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26 Nov 2009 : Column 351W—continued


Both contracts were cancelled recently in order to reduce the Department's carbon footprint and save money.

Diabetes

Mark Hunter: To ask the Secretary of State for Health what recent assessment his Department has made of the adequacy of (a) psychological support and (b) education for people suffering from (i) Type 1 and (ii) Type 2 diabetes; and what steps he plans to take to improve such support. [300860]

Ann Keen: We have not made any recent assessments into the adequacy of either psychological support or education for people suffering from (i) Type 1 and (ii) Type 2 diabetes. It is for primary care trusts to commission comprehensive diabetes services that meet the needs of their local population.

We recognise the important role emotional and psychological support has in enabling people with diabetes to self-manage their condition on a day-to-day basis. The Department is working with National Health Service Diabetes and Diabetes UK to identify what needs to be done to enable the national health service and local care services to meet the psychological and emotional needs of all people with diabetes.

Since the publication of the Department of Health and Diabetes UK joint report: 'Structured Patient Education in Diabetes' in June 2005, a copy of which has been placed in the Library, we have been working with NHS Diabetes to find ways to increase the spread of patient education programmes.


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Drugs: Rehabilitation

Mr. Burrowes: To ask the Secretary of State for Health how many residential drug rehabilitation places there are in England; and what proportion of such places was in use on the most recent date for which figures are available. [301745]

Gillian Merron: The National Treatment Agency for Substance Misuse maintains a voluntary national online directory of organisations that provide residential drug and/or alcohol rehabilitation services. There are currently over 120 residential services listed with 2,565 beds in England. Most of the beds are available for drug or alcohol rehabilitation and therefore cannot be disaggregated. Some services have chosen not to appear in the directory so the total number of places will be greater than this.

Data on bed vacancies are collected as part of the related, and optional, BEDVACS service. The latest occupancy figure for the 116 services currently using BEDVACS was 83.5 per cent. on 17 November 2009.

Mr. Burrowes: To ask the Secretary of State for Health (1) what his most recent estimate is of the average annual cost of an opiate substitute prescription for a problem drug user; [301900]

(2) what his most recent estimate is of the average number of months during which a problem drug user takes a prescribed opiate substitute. [301901]

Gillian Merron: Drug treatment in England consists of various types of treatment, depending on the circumstances of the service user, including opiate substitute prescribing. A service user may therefore receive many different treatments over time which makes it difficult to isolate the cost of a single component such as substitute prescribing.

The National Drug Treatment Monitoring System operated by the National Treatment Agency for Substance Misuse (NTA) records the type of treatment interventions each person receives, e.g. 'specialist prescribing' (from a specialist drug service) and 'GP prescribing' (from their general practitioner). It does not record the medication prescribed.

The annual cost of a person in a prescribing intervention is estimated at between £2,000 and £5,000, depending on the medication prescribed, the intensity of their treatment and ancillary support.

Data on the length of time that an opiate substitute is prescribed are not collected centrally, however research shows that staying in treatment for at least 12 weeks has a lasting positive benefit in reducing the harm associated with dependence.

It is important to note that the duration of drug treatment varies markedly according to individual need and that it is not unusual for drug users to go in and out of treatment several times, often over several years, before becoming drug-free. Additionally, national clinical guidelines do not specify how long a person should be in treatment.

Prescribing an opiate substitute has benefits for both the patient and society. It allows the patient an opportunity to stabilise their drug intake and lifestyle while breaking with the cyclic nature of illicit drug use and dependency, allowing them to take responsibility for their children, earn their own living and to keep a stable home.


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Genetically Modified Organisms: Maize

Alan Simpson: To ask the Secretary of State for Health which studies of links between genetically modified corn and infertility in mice his Department has considered in the last two years; and how many genes were found by those studies to be expressed differently in the mice which were fed genetically modified corn. [301228]

Gillian Merron: The Food Standards Agency has sought advice from the Advisory Committee on Novel Foods and Processes (ACNFP) regarding what conclusions may be drawn from the following publication:

"Velimirov et al., (2008), Forschungsberichte der Sektion IV, Band 3/2008", published by the Austrian Ministry of Health.

