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Angela Watkinson (Upminster) (Con): NICE guidance recommends that newly diagnosed diabetics should have structured patient education made available to them. Given the rising number of people, particularly children, suffering from diabetes, is the Minister confident that PCTs have the necessary resources and diabetic nurses available to provide that service?
Ann Keen: The hon. Member raises an important point about education. We are working continually with the support team that published Improving emergency and inpatient care for people with diabetes, particularly in respect of children and young adolescents. It is an extremely important programme and the diabetes specialist nurse, of course, plays a pinnacle role in the team.
Keith Vaz (Leicester, East) (Lab): In declaring my interest as a sufferer from type 2 diabetes, I welcome the Health Secretarys proposed visit to the Silver Star centre in Leicester, whose aim is to raise awareness so that people can be tested for diabetes. Will the Minister pledge to increase the resources that the Government give to voluntary projects to help the centre to do that assessment, which is so vital to people finding out whether they have diabetes?
Ann Keen: Great work has been done on diabetes in my right hon. Friends area. Since 2006-07, the quality and outcomes framework has rewarded practices for recording the ethnicity of 100 per cent. of new patient registrations. There is, of course, much more work to do, but I believe that we have made great progress.
The Minister of State, Department of Health (Mr. Ben Bradshaw): Data held electronically can be secured using encryption and other measures that are not applicable to old paper-based systems. The NHS national programme for IT has particularly high levels of security because of the sensitive nature of the data held.
Mr. Mackay: Does the Minister accept that, with hardly a week going by without some Government Department having a serious breach of data security, patients are very worried about these sensitive matters. What real assurance can the Minister give that we will not pick up a newspaper tomorrow or next week and find out about a breach in his Department?
There is no such thing as a 100 per cent. guarantee of the type that the right hon. Gentleman seeks. I hope to reassure him on his question about the national programme for IT, however, because none of the data losses over the last few months has involved that programme. It has almost entirely been the old paper-based systems of record holding that have caused the problems, which reinforces the point in my initial replythat computer-based systems, particularly those involving the national programme, are much more secure because of encryption and other measures. Data protection is a very serious matter and we take it very seriously. We welcome the Information Commissioners proposals to
strengthen sanctions against people who breach the Data Protection Act 1998. We require all hospitals to provide information about what action they take when such breaches occur.
David Taylor (North-West Leicestershire) (Lab/Co-op): Did the Minister see the recent article in Computer Weekly, which revealed that the national health service has released 300 million confidential medical recordsincluding dates of birth, postcodes, details of A and E visits and in-patient treatmentto an academic organisation outside the NHS? A further 250 million records of a similar level of detail of out-patient treatments were released. How satisfied is the Minister that the academic world will treat such sensitive information with the necessary confidentiality? Will the framework be as tough as the one he described in respect of the NHS?
Mr. Bradshaw: I could not possibly be such an avid reader of Computer Weekly as my hon. Friend, who takes a close interest in all matters to do with computers. However, I want to reassure him that the sort of release he refers toI think I am right in saying this, but I shall check and write to himis anonymised data used not only to help compile statistics on health care and outcomes, but for research purposes, which is an important function of the use of data.
Sir Nicholas Winterton (Macclesfield) (Con): To follow up the question asked by the hon. Member for North-West Leicestershire (David Taylor), does the Minister accept that, if individuals medical records get into the public domain by whatever means, it can be very damaging to the life and perhaps even the employment prospects of a particular individual? Will he assure me that the Government will do everything possible to ensure that medical records remain private? Are there grounds for saying that there might be compensation to an individual who feels that his or her life has been adversely affected by their records becoming public knowledge?
Mr. Bradshaw: The last part of the question would be better answered by anyone who feels that they have been affected by that taking advice from their lawyer. However, I reassure the hon. Gentleman that the Department certainly places hard strictures on the NHS, including work done by GPs at local level, for that massive organisation to comply with data protection rules. There are clear responsibilities on individual health service managers at local level. They know their legal obligations, and there have been dismissals in the past 12 months as a result of data breaches. We take the issue seriously, but we are always looking to see how we can improve things.
10. Annette Brooke (Mid-Dorset and North Poole) (LD): What discussions he has had with ministerial colleagues on the contribution of local health services to the operation of childrens trusts. 
The Parliamentary Under-Secretary of State for Health (Ann Keen):
My right hon. Friend the Secretary of State for Health has regular meetings with the Secretary of State for Children, Schools and Families about a range of policy and operational issues affecting the health and well-being of children. This of course includes issues relating to the operation of childrens trusts. Children,
families and stakeholders have been engaged in developing the strategy over the summer. We therefore expect to be in a position to publish the child health strategy later this year.
Annette Brooke: The Audit Commission published a report last week that concluded that there is little evidence that childrens trusts have improved outcomes for children. My concern is whether local primary care trusts and other health services right across the country are fully playing their role in childrens trusts. The Audit Commission makes six recommendations for central Government. What action can the Minister promise to ensure that all services contribute to the improvements that we need so badly for children?
