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Medical Treatments Abroad

John Battle: To ask the Secretary of State for Health what estimate he has made of the cost to the NHS of providing medical services to British citizens living abroad in each of the last 10 years. [267831]

Dawn Primarolo: Estimates of the costs of European Economic Area (EEA) healthcare claims are made annually for the purposes of provisions made in the Department’s accounts in accordance with Treasury resource accounting rules. This information can be found in the following table. Comparable information prior to 2002 is not available.

The United Kingdom does not fund the cost of medical services provided to British citizens living in non-EEA countries.


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EEA member state claims against the UK

£000

2002-03

233,200

2003-04

273,909

2004-05

331,900

2005-06

404,100

2006-07

426,600

2007-08

550,300

Notes:
1. Totals are based on estimates of the costs of EEA healthcare claims made annually for the purposes of provisions made in the Department's accounts in accordance with Treasury resource accounting rules.
2. Figures represent lump sum claims under Articles 94 and 95 of EU Regulation (EC) 574/72. This covers claims relating to the family members of workers resident in a different member state from the worker and claims for pensioners and their dependents.
3. Totals are rounded to nearest £100,000.
4. Sub totals may not add up to totals due to rounding.
Source:
Resource Accounting and Budgeting (RAB) exercise

Members: Correspondence

Mr. Stephen O'Brien: To ask the Secretary of State for Health when he plans to reply to the hon. Member for Eddisbury’s letter of 23 April 2008, on Southern Cross. [267375]

Phil Hope: A reply was issued to the hon. Member on 9 June 2008.

Mental Health Services

Mr. Jenkins: To ask the Secretary of State for Health what recent steps he has taken to ensure the needs of mental health patients are met by specialist mental health services. [268094]

Phil Hope: Since 2001-02, real terms investment in adult mental health services has increased by 44 per cent. (or £1.7 billion), putting in place the services and staff needed to transform mental health services. Compared with 1997, we now have 64 per cent. more consultant psychiatrists, 71 per cent. more clinical psychologists and 21 per cent. more mental health nurses, providing better care for people with mental health problems (all full-time equivalent). More than 740 mental health teams provide specialist community mental health services, such as home treatment, early intervention, or intensive support for people who might otherwise be admitted to hospital.

General practitioners and consultant psychiatrists decide on the most appropriate treatment for their patients, and they are expected to take National Institute for Health and Clinical Excellence (NICE) guidance fully into account. Doctors can prescribe any medicine or treatment which they consider to be necessary, including NICE-approved psychological therapies for severe mental illness, provided that the local primary care trust (PCT) or national health service trust agrees to supply it on the NHS. However, it is for PCTs to decide spending levels for specific health care treatments and services, including mental health, and to commission these services.

The Department revised Care Programme Approach (CPA) guidelines in 2008. Under CPA, each mental health service user should have an opportunity to be actively involved in agreeing their treatment plans with their care co-ordinator, wherever possible. This is not dependent on diagnosis, but may be affected by the severity of the condition at any particular time.

Mr. Jenkins: To ask the Secretary of State for Health what recent steps he has taken to ensure mental health conditions do not affect people's ability to access NHS services. [268095]


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Phil Hope: The Department has implemented several measures to help ensure that people with mental health problems and physical illness can access national health service healthcare.

The NHS “Operating Framework” for 2009-10 includes a specific reference to the importance of physical health checks in primary care settings for people with a severe mental illness.

The draft standard NHS contracts for mental health services in 2010-11 onwards, which the Department published in 2008, give providers responsibility for arranging physical health checks for long term in-patients, call for annual improvement targets to be set locally, and suggest progress in improving physical health care as a subject for local reporting from provider to commissioner.

Guidance notes accompanying the standard contracts stress the importance of individualised needs assessments which address service users’ physical health, and recommends local arrangements with primary care services to ensure health checks and inclusion in screening and health promotion activity for mental health service users.

