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Mr. Vara: To ask the Secretary of State for Health (1) how many patients were admitted to each hospital in the East of England as a consequence of (a) alcoholic liver disease and (b) cirrhosis of the liver in each of the last 10 years; 
Gillian Merron: Data on the number of patients admitted for alcoholic liver disease and cirrhosis of the liver for the last 10 years to each hospital in the East of England are not available. However, the following tables provide the number of admissions to hospital for alcoholic liver disease and cirrhosis of the liver for the last 10 years in England and for each hospital provider for the East of England strategic health authority.
that data for 2008-09 is provisional;
to protect patient confidentiality, figures between 1 and 5 have been suppressed and replaced with "*" (an asterisk) and where it was possible to identify numbers from the total due to a single suppressed number in a row or column, an additional number (the next smallest) has been also been suppressed;
that admissions do not represent the number of in-patients, as a person may have more than one admission within the year; and
K70, the ICD-10 code for alcoholic liver disease, was used to identify admissions due to alcoholic liver disease, while K70.3, K71.7, K74.3-K74.6 and A52.7 with K77.0 were the ICD-10 codes used to identify admissions due to cirrhosis of the liver.
Table 1: Number of finished admission episodes for alcoholic liver disease and cirrhosis of the liver for 1999-2000 to 2008-09 for each hospital provider for the East of England strategic health authority has been placed in the Library.
|Table 2: Number of finished admission episodes for alcoholic liver disease and cirrhosis of the liver in England for 1999-2000 to 2008-09|
|Admission for alcoholic liver disease||Admission for cirrhosis of the liver|
|(1) Provisional data.|
1. Finished admission episodes:
A finished admission episode is the first period of in-patient care under one consultant within one health care provider. Finished admission episodes are counted against the year in which the admission episode finishes. Please note that admissions do not represent the number of in-patients, as a person may have more than one admission within the year.
2. Primary diagnosis:
The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was admitted to hospital.
3. Provisional data:
The 2008-09 data is provisional and may be incomplete or contain errors for which no adjustments have yet been made. Counts produced from provisional data are likely to be lower than those generated for the same period in the final dataset. This shortfall will be most pronounced in the final month of the latest period i.e. November from the (month 9) April to November extract. It is also probable that clinical data are not complete, which may in particular affect the last two months of any given period. There may also be a variety of errors due to coding inconsistencies that have not yet been investigated and corrected.
4. Secondary diagnosis:
As well as the primary diagnosis, there are up to 19 (13 from 2002-03 to 2006-07 and six prior to 2002-03) secondary diagnosis fields in HES that show other diagnoses relevant to the episode of care.
5. Data quality:
HES are compiled from data sent by more than 300 NHS trusts and primary care trusts in England. Data is also received from a number of independent sector organisations for activity commissioned by the English NHS. The NHS Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain.
6 . Assessing growth through time:
HES figures are available from 1989-90 onwards. The quality and coverage of the data have improved over time. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series. Some of the increase in figures for later years (particularly 2006-07 onwards) may be due to the improvement in the coverage of independent sector activity. Changes in NHS practice also need to be borne in mind when analysing time series. For example, a number of procedures may now be undertaken in out-patient settings and may no longer be accounted for in the HES data. This may account for any reductions in activity over time.
Hospital Episode Statistics (HES), the NHS Information Centre for health and social care.
Miss McIntosh: To ask the Secretary of State for Health how much was spent on NHS maternity services in (a) the Vale of York, (b) North Yorkshire and (c) England in (i) 2005, (ii) 2006, (iii) 2007 and (iv) 2008. 
Phil Hope: Information is not collected in the format requested. In the following table we show information on maternity expenditure by the primary care trusts (PCT) that cover the York and North Yorkshire area. In 2006-07, the Selby and York, Hambleton and Richmond, Craven, Harrowgate and Rural District, Scarborough, Whitby and Ryedale PCTs amalgamated to form the North Yorkshire and York PCT.
|Purchase of secondary health care-maternity services 2004-05 to 2007-08|
Where possible any inter PCT expenditure is eliminated to avoid double counting in the England figures.
