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Cancer: Health Services

Mr. Lansley: To ask the Secretary of State for Health what benchmarking data his Department collects on the use of cancer treatments in comparable health economies; and what estimate his Department has made of the cost of bringing the UK's use of cancer treatments into line with those benchmarks. [231088]

Ann Keen: We do not routinely collect data on the use of cancer treatments in comparable health economies.

Care Homes: Fees and Charges

Mr. Lansley: To ask the Secretary of State for Health how much was paid in charges for (a) residential and (b) non-residential care, broken down by local authority area, in each of the last five financial years for which figures are available. [226301]

Phil Hope: Data on client contributions made to Councils with Adult Social Services Responsibilities (CASSRs) is collected and published by the NHS Information Centre for health and social care. Data on the total amount of charges paid by service users in England for their care is not available centrally; information is not collected on fees paid for care where the service user receives no funding from the council, except in cases where they are resident in a council-run home or receive council-provided non-residential care. However, information is collected on fees paid by service users where they are part funded by the council and pay the remainder themselves. The available information on client contributions, by CASSR, for residential care and community based services between 2003-04 and 2007-08, has been placed in the Library.

Care Homes: Infectious Diseases

Norman Lamb: To ask the Secretary of State for Health how many (a) cases of healthcare-acquired infections and (b) deaths where the death certificate refers to a healthcare-acquired infection there were in care homes in each of the last three years for which figures are available, broken down by (i) type of infection and (ii) type of care home. [228914]

Ann Keen: The information requested specifying the number of cases of healthcare associated infections in care homes is not available. The surveillance schemes for methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections and Clostridium difficile infections collect data on where the patient was located when the specimen was taken. It is not possible to attribute reliably the origin of an infection to care homes or other settings from this information.

Death certificates record the place where a person dies, but not where any infections may have been acquired. Patients are often transferred between hospitals, nursing/care homes and other establishments and may acquire infections in a different location from their place of death.

The Office for National Statistics (ONS) publishes analyses of deaths in England and Wales where MRSA or Clostridium difficile is mentioned on the death certificate but these data do not indicate if the infection was acquired in hospital or elsewhere. The latest year for
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which figures are available is 2007; the data are published in Health Statistics Quarterly. This has already been placed in the Library.

The following tables, supplied by ONS, provide data on the proportion of all death certificates in NHS nursing homes, non-NHS nursing homes, private residential homes, and local authority residential homes in England and Wales where MRSA or Clostridium difficile were recorded, from 2005 to 2007, the latest year for which figures are available. Table 1 presents the proportion of certificates where MRSA or Clostridium difficile were mentioned and table 2 presents the proportion where MRSA or Clostridium difficile were recorded as the underlying cause of death.

Table 1: Number of death certificates where methicillin-resistant Staphylococcus aureus( 1) or Clostridium difficile( 2) was mentioned, by place of death,( 3) England and Wales, 2005-07( 4)
Deaths (persons)

2005 2006 2007

NHS nursing home

MRSA

17

15

12

C. difficile

24

50

69

Non-NHS nursing home

MRSA

89

69

82

C. difficile

80

147

232

Private residential home

MRSA

39

27

37

C. difficile

32

70

116

Local authority residential home

MRSA

9

7

5

C. difficile

8

24

21

(1) Identified using the methodology described in Griffiths C, Lamagni TL, Crowcroft NS, Duckworth G and Rooney C (2004). Trends in MRSA in England and Wales: analysis of morbidity and mortality data for 1993-2002. “Health Statistics Quarterly” 21, 15-22.
(2) Identified using the methodology described in Office for National Statistics: Report: Deaths involving Clostridium difficile: England and Wales, 2001-2005. “Health Statistics Quarterly” 33, 71-75.
(3) Death certificates record the place where a person dies, but not where any infections may have been acquired.
(4) Deaths registered in each calendar year


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Table 2: Number of death certificates where methicillin-resistant Staphylococcus aureus( 1) or Clostridium difficile( 2) was recorded as the underlying cause of death, by place of death,( 3 ) England and Wales, 2005-07( 4)
Deaths (persons)

2005 2006 2007

NHS nursing home

MRSA

5

8

2

C. difficile

14

26

36

Non-NHS nursing home

MRSA

18

13

22

C. difficile

49

80

124

Private residential home

MRSA

11

4

5

C. difficile

18

39

59

Local authority residential home

MRSA

1

3

2

C. difficile

4

14

12

(1) Identified using the methodology described in Griffiths C, Lamagni TL, Crowcroft NS, Duckworth G and Rooney C (2004). Trends in MRSA in England and Wales: analysis of morbidity and mortality data for 1993-2002. “Health Statistics Quarterly” 21, 15-22.
(2) Identified using the methodology described in Office for National Statistics: Report: Deaths involving Clostridium difficile: England and Wales, 2001-2005. “Health Statistics Quarterly” 33, 71-75.
(3) Death certificates record the place where a person dies, but not where any infections may have been acquired.
(4) Deaths registered in each calendar year.

