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10 Feb 2009 : Column 1932W—continued
Health Authorities
Mr. Lansley: To ask the Secretary of State for Health if he will place in the Library a copy of the (a) agenda and (b) minutes of the meeting he held with the chairs of strategic health authorities on 13 January 2009; and whether he holds meetings with this group on a regular basis. [255598]
Mr. Bradshaw: The meeting on 13 January 2009 was a private, informal dinner between my right hon. Friend the Secretary of State and the chairs of the strategic health authorities (SHAs). There was no formal agenda or minutes taken. Issues discussed at the dinner included: the future of the medical work force, professional revalidation, mixed sex accommodation, NHS productivity, capital investment, regulation and diversity and equality.
My right hon. Friend the Secretary of State normally meets with the SHA chairs on a quarterly basis.
Heart Diseases: Medical Treatments
John Bercow: To ask the Secretary of State for Health if he will amend the quality and outcomes framework to calibrate rewards to GPs reflecting preventative treatment given to patient groups at high risk of coronary heart disease as well as groups of patients with coronary heart disease. [254351]
Mr. Bradshaw: The agreement between NHS Employers and the British Medical Association on the GP contract for 2009-10 included new Quality and Outcomes Framework (QOF) indicators addressing seven clinical priorities, including two new indicators for cardiovascular disease primary prevention. These new indicators will reward practices for carrying out a cardiovascular risk assessment and providing lifestyle advice for patients with a new diagnosis of hypertension.
The Department has asked the National Institute of Health and Clinical Excellence (NICE) to oversee a new independent and transparent process for developing and reviewing QOF clinical and health improvement indicators for England from 1 April 2009 as part of their role in providing guidance for the national health service based on evidence of clinical effectiveness and cost effectiveness. We launched a public consultation on the proposed new process on 30 October 2008. The consultation ended on 2 February. Subject to the outcome of that consultation, any proposal for further changes to QOF indicators would need to be considered under that new process.
Hepatitis
Mr. Amess: To ask the Secretary of State for Health in what proportion of patients with (a) chronic hepatitis, (b) cirrhosis and (c) hepatocellular carcinoma their condition is due to chronic infection with hepatitis B virus; and if he will make a statement. [254998]
Dawn Primarolo: It is not possible to use Hospital Episode Statistics to provide data on chronic hepatitis, cirrhosis or hepatocellular carcinoma due to hepatitis B virus. Although there are disease codes to describe these conditions individually, it is not possible to show that one condition has been caused by the other.
However, it is generally accepted that hepatitis B is a significant cause of chronic hepatitis, and that about 20 to 25 per cent. of individuals with chronic hepatitis B infection world-wide are at increased risk of developing cirrhosis and hepatocellular cancer.
Mr. Amess: To ask the Secretary of State for Health (1) if he will make additional funding available to primary care trusts for the use of pegylated interferon for the anti-viral treatment of chronic hepatitis B; and if he will make a statement; [254999]
(2) how much and what percentage of the 2008-09 budget of each (a) health authority and (b) primary care trust is allocated for the treatment of hepatitis B; and if he will make a statement. [255112]
Dawn Primarolo:
Funding for hepatitis B treatment is included within the revenue allocations for primary care trusts (PCTs). The allocations also fund the costs of meeting recommendations from the National Institute for Health and Clinical Excellence. The 2008-09 PCT allocations represent £74.2 billion investment in the national health service, a total increase in funding of £3.8 billion. PCTs have also been informed of their
2009-10 and 2010-11 allocations, a total of £164 billion investment over the two years, a cash increase of £8.6 billion.
The Department does not break down PCT allocations by policies, at either a national or local level. It is for PCTs to decide their priorities for investment locally, taking into account both local priorities and the NHS Operating Framework.
Responsibility for providing services for the treatment of chronic hepatitis B lies with PCTs and their local partners, as they are best placed to assess what is needed in their areas. Information about local expenditure on hepatitis B services is not available centrally.
Mr. Amess: To ask the Secretary of State for Health (1) what studies have been (a) commissioned and (b) evaluated by his Department into the likely incidence of chronic hepatitis B over the next (i) five and (ii) 10 years; and if he will make a statement; [255002]
(2) what studies have been (a) commissioned and (b) evaluated by his Department on monitoring the changes in the epidemiology of hepatitis B infection following the introduction of an anti-viral treatment with interferon and ribvarin since 1997; and if he will make a statement. [255113]
Dawn Primarolo: The Department has not commissioned or evaluated any studies into the incidence of chronic hepatitis B over the next five or 10 years in England or into the effect of antiviral therapy on the epidemiology of chronic hepatitis B since 1997.