This is a summary report that presents the results of investigations into the fertility of mice fed diets containing a type of genetically modified (GM) maize (NK603 x MON810) and two types of non-GM maize. This research project also included a number of studies on third generation mice fed on these diets, including an innovative microarray analysis of ribonucleic acid levels that found large number of differences between the GM and non-GM groups. Based on this analysis the authors reported that a total of 440 genes were expressed differently in these two groups and a large number of differences were also seen between mice fed on two types of non-GM maize. The authors reported that it was not possible to draw any general conclusion from these findings.

The ACNFP considered this report at its meeting in November 2008 and advised that it was not possible to draw any conclusions about cause and effect or to assess the significance of this report for human health. The minutes of this meeting are available on the ACNFP website at:

Health: Children

Mr. Stephen O'Brien: To ask the Secretary of State for Health (1) whether the Child Health Interim Application is still supported by manual systems; whether it can issue COVER reports; what recent progress has been made in the development and implementation of the Application; and if he will make a statement; [301361]

(2) which primary care trusts in London use the Child Health Interim Application; and what estimate he has made of the number of children resident in areas served by such trusts. [301362]

Ann Keen: The child health interim application (CHIA) was introduced in response to a decision in early 2005 to withdraw support for the ageing Regional Interactive Child Health System (RICHS) from 10 primary care trusts (PCTs) in London taken by its commercial supplier. CHIA was delivered to these PCTs at short notice by BT, the London local service provider under the national programme for information technology, as an interim measure at the request of the local national health service. This is now being taken forward by the local NHS and so the hon. Member may wish to contact the Chief Executive of NHS London.


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Health: Learning Disability

Mr. Stephen O'Brien: To ask the Secretary of State for Health how many and what proportion of GP practices use Directed Enhanced Service for annual health checks for people with learning disabilities. [301372]

Phil Hope: This information is not available centrally. We are however monitoring primary care trusts' spend on this directed enhanced service and have commissioned an independent survey of activity, by general practitioner practices, on this directed enhanced service. Both data sources suggest that since this directed enhanced service was introduced the number of health checks given to patients with learning disabilities has increased significantly, with overall expenditure expected to almost double from £6 million in 2008-09 to over £11 million in 2009-10.

Learning Disability: Administration of Justice

Mr. Baron: To ask the Secretary of State for Health what representations he has received on the new regulatory arrangements for improving access to justice for people with a learning disability; and if he will make a statement. [301411]

Phil Hope: We are not aware of having received any representations on the new regulatory arrangements for improving access to justice for people with a learning disability.

However, we do seek views from the Working for Justice Group when we are developing policy on the implementation of Valuing People Now and delivering training to the criminal justice system.

Liver Diseases: Transplant Surgery

Mr. Stephen O'Brien: To ask the Secretary of State for Health what steps he is taking to develop a new liver allocation scheme. [301356]

Ann Keen: A proposal document has been accepted by the Liver Selection and Allocation Working Party-part of NHS Blood and Transplant's (NHSBT) Liver Advisory Group-with four key stages: agreeing the aims of transplantation (maximising survival from the point of registration onto a transplant list); developing statistical models which can predict as accurately as possible a patient's survival without a liver transplant; developing models to predict survival after liver transplantation; and comparing four possible models of allocation.

The process is being overseen by the Liver Selection and Allocation Working Party, reviewed by the Liver Advisory Group at NHSBT who will make final recommendations to the NHS BT Board for their ratification. The modelling is expected to finish by March 2010. A 12 month simulation will then follow, with the aim of having a final model for implementation by April 2011.

Lung Cancer

Mark Simmonds: To ask the Secretary of State for Health what assessment he made of the finding of the National Lung Cancer Audit for 2007 that only 51 per cent. of lung cancer patients receive any form of active treatment; and if he will make a statement. [301629]


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Ann Keen: The quality of the submitted data has improved compared with previous years and, overall, measures of process and outcome of care appear to be improving. The National Cancer Director has encouraged all networks and trusts to review their own data and to take action, especially if they fall below the helpful benchmarks set out at the end of the report. The NHS Information Centre has offered trusts a local action planning toolkit to help them do this effectively.

Mark Simmonds: To ask the Secretary of State for Health what steps his Department is taking to assist the Lung Cancer Awareness Month initiative. [301631]

Ann Keen: We are committed to raising awareness of the signs and symptoms of cancer, and this is a key focus of the "Cancer Reform Strategy", published in December 2007. A copy has already been placed in the Library.