The care programme approach (CPA) for people with complex mental health needs was revised last year. Under CPA, each mental health service user should have an opportunity to be actively involved in agreeing their treatment plans with their care coordinator, wherever possible. CPA describes a holistic approach covering quality of life, health checks, the physical effects of mental illness and psychiatric treatment and the effect of physical symptoms on mental well-being, smoking and obesity.

Mentally Incapacitated: Community Treatment

Lynne Jones: To ask the Secretary of State for Health how many second opinions for treatment under supervised community treatment have been (a) requested and (b) carried out under the Mental Health Act 1983. [268627]

Phil Hope: The Mental Health Act Commission has received 1,673 requests for second opinions for people on supervised community treatment since 3 November 2008 of which 98 were subsequently withdrawn. As at 31 March, 430 were recorded as having had all action completed. Information on the number of second opinions given but not yet recorded as completed is not available.

Lynne Jones: To ask the Secretary of State for Health how many community treatment orders have been (a) issued and (b) revoked under the Mental Health Act 1993; and how many patients have been (i) recalled to hospital while on a community treatment order and (ii) discharged from a community treatment order. [268628]

Phil Hope: The information requested is not yet available.

MMR Vaccine

Mark Pritchard: To ask the Secretary of State for Health if he will make an assessment of the merits of making provision for parents to have a choice over the means of vaccination of their children against measles, mumps and rubella under the NHS. [263220]


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Dawn Primarolo: The United Kingdom has no policy of compulsory medication. The schedule for the UK routine childhood immunisation programme recommends two doses of the measles, mumps and rubella (MMR) vaccine. Consent for MMR vaccination of young children is given by a person with parental responsibility. Parents have the choice to refuse the vaccinations offered by the national health service.

MMR vaccine is the safest way to protect children against measles, mumps and rubella. The Department encourages parents to exercise their responsibility to participate in important public health programmes such as MMR vaccination.

The Department does not recommend single measles, mumps or rubella vaccines. The use of single vaccines leaves children at risk of catching measles, mumps or rubella in the time periods between doses of the vaccines, and a full course requires six injections rather than the two required for MMR vaccine. The single measles, mumps and rubella vaccines currently available privately in the UK are not licensed for use in the UK.

NHS: Complaints

Mr. Stephen O'Brien: To ask the Secretary of State for Health how many complaints to the Healthcare Commission he expects to be outstanding on 1 April 2009; and whether such complaints will be referred to the Care Quality Commission. [268138]

Ann Keen: The Department of Health, the Healthcare Commission (HCC) and the Parliamentary and Health Service Ombudsman (PHSO) have worked closely together to ensure a smooth transition to the reformed complaints arrangements, which come into force on 1 April 2009.

In accordance with the casework transition plan agreed by the tripartite NHS Complaints Transition Board, there will be no complaints to the HCC outstanding on 1 April 2009. All cases being handled by the HCC have now been passed satisfactorily to the PHSO.

The Care Quality Commission will not intervene in individual NHS complaint cases, so no cases will be referred to it from the HCC.

NHS: Legal Proceedings

Mr. Ancram: To ask the Secretary of State for Health what guidance his Department issues to primary care trusts on their expenditure on legal proceedings. [260892]

Ann Keen: The Department has not issued guidance to primary care trusts on their expenditure on legal proceedings. Lord Justice Jackson is currently undertaking a review of the costs of civil litigation to ensure that they are appropriate and we will consider the results of the review when they are published later this year.

NHS: Pay

John Mason: To ask the Secretary of State for Health what consideration he has given to the merits of introducing a minimum wage of £7 per hour in the NHS in England and Wales in 2009-10. [268050]


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Ann Keen: The 2009-10 pay uplift, the second year of the current three-year pay deal, for the majority of non-medical national health service staff, which has been reviewed by the independent NHS pay review body, means that the minimum wage in the NHS in England in 2009-10 will be £6.78 per hour. This is 18.3 per cent. higher than the statutory national minimum wage of £5.73 an hour. Pay for staff working in the NHS in Wales is a matter for the Welsh Assembly Government.