Primary care trust audited summarisation schedules
Miss McIntosh: To ask the Secretary of State for Health how many times hospitals in (a) the Vale of York, (b) North Yorkshire and (c) England closed maternity units to expectant mothers in (i) 2005, (ii) 2006, (iii) 2007 and (iv) 2008. 
Patients from the Vale of York and North Yorkshire access obstetric care at the Friarage hospital, but there are also women who receive their obstetric care from the James Cook University hospital in Middlesbrough. There has been one occasion when maternity services have closed for a significant amount of time. This is the closure of the Friarage hospital between the 17 July 2009 and the 26 October 2009.
Lynne Jones: To ask the Secretary of State for Health (1) what systems are in place to address non-adherence to treatment or medication amongst mental health service users; and what information his Department holds on the number of mental health services where these systems are applied; 
There are no national systems in place that are specific to addressing non-adherence to treatment or medication. However, non-adherence is a key issue in mental health risk assessment and as such should, where appropriate, form part of a service user's care plan. The introduction of supervised community treatment helps to ensure that service users get the right treatment at the right time and will help with adherence.
Norman Lamb: To ask the Secretary of State for Health what data his Department collects on the availability of low, medium and high secure beds in the independent sector; and if he will make a statement. 
Phil Hope: There are no high secure beds in the independent sector. High secure services can only be provided under licence by the Secretary of State, and such licences can only be granted to national health service trusts approved for this purpose.
Mike Penning: To ask the Secretary of State for Health at what locations in Hertfordshire severely mentally impaired children may be treated; and what choice parents have about the location at which treatment is provided. 
Phil Hope: It is for primary care trusts to commission services in order to ensure that Child and Adolescent Mental Health Services (CAMHS) services are available to the children and young people for which they are responsible, taking into account the needs and wishes of the patients and their carers.
The Department provided £2.5 million capital funding to enable Hertfordshire Partnership NHS Foundation Trust to recently refurbish a facility for children and young people being treated for mental health problems, specifically designed to eliminate the inappropriate use of adult psychiatric wards by children and young people.
The East of England Strategic Health Authority has advised that on 17 September 2009 the £7 million redevelopment of Hertfordshire Primary Care Trust was officially re-opened. This newly expanded and upgraded unit will accommodate 16 young people (up to the age of 18); with several of the beds earmarked for young people with eating disorders. This extra capacity means the trust will be able to care for the most vulnerable young people who need in-patient care within the county, and in easy reach of their families.
Anne Milton: To ask the Secretary of State for Health what steps he has taken to implement each of the recommendations of Lord Bradley's review of people with mental health problems or learning disabilities in the criminal justice system which were accepted by his Department. 
Phil Hope: Lord Bradley made 82 recommendations, many of which Lord Bradley himself recognised needed further work to ensure that all implications are considered for children, young people and adults. The Government have accepted all recommendations and the direction set out in the report and has committed to publish a cross-departmental Health and Criminal Justice Strategic Delivery Plan by the end of October 2009.
A Health and Criminal Justice National Programme Board has been fully operational since June 2009 bringing together senior officials in the key departments (Department of Health, Ministry of Justice, Home Office, Department for Children, Schools and Families). The Programme Board has been meeting monthly to pull together the national delivery plan and ensure appropriate cross-government representation and engagement as actions are being developed.
The Delivery Plan will set out our shared vision for improving health and social care services for all those in touch with the criminal justice system and the newly established Health and Criminal Justice Programme Board are working hard to ensure that all the Bradley recommendations are fully incorporated into this cross-government plan.
Anne Milton: To ask the Secretary of State for Health what estimate he has made of the number of prisoners with acute, severe mental illnesses who have waited more than 14 days for transfer to an appropriate health-care setting in each of the last five years; and if he will make a statement. 
Phil Hope: National data on prison transfers for the current 12-week waiting standard are collected on a quarterly basis with transfer rates compared against a 2005-06 baseline. The data indicate a downward trend in prisoners waiting in excess of 12-weeks for transfers; since 2005-06, these numbers have reduced by 33 per cent.
|Prisoners waiting longer than 12 weeks for mental health transfer|
|Date||Number of prisoners|
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