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To ask the Secretary of State for Health how many applications for product registrations under the provisions of the Traditional Herbal Medicinal
Products Directive have been received by the Medicines and Healthcare Products Regulatory Agency to date; and how many of those applications have been approved. 
Dawn Primarolo: The Medicines and Healthcare products Regulatory Agency has so far received 38 applications from 14 companies to register products under the traditional herbal registration scheme. To date 17 registrations have been granted and the remaining applications are under assessment.
Kate Hoey: To ask the Secretary of State for Health what assessment he has made of the regulatory impact of the Traditional Herbal Medicinal Products Directive on (a) small and medium-sized specialist manufacturers of herbal remedies, (b) specialist retailers and (c) consumer choice. 
Dawn Primarolo: In its regulatory impact assessment of the traditional herbal registration (THR) scheme the Medicines and Healthcare products Regulatory Agency (MHRA) estimated that typically the costs of registering a product under the scheme could be several tens of thousand pounds but that the figure would vary widely according to specific circumstances, not least depending on whether companies already had systematic quality control systems in place. This assessment has not changed. A steadily expanding THR scheme, alongside the availability of licensed herbal medicines, will offer consumers wide choice of over the counter herbal medicines made to assured standards of safety, quality and product information. The likelihood of increased consumer confidence in the standards of products, including the reliability of product information, could also be of benefit to responsible specialist manufacturers and retailers.
Kate Hoey: To ask the Secretary of State for Health what estimate he has made of the number of herbal products marketed under the provisions of Section 12(2) of the Medicines Act 1968 as medicines exempt from the need for a licence in the last 30 years; how many and what percentage of those products will need to secure registrations under the Traditional Herbal Medicinal Products Directive; and what steps he is taking to assist manufacturers with this process. 
Dawn Primarolo: Companies are not required to notify the Medicines and Healthcare products Regulatory Agency (MHRA) of products marketed under section 12(2) of the Medicines Act 1968, therefore no estimates are available in relation to these products. Following the expiry of the transitional period permitted under Directive 2004/24/EC manufactured herbal medicines placed on the market will require either a marketing authorisation or a traditional herbal registration (THR). As now there will continue to be some herbal products that potentially can be placed on the market either as medicinal products or under other product regulatory regimes depending on their presentation.
The MHRA continues to provide a range of help to companies aimed at helping them to progress plans to register products including holding meetings with companies to discuss the progress of actual or prospective applications under the THR scheme and providing a range of detailed advice via the agencys website.
Kate Hoey: To ask the Secretary of State for Health by what date herbal products marketed under the provisions of Section 12(2) of the Medicines Act 1968 as medicines exempt from the need for a licence will need to secure a registration under the provisions of the Traditional Herbal Medicinal Products Directive; and whether he plans to ask the European Union to extend that deadline. 
Dawn Primarolo: From 30 April 2011 no herbal medicine within the scope of Directive 2004/24/EC may be placed on the market or distributed by way of wholesale dealing without a traditional herbal registration. As now there will continue to be some herbal products that potentially can be placed on the market either as medicinal products or under other product regulatory regimes depending on their presentation. We have no plans to ask the European Commission to propose legislation extending the deadline in Directive 2004/24/EC.
Kate Hoey: To ask the Secretary of State for Health what charges are levied by the Medicines and Healthcare Products Regulatory Agency for processing applications for product registrations under the Traditional Herbal Medicinal Products Directive for (a) single ingredient and (b) complex products. 
Dawn Primarolo: The current fees for registering applications for products under the traditional herbal registration scheme range from £555 for single existing ingredient to £7,480 for complex new products. The fees charged by the Medicines and Healthcare products Regulatory Agency (MHRA) are set at a level to reflect fairly the cost related to each activity. These fee levels and costs are reviewed closely every year. This is in line with HM Treasury guidance.
MHRA fees for registering herbal products are significantly lower than those levied on pharmaceutical companies for the registration of other medicines. The fees are based on an estimate of the amount of time it takes to undertake each of the activities and the costs of the relevant staff required to undertake these activities. Applications that are more complex take longer to assess and can require staff with more experience to undertake the work. These costs are reflected in the fee charged. The fee of £7,480 for processing applications for registration of complex herbal products containing two or more ingredients not previously assessed by the agency reflects the additional work necessary when assessing ingredients for the first time.
David Howarth: To ask the Secretary of State for Health what the cost to his Department was of conducting the last Public Health Laboratory Service survey into HIV and hepatitis rates in prisons. 
Mr. Ivan Lewis: The last Public Health Laboratory Service study of HIV, hepatitis B and hepatitis C prevalence in prisoners in England and Wales was conducted in 1997 and 1998. The cost to the Department at that time is not available.
Robert Neill: To ask the Secretary of State for Health how many home information packs have been commissioned by (a) his Department and (b) its agencies to market a residential property; for which properties; at what cost; and whether a voluntary home condition report was purchased as part of the packs. 
Ann Keen: We are committed to reducing mixed sex accommodation to an absolute minimum, and where possible eliminating it. To this end, The Operating Framework. For the NHS in England 2008-09, requires primary care trusts to review the current situation in all trusts and agree, publish and implement stretching local plans for improvement in delivering single sex accommodation, with identified timescales and monitoring mechanisms. The framework specifically requires that patient survey results, where available, be used as the monitoring mechanism.