Work and Pensions

National Insurance Contributions

Steve Webb: To ask the Secretary of State for Work and Pensions pursuant to the answer of 25 November 2008, Official Report, column 1384W, on national insurance contributions, for what reason the estimates assume a 20 per cent. take-up rate; and if he will make a statement. [257081]

Ms Rosie Winterton: National Insurance contribution data were used to show which people had eligible blank years on their record since 1975.

We found that around half a million individuals reaching state pension age between 2008 and 2015 could increase their entitlement to basic state pension by purchasing deficient years from earlier in their working lives.

While basic state pension entitlement could increase, for some people overall income may not because of the interaction with income related benefits, such as pension credit, housing benefit and council tax benefit. Married women also need to consider how much state pension they are entitled to, based on their husband's record, and when they will get it.

Taking these factors into account, along with evidence from a previous Class 3 related exercise, our estimates assume a take-up of 20 per cent.

Pension Credit

Mr. Burstow: To ask the Secretary of State for Work and Pensions how many people are eligible for pension credit; and what estimate he has made of the number of additional people who would become eligible if the tariff income were set according to the Bank of England base rate. [259601]

Ms Rosie Winterton: The latest estimates of the numbers entitled to means-tested benefits in Great Britain, covering income support, pension credit, housing benefit, council tax benefit and jobseeker’s allowance (income based) are published in the report “Income Related Benefits Estimates of Take-Up in 2006-07”.

The tariff income formula is not intended to represent any rate of return that could be obtained from investing capital. It provides a simple method of calculating the weekly contribution that people with capital in excess of £6,000 (£10,000 for those in care homes) are expected to make from their resources to help meet their normal living costs.

As there is no link with actual market rates, tariff income rules are not adjusted when interest rates change.


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Revenue and Customs

Steve Webb: To ask the Secretary of State for Work and Pensions which benefit delivery centres serve residents of each (a) parliamentary constituency and (b) Jobcentre Plus district. [264519]

Mr. McNulty: The administration of Jobcentre Plus is a matter for the acting chief executive of Jobcentre Plus, Mel Groves. I have asked him to provide the hon. Member with the information requested.

Letter from Mel Groves:

Social Security Benefits: Interest Rates

Mr. Burstow: To ask the Secretary of State for Work and Pensions pursuant to the answer of 5 March 2009, Official Report, column 1798W, on social security benefits: interest rates, what factors he takes into account when determining the (a) capital limits and (b) tariff income rules; when his Department last (i) reviewed and (ii) consulted on the limits and the rules; and if he will make a statement. [264087]

Ms Rosie Winterton: In any income related benefit scheme there is a point at which people with capital will have to use their resources to maintain themselves before having recourse to public funds.

The current position is that for income support, employment support allowance (income related) and income-based jobseeker’s allowance, the first £6,000 is disregarded (£10,000 for people permanently living in residential care and nursing homes). The upper capital limit is £16,000. For each £250 of capital (or part of £250) held between the appropriate lower and upper limits benefit is reduced by £1 per week.

For pension credit the first £6,000 is disregarded (£10,000 for people living in a care home). There is no upper capital limit. For each £500 (or part of £500) above the appropriate lower capital limit benefit is reduced by £1 per week.

Those customers in receipt of income support, employment support allowance (income related) and jobseeker’s allowance (income based) or the guarantee credit element of pension credit will be passported on to full housing benefit and council tax benefit, regardless of the amount of capital held. For other claims to housing benefit and council tax benefit, capital of between £6,000 and £16,000 will affect entitlement at a rate of £1 per week for every £250 or part of £250 held over £6,000. For people who have reached the qualifying age
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for pension credit, benefit will reduce by £1 per week for each £500 or part of £500 on capital between £6,000 and £16,000.

The capital rules in income related benefits are kept under continual review but they can be increased only when priorities and resources allow.


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