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6 May 2008 : Column 754W

Ambulance Services: Emergency Calls

Mr. Lansley: To ask the Secretary of State for Health how many medical 999 calls were made in each year since 1997, broken down by region; and what percentage of these resulted in ambulance dispatch in each region in each year. [203448]

Mr. Bradshaw: Calls made to national health service ambulance services through the 999-telephony line are not categorised by type of caller. Information on the number of 999 calls made by the medical profession is therefore not collected centrally. Ambulance services provide data against their trust’s response times to emergency 999 calls, which are collected each year by the Department on return KA34 and published annually in “Ambulance Services, England. Statistical Bulletin, collected in accordance with KA34”. In addition to emergency 999 calls, prior to 1 April 2007, trusts have also reported annual data on urgent cases (i.e. urgent patient journeys), where ambulance services were required to transport patients by an ambulance vehicle to hospital following a request from a doctor, midwife or other health care professional. Information on urgent patient journeys is published annually in the “KA34 statistical bulletin”.

Copies of the “KA34 statistical bulletin” are available in the Library.

Ms Dari Taylor: To ask the Secretary of State for Health (1) how many ambulance calls were made to ambulance call or control centres in (a) Middlesbrough and (b) Tyneside in 2007-08 or the most recent year for which information is available; [203769]

(2) how many ambulance calls made to the call centre in Middlesbrough in the last 12-month period for which information is available were from people in (a) Redcar/Cleveland, (b) Middlesbrough, (c) Darlington, (d) Hartlepool and (e) Stockton; [203797]

(3) how many 999 calls were made to ambulance or control call centres in (a) Middlesbrough and (b) Tyneside in 2007-08 or the most recent year for which information is available; [203798]

(4) how many ambulances arrived late at their destination as a result of being misdirected by the ambulance control centre in (a) Tyneside and (b) Middlesbrough in 2007-08 or the most recent 12-month period for which information is available; [203799]

(5) how many deaths occurred as a result of the ambulance service (a) being misdirected and (b) (i) arriving late and (ii) not arriving at the destination in the Teesside area of the North East, including Redcar, Cleveland, Middlesbrough, Darlington, Hartlepool and Stockton, in 2007-08 or the last 12-month period for which information is available. [203802]

Mr. Bradshaw: The information requested is not centrally collected. The data that the Department does collect on ambulance response times are published on an annual basis in the statistical bulletin, “Ambulance services, England. Statistical Bulletin collected in accordance with KA34”. These documents are available in the Library.


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Breast Cancer: Screening

Mr. Baron: To ask the Secretary of State for Health what steps he is taking to identify possible economies of scale in the procurement of digital mammography services. [203614]

Ann Keen: The ‘Cancer Reform Strategy’ stated that primary care trusts will need to give high priority to full implementation of digital mammography within the national health service breast screening programme, with all breast screening units having at least one full-field digital mammography set by 2010. Discussions are taking place on the most clinically and cost-effective method of achieving this aim.

Cancer: Health Services

Sandra Gidley: To ask the Secretary of State for Health what plans he has to improve support services for cancer patients. [201337]

Ann Keen: The “Cancer Reform Strategy”, published in December 2007, sets out a number of initiatives to improve patient support services for those living with and beyond cancer.

These initiatives include:

More detailed information on these measures is available in chapter five of the “Cancer Reform Strategy” a copy of which is available in the Library and on the Department’s website at:

Mr. Baron: To ask the Secretary of State for Health when he expects the National Cancer Intelligence Network to complete its framework enabling accurate comparisons of England’s cancer services with other countries; and when he plans to begin making such comparisons. [203610]

Ann Keen: The new National Cancer Intelligence Network (NCIN) will be launched on 18 June 2008. The NCIN will bring together relevant stakeholders to develop, build, maintain and quality assure a new national repository of cancer data.

The NCIN will also manage the delivery and publication of comparative national information on diagnosis, treatment and outcomes for types of cancer and types of patients.

During 2008, the NCIN will be collaborating closely with other countries to establish what comparisons can be made, and within what time scales. These plans will be outlined as part of the overall NCIN delivery plans, in the first annual report for 2008-09.


