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30 Oct 2008 : Column 1240W—continued

Health Visitors: Manpower

Ms Keeble: To ask the Secretary of State for Health how many health visitors were employed by each strategic health authority in (a) 1997, (b) 2002 and (c) 2007. [231054]

Ann Keen: The number of health visitors employed by each strategic health authority in 1997, 2002 and 2007 is shown in the following table.

NHS hospital and community health services: health visitors in England by strategic health authority area as at 30 September each specified year

1997 2002 2007





North East Strategic Health Authority Area




North West Strategic Health Authority Area




Yorkshire and The Humber Strategic Health Authority





East Midlands Strategic Health Authority Area




West Midlands Strategic Health Authority Area




East of England Strategic Health Authority Area




London Strategic Health Authority Area




South East Coast Strategic Health Authority Area




South Central Strategic Health Authority Area




South West Strategic Health Authority Area




1. More accurate validation in 2006 has resulted in 232 headcount duplicate records being identified and removed from the non-medical census
2. Data Quality
Workforce statistics are compiled from data sent by more than 300 NHS trusts and primary care trusts (PCTs) in England. The NHS Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data. Processing methods and procedures are continually being updated to improve data quality. Where this happens any impact on figures already published will be assessed but unless this is significant at national level they will not be changed. Where there is impact only at detailed or local level this will be footnoted in relevant analyses.
The NHS Information Centre Non Medical Workforce Census.


Andrew Rosindell: To ask the Secretary of State for Health how many hospitals he has visited in an official capacity in the last 12 months. [227792]

Mr. Bradshaw: My right hon. Friend the Secretary of State has officially visited 30 hospitals in the last 12 months.

Hospitals: Infectious Diseases

Mr. Hancock: To ask the Secretary of State for Health what steps he plans to take to improve (a) the rate of infection control and (b) patient safety in the NHS. [231228]

Ann Keen: The Department's strategy for reducing infections in the national health service is set out in “Clean, safe care”, which has already been placed in the Library.

Infection control is one of the five top priorities in the NHS operating framework for 2008-09 and MRSA and Clostridium difficile targets to 2010-11 have been set under the “Better Care for All” public service agreement. “Clean, safe care” outlines the comprehensive range of measures being employed, backed by £270 million additional investment per year by 2010-11 to tackle health care associated infections (HCAIs) and improve cleanliness.

Steps include screening all elective admissions to hospitals for MRSA by March 2009, and all emergency admissions by 2010-11; a technology programme designed to accelerate the development and uptake of new technologies to improve infection control; and the development of a new national standard for cleanliness in the national health service. The Department is re-launching its nationwide antibiotic awareness campaign alongside an HCAI patient campaign.

These measures should support the NHS to meet their legal requirements on infection control, as set out in the “Code of Practice for the Prevention and Control of Healthcare Associated Infections” (which has already been placed in the Library). All acute NHS trusts are inspected annually against the “Code of Practice” by the Healthcare Commission. From April 2009, the new Care Quality Commission will assess compliance against the “Code of Practice” and will have a broader range of powers to ensure high performance in infection control.

Improving patient safety has been a fundamental priority running through our policies to improve the quality of NHS care. We have put in place national standards for safety. We also established the National Patient Safety Agency (NPSA) to promote reporting of adverse events and support the NHS to manage known risks. We have made good progress in the last decade on establishing a unified system for reporting and analysis when things go wrong.

“Safety First: A report for patients, clinicians and healthcare managers” sets out the Department's current agenda for patient safety. It made 14 recommendations to ensure that patient safety remains a priority for the Government and the NHS.

The final report of Lord Darzi's NHS Next Stage Review, “High Quality Care For All”, states that continuously improving patient safety should be at the top of the health care agenda for the 21st century. To achieve this, from April 2009, the NPSA will run an additional, dedicated national patient safety initiative to tackle central line catheter-related bloodstream infections. It will continue to run regular patient safety initiatives like this in future. The Agency will also work with stakeholders in this country to draw up its own list of ‘Never Events’ such as wrong site surgery. From next year, primary care trusts will select their own priorities from this list in their annual operating plan.

30 Oct 2008 : Column 1241W

Maternity Services

Mr. Gray: To ask the Secretary of State for Health what steps he is taking to respond to the National Audit Office report, Caring for Vulnerable Babies, of 19 December 2008, HC 101; and if he will make a statement. [231467]

Ann Keen: The issues raised in the National Audit Office report of December 2007 were the subject of a Public Accounts Committee (PAC) report, “Caring for vulnerable babies: the reorganisation of neonatal services in England”, published in June 2008. A copy of the Government's Treasury Minute response (Cm 7453) to the PAC report, published on 16 October 2008, is available in the Library.

The Government are committed to the provision of safe, high quality neonatal services. While improvements have been made over recent years, we recognise there is still more to do. In the 2008-09 national health service operating framework we identified neonatal services as a priority and asked primary care trusts to ensure that sufficient numbers of neonatal teams are in place to meet local needs. In addition, the Department has established a Neonatal Taskforce, chaired by Professor Sir Bruce Keogh, to support the NHS to identify and deliver further improvements to neonatal services. As part of its work programme, the Taskforce is working to develop quality standards for a comprehensive neonatal workforce and will develop targeted action plans to assist local decision making regarding staff shortages, incorporating skill mix, staffing levels, retention, recruitment and commissioning of education and training.

