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The term chronic Lyme disease is not defined as there is no convincing evidence for the existence of symptomatic
chronic Borrelia burgdorferi infection among patients after receipt of recommended treatment regimens for Lyme disease.
Post-Lyme syndrome refers to a spectrum of non-specific symptoms, similar to those of chronic or post-viral fatigue syndrome, that are reported by a small percentage of patients despite apparently adequate treatment and lack of objective evidence of continued Borrelia burgdorferi infection activity.
Dawn Primarolo: There are no plans to make Lyme disease notifiable because there is already in place a robust surveillance system based upon laboratory reporting of all confirmed cases of Borrelia burgdorferi infection.
However, we are proposing to include meningitis associated with Borrelia infection as a notifiable infection in the proposed new regulations to be made under the Public Health (Control of Disease) Act 1984, as amended by the Health and Social Care Act 2008, on which we will be consulting shortly.
John Bercow: To ask the Secretary of State for Health what assessment he has made of progress towards agreement of European Union proposals in relation to patients who wish to travel to other EU member states for treatment and have their costs reimbursed. 
Dawn Primarolo: The draft directive on the application of patients rights in cross-border health care is subject to the co-decision procedure and is at an early stage of negotiations. In the European Parliament, the rapporteur has recently published a draft report. It is possible that the European Parliament could complete its first reading before the European elections. If not, it will need to undertake this in the next parliamentary session.
Initial discussions on the draft directive on the application of patients rights in cross-border health care have been held in the Council of the European Union working groups under the French presidency. European Union Health Ministers will discuss several issues including the draft directive on the application of patients rights in cross-border health care at the Employment, Social Policy, Health and Consumer Affairs Council on 16 December. We will provide an update to Parliament on the outcome of the Employment, Social Policy, Health and Consumer Affairs Council.
you have a right to make choices about your NHS care. The options available to you will develop over time and depend on your individual need.
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. Directions will specify services covered, exceptions and whether mental health service users are included. We have recently consulted on the draft constitution and the final Constitution will be published shortly.
John Bercow: To ask the Secretary of State for Health what steps his Department is taking to ensure that it obtains the views of (a) people who have experience of mental health problems and (b) organisations that represent people who have experienced mental health problems in its consultation on the Social Care Green Paper. 
Phil Hope: The Department ran a public engagement process on the future of Care and Support this year, from 12 May until 28 November, in order to gather views and comments from stakeholders, service users and members of the public to help inform the Green Paper. As part of our work to ensure the engagement process was inclusive, people living with mental health problems were targeted, together with those organisations that represent them. In addition, one-to-one interviews with users of mental health services and organisations that represent them have been carried out by Ipsos-MORI and the Central Office of Information as part of the engagement process.
Mr. Chope: To ask the Secretary of State for Health what steps his Department is taking to ensure that all NHS trusts purchasing supplies and equipment under central NHS contracts pay invoices within 10 days of receipt. 
Mr. Bradshaw: David Nicholson, NHS Chief Executive, wrote to all NHS Trust Chief Executives on 21 October asking them to examine and review existing payment practices and payment performance and to move as closely as possible to the 10-day payment commitment that has been set for Government Departments wherever practical. This would include cases in which trusts pay suppliers directly through contracts that have been centrally negotiated.
Dawn Primarolo: There have been no confirmed cases of ill health with long-term chronic exposure to organophosphates identified through the available reporting systems where such symptoms have been attributed to long-term exposure to organophosphates. The available reporting systems are primarily related to reporting on acute rather than chronic adverse effects.
To ask the Secretary of State for Health how many reported cases there have been of people suffering from (a) excessive fatigue, (b) sensory disturbance,
(c) disturbance of higher cerebral functions, (d) loss of cognitive functions and (e) memory loss where such symptoms have been attributed to long-term exposure to organophosphates in each of the last 10 years. 
Dawn Primarolo: There have been no confirmed cases with excessive fatigue, sensory disturbance, disturbance of higher cerebral functions, loss of cognitive functions nor memory loss identified through the available reporting systems where such symptoms have been attributed to long-term exposure to organophosphates. The available reporting system are primarily related to the reporting of acute rather than chronic adverse effects.
Mr. Lansley: To ask the Secretary of State for Health how many deaths have resulted from patient safety incidents in each year since 1997-98 for which figures are available, broken down by type of incident. 
Ann Keen: The table includes the numbers of patient safety incidents associated with the death of a patient that were submitted to the National Patient Safety Agencys Reporting and Learning System each year for the period from the 1 April 2005 to 31 March 2008 broken down by type of incident.
Information about the number of patient safety incidents associated with the death prior to that date is not included because of the low number of incidents submitted to the Reporting and Learning System (RLS) and the reliability of the information available.
|Incidents submitted to the RLS as of 1 December 2008where the date the incident occurred was between 1 April 2005 and 31 March 2008, broken down by incident type|
|Financial year (AprilMarch)|
|Incidents submitted to the RLS as of 1 December 2008where the date the incident occurred was between 1 April 2005 and 31 March 2008 by financial year (AprilMarch): reported deaths as a proportion of all incidents occurring over the same time period|
|Financial year (AprilMarch)|
Phil Hope: Near final versions of the specialist frameworks for practitioners with special interests, including pharmacists, were launched at a conference in London on 17 September 2008. We will be formally issuing the frameworks in their final form in the near future via NHS Primary Care Contracting.
Mr. Stephen O'Brien: To ask the Secretary of State for Health when the £150 million spending for respite care announced in the carers strategy will be disbursed; to whom; and according to what formula. 
Phil Hope: The £150 million funding announced in the Carer's Strategy is included in the 2009-10 and 2010-11 primary care trust (PCT) revenue allocations, announced 8 December. This money will go to all PCTs and will support all carers. These resources are referred to in the NHS Operating Framework for 2009-10. A copy of the framework has been placed in the Library.
Funding is allocated to PCTs on the basis of the relative needs of their populations. A weighted capitation formula is used to determine each PCTs target share of available resources, to enable them to commission similar levels of health services for populations in similar need.
The components of the formula are used to weight each PCTs crude population according to their relative need (age, and additional need) for health care and the unavoidable geographical differences in the cost of providing health care (market forces factor).
Phil Hope: The Department ran a public engagement process on the future of Care and Support this year, from 12 May until 28 November, in order to gather views and comments from stakeholders, service users and members of the public to help inform the Green Paper. The engagement activity included deliberative events with stakeholder organisations and with citizens. People were able to send in their views and comments via a dedicated website, by email or by post. Materials were also available for stakeholder organisations to run discussions within their own networks. We are in the process of analysing the responses and plan to publish a report of the responses received alongside the Green Paper.
Over 1,000 people attended the deliberative events run by the Department. We also received over 1,600 responses via the website, by email and by letter. Some of these responses summarise discussions with groups of people, or the results of surveys or petitions carried out by organisations as part of the engagement. Some of those responding via website did so more than once.
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