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Mr. Drew: To ask the Secretary of State for Health for what reason the requirement for a junior doctor to reside in accommodation supplied by the hospital approved for training was ended in April 2007; and what discussions he has had with the NHS Confederation and individual trusts on putting alternative arrangements in place. 
Ann Keen: Changes to the Medical Act 1983 made in August 2007 remove the requirement for pre-registration doctors to be employed in a residential medical capacity. This represents an improvement in their conditions of service and reflects the reduction in their working hours. As the statutory requirement to be resident no longer exists, these doctors will need to make the same arrangements as other national health service staff.
This issue was considered by the independent Doctors and Dentists Review Body (DDRB) in their 2008 report following evidence submitted by the British Medical Association, NHS Employers (part of the NHS Confederation) and the United Kingdom Health Departments. The DDRB concluded
...we consider it entirely appropriate that junior doctors are treated in exactly the same way as other NHS staff.
Mr. Stephen O'Brien: To ask the Secretary of State for Health with reference to the answer of 7 November 2007, Official Report, column 1285W, on kernicterus, (1) when the Department plans to consider whether additional information should be added to the Pregnancy Book; 
(3) with reference to the answer of 25 January 2007, Official Report, column 2045W, on the Pregnancy Book, what options are under consideration for the future of the Pregnancy Book, contingent on the outcome of the review. 
Ann Keen: We do not hold statistics centrally in the form requested. However, the number of admissions to hospital for which kernicterus was given as the main cause are shown in the following table. This is not, of course, likely to give a complete picture of morbidity since other causes of admission, such as jaundice, may be recorded instead.
|National health service hospitals England and activity performed in the independent sector in England commissioned by English NHS , c ount of hospital admissions where the primary diagnosis was Kernicterus|
Mr. Stephen O'Brien: To ask the Secretary of State for Health with reference to the answer of 25 June 2007, Official Report, column 271W, on the Pregnancy Book, (1) whether standardisation of total serum bilirubin measurements has been accomplished; whether the cases of kernicterus reported to the British Paediatric Surveillance Unit have been analysed with a root cause analysis; whether a system of mandatory reporting of elevated bilirubin levels has been established; and what arrangements have been made for ready access to transcutaneous bilirubin and total serum bilirubin measurements among in-patients and out-patients; 
(2) with reference to the answer of 25 January 2007, Official Report, column 2045W, on the Pregnancy Book, if he will place in the Library the results of the work which was commissioned to complete the review. 
Ann Keen: British Paediatric Surveillance Unit data formed the basis of a Prospective Surveillance Study of Severe Byperbilirubinaemia in the Newborn in the UK and Ireland (Donal Manning, et al Arch Dis Child Fetal Neonatal Ed 2007; 992:342-346). Copies of this study have been placed in the Library.
The National Institute for Health and Clinical Excellence (NICE) is currently developing guidance on the recognition and treatment of neonatal jaundice and recently carried out a consultation on the scope of the guideline. NICE expects to issue the guideline in early 2010.
Ann Keen: The acquisition of imaging equipment such as magnetic resonance imaging scanners is a local matter and individual national health service trusts should base decisions on local needs and the existing capacity they have to meet those needs.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what the procedure is for patients to choose not to have a summary care record; and what steps general practitioners have to take to put that choice into effect. 
Mr. Bradshaw: Currently, patients who do not want a summary care record (SCR) are advised to make their wishes known to their general practice. Guidance has been issued to all general practices entitled Guidance On Managing Requests For No Summary Care Record During The Period Of The Early Adopter Programme on how they should respond to patients inquiries about their options in relation to SCR, including to those patients who have decided not to have a SCR. Copies of the guidance have been placed in the Library and are also available at:
The essence of the guidance is that practices should ensure patients fully understand the implications of their decision, and that a record is kept to that effect, signed both by the patient, and on behalf of the practice.
SCRs cannot be created without the agreement and co-operation of general practitioners, who are currently the data controllers for the records from which the relevant data will be uploaded. The Department can only recommend that practices follow its advice in line with the guidance.
These and other practical aspects of how patients are able to exercise the choices they have in relation to the SCR will be among the key issues to be reviewed by the summary care record advisory group in light of the recently published independent evaluation of the SCR Early Adopters Programme in order to inform the future roll-out of the SCR.
Mr. Stephen O'Brien: To ask the Secretary of State for Health pursuant to the answer of 26 March 2008, Official Report, column 206W, on medical records: databases, for what reasons Connecting for Health cannot comment on the specific monitoring processes; and what estimate he has made of the likely number of alerts (a) per day and (b) each Caldicott Guardian will be able to monitor. 
Mr. Bradshaw: Systems delivered by NHS Connecting for Health will provide the alert data and tools for reviewing alerts, but detailed monitoring arrangements and assessment of follow up actions are the responsibility of local national health service organisations and individual Caldicott Guardians.