Medical Treatments

Mr. Bone: To ask the Secretary of State for Health what treatments have been considered but not recommended for use by the NHS by the National Institute for Health and Clinical Excellence (NICE) in the last five years; what conditions such treatments were principally intended to treat; and what judgment NICE reached on the efficacy of each such treatment. [231816]

Dawn Primarolo: The information requested is shown in the following table. It is not the role of the National Institute for Health and Clinical Excellence to assess the efficacy of drugs as this is a matter for the appropriate licensing authority.

30 Oct 2008 : Column 1242W
Treatments not recommended in NICE'S published technology appraisals or only recommended for use in research

Appraisal Condition

November 2003

Anakinra (Kineret)

Rheumatoid arthritis

August 2005

Raltitrexed (Tomudex)

Colorectal cancer

September 2006

Paclitaxel (Taxol)

Breast cancer

November 2006

Memantine (Ebixa)

Alzheimer's Disease

January 2007

Bevacizumab (Avastin) and Cetuximab (Erbitux)

Colorectal cancer

January 2007

Fludarabine (Fludara)

Lymphocytic leukaemia

August 2007

Permetrexed (Alimta)

Non-small cell lung cancer

April 2008

Infliximab (Remicade)

Ulcerative colitis

April 2008

Abatacept (Orencia)

Refractory rheumatoid arthritis

August 2008

Telbivudine (Sebivo)

Hepatitis B

August 2008

Pegaptanib (Macugen)

Wet Age Related Macugen Degeneration (AMD)

October 2008

Raloxifene (Evista)

Primary Prevention of Osteoporotic fragility fractures in postmenopausal women

Mr. Bone: To ask the Secretary of State for Health whether he has issued guidance to the National Institute for Health and Clinical Excellence (NICE) on the weight to be accorded to representations from patient groups in its evaluation of the value for money of treatments; and what weight was given by NICE to the representations of patient groups during its evaluation of sequential use of anti-TNF treatments. [231817]

Dawn Primarolo: The Department has not issued any guidance to the National Institute for Health and Clinical Excellence (NICE) on the weight that should be accorded to patient groups in its technology appraisals. NICE is an independent body and is responsible for the development of its methods. It consults with a wide range of stakeholders in the development of its methods and in the production of guidance, in accordance with its published processes.

Mental Health Services: Patient Choice Schemes

Lynne Jones: To ask the Secretary of State for Health whether the rights to choose both treatment and providers outlined in the draft NHS Constitution extend to mental health. [231301]

Ann Keen: The draft constitution states that

In the Handbook to the draft constitution it states that directions will be given by the Secretary of State under section 8 of the NHS Act to require primary care trusts to ensure that patients have a right to choose their providers. The directions will specify which services are covered by these arrangements and any exceptions. We have recently consulted on the draft constitution and the Constitutional Advisory forum will publicly report to the NHS Chief Executive and Ministers on the NHS consultation in due course.

We have conducted national consultations on choice in mental health, and recognise there is a strong demand from mental health service users for more personalised services. We are seeking to enable a choice of evidence-based psychological interventions to be available for people with more common mental health problems, like depression and anxiety disorders, entering new services.

Mental Health Services: Prisons

Hywel Williams: To ask the Secretary of State for Health what steps are being taken to (a) reduce the number of people with mental health problems being sent to prison and (b) improve the quality and availability of mental health care in prisons. [231744]

30 Oct 2008 : Column 1243W

Phil Hope: The Government have asked Lord Bradley to consider the diversion of offenders with mental health problems and learning disabilities away from prison and we look forward to considering his report which we expect will be available at the end of the year.

The Department, in partnership with the Ministry of Justice, will publish its strategy “Improving Health Supporting Justice” next year, incorporating our views on the quality and future direction of health care in prisons following a public consultation. The strategy will take account of the recommendations that Lord Bradley will make.

This builds on the work already taking place each year over 500 mentally disordered offenders are diverted to secure hospital settings and over 900 people a year are transferred from prison if they need specialist treatment in hospital. In 2007, 28 per cent. more prisoners, with mental illness too severe for prison were transferred to hospital than in 2002—up to 926 from 723. Tighter monitoring identifies prisoners waiting an unacceptably long period for transfer to hospital, and a protocol has been issued setting out what must be done when a prisoner has been waiting for a place for more than three months following acceptance by the national health service.

All prisoners assessed at the point of reception into prison and those at risk of having a mental health problem, or vulnerable to suicide, are referred for a mental health assessment to the mental health in-reach team. Nearly £20 million per annum is being invested recurrently in mental health in-reach. There are 102 mental health in-reach teams with all prisons having access to them: a total of 360 extra staff altogether.

There are new systems to monitor and support those at risk of harming themselves and prison officers are being trained in mental health awareness. £600,000 has been invested over three years to 2009 to train frontline prison staff.

Furthermore, in relation to the small number of people with a severe personality disorder who are dangerous, the Department and Ministry of Justice is investing in special secure services. This programme has a capacity of over 300 places in two high security prisons (Frankland and Whitemoor); a female prison (Low Newton in Durham) and two high security hospitals (Broadmoor and Rampton). They provide essential clinical services for dangerous offenders whose offending is linked to severe personality disorder.

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