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29 Feb 2008 : Column 1975W—continued


Incontinence: Medical Equipment

Harry Cohen: To ask the Secretary of State for Health (1) what steps he plans to take to ensure continued innovation of new products via proposed changes to the arrangements under Part IX of the Drug Tariff; [189450]

(2) what assessment he has made of the effect on the quality of patient care of the proposed changes to the arrangements under Part IX of the Drug Tariff; [189451]

(3) what assessment he has made of the effect on patient choice of the proposed changes to the arrangements under Part IX of the Drug Tariff. [189452]

Dawn Primarolo: The review of part IX of the Drug Tariff is ongoing; no decisions have been made.

Any proposed changes to the current arrangements would not be intended to stifle innovation. While the Department wishes to ensure both value for money for the national health service the maintenance of patient care, it also wants to ensure that any new arrangements are affordable by dispensing contractors and suppliers.

The Department’s assessment to date has been that the proposed changes to the arrangements under part IX of the Drug Tariff will ensure that no matter where in England a user of a stoma or urology appliance lives, her or his dispensing pharmacist or dispensing appliance contractor will dispense the appliance to the same standard. It is also of the view that these patients will have access to the same services no matter where they live, such as home delivery.

The Department’s view is that the proposed new arrangements would give patients greater choice as to who dispenses their appliance. It is also of the view that as no proposals have been put forward to remove any stoma or urology appliance from part IX of the Drug Tariff, patients—in consultation with their prescriber—will continue to have a full choice of appliances.

The process of consultation has afforded interested parties the opportunity to put forward their assessment
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of the proposed changes and a final impact assessment will be published later in the year and all parties will have the opportunity to comment on it.

Local Involvement Networks: Trafford

Mr. Brady: To ask the Secretary of State for Health what steps his Department has taken to put in place interim arrangements for the period between the closure of the Trafford Patient and Public Involvement Forum and the establishment of the Trafford Local Involvement Network. [190427]

Ann Keen: A local involvement network (LINk) transitional duty, which will be set out in regulations, will mean that for a period of up to six months, from 1 April 2008, local authorities (LAs) that have not yet successfully contracted with a host organisation, and as a result do not have working LINk arrangements in place, should make other arrangements for ensuring ‘LINks activities’ may be carried out. This could take a range of forms, although the LA itself will not be able to carry out the activities, nor will an national health service body.

We would expect LAs to invite local people and patient and user organisations with an interest in, and knowledge of, health and social care to participate in what will be the core group of the LINk when a host is appointed.

We strongly encourage LAs to seek people’s input. Many organisations already have in place stakeholder groups, members of which may well be ideally placed to form the basis of the LINk, whether it be on a transitional basis or the final version. Clearly existing members of Patients’ Forums are well placed to be involved early on, but LINks are to be formed of a much wider base and we have urged LAs seek the involvement of people involved in user and carer groups, and representatives from the wider voluntary and community sector too. Such action will help to ensure that a LA meets its transitional duty.

From 1 April 2008, Trafford metropolitan borough council will be responsible for ensuring that LINk activities take place in its area. Trafford Primary Care Trust (PCT) is working closely with Trafford Council and other partner organisations to establish a Trafford LINk.

Trafford PCT representatives are members on the following LINk related groups:

Trafford PCT is also a member of the Borough’s Local Strategic Partnership (Trafford Partnership). The primary purpose is to enhance the quality of life and prosperity for all Trafford’s residential and business communities. The PCT is currently involved in the development of Trafford Partnership’s Community Engagement Strategy.

After 1 April and LINks coming into force, Trafford PCT will continue engaging with its local population to ensure that commissioning processes are informed and influenced by the views and opinions of local people.


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NHS: Hearing Impaired

Mr. Jim Cunningham: To ask the Secretary of State for Health what steps the Government has taken to improve NHS services for hearing and balance disorders. [189144]

Mr. Ivan Lewis [holding answer 28 February 2008]: The Department published an audiology framework in March 2007, “Improving Access to Audiology Services in England”, to help local health systems to transform the experience of the audiology service for all their patients, including those with hearing and balance problems. Further good practice guidance on audiology services, including hearing and balance disorders will be published later this year.