Surveillance of hepatitis B suggests that the incidence of both chronic and acute hepatitis B in this country remains low. The Health Protection Agency monitors epidemiological trends in hepatitis B infection and published in 2004 a review of the incidence of hepatitis B in England and Wales from 1995-2000(1).
Ribavirin is used (in combination with pegylated interferon) for the treatment of chronic hepatitis C, not chronic hepatitis B, as recommended by the National Institute for Health and Clinical Excellence.
(1) Hahne S, Ramsay M, Balogun K, Edmunds WJ and Mortimer P. (2004). Incidence and routes of transmission of hepatitis B virus in England and Wales, 1995-2000: implications for immunisation policy. Journal of Clinical Virology 29:211-20.
Maternity Services
Mr. Frank Field: To ask the Secretary of State for Health (1) what estimate he has made of the number of maternity ward places needed in England in (a) 2010, (b) 2015 and (c) 2025; and what estimate he has made of the cost of any increase; [255724]
(2) what assessment he has made of the effect of the projected rise in population on the (a) number of and (b) cost of provision of maternity ward places in England in (i) 2010, (ii) 2015 and (iii) 2025; and if he will make a statement. [255890]
Ann Keen: The Department made an overall assessment of the pressures on the national health service for the period 2008-09 to 2010-11 as part of the 2007 comprehensive spending review. This was not at the level of individual services such as maternity wards. Funding for maternity services is included within overall primary care trust (PCT) revenue allocations.
Local NHS organisations are responsible for developing maternity services in response to the needs of their local population, and for ensuring that they have sufficient wards, and sufficient staff, with the right skills, to offer appropriate choices.
We have provided an extra £330 million over three years in PCT baseline allocations for 2008-09 to 2010-11, to support maternity services. Strategic health authorities are planning to recruit an additional 1,000 midwives by September 2009 and altogether 4,000 more by 2012, contingent on the rising birth rate, to meet the demands of rising births and the aspirations of “Maternity Matters”. A copy of “Maternity Matters” has already been placed in the Library.
Mid Yorkshire Hospitals NHS Trust
Mr. Stephen O'Brien: To ask the Secretary of State for Health if he will place in the Library a copy of the report to his Department from PricewaterhouseCoopers on the Mid Yorkshire Hospitals NHS Trust. [254152]
Mr. Bradshaw: A copy of the report has been placed in the Library, Some details in the report have been redacted where the following conditions of the Freedom of Information Act apply;
(1) Section 36(2)(b) and (c)—where disclosure of the information would inhibit the free and frank provision of advice, or the free and frank exchange of views, for the purposes of deliberation, or would otherwise prejudice the effective conduct of public affairs. Section 36 is statutory recognition of the public interest in allowing government to have a clear space, immune from exposure to public view, in which it can debate matters internally with candour and free from the pressures of public political debate. Ministers and Government officials need to be able to engage in free and frank discussion of policy options to expose their merits and demerits, and their possible implications. Their candour in doing so will be affected by their assessment of whether the content of such discussion will be disclosed in the future.
(2) Section 41(1)—where the information in the report was received by PricewaterhouseCoopers (PwC) in confidence. Disclosure of this information would make it less likely that this type of information is provided freely to the Department in the future, and consequently undermine the ability of the Department to fulfil its role. The provider(s) of that information are content that some of this information can be disclosed. The limited amount to which this does not apply has been redacted.
(3) Section 43(2)—where the information in the report is commercially sensitive, and its disclosure has the potential to damage the trust’s commercial interests. The report includes information from the trust’s long term financial model (LTFM) that includes detailed information about future income and expenditure. Release of this information is likely to prejudice the trust’s commercial interests by adversely affecting its position in contractual negotiations and commercial transactions.
NHS: Accountancy
Mr. Lansley: To ask the Secretary of State for Health what assessment he has made of the likely effects of the adoption of International Financial Reporting Standards from April 2009 on the revenue of NHS organisations; and if he will make a statement. [255575]
Mr. Bradshaw: National health service organisations are currently completing their 2009-10 plans and will be assessing the revenue impact of introducing international financial reporting standards (IFRS) as part of this planning process.
The 2009-10 operating framework requires NHS organisations to submit their final IFRS compliant financial plans for 2009-10 by the end of March 2009 and as such, the detailed financial impact of moving to IFRS is not currently available.
NHS: Drugs
Mr. Oaten: To ask the Secretary of State for Health whose responsibility it is to inform a patient in cases where a primary care trust Exceptional Circumstances Panel refuses an application for funding for a procedure. [256027]
Dawn Primarolo: It is for primary care trusts to ensure that arrangements are in place to communicate such decisions to patients.
