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Dawn Primarolo: The Departments interdepartmental working group on sensible drinking reviewed the evidence concerning the beneficial effects of alcohol consumption to both health and mortality and their findings were published in the report Sensible Drinking, in 1995.
They found that light to moderate consumption of alcohol, less than two units of alcohol a day, at ages over 45 for men or post-menopause for women, can have a protective effect against a number of diseases, including coronary heart disease. However, drinking at this level may also contribute to other health harms, although at a lower level of risk.
Government guidance primarily focuses on advising the public about the progressive risks to their health associated with drinking above lower risk levelsi.e. either increasing risk or higher risk levels of consumption. This is because of the clear evidence that alcohol consumption contributes to a wide range of health harms, particularly when drunk regularly above the lower risk levels. The evidence also suggests that regular drinking above the lower risk levels does not incur any additional protective effect for coronary heart disease. Hence, the advice on lower risk drinking levels for men and women remains consistent with the evidence of possible health benefits for coronary heart disease.
Stephen Hesford: To ask the Secretary of State for Health whether his Department has (a) commissioned and (b) evaluated research on the impact of alcohol consumption on public health on Merseyside, with particular reference to its effect on child well-being; and if he will make a statement. 
Dawn Primarolo: The public health consequences from alcohol consumption are well known. On 22 July 2008, the Department published the North West Public Health Observatory (NWPHO) report, Alcohol-attributable fractions for EnglandAlcohol-attributable mortality and hospital admissions, which summarised the current information on the health risks from alcohol consumption. A copy of this report has been placed in the Library.
Although the Departments research is currently focused on improving prevention and treatment services, we continue to keep under review the emergence of any major new evidence on the risks and benefits relating to alcohol consumption, to ensure that guidance remains up-to-date.
Local Alcohol Profiles England, run by the NWPHO, provide data for local authorities and primary care trusts (PCT) on the local impact of alcohol use, which allow local alcohol strategies to be tailored to the needs for specific areas.
During 1 July 2008 and 2 September 2008 Safe Space, a programme to make public spaces safe and to reduce anti-social behaviour, was run in Merseyside. As part of this programme Liverpool PCT and Working Neighbourhood Fund ran Safe Space Plus, an initiative that specially addressed alcohol related anti-social behaviour and engaged with young people to encourage safe and
sensible drinking. Additional objectives for Safe Space Plus included enabling access to brief interventions or treatment to reduce alcohol consumption, where appropriate, and raising awareness of the risks associated with alcohol consumption.
Mr. Bone: To ask the Secretary of State for Health (1) what proportion of patients with rheumatoid arthritis are expected to receive a second anti-TNF treatment used sequentially after the failure of a first anti-TNF treatment in the next two years; and if he will make a statement; 
(2) if he will estimate the number of patients with rheumatoid arthritis who will not be provided with sequential treatments with anti-TNF drugs over the next five years as a result of the ruling by the National Institute for Health and Clinical Excellence on the issue; 
(3) what records he holds for benchmarking purposes on the use of anti-TNF treatments in other EU countries; what assessment he has made of how that pattern of use differs from (a) that of its use in England and (b) the differential results of that use in the UK and other member states; and if he will make a statement. 
We have made no estimate of the number of patients with rheumatoid arthritis who are expected not be provided with sequential treatments with anti-TNF drugs over the next five years. The Department holds no records on the use of anti-TNF treatments in other EU countries.
Mr. Crausby: To ask the Secretary of State for Health what funding his Department has provided to the British Fluoridation Society in the last three years; and whether the Society receives such funding on (a) a regular or (b) an ad hoc basis. 
Ann Keen: The delivery and organisation of services is the responsibility of the national health service locally, working in conjunction with clinicians, patients and other stakeholders. Any proposals regarding cancer services at the Clatterbridge hospital site remain the responsibility of the Clatterbridge Centre for Oncology NHS Foundation Trust in partnership with its local primary care trusts and other relevant stakeholders.
Ann Keen: As at 8 September 2008, 18 of the 30 networks already have a patient information manager in post and the remainder are expected to have one in post by February 2009. The following tables list those cancer networks with a patient information manager currently in post and those without.
Avon, Somerset and Wiltshire
Central South Coast
Greater Manchester and Cheshire
Humber and Yorkshire Coast
Lancashire and South Cumbria
Merseyside and Cheshire
North East London
Northern Cancer Network
Surrey, West Sussex and Hampshire
Kent and Medway
Leicestershire, Northamptonshire and Rutland
South East London
South West London
Mrs. Maria Miller: To ask the Secretary of State for Health (1) how many and what proportion of patients in care homes receiving nursing care (a) have their costs paid by a primary care trust through fully-funded NHS continuing care, (b) are self-funded and (c) are funded by a local authority; 
In October 2001, the Government delivered on time the commitment given in the NHS Plan to introduce national health service funded nursing care for those in a care home providing nursing care, who had previously paid for the care they needed from a registered nurse. From April 2003, all residents of care homes providing nursing care, including those placed by local authorities, have received NHS funding of their nursing care, rather than that element of their care being provided by the local council and subject to a means test.