Staff who breach patient confidentiality are subject to disciplinary measures and the legal penalties provided under the Data Protection Act, and professional staff risk losing their licence to practice. There is no evidence that breaches currently happen other than very exceptionally. We expect this to continue to be the case when systems are deployed that have the ability to audit behaviour.
Mr. Stephen O'Brien: To ask the Secretary of State for Health pursuant to the answer of 26 March 2008, Official Report, column 206W, on medical records: databases (1) under what terms and conditions suppliers will have access; 
Mr. Bradshaw [holding answer 9 May 2008]: The terms and conditions are being agreed but include, for example, limitations on the disclosure of data to third parties and the copying of data, and termination and liability clauses in the event of unauthorised disclosure of personally-identifiable information. There will also be a right of audit to verify adherence to the terms and conditions, which will be the key condition determining permission to access for those wishing to use the service.
Dr. Richard Taylor: To ask the Secretary of State for Health what proportion of medical students studying in English medical schools in England gained entry from (a) British and (b) overseas schools in the latest period for which figures are available. 
Ann Keen: The Department does not collect this information. However, data on the normal place of residency of students are collected by the Higher Education Funding Council for England. The latest provisional figures for student intakes into English medical schools in the academic year 2007-08 show that of the total 6,292 student intakes, 89 per cent. are normally resident in Great Britain and the remaining 11 per cent. are normally resident overseas (including in Northern Ireland, the Channel Islands and Isle of Man). Confirmed figures from the previous three years show that the corresponding percentage of intakes normally resident in Great Britain was 90 per cent.
Higher Education Funding Council for England Annual Medical and Dental Students Survey
John Bercow: To ask the Secretary of State for Health what discussions he has had with the Secretary of State for Justice on recommendations 1.39, 1.42 and 1.44 of the HM Inspectorate of Prisons report entitled The Mental Health of Prisoners Thematic, published in October 2007. 
Mr. Ivan Lewis: The report, The Mental Health of Prisoners Thematic (HMIP, 2007) made a number of recommendations about improving mental health care in prisons. The Department of Health is preparing its response to all these recommendations.
I meet regularly with ministerial colleagues at the Ministry of Justice to discuss matters relating to mental health in prisons. In December 2007, my right hon. Friend the Secretary of State for Justice invited my noble Friend Lord Bradley of Withington to carry out a review into diverting more offenders with severe mental health problems away from prison into more appropriate accommodation, (5 December 2007, Official Report, column 1703-6). Lord Bradley will report jointly to the Department of Health and the Ministry of Justice.
John Bercow: To ask the Secretary of State for Health what recent discussions he has held with the National Audit Office on progress on its examination of plans to develop a comprehensive single complaints system across health and social care by 2009. 
In discussion between the NAO and the Department of Health about its remit for this evaluation, it was agreed that one of the objectives should be to highlight the strengths and weaknesses of the current complaints systems and identify the challenges and risks that will need to be managed in developing a comprehensive single complaints system across health and social care. The NAO is due to produce the report of its evaluation in summer 2008.
We understand from the Healthcare Commission that the information is not available in the form requested, the Commission records complaints by service provider rather than by geographical or local authority area. Information about the number of complaints involving the three main NHS organisations responsible for health care in Wirral reviewed in 2007 is set out as follows:
Cheshire and Wirral Partnership NHS Trust provides services both in and outside Wirral and is now Cheshire and Wirral Partnership NHS Foundation Trust. Wirral Hospitals NHS Trust is now Wirral University Teaching Hospitals NHS Foundation Trust.
Greg Clark: To ask the Secretary of State for Health what payments the (a) NHS Cancer Screening Programme and (b) NHS Sickle Cell and Thalassaemia Screening Programme made to Hanover Communications in each of the last five years; and on what dates and for what purpose the payment was made in each case. 
Mr. Stephen O'Brien: To ask the Secretary of State for Health pursuant to the answer of 25 March 2008, Official Report, column 26W, on NHS: ICT, what the timetable is to which the answer refers. 
Mr. Stephen O'Brien: To ask the Secretary of State for Health with reference to the answer of 27 February 2006, Official Report, column 439W, on the European Health Insurance Card, if he will place in the Library minutes of discussions of the potential costs and benefits of the proposed national health service card with the NHS Connecting for Health National Programme for IT; and what his policy is on whether to introduce an NHS card. 
Mr. Bradshaw: A number of discussions took place in the course of developing policy advice to Ministers on the possible costs and benefits of an national health service card. The Government do not disclose details of internal policy deliberations. There are no current plans to introduce an NHS card.
Mr. Baron: To ask the Secretary of State for Health what the policy of the NHS Litigation Authority is in respect of defending clinical negligence claims funded by (a) conditional fee agreements and (b) legal aid. 
The NHS Litigation Authority (NHSLA) is responsible for handling clinical negligence claims made against members of its schemes. It does not have
a policy in respect of defending claims based upon the funding arrangements of the claim. Case managers at the NHSLA make decisions on the defence of each claim based upon the available facts and expert legal and medical opinion. Claimants are not required to report their funding arrangements unless the claim proceeds to court.
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