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26 Feb 2008 : Column 1473W—continued

Primary Care Trusts: Maternity Services

Mr. Hancock: To ask the Secretary of State for Health by what date primary care trusts are expected to have published their annual prospectuses, including their local vision for maternity services under the Maternity Matters strategy. [185018]

Ann Keen: The national health service operating framework for 2007-08 states that primary care trusts (PCTs) should produce their first prospectus during 2007-08. The prospectuses should include PCT proposals for increasing choice and improving maternity services as outlined in ‘Maternity Matters’.

It is for strategic health authorities to ensure that PCTs complete their prospectuses and publish them.

Prostate Cancer

Mr. Lansley: To ask the Secretary of State for Health how many cases of prostate cancer he estimates there will be in (a) 2011, (b) 2016 and (c) 2021; how many cases of prostate cancer there were in 2006; and what estimate he has made of the (i) inpatient, (ii) outpatient and (iii) other costs of treating prostate cancer in (A) 2006, (B) 2011, (C) 2016 and (D) 2021. [184258]

Ann Keen: Estimates for cases of prostate cancer in individual years are not available, but estimates for the average annual registrations over a five year period are available:

Time period Number of cases







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These estimates are projected from incidence rates from 1974-2003. Projections are not given for individual years because these would be subject to wide uncertainty.

The number of cases of prostate cancer in 2006 is not currently known, the most recently available data are for 2005, in which there were 28,886 registrations.

The estimate of inpatient costs for prostate cancer are:

Time period Average annual cost (£ million)







All the cost estimates are in 2005-06 prices. The inpatient cost figures relate to admissions with a primary diagnosis of prostate cancer, and excludes chemotherapy and radiotherapy costs. It is not possible to provide reliable estimates of any other element of prostate cancer treatment costs because of the lack of appropriate data.

Mr. Lansley: To ask the Secretary of State for Health what estimate he has made of the mean waiting time for a patient with prostate cancer between (a) their first clinic appointment and (b) diagnosis in each year since 1997. [184263]

Ann Keen: Information on average waiting times between first outpatient attendance and diagnosis for cancer patients are not collected centrally and have not been estimated. The Department currently receives aggregate data on cancer waiting times that relate to the standards within the National Health Service Cancer Plan (2000).

For those patients following the 62-day referral to treatment pathway the Department monitors the time taken to complete the entire pathway. Performance against this standard for the most recent period for which figures are available (July, August and September 2007-08) was 97.2 per cent.

Mr. Lansley: To ask the Secretary of State for Health what assessment he has made of the (a) actual and (b) optimum workloads of sites offering prostatectomies, expressed in terms of the number of operations per site. [184278]

Ann Keen: The National Institute for Health and Clinical Excellence (NICE) issued guidance on “Improving Outcomes in Urological Cancers” in September 2002. It stated that:

The guidance went on to recommend that

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This guidance was converted into a series of measures for inclusion in the “Manual of Cancer Services 2004” against which cancer networks are peer reviewed. The Manual includes measures to assess:

If teams were not compliant with the criteria set out in the improving outcomes guidance during the peer review, the peer review team would have raised this as an immediate risk with the trust chief executive or their representative on the day of the visit following up this concern in writing. A trust would be expected to address this concern as a matter of urgency.

Individual cancer networks’ performance against these measures in the 2004 to 2007 round of the national cancer peer review would be set out in their local peer review reports. These reports are available on the Cancer Quality Improvement Network System website at:

A summary report of the 2004 to 2007 national cancer peer review process will be issued shortly.

Mr. Lansley: To ask the Secretary of State for Health what recent estimate he has made of the proportion of prostate cancer patients who are cared for by a multidisciplinary team. [184279]

Ann Keen: The recent round of cancer peer review (2004 to 2007) found that in 92 per cent. of local urology teams and 98 per cent. of specialist urology teams, all new patients with urological cancer, including prostate cancer, were reviewed by a multi-disciplinary team.

Prostate Cancer: Staff

Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 18 December 2007, Official Report, column 1407W, on prostate cancer: staff, when the Leeds Teaching Hospitals NHS Trust plans to initiate its pilot to enhance multi-disciplinary team working and improve the quality of surgical techniques available to prostate cancer patients; when he expects the pilot to conclude; whether any interim findings have emerged from the development of the pilot; when he expects a final report on the pilot to be published; what funding his Department has provided in support of the pilot in (a) 2006-07 and (b) 2007-08; what funding his Department plans to provide in support of the pilot in 2008-09; and if he will make a statement. [184463]

Ann Keen: The prostate cancer multi-disciplinary team training programme was started in February 2007 with the appointment of Leeds Teaching Hospitals NHS Trust to deliver the pilot programme. The trust has been recruiting the necessary staff to develop and evaluate the research elements of the programme with the first training courses due to be delivered in spring 2008. The evaluation report is to be delivered at the end of the 18 month training programme. The pilot is funded by London strategic health authority on behalf
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of the national cancer action team with £190,000.00 being made available in 2006-07. Future funding levels will be agreed with the trust based on planned deliverable training activity.

Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 18 December 2007, Official Report, column 1407W, on prostate cancer: staff, in what ways (a) his Department and (b) the Healthcare Commission monitors progress against the action plans submitted by strategic health authorities to implement the improving outcomes in urological cancers guidance; what progress has been made to date; and if he will make a statement. [184465]

Ann Keen: Strategic health authorities (SHAs) submit six monthly reports to the Department to confirm whether their cancer networks have met any improving outcomes guidance (IOGs) milestones that had been due in the preceding six month period and also to confirm if future milestones are on schedule to be met.

The national health service cancer action team works closely with the cancer networks and the Department’s Recovery and Support Unit liaises with SHAs where deadlines are unlikely to be met to ensure recovery plans are in place.

The Healthcare Commission expects primary care trusts (PCTs) to support the development of agreed action plans within cancer networks as well as to ensure services are commissioned in line with agreed action plans to achieve full implementation of these IOGs. The Department shares information on progress with the Healthcare Commission. The Commission use this information to inform the ratings they give to individual PCTs.

Radiotherapy: Waiting Lists

Mr. Baron: To ask the Secretary of State for Health further to the publication of the Cancer Reform Strategy, when he estimates that NHS providers will have sufficient capacity to meet the 31 day waiting time standard for all radiotherapy; and what the timetable is for ensuring that the recommendations set out in the National Radiotherapy Advisory Group's report are achieved. [183987]

Ann Keen: The Cancer Reform Strategy set a deadline for extension of the 31-day waiting time standard of December 2008 for chemotherapy and surgery. The deadline for extension of the 31-day standard for radiotherapy is December 2010. The later date for radiotherapy is in recognition of the length of time needed to increase radiotherapy capacity, for example building bunkers and purchasing and installing machinery.

The National Radiotherapy Advisory Group recommended that radiotherapy services should be developed to deliver up to 54,000 fractions per million population throughout the country by 2016, with an interim aim of delivering 40,000 fractions per million population by 2010. In addition, all departments were, as an immediate aim, to deliver at least 8,000 fractions per linac (linear accelerator) per year; increasing to at least 8,300 fractions per linac per year by 2010-11, and at least 8,700 fractions per linac per year by 2016.

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Mechanisms for reviewing progress are under discussion. A national radiotherapy dataset is being developed and will be used from April 2009 to help monitor progress in radiotherapy centres around the country.

Sexually Transmitted Diseases: Drugs

Norman Lamb: To ask the Secretary of State for Health how many recorded cases of drug resistant gonorrhoea have been confirmed in each of the last five years; what steps he has taken to tackle drug resistant gonorrhoea; whether he has received representations on (a) penicillin, (b) tetracycline and (c) fluoroquinolone resistant gonorrhoea; how many representations he has received on antibiotic resistance
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relating to the treatment of gonorrhoea; and if he will place in the Library copies of such representations. [187202]

Dawn Primarolo: The Gonococcal Resistance to Antimicrobial Surveillance Programme (GRASP) funded by the Department and run by the Health Protection Agency, monitors gonococcal antimicrobial resistance at a number of sentinel sites in England and Wales. The percentages of gonorrhoea isolates from genito-urinary medicine (GUM) clinic patients submitted to GRASP in England and Wales between 2002 and 2006 which had confirmed resistance to penicillin, tetracycline and ciprofloxacin (a fluoroquinolone) are contained in the following table:

Percentage of isolates resistant to specific antimicrobials, 2002-06
Antimicrobial 2002 2003 2004 2005 2006

Penicillin (MIC> = l mg/l)






Tetracycline (MIC> = 2 mg/l)






Ciprofloxacin (MIC> = l mg/l)






1. MIC means minimum inhibitory concentration and is defined as the lowest concentration of an antimicrobial that will inhibit the visible growth of a micro-organism after overnight incubation. The MICs shown for the specific antimicrobials define the cut-off for resistance to these antimicrobials.
2. Due to variations in the retrieval and confirmation of isolates submitted in different years, the data on resistance prevalence are statistically weighted. This is done to avoid resistance estimates being under representative of sites that have a low retrieval rate and over representative of sites that have a high retrieval rate.
GRASP from specimens collected at genito-urinary medicine clinics.

Data from GRASP provide the evidence-base for treatment guidelines in the management of gonorrhoea. In 2002, this led to prescribing policy being updated to recommend that gonorrhoea should be treated with third generation cephalosporins, ceftriaxone or cefixime. Further information is contained in the GRASP annual report (year 2006 collection) which has been placed in the Library. No specific representations have been received by the Department on this issue.

Skin Cancer

Mr. Jenkins: To ask the Secretary of State for Health what the age is of (a) the youngest and (b) the oldest skin cancer patient who have been diagnosed where use of sunbed salons has been a contributing factor in their condition. [187729]

Angela Eagle: I have been asked to reply.

The information requested falls within the responsibility of the National Statistician, who has been asked to reply.

Letter from Colin Mowl, dated 26 February 2008:

Testicular Cancer: Screening

Mr. Jim Cunningham: To ask the Secretary of State for Health what steps the Government have taken to promote screening for testicular cancer. [188541]

Ann Keen: There is no effective screening method for testicular cancer, therefore no action has been taken to promote screening for testicular cancer.

Testicular cancer is almost always curable if found early and the Department has collaborated with Cancer Research UK in the production of a testicular self-awareness leaflet, “Testicular Cancer: Spot The Symptoms Early”. Over 300,000 copies of this leaflet are printed each year.

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