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Ann Keen: There have been no compulsory redundancies for national health service midwives in Peterborough and Cambridgeshire in the last two years. The total number of NHS midwives to receive compulsory redundancy notices in the last two years in England is listed in the following table:
|Period||Total number of compulsory redundancies for midwives||Total number of compulsory redundancies (all groups)|
Mr. Gray: To ask the Secretary of State for Health what assessment he made of the effectiveness of the risk sharing scheme for the provision of multiple sclerosis disease modifying drugs; what value for money assessment he has made of the risk sharing scheme since its inception; when he will make available the full ScHARR report, including Annex C, as requested by the Health Select Committee in 2007; what the cost of the scheme has been since its inception; what the cost of (a) providing Avonex, Beteferon, Copaxone and Rebif and (b) the administration of the scheme by the MS Trust has been; and if he will make a statement. 
Ann Keen: The risk-sharing scheme for disease modifying drugs for multiple sclerosis is a unique UK-wide programme set up to allow access to treatment through the national health service in a cost-effective manner. Over 5,000 patients are routinely monitored to assess their progress on treatment and it is estimated that, overall, some 10,000 patients are being treated with these drugs. The first two-year analysis of scheme data has been undertaken and it is planned to publish the results in a peer-reviewed medical journal. The independent Scientific Advisory Group, which advises the study, is considering how to modify the scheme in time for the next two-year analysis due in 2009. We hope then to determine reliably whether the drugs at current prices represent value for money for the NHS. The Health Select Committee was sent, in confidence, a full copy of the report from Sheffield's School of Health and Related Research (ScHARR) earlier this year.
We estimate that the costs incurred since the scheme's inception are in the order of £300 million. This figure is made up of £200,000 a year representing the Department's 20 per cent. share of running the contract; an average £35,000 a year to meet the Multiple Sclerosis Trust's administration costs for the scheme and drug costs of around £50 million a year.
Sir Nicholas Winterton: To ask the Secretary of State for Health how many people were employed in the National Health Service in 2007, expressed on (a) headcount and (b) full-time equivalent basis. 
|Number of people|
Paul Rowen: To ask the Secretary of State for Health how much was paid (a) by (i) employees and (ii) employers into and (b) to those receiving pensions payments from the National Health Service Pension Scheme in each of the last five years. 
Total pensions paid to members and dependants includes pensions and lump sums paid to members, and pensions paid to widows and dependants together with death gratuities.
Mr. Waterson: To ask the Secretary of State for Health (1) how many part-time employees of NHS ambulance service trusts and their predecessors who were excluded from the NHS pension scheme before 1999 were women; 
(2) how many part-time employees of NHS ambulance service trusts and their predecessors were not included in the NHS pension scheme in each year prior to 1999 for which figures are available. 
Ann Keen: Individuals who had been excluded from membership of the scheme prior to 1 April 1991 and wishing to make a claim were required to do so through an employment tribunal. Under employment tribunal rules claims had to be made while still working for that employer or within six months of the end of the employment relationship. Those successful in this process pay the contributions that are due to the scheme for the excluded period and their membership for this period is reinstated.
Ann Keen: The NHS Pension Scheme is a final salary pension scheme, which offers a defined package of benefits to scheme members in accordance with the scheme regulations. NHS ambulance staff, like other national health service employees enjoy a benefit package which includes:
index linked retirement benefits
life assurance and family benefits
ill health retirement benefits
The aforementioned benefits are subject to the scheme member meeting relevant qualifying criteria set out in the scheme regulations. Full-time and part-time staff have the same benefits. The membership of part time staff is scaled according to the hours worked.
Mr. Hoban: To ask the Secretary of State for Health whether (a) his Department's officials and (b) NHS officials have been instructed to review the cost to the public purse of providing more single rooms within the NHS estate since 27 September 2008. 
Ann Keen: In October 2008 the Department's officials reported a capital cost estimate of about £9.51 billion (at Quarter 1 2008 prices) for providing 45,000 more single rooms, £211,401 per bed, while maintaining the existing bed capacity of the national health service estate. This costing was based on standard NHS costing methodologies.
NHS organisations make decisions locally based on practical considerations such as site restrictions, affordability as well as clinical and operational limitations. Any national estimate must therefore make assumptions regarding the methods likely to be used for providing more single rooms and the likely cost effects of such methods.
Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 16 October 2008, Official Report, column 1466W, on nurses, (1) when his Department last issued guidance on the modern matrons programme; and if he will place in the Library a copy of that guidance; 
The definition of modern matrons was provided in the NHS Plan and detailed guidance was given in Health Service Circular 2001/010 Implementing the NHS Plan: Modern Matrons: strengthening the role of ward sisters and introducing senior sisters. Education and training of modern matrons is the responsibility of their employers in light of local priorities and local assessment of training needs.
A directed enhanced service (DES) for osteoporosis has been agreed for 2008-09 and 2009-10, which will encourage general practices to diagnose and prescribe appropriate secondary prevention for patients with osteoporosis. This will help improve patient care by ensuring that specific patient groups are managed appropriately and in accordance with existing guidance
published by the National Institute for Health and Clinical Excellence (NICE).
Additionally, as part of the prevention package for older people, we intend to establish an expert group, who will develop a commissioning framework, which will help the national health service better provide services for falls, fractures and osteoporosis. The Department has started the process of engagement with key stakeholders from the NHS, social care and the third and private sector to develop the detail of the package, which it expects to publish by March 2009.
Ann Keen: The Department is committed to improving the outcomes for babies and therefore supports the Confidential Enquiry for Maternal and Child Health (CEMACH). CEMACH published their report Perinatal Mortality 2006England Wales and Northern Ireland, in May 2008 and found a continuing decline in the overall neonatal mortality rate and in the stillbirth, perinatal and neonatal mortality rates in multiple pregnancies. This report has already been placed in the Library.
The Department has also introduced a new maternity indicator to measure the percentage of women who have seen a midwife or a maternity health care professional for a health and social care assessment of needs, risk and choices by 12 completed weeks of pregnancy. This will improve early access to maternity care and outcomes for mothers and babies as risks will be identified early and an individualised plan of care developed.
In 1953 a large clinical trial in the United States showed no beneficial effect of DES on pregnancy outcome. In 1973, the UKs Committee on Safety of Medicine (CSM) (now the Commission on Human Medicines) considered data from a US study that identified an association between the development of clear-cell adenocarcinoma of the vagina/cervix in the daughters of women exposed to DES during pregnancy. On the
basis of the lack of benefit and evidence of harm the CSM wrote to all doctors in the UK with the recommendation that DES should no longer be used in pregnancy.
The Department is aware of several overseas studies, including a number in the United States (where diethystilboestrol was used extensively), which have investigated the long-term effects of diethystilboestrol on women who took it during pregnancy. A large ongoing study conducted by the National Institute of Cancer in the United States is investigating the risks of DES to children who were exposed in utero. The Department has not formally evaluated these studies.
The Department has in the past sought advice on this issue from the Advisory Committee for Cervical Screening. On the basis of this advice, the Department is of the view that a public education campaign would not be helpful. Many of the women at risk are not aware they or their mothers received DES. Proactively campaigning to find these women would create further anxiety.
Although the Health Protection Agency collects information on blood stream infections these data do not provide a complete picture as sepsis is a clinical condition caused by a range of bacteria that are manifest as localised infections as well as blood stream infections.
Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 16 October 2008, Official Report, column 1468W, on social services, what assessment he has made of the likely financial situation of organisations responsible for adult social care provision in each year from 2012 to 2041 for which figures are available. 
Phil Hope: The projected funding gap for 2012 to 2041, which was published in Care Support Independence: The Case for Change (a copy of which has been placed in the Library) was calculated for illustrative purposes only and no assessment of the current financial situation on the funding gap has been made. The wider issue of the reform of the care and support system is being considered in the Green Paper, due to be published next year.
Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 21 October 2008, Official Report, column 321W, on social services, how the personal expenses allowance is calculated; and what the average weekly allowance for care home residents was in the last period for which figures are available. 
The requirement for an allowance for expenditure on personal items for those living in residential care settings has its origins in section 22(4) of the National Assistance Act 1948. The National Assistance
(Charges for Accommodation) Regulations 1948 set the sum for personal requirements at five shillings per week. These Regulations came into force on 5 July 1948. Due to the passage of time, it has not proved possible to establish the reasons that the level set was felt to be appropriate. Contemporary papers and reports are not available.
The Department now uprates the personal expenses allowance (PEA) annually on the basis of the increase in average earnings. The 2008-09 rate of PEA is £21.15 per week. This took effect on 7 April 2008.
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