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Charlotte Atkins: To ask the Secretary of State for Health what percentage of services at Burton Independent Sector Treatment Centre has been taken up by patients (a) across the whole contract, (b) from within the North Staffordshire Primary Care Trust area, (c) from within the Stoke-on-Trent Primary Care Trust area and (d) from within the South Staffordshire Primary Care Trust area (i) in 2006-07 and (ii) at present. 
[holding answer 19 March 2008]: Utilisation data for the Burton independent sector treatment centre (ISTC) contract as a whole were collected for the financial year 2006-07 in line with the Department's contractual requirements. In addition to this, for the year 2007-08, the local national health
service with support of the Central Contract Monitoring Unit of the Department's Commercial Directorate decided also to collect primary care trust (PCT) based data to support intensive efforts to improve overall utilisation and PCT specific initiatives. This was part of a range of initiatives that have improved utilisation in all PCTs and therefore the contract as a whole.
|2006-07||2007-08 (up to 31 January 2008)|
| Note: PCTs are contracted to refer an agreed value of activity to the ISTC and utilisation shows the percentage of their agreed value that has actually been used.|
Mr. Lansley: To ask the Secretary of State for Health pursuant to the Answer of 27 February 2008, Official Report, column 1734W on care homes, if he will break down the statistics provided by (a) region and (b) local authority. 
Mr. Ivan Lewis: Information provided by the Commission for Social Care Inspection has been placed in the Library. The information shows the numbers of care homes for older people with scores of 1standard not metand 2standard not met with minor shortfallagainst each of the National Minimum Standards for the year ending 31 March 2007.
(2) how many (a) recorded incidents of and (b) deaths attributed to (i) MRSA and (ii) clostridium difficile in (A) care homes and (B) other community settings there were in each of the last five years. 
Ann Keen: The information requested is not available however the Health Protection Agencys (HPA) mandatory surveillance scheme provides some limited information for methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections.
Death certificates record the place where a person dies, but not where any infections may have been acquired. It is not possible from the information on a death certificate to know whether an infection was acquired in the care home or other place where a patient died. Patients are often transferred between hospitals, nursing/care homes and other establishments and may acquire infections in a different place from where they died.
Mr. Lansley: To ask the Secretary of State for Health how many care homes for the elderly were closed (a) temporarily and (b) permanently on grounds of failure (i) to meet national minimum standards and (ii) to comply with conditions placed on them as a result of not meeting national minimum standards in each of the last three years. 
Mr. Ivan Lewis: We have been informed by the Commission for Social Care Inspection (CSCI) that, during the current inspection year, from 1 April 2007-29 February 2008, there have been eight urgent and 16 non-urgent de-registrations of care homes for older people.
While CSCI keeps individual records containing the history and reasons for closures of older peoples care homes, it does not hold overall statistics that would enable the numbers of de-registrations to be broken down into the categories requested.
Mrs. Curtis-Thomas: To ask the Secretary of State for Health (1) what guidance is given by (a) his Department and (b) NHS trusts to clinicians on substantiating clinical opinion and medical diagnosis prior to the instigation of child protection measures; 
(2) how many child protection investigations were initiated by the Royal Liverpool Childrens NHS Trust in (a) 2005 and (b) 2006; and in what percentage of these cases a child was shown to be (i) in need of and (ii) not in need of protection; 
Ann Keen: We understand that the Childrens Safeguarding team at the Rainbow Centre at Alder Hey Childrens Hospital, Liverpool, which is a part of the Royal Liverpool Childrens NHS Trust, sees on average 40 children per month, taken from a large catchment area that includes the boroughs of Liverpool, Knowsley and South Sefton. We do not have any further information on the percentage of cases at the Rainbow Centre where children did or did not need protection.
The Governments guidance for organisations working with children including both primary care trusts and NHS trusts are contained in Working Together to Safeguard Children, published by the Stationery Office in April 2006, copies of which are available in the Library. This sets out a whole chapter (chapter 5) on managing individual cases and a chapter (chapter 2) on roles and responsibilities has a section on health services. National health service trusts are not required to publish data on the number of child protection investigations undertaken.
A diagnosis of child abuse is not a matter for a clinician alone, but would be for multi-disciplinary decision. Primary care trusts and NHS trusts are
required to work with local authorities in the establishment of Local Safeguarding Children Boards (LSCBs) and as statutory partners. The LSCBs ensures that the duty to safeguard and promote the welfare of children is carried out appropriately.
