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12 Mar 2010 : Column 572W—continued
Local national health service organisations are best placed to assess the health needs of their local health community and plan the workforce they need. SHAs are responsible for commissioning the correct number of training places to maintain a work force to meet the needs of the local population.
Mr. Laurence Robertson: To ask the Secretary of State for Health what recent assessment he has made of the adequacy of provision of audiology services for children in (a) England and (b) Gloucestershire, with particular reference to the number of practitioners; and if he will make a statement. [321858]
Ann Keen: The Department in its "Transforming Services for Children with Hearing Difficulty and their Families: a good practice guide", outlined the work force roles required to deliver different levels of service. Within Modernising Scientific Careers, training programmes are being developed to reflect these work force requirements and we are working with strategic health authorities to ensure a smooth transition.
Hospices: Charities
Mr. Chope: To ask the Secretary of State for Health for what reason the Care Quality Commission requires small charities providing hospice places to produce 75 policies in order to achieve registration. [322149]
Mr. Mike O'Brien: Registration allows the Care Quality Commission (CQC) to give the public assurance that wherever they receive care or treatment, they can be confident that essential, common standards of safety and quality are being met. CQC strives to operate in accordance with better regulation principles, particularly to minimise regulatory burden.
The CQC has advised us that it does not require a set number of policies from providers seeking registration. It does, however, require that providers have policies in place relating to the management of their organisation, and can demonstrate that they have a good infrastructure in place to deliver safe care.
Under the current Care Standards Act 2000, CQC refers any queries about which policies might be appropriate to the list of suggested policies in the National Minimum Standards for Independent Health. This was published in February 2002 following extensive consultation with the sector in 2001.
The CQC is now in the process of registering all providers of health and adult social care under a new system of registration in line with the Health and Social Care Act 2008.
This new system will apply to independent health care providers, including hospices, from 1 October 2010. CQC is intending to send high level guidance on how to apply for registration to hospices shortly. The CQC's guidance about compliance which sets out how providers can comply with the new registration regulations is already available on its website at:
Mr. Chope: To ask the Secretary of State for Health if he will take steps to exempt charitable hospices from the requirement to pay registration fees to the Care Quality Commission. [322150]
Mr. Mike O'Brien: Registration provides assurance to users of registered services that the care that a provider delivers at least meets essential levels of safety and quality. It is a standard principle that organisations that are regulated should meet the cost of regulation. The Care Quality Commission is responsible for setting the level of fees that are paid by different providers and is required to consult on these fees.
Hospitals: Police
Chris Huhne: To ask the Secretary of State for Health how many hospitals with accident and emergency departments provide anonymised data to their local (a) police and (b) crime and disorder reduction partnership. [321964]
Mr. Mike O'Brien: There are 103 accident and emergency departments, which are currently collecting and sharing anonymised data with local partners, in England. In most cases, these data are being shared with the crime and disorder reduction partnerships. However, in some cases data are being shared directly with the police.
MMR Vaccine
Mr. Baron:
To ask the Secretary of State for Health whether there has been an investigation of purported ethical approval for blood tests funded by legal aid to
detect the presence of the measles virus carried out on claimants and controls in research in connection with concluded MMR vaccine litigation. [321636]
Gillian Merron [holding answer 11 March 2010]: We understand that the tests in question were carried out as part of now concluded litigation that followed claims that the measles, mumps and rubella vaccine was linked to autism. It appears that the tests were organised by the legal teams involved and the Department played no part in these arrangements.
NHS: Finance
Mr. Lansley: To ask the Secretary of State for Health what assumptions his Department is asking NHS organisations to make in their financial planning for (a) 2011-12, (b) 2012-13 and (c) 2013-14. [320781]
Mr. Mike O'Brien: The NHS Operating Framework for England 2010-11, published in December 2009, advised primary care trust (PCTs) to allow for flat real revenue allocations growth for the years 2011-12 and 2012-13. The national health service was also to expect the full deployment during the years of 2010-11, 2011-12 and 2013-14 of any surplus generated by the PCT and strategic health authority (SHA) sector in 2009-10. Alongside this SHAs were to ensure that all PCTs in their region did not recurrently commit the totality of their recurred funding, such that at least 2 per cent. of recurrent funding was only committed non-recurrently by 2013-14.
In addition the Operating Framework stated that the uplift in tariff for 2011-12, 2012-13 and 2013-14 will be set at a maximum of 0 per cent.
