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Miss McIntosh: To ask the Secretary of State for Health how much (a) North Yorkshire and York Primary Care Trust, (b) South Tees Hospitals NHS Foundation Trust and (c) York Hospitals NHS Foundation Trust spent on healthcare in each of the last three years. 
Ann Keen: The following table shows the amounts spent by North Yorkshire and York Primary Care Trust (PCT), South Tees Hospitals NHS Foundation Trust and York Hospitals NHS Foundation Trust on healthcare in each of the last three years.
1. The figures provided for the PCT represent the total expenditure on the purchase of healthcare from providers for its own resident population (with the exception of dental and ophthalmic services where there is no need for PCTs to distinguish between spend on residents or non-residents). The figures include healthcare commissioned from the PCT's own provider function.
2. National health service trusts are not funded directly by the Department. Money voted to the Department by Parliament is allocated to PCTs who act as commissioners to ensure that the health needs of their local populations are addressed.
3. NHS trusts are not required to disclose separately their spend on healthcare and non-healthcare items in their summarisation schedules or accounts. The data provided are the trusts' total operating expenses.
Audited summarisation schedules.
Sandra Gidley: To ask the Secretary of State for Health pursuant to the answer of 1 July 2009, Official Report, column 334W, on cardiovascular system: screening, if he will place in the Library a copy of the findings of the qualitative research project commissioned by the Central Office of Information. 
Mr. Lancaster: To ask the Secretary of State for Health whether his Department is considering the provision of additional support for general practitioner surgeries in the winter months to assist with (a) administering the swine influenza vaccine and (b) an increase in patients suffering from influenza. 
Mr. Mike O'Brien: General practices will receive an additional payment of £5.25 for each dose of swine flu vaccine they administer to patients in the clinically at-risk priority groups announced by the Department's chief medical officer on 13 August 2009. In addition, NHS Employers, on behalf of the Government, are discussing with the British Medical Association's General Practitioners Committee arrangements for supporting practices in the event of there being a significant increase in the number of patients suffering from swine influenza.
Bill Wiggin: To ask the Secretary of State for Health how many doses of (a) the H1N1 influenza vaccine and (b) seasonal influenza vaccines are available for distribution (i) nationwide and (ii) in Herefordshire; what the timetable for distribution is in each case; and if he will make a statement. 
As of 2 November 2009 6.2 million doses of H1N1 vaccine have been delivered into the Department's central warehouse. This vaccine is in the process of being delivered to trusts and general practitioner (GP) surgeries. So far, 17,100 doses have been sent to
locations within Herefordshire Primary Care Trust. The remainder of scheduled deliveries will be completed in November.
Vaccine manufacturers have advised the Department that 15.3 million doses of seasonal influenza vaccine are available in the United Kingdom for the 2009-10 influenza season. Seasonal influenza vaccine is ordered by GP practices direct from the manufacturers. The Department is not involved in the ordering process and does not have information about amounts ordered for particular localities. Seasonal influenza vaccine is distributed from mid-September onwards, with most GP practices starting vaccination from early October.
Bill Wiggin: To ask the Secretary of State for Health how many people are eligible to receive (a) the H1N1 influenza vaccine and (b) seasonal influenza vaccines (i) nationwide and (ii) in Herefordshire; and if he will make a statement. 
Gillian Merron: In calculating those identified to receive the H1N1 and seasonal flu vaccines, planning estimates have been used and figures have been rounded up to the nearest 0.25 million at a national level and nearest 5,000 at a local level.
Mr. Stephen O'Brien: To ask the Secretary of State for Health whether officials of his Department have had discussions with the Equality and Human Rights Commission on the incidence of malnutrition in (a) NHS hospitals and (b) care homes; and if he will make a statement. 
The importance of good quality food for patients is recognised, both in terms of improving their health and in relation to their overall experience of services. Clinicians have a duty to ensure patients receive appropriate treatment for any condition. This includes malnutrition.
Mr. Baron: To ask the Secretary of State for Health what progress has been made in improving the timeliness of decision-making by the National Institute for Health and Clinical Excellence since the publication of his Department's report on Improving access to medicines for NHS patients in November 2008; how his Department plans to monitor progress in implementing this recommendation in the future; and if he will make a statement. 
Mr. Mike O'Brien: Good progress is being made in improving the timeliness of National Institute for Health and Clinical Excellence (NICE) technology appraisal guidance, supported by increased investment in appraisal capacity and the introduction of new, simpler arrangements for identifying the topics that NICE will appraise. Progress will be monitored through routine performance monitoring arrangements between the Department and NICE.
Sandra Gidley: To ask the Secretary of State for Health what assessment he has made of the effectiveness of enforcement of Article 81 of the European Directive on Control of Medicines in tackling medicines shortages in the UK. 
