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Ann Keen: This information can be found in the first annual report of the Cancer Reform Strategy, Cancer Reform Strategy: Maintaining momentum, building for the futurefirst annual report, published on 1 December 2008. A copy of this report has been placed in the Library.
Mike Penning: To ask the Secretary of State for Health (1) what recent assessment he has made of the level of regional differences in cervical cancer rates in England; what steps his Department is taking to reduce higher rates; and if he will make a statement; 
On 2 December 2008, the National Cancer Intelligence Network (NCIN) published a study showing that women living in more deprived areas were nearly twice as likely to be diagnosed with cervical cancer than those living in more affluent areas. In the most deprived areas of England, there were 12 women per 100,000 diagnosed with cervical cancer between 2000 and 2004, compared to only six per 100,000 in the most affluent areas. The researchers mainly attributed this gap to the lower uptake of cervical screening in deprived areas.
The Cancer Reform Strategy, published in December 2007, (a copy of which has already been placed in the Library) said that we wished to reduce the variation of cervical screening coverage between primary care trusts. NHS Cancer Screening Programmes have commissioned the Improvement Foundation to work with six primary care trusts with deprived communities to develop and test initiatives that aim to improve the uptake of cervical screening in women aged 25 to 35. They are using social marketing techniques and, once the different possible initiatives have been evaluated, the results will be disseminated. The project begins in January 2009 and will run for one year.
In addition, in order to provide services with an incentive to introduce higher coverage, the decision has been taken to have a tariff for cervical screening. This is being taken forward by the Department working closely with NHS Cancer Screening Programmes.
David Simpson: To ask the Secretary of State for Health what assessment he has made of the relative condition of children's teeth in England in comparison (a) with previous years and (b) with other EU countries for benchmarking purposes. 
Ann Keen: There has been a most impressive improvement in children's oral health. National surveys undertaken every 10 years show that between 1973 and 2003 the proportion of children starting school with no experience of tooth decay increased from 30 per cent. to 59 per cent. Over the same period, the proportion of 12-year-old children with decayed missing, or filled (DMFT) permanent teeth has fallen from 93 per cent. to a historic low of 38 per cent. As the following extract from The World Health Organisation Global Database of Oral Health shows, in this age group, the United Kingdom and Germany have the lowest levels of tooth decay.
|Europe 2002-06, DMFT for 12-year-olds|
The number of courses of treatment (CoTs) delivered, by patient type (including children) during 2007-08, is available in Table F1 of Annex 3 of the NHS Dental Statistics for England: 2007-08 report. This table includes CoTs that can attract a patient charge only and therefore excludes those CoTs occurring in charge-exempt courses, such as denture repair. Information is provided by strategic health authority (SHA) and by primary care trust (PCT).
An activity analysis of a sample of child CoTs processed in 2007-08, by treatment band, is available in Table B4 of the Dental Treatment Band Analysis, England and Wales 2007-08 report. This information is available at a national level only for both England and Wales.
This table includes information on fillings and extractions and presents this as the percentage of CoT that included these items of treatment, the number of items of treatment per 100 CoT and the average number of treatment items per CoT.
Mr. Sanders: To ask the Secretary of State for Health how many instances of exception reporting relating to diabetes there were in each primary care trust area in each of the last three years for which figures are available, ranked by local authority in descending order. 
Ann Keen: The report Making Every Young Person with Diabetes Matter focuses on the effective commissioning, organisation and provision of services, and recognises the key role played by specialist diabetes teams for children and young people. A copy of the report has already been placed in the Library.
A Children and Young People Diabetes Implementation Support Group has been set up to take forward work on the report's recommendations. The group is chaired by the National Clinical Director for Children, Dr. Sheila Shribman, and includes representation from Diabetes UK, royal colleges, young people with diabetes, parents and representatives from organisations with an interest in this area, including the Healthcare Commission.
Anne Milton: To ask the Secretary of State for Health (1) what assessment he has made of the role of diabetes specialist nurses in ensuring that people with diabetes achieve the recommended HbA1c levels; 
(2) what assessment he has made of the role of diabetes specialist nurses in improving standards of care for those admitted to hospital with particular reference to (a) access to the inpatient diabetes specialist nurses, (b) reducing medicines error and length of stay and (c) production of local guidelines regarding continuity of care once patients are discharged into the community. 
Ann Keen: The Department has not made a formal assessment of the role of diabetes specialist nurses in helping people with diabetes achieve recommended HbA1c levels or in improving standards of care for those admitted to hospital.
We are clear, however, that diabetes specialist teams, including diabetes specialist nurses, are a vital part of good diabetes care. The importance of this team working was highlighted in the National Diabetes Support Teams 2007 report Diabetes in the NHS. In 2008 the National Diabetes Support Team also produced Improving emergency and in-patient care for people with diabetes, which sets out the valuable role that diabetes in-patient specialist nurses can play in improving the experience of people with diabetes in hospital, reducing length of stay and reducing rates of readmission. A copy of this report has been placed in the Library.
Ann Keen: The target to offer screening for retinopathy to all people with diabetes was not met in all places. Latest figures for September 2008 show that 93.1 per cent. of people with diabetes were offered screening for diabetic retinopathy that met stringent national clinical standards of quality and safety in the previous twelve months. Great progress has been made and more people with diabetes are being offered screening for retinopathy than ever before.
We are providing support to the minority of primary care trusts that have not met the target to ensure that all people with diabetes are offered screening to national clinical standards as quickly as possible.
Ann Keen: The Government allocated a budget of £7 million across 2006-07 and 2007-08 to support, deliver and test the Family Nurse Partnership (FNP). It announced in October 2007 that it would invest £30 million over 2008-09, 2009-10 and 2011-12 to continue to test and expand the FNP.
A two-year formative evaluation of implementation in the first 10 FNP test sites is being conducted by the University of London, Birkbeck. A report of findings in the first year was published on the Department for Children, Schools and Families (DCSF) research website in July this year, and this suggested that early signs are promising.
The FNP programme will also be evaluated through a randomised controlled trial, from April 2009. The trial is being led by the South East Wales Trials Unit at the School of Medicine, Cardiff University. It will test the impact of the FNP compared with other services on pregnancy and birth outcomes, on child health and development and on parental life course. It will also assess costs, through an economic evaluation.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what estimate he has made of the proportion of the working population who are absent as a result of headache or migraine on any one day. 
Ann Keen: The Department has published the National Service Framework for Long-term Neurological Conditions that details service provision for those living with neurological conditions, including migraine and severe headaches. A copy of the framework has been placed in the Library. The strategic health authorities now have the responsibility for commissioning and ensuring the provision of health and social care services to meet the local needs of those in their local population living with headaches.
John Bercow: To ask the Secretary of State for Health whether the independent evaluation of patients' experience, the workforce implications and the costings of a national primary angioplasty service has been completed. 
Ann Keen: The independent evaluation of patient experience and workforce implications and the economic evaluation of primary angioplasty was published on 20 October 2008 by the National Institute for Health Research Service Delivery and Organisation Programme. The costings of the national roll out of primary angioplasty were published as part of the Impact Assessment for the best practice guidance, "Treatment of Heart Attack National Guidance" on the same date.
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