in the NHS, bringing the total to 6,623 (NHS staff census September 2006 headcount). The number of SLTs entering training has increased by 65 per cent. since 1998-99. We acknowledge the significant value of SLTs in the management of swallowing, speech and communication disorders following a stroke. In addition we have announced spending proposals totalling £105 million to provide national support for implementation of the National Stroke Strategy.
In the United Kingdom, the Medicines and Healthcare products Regulatory Agency (MHRA) runs the Yellow Card Scheme. This scheme allows health professionals and patients to report suspected adverse drug reactions, which include suicides, on a voluntary basis. Over the last five years a total of 15 suspected adverse drug reactions of suicide
have been reported in association with isotretinoin (Roaccutane) through this scheme. It is important to note that a report of an adverse drug reaction does not necessarily mean that it was caused by the drug. Other factors such as an underlying illness or other medicines may have contributed. Severe acne itself is known to be associated with an increased risk of depressive illness.
The safety of isotretinoin has been closely monitored by the MHRA since it was approved in 1983. The benefits of isotretinoin in the treatment of acne are considered to outweigh the risk of adverse effects by regulatory authorities throughout Europe and worldwide.
Warnings about the risk of depression and suicidal behaviour were added to the product information for prescribers and patients in 1998. These warnings have been strengthened following a European review of the isotretinoin product information and most recently the Roaccutane Patient Information Leaflet has been subject to user testing to ensure that the information, including that about risk of suicidal thoughts and behaviour, is clear, comprehensive and understandable.
Mr. Bradshaw: We do not have exact figures on private operations but we do collect information on finished consultant episodes (FCEs). FCEs are different from operations because they also include other interventions such as high-cost drug treatments, diagnostic imaging, testing and rehabilitation. The latest figure is shown in the following table.
|Private FCEs carried out in national health service premises|
| Notes: 1. An FCE is defined as a period of admitted patient care under one consultant within one health care provider. 2. Data excludes a small proportion of invalid data. Source: Hospital Episode Statistics, The Information Centre for health and social care.|
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