Mr. Mike O'Brien: Article 81 of directive 2001/83/EC requires that marketing authorisation holders and distributors of their medicines for human use ensure, within the limits of their responsibilities, appropriate and continuous supplies of the medicines so that the needs of patients are covered. This requirement was transposed into United Kingdom medicines legislation in 2005 and guidance was issued by the Medicines and Healthcare products Regulatory Agency (MHRA), the enforcement authority for the UK.
The MHRA is aware of concerns that the parallel export of medicines may contribute to shortages in the UK. The MHRA however, has no evidence that licensed wholesalers are failing to meet this obligation.
Mr. Mike O'Brien: The Department, in conjunction with the pharmaceutical industry, has published joint best practice guidelines, entitled "Notification and Management of Medicines Shortages". They are designed to help minimise the impact of any medicine shortage. These guidelines can be found on the Department's website at:
I recently met with my hon. Friend the Member for Watford (Claire Ward) to discuss among other things, possible medicines shortages, on 21 October. Also present were SIGMA Pharmaceuticals and Carter Chemist. Departmental officials have frequent contact with manufacturers, wholesalers and health care professionals about shortages and discontinuations of medicines.
Mr. Baron: To ask the Secretary of State for Health whether he plans to assess the level of transparency in primary care trust decision-making on the funding of treatments for patients with (a) cancer and (b) other conditions; if he will make it his policy to ask the Care Quality Commission to assess the level of transparency in such decision-making in its periodic reviews; and if he will make a statement. 
Mr. Mike O'Brien: Directions came into force on 1 April 2009, which require primary care trusts to put in place robust and transparent processes for making decisions on new drugs and treatments. We have no plans to conduct a specific assessment of primary care trust compliance with these nor to ask the Care Quality Commission to do so.
Dr. Stoate: To ask the Secretary of State for Health whether his Department has directed NHS trusts to implement the provisions of the October 2005 joint statement on Agenda for Change and NHS Contractors Staff; and if he will make a statement. 
The Department has not directed NHS trusts to implement the joint statement, which was published in October 2005. The Department continues to work to ensure employers are fully aware of the joint statement, to promote implementation of this national agreement and to help resolve issues where appropriate
by issuing best practice guidance, writing to the national health service and working with employers and unions where issues arise.
Dr. Stoate: To ask the Secretary of State for Health which NHS bodies in the South East have implemented the provisions of the October 2005 joint statement on Agenda for Change and NHS Contractors Staff. 
Ann Keen: This information is not collected centrally. Where the Department is made aware of local difficulties, we encourage local resolution. We are not aware of any specific difficulties with implementation of the joint statement in the South East.
Mr. Baron: To ask the Secretary of State for Health what representations his Department has received on the effectiveness of the operation of his Department's guidance on NHS patients who wish to pay for additional private care, since the guidance was published in March 2009; and if he will make a statement. 
Mr. Mike O'Brien: We have received a number of inquiries about how the guidance applies in particular circumstances but no formal representations since the Department's guidance on national health service patients who wish to pay for additional private care was published in March 2009.
Miss McIntosh: To ask the Secretary of State for Health how many people were employed as (a) managers, (b) nurses, (c) doctors and (d) other administrative staff by North Yorkshire and York Primary Care Trust in each of the last five years. 
|National health service hospital and community health services (HCHS): NHS staff in the North Yorkshire and York Primary Care Trust (PCT) as at 30 September each year|
1. North Yorkshire and York PCT was formed in October 2006 from a complete merger of Craven, Harrogate and Rural District PCT, Hambleton and Richmondshire PCT, Scarborough, Whitby and Ryedale PCT and Selby and York PCT. Figures for 2004 and 2005 are an aggregate of these predecessor organisations.
2. Examples of staff in central functions are staff in human resources, informatics, payroll, and library staff. Examples of staff in hotel, property and estates are clerical laundry staff, domestic services and home wardens. Examples of staff in science, therapeutic and technician support are clerical staff in audiology, haematology, dietetics and microbiology. Examples of staff in clinical support are clerical staff in medical records, patient services, medical secretaries.
3. North Yorkshire and York PCT have not submitted a return GP practice staff since 30 September 2006.
4. Excludes medical hospital practitioners and medical clinical assistants, most of whom are GPs working part time in hospitals.
5. Data Quality
Workforce statistics are compiled from data sent by more than 300 NHS trusts and PCTs in England. 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. Processing methods and procedures are continually being updated to improve data quality. Where this happens any impact on figures already published will be assessed but unless this is significant at national level they will not be changed. Where there is impact only at detailed or local level this will be footnoted in relevant analyses.
The NHS Information Centre for health and social care.
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