Ann Keen: The hon. Lady mentioned the Audit Commissions criticism. We are very disappointed that it chose to take such a negative approach. The headline message that has been quoted from the commissions press release is a misrepresentation of what its report as a whole says and draws on fieldwork that is now almost a year old. Since then, the childrens plan sets out clearly our high ambitions for children and the role of childrens trusts in delivering them. That will become more apparent with the launch of the childrens strategy later this year. I believe that more information for PCTs will be announced by the Secretary of State for Children, Schools and Families on 19 November.
The Secretary of State for Health (Alan Johnson): The responsibilities of my Department embrace the whole range of NHS social care, mental health and public health service delivery, all of which are of equal importance.
Mr. Burstow: I am grateful to the Secretary of State for that answer. After a decade or more of the NHS in my constituency, covering Sutton, Cheam and Worcester Park, going in ever-decreasing circlesconsulting, drawing up plans, devising strategies and holding stakeholder eventsat last it has come forward with an outline business case for much-needed investment in patient facilities at St. Helier hospital. Will the Secretary of State tell my constituents just how much longer they will have to wait for the Department and the Treasury to give the go-ahead, and will he meet me and other Members of Parliament with an interest in the matter to discuss it further?
Alan Johnson: I am glad that, despite the long period of consultation, plans are now coming forward. I cannot give the hon. Gentleman any idea of how long the process will take, because I am not aware of the situation, but I will be after we have met, and I very much welcome a meeting with him and his colleagues.
T4.  Mr. Lindsay Hoyle (Chorley) (Lab):
My right hon. Friend received a nice invitation to visit Chorley and Preston hospitals. I believe that there is a great success story there. My right hon. Friend ought
to come and see how the access treatment service centre is working under the NHS. He could learn from that, and I believe that it would be a good visit. Will he reconsider his position, and visit those hospitals sooner rather than later?
Norman Lamb (North Norfolk) (LD): The Secretary of State will be aware that the number of care home residents who have died as a result of clostridium difficile trebled between 2005 and 2007. I believe that the number is now 438, which is a horrifying death toll. Given that the Government have focused largely on tackling the problem in hospitals, what steps is he taking to address the problem in the wider community and does he agree that there must be zero tolerance for low hygiene standards in any health or care setting, wherever it is?
Alan Johnson: I agree that this is a crucial issue. We have not been concentrating on reducing the number of cases of clostridium difficile in hospitals to the exclusion of social care. Indeed, we have insisted on proper records being kept, and by next year we shall have in place a registration system for care homes that will be an important factor in raising standards. Our campaigns to increase awareness of the dangers of over-prescription of antibiotics, the need for people to clean their hands, and all the other issues that apply to hospitals have been conducted in care homes as well.
We do need to ensure that there is no continuing increase in clostridium difficile cases in care homes. I believe that the registration scheme will be the biggest single factor in helping us, but we must take all the other measures as well to ensure that we do not see any further increase in cases in adult social care.
T8.  John Robertson (Glasgow, North-West) (Lab): Will my right hon. Friend allay my fears about the problems with clostridium difficile, which is on the increase in Scotland, by ensuringthrough his cross-border discussions with the Scottish Executive and, for that matter, with the Welsh Assembly and the Northern Ireland Assemblythat best practice is shared so that everyone receives the same deal in the NHS?
Alan Johnson: My hon. Friend will know that, according to the latest statistics relating to the period between April and June, there has been a 38 per cent. decrease in cases of clostridium difficile among those over 65. That builds on decreases of 32 per cent. in the preceding quarter and 22 per cent. in the quarter before that. All those figures are in comparison with the same quarter in the previous year.
This is a national health service, and we are constantly in touch with the devolved Administrations to discuss how we can learn from each other about tackling these issues. As I said in my reply to the hon. Member for North Norfolk (Norman Lamb), there are three basic messages: the need for clean hands, responsible prescription of antibiotics, and the provision of cohort nursing and isolation facilities when outbreaks occur. Those three simple messages must be repeated over and over again.
T2.  Tony Baldry (Banbury) (Con): In Oxfordshire, we all want to see the Oxford Radcliffe Hospitals NHS Trust succeed. Will the Minister confirm, however, that when the trust draws up its business plan for foundation trust status, it cannot expect year-on-year funding increases greater than the predicted funding increases for Oxfordshire primary care trust? Will he also confirm that when members of the independent reconfiguration panel speak of the need for county-wide health proposals, they, and the Secretary of State, expect exactly thatcounty-wide health proposals for Oxfordshire, not just Oxford-focused proposals?
The Minister of State, Department of Health (Mr. Ben Bradshaw): When the independent reconfiguration panel reported, my right hon. Friend the Secretary of State made it absolutely clear that he accepted its recommendations in full, so the answer to the second part of the hon. Gentlemans question is yes. As for the first part, I have been reassured by the Radcliffe that it is entirely aware that its financial planning must reflect the commissioning planning of the primary care trusts, and that it must continue to work closely with Oxfordshire PCT to ensure that it delivers what the hon. Gentleman wishes to see.