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Mr. Baron: To ask the Secretary of State for Health which costs associated with implementation of the cancer reform strategy will be met by his Department in each of the next five years; and what additional resources have been included in primary care trust allocations to cover other costs of implementing the strategy. [203611]

Ann Keen: The Impact Assessment published alongside the “Cancer Reform Strategy” sets out the estimated costs of implementing the strategy in each year. The funding to meet these expected costs is mainly being provided through primary care trusts (PCT) general allocations, with some costs met centrally. PCT allocations are not broken down into funding streams for individual services, and it is for the national health service to decide locally how best to deliver the outcomes set out in the strategy, and the actual level of resources required to do so.

Expected central programme budget expenditure in 2008-09 by the Department in support of the “Cancer Reform Strategy” is estimated at £8.6 million. Decisions on the split between central budgets and primary care trust allocations for later years have yet to be taken.

Mr. Baron: To ask the Secretary of State for Health what plans he has to monitor how (a) commissioners and (b) providers implement (i) advice, (ii) support and (iii) examples of best practice on (A) how to deliver high-quality, cost effective cancer services and (B) how cancer expenditure should be prioritised. [203613]

Ann Keen: Commissioners of cancer services will be subject to the wider assurance system being developed under the World Class Commissioning Programme and managed by the strategic health authorities. The Healthcare Commission will also provide an independent assessment of provider and commissioner health care organisations to ensure that they are providing a high standard of care.

Primary care trusts are funded to meet the health care needs of their populations. It is for them to prioritise this expenditure in accordance with local needs.

Cancer: Medical Treatments

Mr. Heald: To ask the Secretary of State for Health (1) how much funding his Department has allocated to the development of photodynamic therapy in the treatment of cancer in the next three financial years; [200439]

(2) what recent representations he has received on the effectiveness of photodynamic therapy in the treatment of cancer; [200440]

(3) how many patients were receiving photodynamic therapy at the latest date for which figures are available; [200442]

(4) how many patients received photodynamic therapy in each of the last three years, broken down by hospital at which treatment was dispensed. [200443]


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Ann Keen: The Department does not collect information on the number of patients receiving photodynamic therapy (PDT), where this treatment is provided or the cost of the treatment.

The Department has received a number of written representations about the effectiveness of photodynamic therapy cancer treatment from the charity Killing Cancer.

The National Institute for Health and Clinical Excellence has issued guidance on the use of PDT in the treatment of several cancers.

It is for the national health service at a local level to decide whether to offer this treatment to patients.

Mr. Heald: To ask the Secretary of State for Health if he will commission research on the efficacy of photodynamic therapy; and if he will make a statement. [200441]

Ann Keen: The Department's National Institute for Health Research (NIHR) is investing £1 million in a study to gather evidence on the clinical and cost effectiveness of photodynamic therapy for people with age-related macular degeneration.

In addition, two of the NIHR biomedical research centres established in 2007 will be undertaking research concerned with the use of photodynamic therapy. At the University College London Hospitals Biomedical Research Centre, the photodynamic therapy research will form part of a gastroenterology and hepatology research theme to which £5 million has been allocated over five years. At the Moorfields Eye Hospital Biomedical Research Centre it will be part of a programme of research to do with age-related macular degeneration to which £2.9 million has been allocated over five years.

The Department is also providing national health service support for two trials of photodynamic therapy for biliary tract cancers through the NIHR Cancer Research Network, and for two trials of photodynamic therapy for cancer of the gullet (oesophagus) through the joint Cancer Research UK/NIHR Experimental Cancer Medicine Centre at University College Hospital London.

The Medical Research Council has in the last six years funded two studies relating to photodynamic therapy at a total cost of £300,000.

Cancer: Screening

Joan Ryan: To ask the Secretary of State for Health what plans there are to increase levels of cancer screening in (a) Enfield and (b) England. [200572]

Ann Keen: We recognise the important role that screening plays and, as set out in the “Cancer Reform Strategy”, we are taking steps to build on and improve our existing screening services. This includes extending the age ranges for both breast and bowel screening, so that as many people as possible have the opportunity to be screened. We estimate that this will mean that an extra three million men and women will be screened over the next five years.


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It is important to remember that no screening method is perfect and anyone invited to be screened for cancer must be aware of both the benefit and harm of being screened and be able to make an informed decision on whether to take part or not.

It is for strategic health authorities working in partnership with their primary care trusts, local screening services and stakeholders to provide appropriate cancer screening services for their local populations and this includes promotion of local screening services.

