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Mr. Lansley: To ask the Secretary of State for Health (1) which primary care trusts responded to the survey of exceptional funding requests described in appendix 1 of the report to him by the National Cancer Director, Improving access to medicines for NHS patients, published on 4 November 2008; and, for each primary care trust, what the (a) number of exceptional circumstances requests made in the last 12 months was, (b) number of exceptional circumstances requests made for cancer treatment in the last 12 months was, (c) proportion of all exceptional circumstances requests made in the last 12 months which were approved was and (d) proportion of all exceptional circumstances requests made in the last 12 months for cancer treatments which were approved was; 
(2) with reference to the answer of 24 November 2008, Official Report, columns 927-28W, on NHS: drugs, which primary care trusts responded (a) in full and (b) in part to the Department of Health survey on exceptional funding procedures; and if he will place in the Library copies of all responses. 
Mr. Bradshaw: In accordance with directives issued by the Department of Business, Enterprise and Regulatory Reform, Government Departments do not measure payment performance against the dates that appear on invoices, but rather against the date on which invoices are received at the address quoted on purchase orders or similar documents. This is also in line with the requirements of the Late Payment of Commercial Debts (Interest) Act 1998.
The most significant costs of implementing the SotD schemes are those of the FSA. These costs are for providing support to local authorities operating the scheme, a communications strategy, and for establishing a web-based information technology platform for disseminating scores to consumers. These costs are estimated to be between £3 million and £5.7 million over the first three years.
Costs for local authorities and the food industry will depend on the number of local authorities that choose to implement the SotD schemes. For businesses covered, there will be a one-off cost for familiarisation which is estimated at £16 per business. For local authorities there will be time costs associated with the FSA-funded training that are estimated at £125 per officer trained. There will also be annual costs per authority of an estimated £3,000 for printing and issuing of certificates, and an estimated £600 for handling appeals. There may also be costs for re-inspection or re-visits for the purposes of re-scoring for which local authorities may charge, along with costs associated with any legal challenge.
It is estimated that there will be an economic saving of around £12.3 million over a three year period associated with a one per cent, decrease in food-borne illness resulting from operation of the SotD schemes.
In addition, we are identifying proxy indicators to assist us in monitoring national progress against the public service agreement trajectory. These will be set out in the Healthy Weight, Healthy Lives annual report this spring.
John Bercow: To ask the Secretary of State for Health what progress he has made towards meeting the target to reduce health inequalities by 10 per cent. by 2010; and if he will make a statement. 
Dawn Primarolo: The national health inequalities public service agreement target (PSA) aims to reduce inequalities in health by 10 per cent. by 2010, as measured by infant mortality (by socio-economic group) and life expectancy at birth (by geographical area).
Since the 1997-99 baseline the infant mortality gap has widened, and latest 2005-07 data show the infant mortality rate among the Routine and Manual group was 16 per cent. higher than in the total population. However, the gap has narrowed in recent years and if the rate observed since 2002-04 continues, the infant mortality element of target will be met.
Life expectancy in England and in the Spearhead Group (the 70 local authority areas with the worst health and deprivation indicators, and the 62 primary care trusts mapping to them, and a focus of action for this element of the target) is at record levels. If the rest of England still had the life expectancy it had in 1995-97 (the target baseline), Spearhead areas would not just have narrowed the gap by 10 per cent., they would have closed it completely. However, the increase in Spearhead areas is not as great as in non-Spearheads so the gap has not narrowed. The latest 2005-07 data show that the percentage gap in life expectancy between the Spearhead Group and the England average has increased to 4 per cent. above baseline for men and 11 per cent. above baseline for women (the target is a 10 per cent. narrowing for both).
The health inequalities target was deliberately set to be ambitious. Some progress has been made. However, we acknowledge that more remains to be done. Health Inequalities: Progress and Next Steps (June 2008), a copy has already been placed in the Library, reaffirmed our commitment to tackling inequalities, and meeting this PSA target. Our focus now is to provide tailored, intensive, support to the Spearhead areas, and areas with high infant mortality, including:
an additional £34 million in spending for inequalities programmes in 2008-09;
investing more in the National Support Team for health inequalities to reach all Spearheads by summer 2009, enhancing the National Support Team for Tobacco Control, and establishing new National Support Teams for Alcohol and Infant Mortality; and
support to local partners for planning and commissioning of services through the Health Inequalities Intervention Tool.
Mr. Lansley: To ask the Secretary of State for Health what estimate he has made of the proportion of (a) people aged over 65, (b) people in other at risk groups, (c) health care workers and (d) poultry workers who received the seasonal influenza immunisation in each of the last five winters. 
|People aged 65 and over||People in clinical at-risk groups||Health care workers||Poultry workers|
|(1) Those years when data was not collected or policy was not in place.|
This year the Department has reminded health professionals of the importance of protecting younger patients in other risk groups and we will look carefully at the results when final vaccine uptake data for 2008-09 is available.