The need to treat and admit patients will on occasions need to take priority over provision of a single sex accommodation. We emphasise that under such circumstances, good standards of segregation can be achieved within a mixed ward, for example by using single rooms or single sex bays.
Mr. Lansley: To ask the Secretary of State for Health what the evidential basis is for the statement on page 21 of NHS Next Stage Review: Our vision for primary and community care that rates of emergency hospital admissions for long-term conditions vary more than twofold across the country. 
Ann Keen: There are no plans for the Department to take part in planning a further national-level programme of deep cleaning hospitals in England. Rather, national health service trusts strategic and operational cleaning plans are expected to make provision for ongoing deep cleaning activity.
Ann Keen: The Department issued 'Managing Food Waste in the NHS' in March 2005. This document provides best practice guidance for catering managers, nurses, ward housekeepers, doctors, dieticians and the ward-based teams in general. It identifies reasons why wastage occurs and provides guidance on reducing the volume of food that is supplied or cooked, but is not subsequently served. It also provides guidance on identifying the responsibilities for reducing waste and on the factors likely to be involved in wastage. A copy of this document has been placed in the Library.
Anne Main: To ask the Secretary of State for Health how many missed appointments there have been (a) at St. Albans City Hospital, (b) in West Hertfordshire Hospitals NHS Trust and (c) in East and North Hertfordshire NHS Trust in the last 12 months; and what the cost of missed appointments in each category was in that period. 
Mr. Bradshaw: Information about missed appointments (did not attendsDNAs) is collected at national health service trust level, not at individual hospital level. The following table contains information about DNAs at West Hertfordshire hospitals NHS trust, which includes St. Albans City hospital, and at East and North Hertfordshire NHS trust in 2007-08. Information about the cost of missed appointments is not collected centrally.
|DNAs in Hertfordshire acute NHS trusts in 2007-08|
|Organisation||First out-patient attendances||Subsequent out-patient attendances||In-patient||Total|
| Source: Department of Health Form Quarterly activity return: provider-based.|
Mr. Hancock: To ask the Secretary of State for Health (1) what the average cost to the NHS is per in-patient of treating healthcare associated infections, including those who do not contract an infection; 
The Department does not routinely collect this information and no single definitive cost figure exists. However, a study by the Public Health Laboratory Service (PHLS)(1) in 1999 estimated that hospital-acquired infections (HCAIs) cost the national health service £1
billion a year. This is still the best available estimate of NHS costs, although based on data from 1994-95. There were 11.4 million in-patient episodes in 1994-95. This suggests that the cost of HCAIs in 1994-95 was equivalent to £87 per patient. A cost of £87 in 1994-95 would be equivalent to £137 in 2006-07 prices (applying standard deflators).
Estimates of the cost of treating specific infections are not available. The Department published a HCAI productivity costing(1) tool in May 2006, which suggested a cost of around £4,300 per HCAI case in 2003-04. This analysis was based primarily on the PHLS report and figures were uprated to 2003-04 prices using standard deflators.
(1) R. Plowman, N. Graves, M. Griffin, J. A. Roberts, A. V. Swan, B. Cookson, L. Taylor. The socio-economic burden of hospital acquired infection. Public Health Laboratory Service 1999.
2 Costing tool available on the Department's website at:
Mr. Lansley: To ask the Secretary of State for Health what standards his Department expects NHS trusts to meet in relation to the privacy and dignity of changing facilities provided for patients. 
Mr. Bradshaw: Health Building Note 12: 'Out-patients Department' (NHS Estates, 2004) recommends for consulting examination rooms, that there should be sufficient space within a curtained area for a patient to undress/dress in privacy, with assistance when required.
Health Building Note 10-02: Surgical Services' (Department of Health, May 2007) recommends the provision of individual changing rooms for admissions leading to either a dedicated individual waiting space for every patient or separate male, female and children's waiting provision.
| Note: Figures are provider based, for NHS trusts in England.|
|Period ending||Median in-patient waiting time (weeks)|
| Note: Figures are commissioner based collated from primary care trusts in England.|
Mr. Bradshaw: The national health service continues to deliver the 26-week in-patient maximum waiting standard established in December 2005, with only a small number of breaches representing a tiny fraction of the total waiting list.
At the end of May 2008, 42 patients were waiting longer than the 26 weeks in-patient admission compared with 284,000 at the end of March 1997, a reduction of around 99.9 per cent. The average waiting time for an in-patient admission has fallen from 13 weeks in 1997 to 4.3 weeks in May 2008.
Mr. Donohoe: To ask the Secretary of State for Health what assessment he has made of the performance of NHS trusts in reducing accident and emergency waiting times to below the four hour target. 
Mr. Bradshaw: National health service trusts in England are expected to meet the four hour accident and emergency (A and E) operational standard of 98 per cent. of patients being seen, diagnosed and treated within four hours of their arrival at A and E. This standard is set out as an existing commitment for the NHS to meet in The NHS in England: The Operating Framework for 2008-09.
The waiting experience for millions of patients in A and E has dramatically improved from just a few years ago. For two out of the last three financial years, trusts have exceeded the A and E four hour operational standard. For 2007-08 as a whole performance was just below the operational standard, however the overwhelming majority of trusts are still achieving the four hour standard. Performance against the standard is published on a quarterly basis and is available at:
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