Cancer: Waiting Lists

Sandra Gidley: To ask the Secretary of State for Health (1) what assessment he has made of the adequacy of the NHS's radiotherapy capacity to meet the 31-day waiting time target for cancer patients; and what plans he has to increase the NHS's radiotherapy capacity; [201173]

(2) whether he plans to expand the scope of the 31-day waiting time target for radiotherapy from initial to all treatment. [201174]

Ann Keen: As set out in the ‘Cancer Reform Strategy’, published in December 2007, the 31-day standard will be extended to cover all cancer treatments not just the initial treatment. It also acknowledges that this extension will have an impact on radiotherapy services where increased capacity will be needed if NHS trusts are to meet the extended 31-day standard. Copies of the strategy are available in the Library.

The most recent assessment of radiotherapy was undertaken by the National Radiotherapy Advisory Group as part of their report to Ministers. ‘Radiotherapy: developing a world class service for England’, was published in May 2007. Copies of this document are available in the Library. The report set out recommendations for improving productivity of existing radiotherapy services and for planning the increase in capacity over the coming years. These recommendations were considered as part of the development of the ‘Cancer Reform Strategy’, which makes clear that local investment will be needed in both equipment and work force in order to deliver a world class radiotherapy service.

Cardiovascular System: Health Services

Mr. Drew: To ask the Secretary of State for Health (1) what assessment he has made of the potential of telemedicine as an effective and affordable tool for carrying out vascular checks for those aged between 40 to 74 years; [201367]

(2) what assessment he has made of the potential contribution of telemedicine pharmacies to meeting the Government's programme of free vascular checks for those aged 40 to 74 years. [201470]

Ann Keen: On 1 April 2008, the Department published ‘Putting Prevention First’; a copy of this publication is available in the Library. This outlined initial analysis which confirmed that a programme to reach everybody between the ages of 40 and 74, to check their vascular risk and provide them with an individual assessment, would be both clinically effective and cost-effective.


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The next step is to develop an implementation and delivery programme with key stakeholders. We will be considering different options for delivering vascular checks involving a range of providers, including pharmacies.

Colorectal Cancer: Screening

Justine Greening: To ask the Secretary of State for Health (1) how many people have been contacted about bowel cancer screening by the bowel cancer screening system in (a) 2003-04, (b) 2004-05, (c) 2005-06, (d) 2006-07 and (e) 2007-08; [200893]

(2) what percentage of people contacted about bowel cancer screening by the bowel cancer screening system participated in the bowel cancer screening programme in (a) 2003-04, (b) 2004-05, (c) 2005-06, (d) 2006-07 and (e) 2007-08. [200894]

Ann Keen: The information requested is not available prior to July 2006.

Roll-out of the national NHS bowel cancer screening programme only began in April 2006, with the first invitations sent out in July 2006. Full national implementation is expected by December 2009. Within the programme, men and women are sent an invitation letter a week before they are sent a testing kit to give them the opportunity to decline receiving a testing kit if they do not wish to receive one for personal or clinical reasons.

As at 31 March 2008, 1,185,791 men and women had been sent an invitation letter, 1,099,653 had been sent a testing kit, and 590,769 had completed and returned a testing kit. This represents 50 per cent. of those who had been sent an invitation letter, and 54 per cent. of those who had been sent a testing kit. In addition, 17,192 men and women aged 70 or over had been sent a testing kit on request.

Justine Greening: To ask the Secretary of State for Health (1) from where the NHS Connecting for Health: bowel cancer screening system draws its contact data; [200895]

(2) how often the dataset used by the NHS Connecting for Health: bowel cancer screening system is refreshed. [200896]

Ann Keen: The bowel cancer screening system draws its data from the National Health Applications Infrastructure Services (the ‘Exeter’ system), which contains the names and details of all people registered with a general practitioner in England. The system is refreshed on a daily basis.

Sandra Gidley: To ask the Secretary of State for Health (1) what plans he has to broaden the age range of the bowel cancer screening programme; [201175]

(2) what steps he plans to take to maximise up-take of bowel cancer screening among the target population; and what arrangements he has made to monitor the efficacy of the programme. [201176]

Ann Keen: As my right hon. Friend the Prime Minister announced in September 2007 the NHS bowel screening programme will be extended from 2010 to invite men and women aged 70 to 75 to take part.


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