It also confirmed that the NHS needs to identify £15 billion to £20 billion of efficiency savings by the end of 2013-14 and specifically set an aggregate target reduction of 30 per cent. in management and agency costs by 2013-14 for each SHA.
These savings will remain with the NHS, enabling it to continue to deliver service improvements. There will be no cuts to NHS front line spending.
As an interim step, "NHS 2010-15 From Good to Great", published in December 2009, set an interim challenge of £10 billion efficiency savings by 2012-13.
Patient Choice Scheme: Mentally Ill
Norman Lamb: To ask the Secretary of State for Health what assessment has been made of whether his Department's guidance to Extended Choice Network providers not to treat patients with unstable psychiatric disorders discriminates against patients with mental illness. [321762]
Mr. Mike O'Brien: Patient welfare and safety is a priority for patients being treated under the Extended Choice Network (ECN) as it is across the national health service.
The ECN rules are in place to govern the referral of patients by general practitioners (GPs) to elective care facilities operated by independent providers. The rules are also in place to help safeguard patient safety. NHS patients referred to ECN facilities are assessed before they receive treatment to ensure that they are treated at
a hospital that has the facilities and level of care required to meet their needs. The ECN rules state that ECN providers should not treat a patient who has a current and significantly unstable psychiatric disorder where the approved facility cannot reasonably be expected to accommodate the patient's needs.
ECN providers are not permitted under the ECN rules to exclude patients who have a history of mental illness and who are currently in a stable condition whether on medication or not. A GP will use their clinical judgment and knowledge of the patient and their medical history to determine this. However, many of the hospitals in the ECN network do not have the psychiatric facilities or trained psychiatric staff required to safely care for a patient with a current and significantly unstable mental illness. For this reason current and significantly unstable mental illness is included as a co-morbidity in the ECN exclusion criteria.
ECN providers are required to take their obligations under the Disability Discrimination Act into account when listing services available for ECN.
ECN and Free Choice Network have given patients a greater choice of healthcare providers and helped to reduce waiting times. As at 30 January 2010, more than 150,000 procedures have been performed under the Extended Choice and Free Choice networks.
Prescription Drugs
Sir Paul Beresford: To ask the Secretary of State for Health pursuant to the answer of 25 January 2010, Official Report, column 553W, for what reason the views of the National Patient Safety Agency were not sought before publication of his Department's consultation on proposals to implement generic substitution in primary care. [322158]
Mr. Mike O'Brien: During 2009, the Department undertook a series of meetings with key national stakeholders, representing general practitioners, community pharmacists, and manufacturers, to discuss the commitment in the Pharmaceutical Price Regulation Scheme (PPRS) agreement in England. These national stakeholders were the General Practitioners Committee of the British Medical Association, the Pharmaceutical Services Negotiating Committee, the Association of British Pharmaceutical Industry, the British Generic Manufacturers Association and the Ethical Medicines Industry Group. We recognise that we could not have meetings with all stakeholders that might have views on the PPRS commitment and this informed our decision to hold a full public consultation, which gives all stakeholders the opportunity to input.
Patient safety is at the core of the proposals. Substitution will not be permissible where it may pose a potential risk to patient safety. Option 1 involves no change to the current arrangements. Both options 2 and 3, which involve changes, would give the flexibility to create a list of drugs that is either exempt from any arrangements (option 2), or included in any arrangements (option 3), which allows implementation to take account of whether there are any general clinical or patient safety concerns with regard to interchange between different manufacturers' products. Furthermore, both options 2 and 3 also maintain prescribers' clinical autonomy to tailor prescribing to their individual patients' clinical needs, through the
ability of prescribers to opt in or out of the generic substitution arrangements for any prescription item. Therefore, patients would continue to receive a specific manufacturer's product where their treating clinician judges that there is clinical need.
Sir Paul Beresford: To ask the Secretary of State for Health for what reason his Department opted to undertake a partial impact assessment on its proposals relating to automatic generic substitution; and what his Department's practice is on the preparation of (a) full and (b) partial impact assessments on matters which concern patient safety. [322159]
Mr. Mike O'Brien: Generic substitution is not automatic under any of the options which are currently being consulted on and patient safety is at the core of these proposals.
It is good practice to issue a consultation impact assessment (previously known as a partial impact assessment) alongside a consultation paper and to seek views from stakeholders on its content, so these can be considered in the final impact assessment later in the policy development process.