Cholesterol

Mr. Burstow: To ask the Secretary of State for Health what consideration he gave to setting the quality and outcomes framework measure for cholesterol management in accordance with guidance issued by the National Institute for Health and Clinical Excellence; and if he will make a statement. [230735]

Dawn Primarolo: The development of new indicators for the quality and outcomes framework are considered following an analysis of the evidence base which is carried out by an independent expert panel. Any subsequent changes are made following negotiations between NHS employers and the general practitioners committee of the British Medical Association.

Chronically Sick: Health Services

Mr. Burstow: To ask the Secretary of State for Health what plans he has to evaluate the (a) implementation and (b) outcomes of the national service framework for long-term medical conditions. [230736]

Ann Keen: The national service framework (NSF) for long-term conditions was published in March 2005, and will be implemented over 10 years with flexibility for local health and social care communities to take account of local priorities and needs. A copy of this document has been placed in the Library.

The Department has provided service planners, commissioners and providers with guidance, expert advice and support to help them to deliver the NSF’s quality requirements. However, in line with devolving responsibility to local organisations, we are moving to a new phase with much greater emphasis on local health and social care communities and the third sector taking responsibility for driving forward service change and improvement. This also recognises that the NSF is not a stand-alone priority but that it needs to be closely aligned and integrated into mainstream NHS and social services activity.

Contraceptives

Sandra Gidley: To ask the Secretary of State for Health how many women aged (a) 16 to 24, (b) 25 to 34, (c) 35 to 45 and (d) 46 or more years were taken off combined levonorgestrel and ethinyl estradiol preparations and prescribed an alternative contraceptive in each of the last five years, broken down by alternative contraception prescribed. [231296]

Dawn Primarolo: The information is not available in the format requested.


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Dementia: Drugs

Mr. Burstow: To ask the Secretary of State for Health pursuant to the Answer of 15 October 2008, Official Report, column 1348W, on dementia: drugs, if he will set out details of (a) the work programme and (b) the consultation and stakeholder engagement that is currently being undertaken. [231022]

Phil Hope: Priority is currently being given to work on finalising the National Dementia Strategy and Implementation Plan. This involves analysis of the findings from over 50 consultation events throughout the country, and over 500 written responses. Details of the work programme and stakeholder engagement for the review of the prescription of anti-psychotic drugs to people with dementia will be set out when the review is published in early 2009.

Dementia: Research

Mr. Drew: To ask the Secretary of State for Health how much is being spent on Government commissioned and funded medical research on (a) Alzheimer’s disease and (b) other forms of dementia in 2008-09. [231162]

Dawn Primarolo: The information requested is not yet available.

In 2007-08, national health service support for degenerative neurological disorder research and National Institute for Health Research investment in dementia research amounted to some £23 million.

The Medical Research Council and the Wellcome Trust announced on 2 October 2008 their intention to make £30 million available to boost research into neurodegenerative diseases.

Dental Services

Mr. Hancock: To ask the Secretary of State for Health what recent assessment he has made on the adequacy of the current level of access to NHS dentistry. [231227]

Ann Keen: The Department estimated in 2000 that there are some two million people in England who would like to access national health service dental services but are unable to do so.

Since the reforms to the dental contractual arrangements introduced in April 2006, primary care trusts (PCTs) are now responsible for assessing local need and developing services to meet this need. Increasing the number of patients seen within the NHS dental service is now a national priority in “The Operating Framework for the NHS in England 2008-09”. We have supported this with an 11 per cent. uplift in overall dental allocations to PCTs worth £2,081 million (net of patient charge income). Copies of the operating framework have already been placed in the Library.

Departmental Freedom of Information

Mr. Amess: To ask the Secretary of State for Health in relation to what requests for information under the Freedom of Information Act 2000 on (a) abortion, (b) contraception, (c) reproductive health issues and (d) euthanasia refused by his Department appeals were made to the Information Commissioner in each year since 2005; how many such appeals were successful; if
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he will place in the Library copies of the information subsequently provided by his Department in each case; how much was spent by his Department opposing each appeal; what (i) consultants and (ii) law firms his Department employed in connection with each appeal; and if he will make a statement. [229509]

Dawn Primarolo: Since 2005, requesters have complained twice to the Information Commissioner about the Department’s handling of applications for information about abortions under Freedom of Information legislation; one in 2005 and one in 2006. In the first case, the Information Commissioner decided that the Department should release information and a copy of the information was released to the applicant and has already been placed in the Library. In the second case, the Information Commissioner decided in July 2008 that the Department should release the information. After careful consideration and taking into account all the circumstances in both cases, the Department has lodged grounds for appeal with the Information Tribunal and is currently undertaking preparatory work. The Information Commissioner has not received similar complaints about the Department’s refusal of requests on contraception, reproductive health issues and euthanasia.

Legal advice in both cases is provided to the Department by DH Legal Services, which is part of the Department for Work and Pensions (DWP) legal group. DH Legal Services provides a full range of legal services to the Department including arranging representation in court. No external consultants were employed in either case. No consultants or law firms were instructed in relation to these cases, although DH Legal Services sought advice from Counsel in relation to some matters. The costs associated with these two cases have amounted to £4,400.00 to date. The Department is not expecting the outstanding appeal from the 2006 case to be heard in the current calendar year and therefore the law firm representing the Department is yet to be identified.


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