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John Austin: To ask the Secretary of State for Communities and Local Government what recent discussions she has had with (a) the Mayor of London and (b) Transport for London on the Thames Gateway Bridge; what her policy is on the re-opening of the associated public inquiry; and if she will make a statement. 
Caroline Flint: There have been no meetings between Ministers or officials from Communities and Local Government Department with the Mayor of London or Transport for London on the proposed Thames Gateway Bridge since the Mayoral elections. The Secretary of States reasons for re-opening the public inquiry were set out in her letter of 25 July 2007.
Mr. Jenkins: To ask the Secretary of State for Health how much was spent on treating bone cancer in young people in Staffordshire in each of the last five years; and what the rate of success was in each year. 
Andrew George: To ask the Secretary of State for Health what steps his Department is taking to monitor the policy of primary care trusts in respect of support for the clinical prescribing of anti-tumor necrosis factor remedies for those diagnosed with ankylosing spondylitis. 
Ann Keen: All primary care trusts in England and Wales are obliged to fund, from general allocations, anti-tumour necrosis factor therapy for those patients with severe ankylosing spondylitis who meet the clinical guidelines issued by the National Institute for Health and Clinical Excellence (NICE). This is effective three months from the date of issue of the guidance by NICE.
Ensuring compliance with NICE guidance is the responsibility of strategic health authorities, failure risks an adverse report to the Secretary of State from the independent Healthcare Commission. Ultimately, the Secretary of State reserves powers to intervene through the Recovery Support Unit.
Mr. Lansley: To ask the Secretary of State for Health whether the extension of the 31-day treatment standard, as referred to in his Department's Cancer Reform Strategy of 3 December 2007, will include treatments which fall outside the commissioning policies of primary care trusts and require exceptional requests for funding from clinicians. 
Ann Keen: The extension to the 31-day cancer waiting time standard introduced by the Cancer Reform Strategy (copies of which have already been placed in the Library) will apply to surgical and drug treatments from December 2008, and radiotherapy and all other treatments from December 2010. All treatments commissioned by the English national health service will fall within the scope of the extended standard.
Mr. Jenkins: To ask the Secretary of State for Health what per capita public expenditure on cancer care within South Staffordshire NHS primary care trust area was in the latest period for which figures are available. 
Mr. Lancaster: To ask the Secretary of State for Health how many (a) care homes, (b) residential homes and (c) nursing homes in (i) Milton Keynes and (ii) Buckinghamshire were ordered to close in each of the last five years; and for what reasons in each case. 
Mr. Ivan Lewis: We have been informed by the Commission for Social Care Inspection (CSCI) that the information held centrally with regard to the cancellation of registration of providers of care homes and care homes with nursing in Milton Keynes and Buckinghamshire is shown in the table.
In 2004-05, CSCI took action to cancel the registration of a provider who owned two nursing homes, following a number of serious breaches of regulations in one of the homes. In 2005-06, CSCI deregistered a care home when it was sold by the provider.
|Providers in Milton Keynes and Buckinghamshirecancellations of registration, 2003-04 to 2007-08|
|Type of home( 1)||Area||2003-04( 2)||2004-05||2005-06||2006-07||2007-08||Total|
|(1) All care homes are residential. CSCI distinguishes between those providing personal care only, nursing homes (which provide personal care with nursing), and non-medical nursing homes.|
(2) This data was collected by the National Care Standards Commission. CSCI took over responsibility for regulating care and nursing homes on 1 April 2004.
1. Data as at 27 June 2008.
2. Where numbers are not specified, it should be assumed that the return is zero.
CSCI registration and inspection database
Mr. Amess: To ask the Secretary of State for Health what (a) primary and (b) secondary legislation covers the care provided to residents in care homes for the elderly; what changes are planned during the next 12 months; how his Department currently enforces these obligations; what representations he has received since January 2007 on this legislation; and if he will make a statement. 
Mr. Ivan Lewis: The primary legislation governing the quality and safety of care provided to residents in care homes is the Care Standards Act 2000. The secondary legislation is the National Care Standards Commission (Registration) Regulations 2001 and the Care Homes Regulations 2001.
The Care Homes Regulations are accompanied by the Care Homes for Older People National Minimum Standards (NMS)aged 65 or over (copies of this publication have already been placed in the Library). The NMS are not statutory requirementscompliance with them is not enforceable. However, compliance with the regulations is, subject to the NMS being taken into account by the regulator, the Commission for Social Care Inspection (CSCI). The Care Homes Regulations apply to all providers, whether in the private, voluntary or public sectors.
The Care Standards Act established the National Care Standards Commission (NCSC) as the regulator of care homes, with responsibility for enforcement of the regulations. The NCSC began work on 1 April 2002.
The Health and Social Care (Community Health and Standards) Act 2003 established CSCI as the independent inspectorate for all social care services in England. CSCI was created as a legal entity on 1 January 2004 and became fully operational on 1 April 2004, when the functions of the NCSC were transferred to it.
CSCI is more independent of Government than the NCSC was. Its Chair and Commissioners are appointed by the NHS Appointments Commission. It presents its annual report direct to Parliament, rather than the Department, and it is not required to act under the general guidance of the Secretary of State.