NHS: Private Sector

Anne Milton: To ask the Secretary of State for Health (1) if he will place copies in the Library of all guidance his Department has issued to the NHS on the mixing of public and private treatment (a) within an episode of care and (b) within a care pathway; how he defines an episode of care for the purposes of the former; when the guidance was last updated in each case; and if he will make a statement; [188052]

(2) what his Department’s policy is on the mixing of public and private treatment (a) within an episode of care and (b) within a care pathway; and if he will make a statement; [188053]

(3) what representations he has received from hon. Members, ( a ) members of the public, ( b ) clinicians and ( c ) other interested parties on mixing NHS and private treatment in the last six months; what the content was of these representations; and if he will make a statement. [188054]

Mr. Bradshaw: It is a long-standing principle that an individual cannot simultaneously be a national health service and a privately funded patient of the same national health service hospital within the same episode of care. Allowing top-up payments would risk creating a two-tier service, undermining the core principle of the NHS that treatment is provided free at the point of use, based on clinical need, not ability to pay. I also refer the hon. Member to the reply given to the hon. Member for Ribble Valley (Mr. Evans) on 18 December 2007, Official Report, columns 723-24.

Guidance issued to the NHS has established the basic principles of clear separation of public and private treatment. It is for NHS organisations to form policy in line with this guidance and decide the extent of an episode of care or care pathway where a patient decides to self-fund a treatment.

Copies of the guidance are available in the Library. I refer the hon. Member to the reply given to the hon. Member for Christchurch (Mr. Chope) on 22 January 2008, Official Report, column 1939W, for details of the guidance.

The Department has received a small number of representations from hon. Members, clinicians and the public on the issue of combining privately funded and NHS funded treatments in the last six months.


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NHS: Standards

Mr. Stephen O'Brien: To ask the Secretary of State for Health on what dates in the last six months officials in his Department discussed the Quality and Outcomes Framework with representatives of the British Medical Association; what the content of the discussions was; and if he will make a statement. [189467]

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 attended only one meeting of the Quality and Outcomes Framework (QOF) Negotiating Sub Group, on 23 August 2007 as an observer. Wider meetings between departmental officials and representatives of the GPC do also take place regularly but not specifically to discuss changes to the QOF.

Mr. Stephen O'Brien: To ask the Secretary of State for Health pursuant to the answer to the hon. Member for South Cambridgeshire of 8 October 2007, Official Report, column 300W, on NHS: standards, whether the team of experts appointed by NHS Employers and the British Medical Association submitted reports to Ministers to inform the review of the Quality and Outcomes Framework for 2008-09. [190244]

Mr. Bradshaw: The expert panel reports written as part of the evidence gathering phase of the development of the Quality and Outcomes Framework (QOF) are not submitted to Ministers. The reports are submitted to the QOF subgroup to inform the confidential negotiations between NHS Employers and the General Practitioners Committee of the British Medical Association, during negotiation of the general medical services contract. The negotiated agreement is subject to approval by Ministers.

Obesity: Greater London

Mr. Hoban: To ask the Secretary of State for Health what estimate he has made of the number of obese people in each London borough in each of the last 10 years; and what steps he is taking to reduce obesity in London. [189295]

Dawn Primarolo: It is for primary care trusts (PCTs) to monitor the prevalence of obesity in their area and put in place strategies to address the situation. From April 2008, tackling child obesity will be a national priority for PCTs, working with their local partners. This was this set out in the national health service operating framework in December 2007.

More generally, the 2007 comprehensive spending review resulted in a new ambition to reverse the rising tide of obesity and overweight in the population by enabling everyone to achieve and maintain a healthy weight. Our initial focus is on children: by 2020, we aim to reduce the proportion of overweight and obese children to 2000 levels. The Government have mapped out how this ambition will be delivered in a new £372 million comprehensive cross Government strategy, “Healthy Weight, Healthy Lives”, launched in January
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2008. It identifies the following areas for action: children’s health, healthier food choices, physical activity, health incentives and personalised advice and support.