The Government have produced a new national framework, which sets out a single, national system for determining eligibility for NHS Continuing Healthcare. The Framework, which was implemented, in October 2007, will lead to fair and consistent access to NHS funding across England, irrespective of location, so that people with equal needs have an equal chance of getting all their care free.
(1 )SourceDepartment of Health form LDPR 2007-08, quarter 4.
Andrew Mackinlay: To ask the Secretary of State for Health what advice on what occasions the (a) Kensington and Chelsea Primary Care Trust and (b) Westminister Primary Care Trust have received from (i) his Department and (ii) the Healthcare Commission on the requirement for patients referred to the Chelsea and Westminister Hospital Foundation by GPs contracted to their primary care trust, to be able to use the choose and book appointment system; and if he will make a statement. 
Mr. Bradshaw: Advice has been continually given by the Department and national health service Connecting for Health, to primary care trusts (PCTs) and providers of NHS care on the implementation of Choose and Book. The NHS Operating Framework for 2006-07 set a target that 90 per cent., of general practitioner referrals to first consultant-led out-patient services should be made through the Choose and Book system to a directly bookable service by March 2007. This was reconfirmed in the Operating Framework for 2007-08, and also mentioned in the Information Management and Technology guidance, with the aim of moving towards a position where Choose and Book is used as the standard safe and secure method for all referrals.
We are informed that the Healthcare Commission has given no advice to the Kensington and Chelsea PCT, and Westminster PCT on the requirement for patients referred to the Chelsea and Westminster NHS Foundation Trust to be able to use the Choose and Book appointment system.
Andrew Mackinlay: To ask the Secretary of State for Health what advice on what occasions the Chelsea and Westminister Hospital Foundation Trust has been given on the implementation of the policy of allowing patients to use the choose and book appointments system by (a) Monitor, the independent regulator of NHS foundation trusts and (b) the Healthcare Commission; and if he will make a statement. 
Mr. Bradshaw: We are informed by the Chairman of Monitor (the statutory name of which is the Independent regulator of NHS Foundation Trusts) that no advice has been given to the Chelsea and Westminster NHS Foundation Trust on the implementation of Choose and Book, except to specify the basis on which NHS foundation trusts (NHSFT) should report compliance, and to draw attention to the definition of the Choose and Book target.
We are also informed that the Healthcare Commission has given no advice to the Chelsea and Westminster NHSFT in relation to the implementation of the policy of allowing patients to use the Book and Choose system.
Choose and Book is a national service that combines electronic booking and a choice of time, date and place for first consultant led out-patient appointments. Advice has been continually given by the Department and NHS Connecting for Health to primary care trusts and providers of NHS care on the implementation of Choose and Book. The NHS Operating Framework for 2006-07 set a target that 90 per cent. of general practitioner referrals to first consultant-led outpatient services should be made through the Choose and Book system to a directly bookable service by March 2007. This was reconfirmed in the Operating Framework for 2007-08 and also mentioned in the Information Management and Technology guidance with the aim of moving towards a position where Choose and Book is used as the standard safe and secure method for all referrals.
Mr. Stephen O'Brien: To ask the Secretary of State for Health (1) pursuant to the answer of 21 April 2008, Official Report, column 1777W, on child health who the suppliers are of information for appendices 4, 7, 13 and 17; and what those documents refer to; 
(2) pursuant to the answer of 12 December 2007, Official Report, column 634W, on the Child Health Interim Application (CHIA) for what reasons (a) the output based specification for the CHIA options appraisal report and (b) the weighting and scoring spreadsheet are commercially sensitive. 
Appendix 4: Description of Standalone Service Community Solution (extract from output based specification);
Appendix 7: Supplier Responses (from CSW Group, CSE Servelec, McKesson UK, Health Solution Wales) to Child Health Standalone Service Requirements VI.0 04/08/06;
Appendix 13: Supplier Responses (from CSW Group, CSE Servelec, McKesson UK, Health Solution Wales) to Additional NHS Questions Post Demonstration;
Appendix 17: Weighting and Scoring Template (BT document).
Following further discussion with BT, the basis on which this material was withheld previouslynamely, that it would, or would be likely to, cause prejudice to the commercial interests of the suppliershas been reviewed. While appendices 7 and 13 continue to be judged commercially sensitive, copies of appendices 4 and 17 have now been placed in the Library.
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