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Mr. Clifton-Brown: To ask the Secretary of State for Health what guidance his Department issues on the suitability of the use of (a) pushchairs and (b) car seats of categories 0 and 0+ as domestic seating for infants. 
This Department does not offer advice to parents and carers who wish to use pushchairs as domestic seating for infants, although we would recommend that anyone wishing to do so consults the pushchair manufacturer for guidance.
The Department for Transport has responsibility for child restraint systems, the construction of which is governed by international UNECE Regulation 44. Compliance with this regulation ensures that children are provided with the best level of protection when travelling in a vehicle. There is no assessment made of the suitability of such a device for use in the home, and therefore the Department offers no guidance on this issue. However, we would recommend that adults wishing to allow infants to remain seated in such a device while in the home consult the child restraint manufacturer.
Phil Hope: All Departments are actively involved in the cross-Government Adapting to Climate Change Programme, which aims to help society adapt to climate change. The role of the programme is to develop and provide a comprehensive evidence base including adaptation tools, to raise awareness of the need to adapt, to measure success and to work across Government at all levels to embed adaptation. Further details about the programmes work can be found at:
published a report with the Health Protection Agency on the Health Effects of Climate Change in the UK, 2008, using the UKCIP02 scenarios. The report sets out the various health effects facing the United Kingdom from climate change. A copy has already been placed in the Library;
produced a National Heatwave Plan, first launched in 2004, that is updated yearly based upon the latest available evidence. The plans purpose is to enhance resilience in the event of a heatwave. A copy has already been placed in the Library. A traffic light Heat-Health Watch system operates in England during the summer months;
produced guidance with the Health Protection Agency on dealing with disruptive challenges and managing incidents including from flooding. The guidance NHS Resilience and Business Continuity Management Guidance has been placed in the Library;
raised awareness of the health impacts of climate change with guidance documents on climate change and promoting sustainable communities for the health sector, outlining key mitigation and adaptation policies and also suggesting a code for reducing carbon footprints;
in December 2008, launched a new public health workforce initiative funded by the Department to address climate change. This is tasked with creating a new vision of the role for public health in tackling climate change, equipping the profession to take action on both reducing emissions and on preparing for climate change;
on national health service energy targets, the NHS is working towards mandatory energy and carbon efficiency targets (from 2000 to 2010) and key performance indicators for new capital build developments and refurbishments, and the existing operational estate;
the NHS Carbon Reduction Strategy was recently launched on in January 2009 and sets out ways that these reduction targets can be achieved. The plans cover many aspects of patients care, from building design to transport, waste, food, water and energy use;
internationally and following on from the WHO Climate Change and Health Resolution, 2008, UK officials have worked with the World Health Organization (WHO) Secretariat to develop a WHO work plan for its implementation. This work plan was agreed at the 62nd World Health Assembly this year; and
the UK also co-chairs a Climate Change and Health Task Force, drafting a Framework for Action for WHO-Europe, given that, since the resolution was passed last year, WHO regions are developing their own climate change action plans.
Miss McIntosh: To ask the Secretary of State for Health what estimate he has made of his Departments potential gross (a) costs and (b) savings arising from its climate change adaptation measures in the next three years. 
Phil Hope: It is not currently possible to provide estimates of the potential costs and savings over the next three years. It has, however, been shown in the Stern Review on the Economics of Climate Change that timely and well-targeted climate adaptation measures will yield benefits in excess of their costs. The main rationale for investment to address climate risk will be to reduce the United Kingdoms vulnerability to longer-term climate change impacts.
The Government are undertaking a Climate Change Risk Assessment and Economic Analysis, which will provide estimates of the costs and benefits of adaptation
to the UK. This analysis will be presented to Parliament within three years of the Climate Change Act 2008 coming in to force.