Ann Keen: No recent assessment has been made of podiatry services in London. It is for local primary care trusts to determine how best to use their funds to meet national and local priorities for improving health services, including podiatry, and to commission services accordingly.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what progress has been made in implementing the targets for the national service framework for long-term conditions in Eddisbury. 
Ann Keen: It is for individual primary care trusts (PCTs), including Western Cheshire PCT and the Central and Eastern PCT, within the national health service to develop locally the levels of service described in the National Service Framework for Long-term (Neurological) Conditions (the NSF). The NSF has a 10-year implementation programme from its publication in March 2005, with flexibility for organisations to set the pace of change locally to take account of differences in local priorities and needs. A copy of the NSF is available in the Library.
Information on the progress that has been achieved locally with regard to the implementation of the targets set out in the NSF can be obtained direct from Western Cheshire PCT and the Central and Eastern PCT.
Damian Green: To ask the Secretary of State for Health how many dentists accepting NHS patients in Ashford he estimates will have used all their units of dental activity before the end of the financial year. 
Ann Keen: The Department does not assess the performance of individual dental providers. Primary care trusts, as the commissioning bodies, are responsible for monitoring the delivery of services by their local dental providers.
Damian Green: To ask the Secretary of State for Health what estimate he has made of the number and percentage of the population of (a) children and (b) adults in (i) the South East of England and (ii) Kent who were seen by an NHS dentist in each of the last five years. 
Ann Keen: The number of patients seen in a 24-month period replaced registration as a measure of access to national health service dentistry on 1 April 2006. Under the old contractual arrangements, which were in place up to and including 31 March 2006, access was measured through the number of patients registered with an NHS dentist. This measure is not directly comparable to the patients seen measure used under the new contractual arrangements.
The number and percentage of the population registered with an NHS dentist in England at 31 March each year from 1997 to 2006 are available in Annex A and Annex B of the report NHS Dental Activity and Workforce Report, England: 31 March 2006. The information is provided for children and adults by primary care trust (PCT) and strategic health authority (SHA).
The number and percentage of the population seen by an NHS dentist in the 24-month periods ending 31 March 2006, 31 March 2007, 30 June 2007 and 30 September 2007 are available in tables Cl and C2 of Annex 3 of the report NHS Dental Statistics for England: Quarter 2, 30 September 2007. The information is provided for children and adults by PCT and SHA.
Ann Keen: The Governments fundamental reform programme for primary dental care services was introduced from 1 April 2006. Primary care trusts (PCTs) were given responsibility for planning and commissioning primary dental services and provided with local, devolved, dental budgets.
Wirral PCT reported the following expenditure on primary dental care services in 2006-07, the first year of the new service arrangements. This has been set out in the following table. However, data on expenditure by individual parliamentary constituency are not collected centrally.
|National health s ervice expenditure on primary dental care services, Wirral PCT, 2006-07|
Resource expenditure, as noted in end year accounts
Prior to April 2006, most primary dental care services were provided under former general dental service (GDS) arrangements. These were demand led services where the pattern of dental expenditure was largely determined by where dentists chose to practice, and how much NHS work they chose to undertake. PCTs were not given fixed funding allocations, except in those areas where personal dental services (PDS) pilots were established to test alternative, local commissioning arrangements and new forms of contract remuneration.
Local level data on primary dental care expenditure prior to April 2006 is held by the Information Centre for health and social care. Copies of the report NHS Expenditure for General Dental Services and Personal Dental Services: England 1997-98 to 2005-06 have been placed in the Library and is also available at:
Mr. Bradshaw: The figures in the table are the agreed contract costs associated with the provision of all horticultural services to the Department across its estate. It is not possible to break down these figures further. The figures include the salary costs of the contract personnel. Figures in each of the last five years are as follows:
Damian Green: To ask the Secretary of State for Health how many attacks on NHS staff have been reported by (a) Eastern and Coastal Kent Primary Care Trust, (b) East Kent Hospitals NHS Trust and (c) their predecessor Trusts in each of the last five years. 
In April 2003 the National Health Service Security Management Service (NHS SMS) was created and assumed responsibility for tackling violence against NHS staff. Since 2004-05 the NHS SMS has collected statistics for the number of reported physical assaults against NHS staff.
|Violent incidents||Physical assaults|
|(1) On 1 October 2006, the mentioned primary care trusts merged to form Eastern and Coastal Kent primary care trust.|
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