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6 Oct 2008 : Column 441W—continued

Malnutrition: Children

Mrs. Maria Miller: To ask the Secretary of State for Health how many children in England were (a) treated by a GP for undernutrition not caused by an eating disorder and (b) admitted to hospital for treatment for undernutrition not caused by an eating disorder in each of the last five years. [222684]

Ann Keen: Data on general practitioner activity for those being treated for undernutrtion not caused by a eating disorder are not collected centrally.

Information on the total admissions to hospital of 0 to 18-year-olds in which the patient had a primary diagnosis of undernutrition without a primary or secondary diagnosis of an eating disorder at the start of his/her stay from 2002-03 to 2006-07 is set out in the following table. This covers national health service hospitals England and activity performed in the independent sector in England commissioned by English NHS.

Total admissions











Hospital Episode Statistics, The NHS Information Centre for health and social care.

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Maternity Services

Anne Milton: To ask the Secretary of State for Health (1) what plans he has to improve quality and safety in maternity services; and whether there are mechanisms in place to monitor and audit the implementation of the maternity dashboard in trusts, as recommended by the Chief Medical Officer in his report in 2007 and by Lord Darzi in the NHS Next Stage Review; [221818]

(2) what plans he has to incorporate and implement the latest standards developed by (a) the Royal Colleges on maternity and (b) the Royal College of Obstetricians and Gynaecologists standards on gynaecology in delivering NHS services. [221906]

Ann Keen: The Department’s strategy for safe, high quality, modernised maternity services is set out in “Maternity Matters: Choice, access and continuity of care in a safe service”. A copy has already been placed in the Library. It is for trusts to provide maternity care in line with the clinical standards outlined in guidance issued by the Department, the National Institute for Health and Clinical Excellence and the professional bodies.

The new standards for maternity and gynaecological care, developed by the Royal Colleges, and the maternity dashboard, produced by the Royal College of Obstetricians and Gynaecologists (RCOG), are useful tools, which commissioners and providers are encouraged to use to develop high quality maternity care. The president of the RCOG has written to all clinical directors asking them to use and adapt the dashboard in their maternity units. Its use will be evaluated by the RCOG.

Maternity Services: Newcastle upon Tyne

Mr. Henderson: To ask the Secretary of State for Health what plans his Department has to prepare for the likely effect on demand for maternity services in Newcastle upon Tyne NHS Foundation Trust area of the possible reorganisation of maternity facilities in neighbouring trust areas. [222630]

Ann Keen: Proposals for the reconfiguration of services are a matter for the national health service locally, working in conjunction with clinicians, patients and other stakeholders.

However, the north east strategic health authority report that commissioners from the North of Tyne ‘cluster’ of primary care trusts (PCTs) (Northumberland National Health Service Care Trust, Newcastle PCT, and North Tyneside PCT) are in close contact with the two trusts (Newcastle Hospitals NHS Foundation Trust and Northumbria Healthcare NHS Foundation Trust) and are in the process of organising a progress meeting with the heads of midwifery and lead obstetricians of the trusts to discuss the impact of the reorganisation.

The PCTs are also providing three-monthly updates for the North Tyneside Overview and Scrutiny Committee (OSC), which representatives of the Newcastle and Northumberland OSCs are also attending.

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Medical Equipment

Anne Main: To ask the Secretary of State for Health when he expects to receive the evaluation report for the community equipment model; and if he will place a copy in the Library. [222404]

Dawn Primarolo: The retail model developed for community equipment met with overall approval from the sector. The outline business case was sufficiently robust to support developing the outline model to operational status. This is currently being undertaken through a shadow running process in the North West with local authority and health partners in Manchester, Oldham and Cheshire.

The shadow running process demonstrated improvements in the user experience and efficiency of the service.

Cheshire and Oldham have decided to implement the model locally. This confirms that, in their areas, the new prescription processes have been demonstrated to be effective and are capable of being scaled up to support full implementation of the retail model.

The business case for a new model of delivery of wheelchair services is currently being considered by senior officials in the Department. At the present time we are unable to specify a time scale for any future decisions to be made and announced.

Medical Examinations: Immigrants

Damian Green: To ask the Secretary of State for Health which ports of entry where in-bound international traffic is expected have port medical inspectors on duty at all times at which the port is open. [223841]

Dawn Primarolo: Medical inspectors are appointed under the Immigration Act 1971 to advise immigration officers at ports and airports on health issues relating to applicants for admission to the United Kingdom. Medical inspectors may be located at a port or airport, or brought in on call, according to local assessment of the most cost-effective deployment of resources. Information is not collected centrally on the deployment of medical inspectors at ports and airports.