NHS: Energy
Norman Lamb: To ask the Secretary of State for Health how much the NHS has spent on energy efficiency and energy conservation measures in each of the last five years; and how much it is spending on such measures in 2008-09. [256022]
Phil Hope: The information is not collected centrally for the time scales requested.
The Department’s energy and sustainability fund has been allocated to national health service trusts. From this fund, there has been £18.9 million provided to schemes in 2007-08 and £76.3 million has been provided for 2008-09. These figures do not include similar schemes that trusts have funded from their own resources.
NHS: Equality
Dr. Stoate: To ask the Secretary of State for Health what steps he plans to take to facilitate the NHS’s compliance with its gender equality duty under the Equality Act 2006 with respect to service design and delivery. [254484]
Phil Hope: The NHS Constitution for England, published in January 2009 states that the national health service should provide a comprehensive service, available to all irrespective of gender, race, disability, age, sexual orientation, religion or belief. At the same time, the NHS is reminded that it has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population.
In conjunction with a range of stakeholders, the Department supports the NHS to mainstream gender equality in a variety of ways. In 2007 we published practical guidance on how NHS organisations should develop and use gender equality schemes, and integrate gender equality into mainstream business. In the same year, we co-published an equality guide to enhance NHS board members’ understanding of their legal duties under gender and other equality legislation. A copy of both publications has been placed in the Library. In March 2008, the chief executive of the NHS wrote to all strategic health authority chief executives, reminding them of their duties in relation to gender equality and other equality and human rights legislation, and
encouraging them to be legally compliant and to support trusts in their areas to be compliant as well. We are currently running a ‘Learning Sites’ programme to support the development of single equality schemes, with a clear focus on gender and other specific equality issues. The Department’s Pacesetters programme is trialling a number of innovative approaches to improving the NHS’s equality performance. A number focus on gender equality.
NHS: Private Sector
Mr. Hoyle: To ask the Secretary of State for Health if he will take steps to ensure that the arrangements for patients to pay privately for treatments that the NHS will not pay for do not act as a disincentive for pharmaceutical companies to develop cheaper treatments. [256025]
Dawn Primarolo: The 2009 Pharmaceutical Price Regulation Scheme (PPRS) recognised that it is in all of our interests to encourage research and reward innovation, which is why, for the first time, it promotes the uptake of cost-effective innovative treatments. At the same time, the PPRS will ensure that the national health service gets better value for money. The PPRS will deliver efficiency savings and includes new arrangements on flexible pricing and patient access schemes to ensure that value is better reflected in pricing.
Obesity: North East
Dr. Kumar: To ask the Secretary of State for Health what steps are being taken by his Department to combat obesity amongst young people in the North East. [254891]
Dawn Primarolo: I refer the hon. Member to the answer given by the Under-Secretary of State for Children, Schools and Families on 28 January 2009, Official Report, column 650W.
At a local level, it is the responsibility of primary care trusts (PCTs) working with local authorities to co-ordinate work to tackle childhood obesity. PCT plans, developed alongside local authority Children and Young People's Plans, will feed into local area agreements agreed with the Government offices. Local areas will develop and implement their own initiatives based on local needs and circumstances.
Obesity: Surgery
Siobhain McDonagh: To ask the Secretary of State for Health what guidance his Department and its agencies have issued to healthcare professionals on assessing patients for (a) the fitting of gastric bands and (b) other bariatric surgery. [254840]
Dawn Primarolo: The National Institute for Health and Clinical Excellence (NICE) has set ‘Guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children’, available at
This guidance is for both health and non-health professionals, and contains guidance on when bariatric surgery may be considered as an option.
It is up to primary care trusts as local commissioners and providers of services to determine the most appropriate methods to deliver health care to their populations, based on clinical need and effectiveness, and following medical advice.
Siobhain McDonagh: To ask the Secretary of State for Health how many NHS patients have had a gastric band fitted in 2007-08; and how many of them were readmitted to hospital as an emergency within three months of surgery as a result of complications. [254841]
Dawn Primarolo: The information is not available in the form requested.
Data are not yet available for 2007-08. Data are provided for 2006-07 which show that there were 706 finished consultant episodes where there was a primary diagnosis of obesity and an insertion of a gastric band as a main operation carried out in England. Gastric bands are only one type of procedure recommended for the treatment of obesity by the National Institute for Health and Clinical Excellence.
Data on emergency readmissions rates are collected by the National Centre for Health Outcomes Development and published at www.nchod.nhs.uk. Analysis from this source for gastric band surgery can be produced only at disproportionate cost.
Notes:
Finished Consultant Episode (FCE)
A finished consultant episode (FCE) is defined as a continuous period of admitted patient care under one consultant within one health care provider. FCEs are counted against the year in which they end. The figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year.
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