Reducing the number of amputations due to diabetes mellitus relies on good self-management of diabetes and good services to support people with diabetes. The Diabetes National Service Framework sets out the overall strategy for preventing long-term complications of the condition. This has also been supplemented by the National Institute for Health and Clinical Excellence guidance, which recommends that people with diabetes should be offered foot examinations by trained personnel as part of their annual review. It also recommends that local national health service organisations have systems in place to identify people who may be at risk of developing foot complications and to offer them preventative foot care.
Commissioning guidance Putting feet first was published by NHS Diabetes and Diabetes UK on 12 June and is to assist national health service organisations in developing services for the management of foot complications and the prevention of amputations.
|Expenditure on epilepsy research|
|Department of Health||Medical Research Council|
|(1) Not yet available.|
The departmental figures relate to national research programmes. They do not include expenditure on epilepsy research from the research and development allocations made over the period concerned to national health service organisations as that information is not held centrally.
Mr. Sanders: To ask the Secretary of State for Health what steps his Department is taking to provide guidance on service improvement to those parts of the NHS engaged in the delivery of services to patients with epilepsy. 
Ann Keen: Following my meeting with the all-party parliamentary group on epilepsy on 19 May, I have asked officials to work with epilepsy groups to consider what additional support is needed to improve the commissioning of epilepsy services in those areas of the country where services are not meeting the standards expected within the national health service.
This work will build on earlier guidance to the NHS, including the national service framework for long-term conditions and the clinical guideline the Department commissioned from the National Institute for Health and Clinical Excellence on the diagnosis and management of the epilepsies in adults and children in primary and secondary care.
Mr. Crausby: To ask the Secretary of State for Health how many instances of too much fluoride entering the water supply in relation to each water (a) authority and (b) company have been reported since 1997. 
The European standard for the maximum permitted level of fluoride in drinking water (1.5mg/l) is enshrined in the Water Supply (Water Quality) Regulations 2000 (as amended). The Drinking Water Inspectorate is the enforcement body for these regulations.
Water authorities ceased to exist on privatisation of the water industry in 1989. Water companies are required to notify the Inspectorate of any breach of regulatory standards and the Inspectorate independently assesses the actions taken by the company.
|Occasions of fluoride exceeding the standard||Water company|
Phil Hope: The Department values the substantial contribution voluntary organisations and the wider third sector make to the delivery of high quality health and social care services and has taken a strongly pro-active approach to recognising and embracing their contribution as critical and integral to the delivery of improved outcomes in health and social care.
A cross-cutting third sector programme was established in 2007, with the key objective of increasing opportunities for third sector organisations to inform and influence national health service and local authority commissioning and to participate in the provision of services.
The Departments Third Sector Investment Programme helps to strengthen and develop the partnership between the Department and third sector organisations; supporting innovative projects that help secure and promote high quality health and social care throughout England. £17,945,222 was made available in 2009-10 to fund 11 strategic partners, 116 new projects and 191 continuing projects.
Ann Keen: The Departments strategy for reducing healthcare associated infections (HCAIs) in the national health service is set out in Clean, safe care, which has already been placed in the Library.
In addition infection control is one of the top priorities in the NHS Operating Framework. Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile targets to 2010-11 have been set under the Better Care for All Public Service Agreement. The NHS has met the 50 per cent. MRSA national reduction target. To follow this the National Quality Board is overseeing the development of a new minimum standard for MRSA, which will come into effect from April 2010.
All relevant elective admissions to hospitals are now screened for MRSA, and all emergency admissions will be by 2011. Other steps include a technology programme designed to accelerate the development and uptake of new technologies to improve infection control, the development of a new national standard for cleanliness in the NHS, the expansion of the code of practice for the NHS on the prevention and control of healthcare associated infections to cover all care providers, and a new HCAI patient awareness campaign to be launched in the autumn.
These measures should support the NHS to meet their legal registrations requirements on infection control with the new Care Quality Commission, which has a
range of enforcement powers to ensure high performance in infection control. All acute NHS trusts are inspected annually to assess compliance against these requirements.
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