Obesity: Health Education

Mr. Lansley: To ask the Secretary of State for Health (1) what public health campaigns targeted at the prevention and management of obesity his Department ran in each of the last five financial years; and what the (a) start and (b) end date was of each campaign; [179121]

(2) how much his Department (a) allocated to and (b) spent on public health campaigns targeted at the prevention and management of obesity in each of the last five financial years for which figures are available. [179122]

Dawn Primarolo: Over the past five years, the Department has funded a range of initiatives and materials demonstrating its commitment to the prevention and management of obesity.

The following table gives more information:

£ million
Campaign Started 2002-03 2003-04 2004-05 2005-06 2006-07

5 a Day

2002- ongoing

0.50

0.48

1.03

0.90

0.92

Maternal infant nutrition

ongoing

0.28

0.46

0.75

0.74

0.73

School fruit and veg

2001- ongoing

0.3

23.7

37.41

36.21


For obesity campaigns figures are only available for two financial years. In 2006-07 £6.1 million was allocated to obesity campaigns and £1.3 million spent and for 2007-08 the budget allocation was £2.47 million and the forecast is that we will spend £2.6 million.

Obesity: Surgery

Daniel Kawczynski: To ask the Secretary of State for Health how his Department monitors primary care trusts’ compliance with guidelines from the National Institute for Health and Clinical Excellence on obesity surgery. [187694]

Dawn Primarolo: Performance in implementing National Institute for Heath and Clinical Excellence (NICE) clinical guidelines is included within the scope of the Healthcare Commission’s Annual Health check. The 2006-07 annual health check self-assessments, which have been subject to targeted and random inspections by the Healthcare Commission, show that 90 per cent. of national health service trusts have assessed themselves as making excellent, good or fair progress towards implementing NICE’s clinical guidelines (obesity having a 96.7 per cent. compliance). The full ratings have been published on the Healthcare Commission’s website at:


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Organs: Donors

Gordon Banks: To ask the Secretary of State for Health (1) what response he has made to the recent report of the Organ Donation Taskforce; and if he will make a statement; [188617]

(2) what estimate he has made of the potential increases in organ donations possible within the parameters of existing arrangements over the next five years; [188618]

(3) what steps his Department is taking to improve the infrastructure related to organ donations, with particular reference to histocompatibility and immunogenetics laboratories; [188620]

(4) what steps he is taking to encourage older people to become organ donors; [188621]

(5) what steps he is taking to encourage more organ donations from within black and ethnic communities; [188622]

(6) what research his Department has commissioned on providing recognition for the families of organ donors; [188623]

(7) what estimate he has made of the potential costs of the additional training for staff recommended by the Organ Donation Taskforce; [188624]

(8) what assessment he has made of the Organ Donation Taskforce’s recommendations on a centralised system for organ donation which is UK-wide; [189201]

(9) what assessment he has made of obstacles within the system of organ donation to ensuring greater availability of organs for transplant; and if he will make a statement; [189202]

(10) what assessment he has made of the Organ Donation Taskforce’s recommendation on the reinforcement of training in organ donation and the provision of regular refresher training for staff; [189203]

(11) what steps he is taking to increase the numbers of organ donor transplant co-ordinators; [189216]

(12) what recent discussions he has had on the creation of a UK-wide organ donation ethics group. [189218]

Ann Keen: The Government welcome the first report, “Organs for transplants: A Report from the Organ Donation Taskforce”, and recommendations of the Organ Donation Taskforce, published on 16 January 2008, which have been accepted by all four United Kingdom Health Ministers. A copy of the report is available in the Library. The report usefully identifies the current barriers to donation in the UK and the investment necessary in the infrastructure to see organ donor rates rise to match other successful countries and achieve a 50 per cent. increase within five years.

Funding of £11 million has been made available for 2008-09 with significant additional funding identified for subsequent years. Work has started with stakeholders to agree what further action, such as research, public awareness campaigns, training and work force requirements, is needed to enable each recommendation to be implemented.


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