CSCI regulates, registers and inspects all social care providers, including care homes, in England. It is unlawful to carry on a care home without being registered, unless the case comes within prescribed exceptions. CSCI has a range of powers, ranging from statutory improvement notices to immediate closure of a service which it uses proportionately to ensure providers comply with regulations.
Subject to the passage of the Health and Social Care Bill, all health and adult social care providers that come within the scope of registration will be required to register with the new regulator of health and social care services, the Care Quality Commission (CQC). The CQC will be established later this year. It will begin its work in April 2009, when it will assume responsibility for healthcare associated infections in respect of national health service providers and take on the duties of the Mental Health Act Commission. In April 2010, it will assume the responsibilities of CSCI and the Healthcare Commission.
The establishment of the CQC will give patients and service users confidence in the safety and quality of whichever service they use. For the first time, there will be a single coherent set of national safety and quality requirements and regulations for all providers of health and adult social care services.
The CQC will embody the Government's principles of good regulation to give people the best and safest care and the best possible outcomes for public money. It will reduce the burden of public service inspection, while applying a coherent approach to regulation for all types of health and adult social care providers.
The Department has received a range of representations on the regulation of care homes since January 2007. Of particular relevance is the recently conducted formal consultation on the future framework for the registration of health and social care providers.
A total of around 230 responses was received and officials are now analysing them. A consultation response will be published in due course. Subject to the passage of the Health and Social Care Bill, the consultation response will inform regulations on the scope of regulation and the requirements for registration with the new CQC. It is the intention that these will come into force in 2010.
Mr. Jenkins: To ask the Secretary of State for Health what per capita public expenditure on dementia care within South Staffordshire NHS primary care trust area was in the latest period for which figures are available. 
Mr. Jenkins: To ask the Secretary of State for Health (1) how many (a) adults and (b) children are registered with NHS general dental practices in the South Staffordshire NHS primary care trust area; and how many were registered at Tamworth practices in each year since 1997; 
Ann Keen: The numbers of patients registered with a national health service dentist as at 31 March, 1997 to 2006 are available in Annex A of the NHS Dental Activity and Workforce Report, England: 31 March 2006. Information is provided for adults and children by strategic health authority (SHA) and by primary care trust (PCT). This information is available by constituency at Annex C.
Information on the numbers of patients registered with an NHS dentist, as a percentage of the population is available in Annex B of this report. Information is provided for adults and children by SHA and by PCT.
This information is based on the old contractual arrangements, which were in place up to and including 31 March 2006. This Report was published on 23 August 2006, and copies have already been placed in the Library and is also available on the Information Centre for health and social cares website at:
Under the new dental contractual arrangements, introduced on 1 April 2006, patients do not have to be registered with an NHS dentist to receive NHS care. The closest equivalent measure to registration is the number of patients receiving NHS dental services (patients
seen) over a 24-month period. However, this is not directly comparable to the registration data for earlier years.
Information on the numbers of patients seen by an NHS dentist in England, over the previous 24-month period, is available in Table CI of Annex 3 of the NHS Dental Statistics for England: Quarter 3: 31 December 2007 report. Information is available for the 24-month periods ending 31 March 2006, 31 March 2007, 30 June 2007, 30 September 2007, and 31 December 2007. Information is provided for adults and children by SHA and by PCT. Under the new contractual arrangements, information is not available by constituency.
Information on the numbers of patients seen by an NHS dentist over the previous 24-month period, as a percentage of the population is available in Table C2 of Annex 3. Information is provided for adults and children by SHA and by PCT.
Mr. Jenkins: To ask the Secretary of State for Health how much was spent on NHS general dental services in (a) Tamworth constituency and (b) Staffordshire in (i) cash and (ii) real terms in each of the last 10 years. 
Ann Keen: For 2006-07, data on primary dental care expenditure can be derived from primary care trust (PCT) accounts. As the data reflects the new contract framework for primary dental care services introduced from 1 April 2006, incorporates all relevant service costs, and is based on the PCT areas introduced from 1 October 2006, it is not directly comparable with the available data prior to 2006. Expenditure on primary dental services in the North and South Staffordshire PCTs in 2006-07 is set out in the following table. However, the PCT accounts do not separately distinguish expenditure by constituency areas.
|Expenditure on primary dental care services in North and South Staffordshire PCTs, 2006-07|
|Gross expenditure||Dental charges paid by patients||Net expenditure|
Calculated from details of gross primary dental care expenditure, and income from dental charges, recorded in the notes to the 2006-07 PCT accounts.
Prior to April 2006, most primary dental services were provided under former general dental services (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 national health service work they chose to undertake.
The Information Centre for health and social care holds local-level information on the expenditure for NHS primary dental care under the former GDS and certain equivalent personal dental service arrangements. Expenditure information in cash and real terms (2006-07 prices), for the financial years 1997-98 to 2005-06 is available for the Tamworth constituency and the following PCTs; Newcastle-under-Lyme; Staffordshire Moorlands; Burntwood, Litchfield and Tamworth; Cannock Chase; East Staffordshire; and South Western Staffordshire. This information is contained in the document Expenditure on General Dental Services and Personal Dental Services in North and South Staffordshire, 1997-98 to 2005-06, copies of which have been placed in the Library.
Mr. Jenkins: To ask the Secretary of State for Health how many full-time equivalent NHS general dental practitioners there are in (a) Tamworth constituency and (b) Staffordshire; and how many there were in each of the last two years. 
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