Radiotherapy
Anne Milton: To ask the Secretary of State for Health what proportion of cancer patients in England have received radiotherapy treatment in the last 12 months. [321572]
Ann Keen: It is not currently possible to calculate a reliable estimate of the proportion of cancer patients receiving radiotherapy.
The Department is working with the national health service to implement a comprehensive and robust data collection and monitoring system to support the implementation later this year of the commitment that no patient should wait longer than 31-days for subsequent radiotherapy, as set out in the Cancer Reform Strategy.
Stroud
Mr. Drew: To ask the Secretary of State for Health if he will set out, with statistical information related as directly as possible to constituency, the effects on that constituency of his Department's policies and actions since 2000. [321474]
Mr. Mike O'Brien: The Government have put in place a programme of national health service investment and reform since 1997 to improve service delivery in all parts of the United Kingdom. 93 per cent. of people nationally now rate the NHS as good or excellent. The NHS Constitution contains 25 rights and 14 pledges for patients and the public including new rights to be treated within 18 weeks, or be seen by a cancer specialist within two weeks and a NHS Health Check every five years for those aged 40-74 years.
There is significant evidence that these policies have yielded considerable benefits for the Stroud constituency. For example:
Figures for December 2009 show that in Gloucestershire Primary Care Trust (PCT):
91 per cent. of patients whose treatment involved admission to hospital started their treatment within 18 weeks.
97 per cent. of patients whose treatment did not involve admission to hospital started their treatment within 18 weeks.
In December 2009, at Gloucestershire Hospitals NHS Foundation Trust, 97 per cent. of patients spent less than four hours in accident and emergency from arrival to admission, transfer or discharge.
Between September 2007 and September 2008, the number of consultants at Gloucestershire Hospitals NHS Foundation Trust has increased from 272 to 287. Between September 1997 and September 2008, the estimated number of nurses has increased from 2,320 to 2,407.
Between September 2001 and September 2008 the number of general practitioners (GPs) per 100,000 within Gloucestershire PCT has increased from 61.6 to 68.7.
97.5 per cent, of urgent GP referrals to Gloucestershire Hospitals NHS Foundation Trust with suspected cancer are seen by a specialist within two weeks of the referral.
A new GP health centre opened at the Gloucester Health Access Centre, Gloucester in May 2009. It is open between 8am and 8pm, seven days a week, 365 days a year, offering appointments and walk-in services for any member of the public; patients may also choose to register at the health centre if more convenient than their existing practice, or use the service while remaining registered at another practice.
There is a private finance initiative (PFI) scheme in the area that serves this constituency: a £32 million PFI scheme at Gloucestershire Royal Hospital opened in September 2005.
Although statistical information is not available at a local level, Stroud will have also benefited from national policies in other areas. For example:
Since 1997, gross current expenditure on personal social services has increased by around 70 per cent. in real terms with around 105,000 households now receiving intensive home care and 3,076 new extra care housing units-exceeding the original target of 1,500 new extra care units.
Other strategies currently being implemented are:
Subject to parliamentary approval, the Personal Care at Home Bill will guarantee free personal care for 280,000 people with the highest needs and help around 130,000 people who need home care for the first time to regain their independence.
"Shaping the Future of Care Together" Green Paper, published in July 2009, sets out a vision of a National Care Service for all adults in England which is fair, simple and affordable. The Department has consulted widely on this reform and is currently analysing the responses, which will feed into a White Paper later this year.
The National Carer's Strategy-"Carers at the heart of 21st century families and communities" launched in 2008.
The first National Dementia Strategy was published in February 2009.
"Valuing People Now"-a three-year strategy for people with learning disabilities was published in January 2009.
"New Horizons-A Shared Vision for Mental Health" was launched in December 2009 to maintain improvements in mental health services combined with a new cross-Government approach to promoting public mental health.
Since 1998, there are now 2.4 million fewer smokers in England as a result of the Government's comprehensive tobacco control strategy which has a measurable impact on reducing smoking prevalence.
Child obesity levels are reducing due to the efforts of families across England, supported by the Government's obesity strategy. In 2008, 13.9 per cent. of children (aged 2 to 10) in England were classified as obese, compared with 17.3 per cent. in 2005.
Overall, life expectancy at birth for men has increased from 74.5 years (1995-1997 data) to 77.7 years (2006-08 data) while for women, life expectancy at birth has increased from 79.6 years (1995-97 data) to 81.9 years (2006-08 data).
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