In 2008 research was carried out with adults in at-risk groups. It identified that there are a number of challenges to improving vaccine uptake in younger at-risk groups and that because the use of the term flu and cold had become almost interchangeable, flu was not regarded as a serious concern.
The Department is planning to introduce a new flu vaccination advertising campaign for the 2009-10 flu season. One of the aims of the new advertising approach is to improve targeting of the message to people aged under 65 with long-term conditions, while maintaining uptake rates among those aged 65 and over. These research findings are being fed into the development of the new campaign.
Uptake among health care workers is low in most developed countries and this is a concern that is not specific to the UK. To address low uptake in health care workers, the Department held a flu conference in June 2008 for flu leads working in PCTs and also in occupational health. The conference focused on sharing ideas for improving vaccine uptake among health professionals.
We also launched a new flu vaccine leaflet for health care workers and are currently working on a communications strategy that will provide support to occupational health departments in delivering all occupational health vaccinations, because immunising health care workers with the flu vaccine is the responsibility of the employer.
The poultry workers programme has a slightly different focus to the other seasonal flu programmes. Its purpose is to reduce the risk of a poultry worker being exposed to an avian flu virus at the same time as they were infected with seasonal flu virus. It is theoretically possible that the two viruses could mix to produce a new strain of flu virus which could possibly lead to a pandemic. This programme is primarily aimed at reducing the risk of a pandemic virus emerging in this country.
John Bercow: To ask the Secretary of State for Health what progress has been made in meeting the targets set by local area agreements to which Ministers in his Department have subscribed; and if he will make a statement. 
Phil Hope: 150 local area agreements (LAAs) covering priorities in every locality in England from 2008-09 to 2010-11 were agreed in June 2008. It is too early to make an assessment of progress against targets in the LAAs but Government offices for the regions will take stock of emerging findings early in 2009. From April 2009, the comprehensive area assessment (CAA) will bring together assessments of performance across each local area and these may apply to anything done by local authorities acting alone or in partnership. It will place particular emphasis on delivery against identified LAA priorities for the local area. The first findings under CAA are likely to be reported in autumn 2009. Data which is used to measure the performance of different places with respect to key Government targets will be available at:
Individual targets were monitored by Government offices for the regions and strategic health authorities but no comprehensive assessment was made against the health targets in the previous rounds of LAAs in place since 2005-06. To do an assessment of the thousands of health-related targets in these LAAs would involve a disproportionate cost to the Department.
Mr. Amess: To ask the Secretary of State for Health what files his Department holds on the Medical Treatment (Prevention of Euthanasia) Bill of Session 1999-2000; and if he will make a statement. 
Dawn Primarolo: The Department holds one file in respect of the Medical Treatment (Prevention of Euthanasia) Bill of the 1999-2000 session. The file is entitled Withdrawing and Withholding Medical Treatment; Medical Treatment (Prevention of Euthanasia) Bill and extends to four volumes.
John Bercow: To ask the Secretary of State for Health what recent progress has been made in the development of a public mental health framework for creating well-being; and if he will make a statement. 
Phil Hope: We expect to publish a public mental health framework early in 2009. The framework is intended to provide health care commissioners, providers and a wider cross-governmental audience with evidence-based advice on promoting good mental health and well-being.
John Bercow: To ask the Secretary of State for Health whether the Governments undertaking that by November 2008 no child under the age of 16 years would be treated on an adult psychiatric ward has been met. 
Ann Keen: The latest available figures, for July to September 2008, show children and young people under 16 spent only four bed days on adult psychiatric wards, the lowest level since collection started in 2005. This supercedes the figure given in reply to the hon. Member for North Norfolk (Norman Lamb) on 19 November 2008, Official Report, column 528W, when I regret as a result of data error, five bed days were originally reported for this quarter.
Dawn Primarolo: Since we launched the measles, mumps and rubella (MMR) vaccination catch-up programme in August 2008, we have provided extra funding to primary care trusts (PCTs), sourced additional supplies of vaccine and provided extra technical support to general practitioners to help them identify children who have not received the MMR vaccine.
A public relations campaign is planned to be implemented and rolled out shortly. Key messages will include how serious and infectious measles is and how it is never too late to have the MMR vaccine. A measles leaflet is already available which can be viewed and downloaded from:
David Davis: To ask the Secretary of State for Health if he will undertake an investigation of the public interest implications of local authorities withholding money for administrative purposes from LINKs budgets. 
In line with wider Government policy to encourage greater local accountability, funding to support the establishment and operation of local involvement networks (LINks) has been given to local authorities as part of the annual area based grant. Local authorities with social services responsibilities are under a duty (set out in the Local Government and Public Involvement in Health Act, 2007) to make arrangements for the activities of LINks to be carried on in their area. It is for each local authority to decide how to use the allocated funding to fulfil this duty.
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