Medical Records: Data Protection

James Duddridge: To ask the Secretary of State for Health pursuant to the Written Ministerial Statement of 25 June 2008, Official Report, columns 25-27WS, on data handling procedures, if he will commission a privacy impact assessment for the NHS Spine database project. [222208]

Mr. Bradshaw: This matter has been carefully considered, but we do not believe that such an assessment would serve any useful purpose at this stage of the project.

The aim of a privacy impact assessment is to ensure that privacy is considered at every stage of a project involving the handling of information, and that action is taken to mitigate against identified risks to the privacy of individuals. While this is clearly a useful tool for many projects where these matters might otherwise be neglected, the need to safeguard privacy and confidentiality is a necessary deliverable of any health record system,
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and the management of risk in this area has been a core deliverable of the national health service care records service (the spine project).

The security safeguards around access to patient data held within the new care records will provide an unprecedented level of assurance compared with existing electronic and paper systems. The Department has also produced what we believe is the most comprehensive privacy statement of any public service in the form of the NHS care record guarantee for England, setting out 12 commitments the NHS. makes to patients in order to protect their confidentiality.

The Information Commissioner has confirmed that, properly deployed, the new systems have the potential to allow the NHS to better meet the various informational and privacy challenges which it faces than the systems currently in existence, and that he is content with the general approach being taken with the care records service.

Medical Records: Databases

Mr. Stephen O'Brien: To ask the Secretary of State for Health pursuant to the answer of 13 May 2008, Official Report, column 206W, on medical records: databases, whether Connecting for Health is able to comment on the monitoring processes Caldicott Guardians will use in relation to their collective access to the Care Records Service. [222409]

Mr. Bradshaw: NHS Connecting for Health provides information governance policies, guidance and tools to the NHS. However, the local processes are matters of local accountability, and for local discretion.

NHS Connecting for Health also provides a web-site:

on which are posted the minutes of meetings of the UK Council of Caldicott Guardians, back issues of the Caldicott Guardian newsletter, frequently-asked questions, example job descriptions and specifications, and other useful resources and information for those appointed to this important role.

Medical Treatments Abroad

Sandra Gidley: To ask the Secretary of State for Health how many NHS patients paid for their own treatment within the European Economic Area in each of the last three months. [222996]

Dawn Primarolo: It is not known how many national health service patients have paid for their own treatment in the European economic area in the last three months as this information is not collected centrally.

Mental Health Services

Lynne Jones: To ask the Secretary of State for Health what the average weekly cost is of commissioning treatment for an individual through (a) Tier 5 NHS medium secure services, (b) community forensic services and (c) Tier 4 NHS mental health services; and how many people received treatment in each category in each of the last five years. [223862]

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Dawn Primarolo: From the 2006-07 reference costs the national average cost, per bed day, for medium secure mental health units is £453. This is for national health service trusts and primary care trusts combined and is sourced from Schedule 4 of the 2006-07 reference costs.

For the number of people who received treatment in Tier 5 NHS medium secure services, I refer the hon. Member to the written answer I gave the hon. Member for Somerton and Frome (Mr. Heath) on 20 March 2008, Official Report, 1315-16w.

The information requested on community forensic services is not available centrally.

Tier 4 services are mainly specialist in-patient services for those people with severe and complex personality disorder but who do not present a risk to other people and who are not detained. For the year 2005-6 these services were treating approximately 100 to 120 people per year on an in-patient basis; and 70 patients per year on a day basis. The cost is approximately £1,500 to £2,000 per week for in-patient services.

Mental Health Services: Young Offenders

Mrs. Moon: To ask the Secretary of State for Health what recent estimate he has made of the average time taken between initial assessment by a psychiatrist at Young Offender Institution Ashfield and Huntercombe and transfer to facilities provided by St. Andrews Healthcare. [222237]

Dawn Primarolo: This work has not been undertaken centrally.

The “Procedure for the Transfer of Prisoners to and from Hospital under Sections 47 and 48 of the Mental Health Act 1983” was published in December 2007 with contributions from the Department of Health, HM Prison Service and National Commissioning Group. A copy has been placed in the Library. The National Commissioning Group are responsible for commissioning a range of specialist services including the national in-patient Secure Forensic Mental Health Service for Young People, which oversees in-patient treatment and referrals to seven specialist units for under 18s in England.