We know that awareness weeks and months for specific cancer types can be an effective way of raising awareness of cancer. As part of this year's Lung Cancer Awareness Month, we have provided funding of £15,000 for lung cancer awareness leaflets to be sent to all pharmacies in England for public distribution. This is the second year that we have provided funding for these leaflets.

A stakeholder group has been formed to address lung cancer awareness at a strategic level. The Lung Cancer Awareness Action and Advisory Group is working to raise awareness of lung cancer.

Through the National Awareness and Early Diagnosis Initiative, formally launched in November 2008, we are working to raise awareness of the signs and symptoms of cancer, including lung cancer, amongst the public and health professionals. This work includes: the development of key messages on a number of cancers (key messages for lung cancer are available on the NHS Choices website at:

carrying out a baseline national cancer symptom awareness survey; commissioning an audit of cancer diagnoses in primary care; and providing funding for a number of cancer awareness campaigns.

As part of the Initiative, almost £5 million has been allocated to the national health service to support cancer networks and primary care trusts in implementing local services that will improve awareness of cancers, including lung cancer, and promote early diagnosis.

The Department is investing in a campaign to raise awareness of the signs and symptoms of lung, breast and bowel cancers to encourage people with symptoms to seek help earlier than they do currently. The Improvement Foundation's Healthy Communities Collaborative is working in 20 of the most deprived areas of the country to target those most at risk and is working with local people to develop and test methods of awareness raising.

In addition, the Department and the Football Foundation are jointly funding the Ahead of the Game programme. Ahead of the Game is a one-year pilot programme that uses the appeal of football to raise awareness of lung, bowel and prostate cancers in men aged 55 and over.


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Manchester Mental Health and Social Care NHS Trust

Graham Stringer: To ask the Secretary of State for Health what the cost to the public purse was of the financial settlement reached between the Manchester Mental Health NHS and Social Care Trust and its former chief executive. [301737]

Ann Keen: The information requested in relation to the financial settlement between Manchester Mental Health and Social Care National Health Service Trust and its former chief executive is confidential.

Mental Health Services: Finance

Chris Ruane: To ask the Secretary of State for Health what the mental health budget was in each of the last 30 years. [300912]

Phil Hope: This information is not available in the format requested. Data are collected by the Department from the programme budgeting data collection from 2003-04 onwards. Prior to this, data was collected through the national health service Health and Community Health Services collection (HCHS). The two data collections are not compatible, and the HCHS data set underestimates total expenditure, so has not been used.

Data on mental health budgets from 2003-04 to 2007-08 only are available from the NHS programme budget data collections for mental health disorders and this is shown in the table.

Department of Health: Programme budget data collection total expenditure on mental health services by the NHS in England 2003-04 to 2007-08
Expenditure (£000)

2003-04

7,386,096

2004-05

7,905,131

2005-06

8,538,755

2006-07

9,125,740

2007-08

10,291,979

Source: Department of Health.

Mental Health: Unemployed

Chris Ruane: To ask the Secretary of State for Health what his most recent assessment is of the effect of unemployment on a person's mental health. [300409]

Phil Hope: The Department has not commissioned research on the impact of the economic downturn on levels of demand for mental health services. However, we recognise that there are links between poor mental health and difficult economic circumstances.

Thanks to nine consecutive years of increased spending, mental health services in England are now better prepared than ever before to provide help for people who are affected by the economic downturn. Many more staff, more community mental health services and increased access to psychological therapies have transformed services since 1997. Our New Horizons vision, to be published shortly, will build upon these achievements.


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Musculoskeletal Disorders: Voluntary Organisations

Paul Rowen: To ask the Secretary of State for Health what recent discussions he has had with voluntary and community organisations concerned with the delivery of care to patients with musculoskeletal conditions. [301107]

Ann Keen: The Secretary of State has had no recent discussions with voluntary or community organisations concerned with the delivery of care to patients with musculoskeletal conditions.

On 20 January 2009, Lord Darzi, then Parliamentary Under-Secretary of State, met with a group of stakeholders to discuss the research of the Rheumatology Futures Group. This stakeholder group included representatives of the national rheumatoid arthritis society (NRAS) and the British Society for Rheumatology.

On 25 November 2009, a meeting took place between Jenny Snell of NRAS and my right hon. Friend the Minister of State for Health, and a further meeting is scheduled for 1 December.


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