Dr. Ian Gibson (Norwich, North) (Lab): Will my right hon. Friend consider delaying his statement on co-payments until he has accepted that the exceptional cases and disparities across the country should be handled first? Does he agree that if they were handled first, there might be no need for co-payments?
T3.  Ann Winterton (Congleton) (Con): Given that UK-trained radiographers demonstrate best practice, why is no funding available to provide courses for the statutory 30 days academic study, so that those who wish to return to practice after a five-year break, for example to have a family, can do so? Does it not make good economic sense to support motivated returners so that they can enhance the UKs radiography skill base, rather than relying on attracting foreign nationals?
Mr. Eric Illsley (Barnsley, Central) (Lab): The medical director of my local NHS hospital trust has reported great difficulty in recruiting doctors to essential positions in the hospital below consultant level as a direct consequence of the restrictions placed on the number of international graduates coming into the country last year. Does my right hon. Friend have any proposals to review that system, as it would appear that there are too few doctors for the posts that are now available?
I am perfectly willing to speak to my hon. Friend about the problems in his patch, but the issue here is that we cannot have both a policy of self-sufficiency and an open-door policy. We now have the medical schools in place to produce our own graduates for jobs. The contribution made by international medical graduates has been enormous, but we ran into problems
a couple of years ago because there were sometimes as many as 20 or 25 applicants for every position, and that does not make sense if the British taxpayer is putting more money into training our own graduates. We took measures this year to ensure that that situation did not arise, but I am perfectly willing to talk about any problems occurring in any part of the country, and particularly in my hon. Friends constituency.
T6.  Peter Luff (Mid-Worcestershire) (Con): Did the Minister of State, the right hon. Member for Bristol, South (Dawn Primarolo), really mean her answer to my hon. Friend the Member for South-West Devon (Mr. Streeter) that the Government have no plans that will adversely impact on GP dispensing? I have received literally hundreds of letters from constituents who all share my view, and the view of GPs, that three of the four proposals in the current consultation document would seriously adversely impact on GP dispensing and, therefore, the rural areas they serve, and only oneoption 1, which recommends the status quois acceptable.
The Minister of State, Department of Health (Dawn Primarolo): Yes, I did seriously mean that answer, and if the hon. Gentleman refers back to the consultation document, he will see that it sets down four possible ways of looking at an issue that has not been reviewed for more than 60 years, but there are no specific proposals to do anything. [Hon. Members: Oh!] There are no specific proposals to do anything, as that is not the purpose of the consultation. So if the hon. Gentleman is saying the Government intend to abolish GP dispensing, that is not true.
T7.  John Bercow (Buckingham) (Con): Can the Secretary of State reassure me that, when the child health strategy is eventually published, I shall have cause to dance around the mulberry bush in joyous appreciation of its explicit commitment to take forward the speech and language agenda, or will the Treasury have spoiled my fun?
Alan Johnson: The hon. Gentleman did a first-class piece of work on behalf of myself and the Department for Children, Schools and Families. He will be ecstatic when he sees the results of the child health strategy review, and I will dance around the mulberry bush with him.
Mr. Andy Reed (Loughborough) (Lab/Co-op): Speaking at the mens health forum event in Manchester last week, I was struck by some of the innovative projects around the country to tackle the inequalities in mens health, but there was a common theme for all those projects: they were innovative and they worked, but their level of funding was unsustainable. When the physical activity strategy is launched, will my right hon. Friend ensure that we try to find out which projects work, and then fund them and deliver them right across the country, rather than think of new pilot projects?
Dawn Primarolo: Yes, I can give that assurance to my hon. Friend. Where such projects are clearly working, it is important that that experience is shared with other areas and its benefits taken forward. We must focus on that.
Mr. Andrew Lansley (South Cambridgeshire) (Con): Can the Secretary of State explain why he believes it is wrong for a cancer patient to pay £7.10 for a prescription in the community, while at the same time they can be made to pay more than £11,000 for a bowel cancer drug, despite its being recommended by their hospital doctors?
Alan Johnson: We are straying into the territory that will shortly be the subject of my statement. The issue of charging for drugs that are not available on the national health service is important, and I believe that I picked the right person to look into it. When I make my statement in a few minutes, I believe that hon. Members on both sides will agree that he has done an excellent job of the task that we gave him.
Mr. John Grogan (Selby) (Lab): Does the Secretary of State agree with the findings of the Rarer Cancers Forums survey of English primary care trusts, which concluded that the wide variety of processes used to determine exceptional cases causes confusion among patients, that things are often dominated by administrators rather than by clinicians, and that results are sometimes not produced in a timely fashion?
Alan Johnson: I do agree with my hon. Friend. As I mentioned, we need to address that issue about transparency, consistency and a lack of clarity. If he remains in his place, he will hear that some very important proposals in that area are contained in the report from Professor Mike Richards.
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