The “Procedure for the Transfer of Prisoners to and from Hospital under Sections 47 and 48 of the Mental Health Act 1983” aims to help colleagues to work together more effectively to secure and sustain significant improvements in any unacceptable delays transferring patients from custodial care to hospital care and includes a specific section on young people. The procedure states that a child with an acute need for a mental health secure bed should be moved within seven days.

Mentally Ill: Legal Services

Lynne Jones: To ask the Secretary of State for Health pursuant to the oral answer of 17 June 2008, Official Report, columns 799-800, what funding has been allocated for statutory independent advocacy services in (a) 2009, (b) 2010 and (c) 2011. [213310]

Mr. Bradshaw: We are committed to funding independent mental health advocacy and funding for this will be announced together with other departmental priorities as part of the Department's 2009-10 business plan which we expect to publish in the spring.

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Mentally Incapacitated: Protection

Sandra Gidley: To ask the Secretary of State for Health if he will bring forward proposals for legislative provisions to strengthen the safeguarding of vulnerable adults and the regulation of those that work with them so as to establish parity between such provisions and those that apply in the field of child protection; and if he will make a statement. [222373]

Ann Keen: The Government are committed to strengthening safeguarding for adults and is consulting on a range of ways of doing so. We are currently conducting a review of the No Secrets guidance, in light of the knowledge we have gained since it was introduced in 2000. We will consider the case for legislation as part of the review process.

We are working closely with other Government Departments on the review and will shortly be launching a public consultation exercise as part of it. We have already undertaken a listening exercise with key stakeholders to support the consultation process.

We want to enable adults to make informed decisions about how they live, how they are supported and what level of risk they are comfortable with. It is important that we do not assume that they automatically need the same type of protection as children.


Mr. Crausby: To ask the Secretary of State for Health what progress has been made in eradicating MRSA infection in NHS hospitals. [222623]

Ann Keen: The latest Health Protection Agency data for January to March 2008 shows significant progress, with a reduction in methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections of 33 per cent. compared to the same quarter last year. These figures also show a 49 per cent. reduction compared to the quarterly average in 2003-04, so the national health service is on course to reach the current nationwide target to halve the number of MRSA bloodstream infections by the end of March 2008 compared to 2003-04 levels.

It is not possible to eradicate health care associated infections completely as many health care interventions have some element of risk and sick people are more vulnerable to infection. However, the NHS is seeking to ensure that no avoidable infection occurs, as well as working towards the current nationwide target for MRSA bloodstream infections.

Under the “Better Care for All” public service agreement, the NHS is required to sustain progress on reducing the number of MRSA bloodstream infections to 2010-11. This means that the annual number of MRSA bloodstream infections for the period 2008-09 to 2010-11 should be less than half of the 2003-04 figure. As we have said in the “Clean, Safe Care” strategy, we do not, however, expect that this should limit the ambitions of organisations that wish to go further, faster. The NHS has made extraordinary progress in reducing MRSA levels and there is no reason to think that the progress cannot be maintained.

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National Institute for Health and Clinical Excellence

Anne Milton: To ask the Secretary of State for Health what plans are being developed based on the proposals in the NHS Next Stage Review for an extended role for the National Institute for Health and Clinical Excellence to develop standards to monitor quality and safety of services; and what effect this role will have on organisations involved in standards-setting, with particular reference to (a) the Healthcare Commission, (b) the Clinical Negligence Scheme for Trusts and (c) the Royal Colleges. [221823]

Mr. Bradshaw: The Department's report High Quality Care for All: NHS Next Stage Review Final Report (CM7432) states that, from 2009, the National Institute for Health and Clinical Excellence (NICE) will expand the number and reach of national quality standards
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either by selecting the best available standards, including the adoption of the relevant parts of national service frameworks or by filling in gaps. We are taking forward work on this proposal with NICE. NICE will need to work with a range of stakeholders as it develops national quality standards.

Mr. Stephen O'Brien: To ask the Secretary of State for Health which interventions (a) have been assessed and (b) are being assessed by the National Institute for Health and Clinical Excellence (NICE) through its Single Technology Appraisal process; and on which date (i) the intervention received its product licence, (ii) the intervention was referred to NICE, (iii) NICE started its appraisal and (iv) NICE completed its appraisal in respect of each. [222426]

Dawn Primarolo: The information is in the following table.

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