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Mr Simon Burns: Information on office space per employee has only been collected since 2004 as part of a pan-government annual property benchmarking exercise. Property benchmarking data for the Department only include data for Richmond House, Wellington House, Skipton House, New Kings Beam House and Quarry House. Data for 2009-10 are not yet available as the benchmarking exercise is still underway. Office space per employee from 2004-05 to 2008-09 is as follows:
|Square metres per employee|
Graham Evans: To ask the Secretary of State for Health how much (a) his Department and (b) its agencies and non-departmental public bodies has spent on information and communication technology in each year since 1997. 
Mr Simon Burns: The Department's expenditure on information and communication technology (ICT) between 2006-07 and 2009-10 is set out in the following table. Expenditure on ICT between 1997-98 and 2005-06 is not held centrally and could be obtained only at disproportionate cost.
|(1 )Includes accommodation and building services spend.|
The Department's expenditure incurred in ensuring delivery of the information technology systems under the national programme for information technology, and for maintaining the critical business systems previously provided to the national health service by the former
NHS Information Authority, in the years for which information is available, is shown in the following table.
|ICT||Total (£ million)|
All sums are actual expenditure for the year in question, compiled using the accruals accounting convention, and exclude capital charges.
The Department's non-departmental public bodies and agency's expenditure on ICT is not held centrally. Information for period 2001-02 to 2009-10 where central contracts have been used, is set out in the following table. Details of expenditure on ICT prior to 2001 could be obtained only at disproportionate cost.
|(1 )Cells are blank if the arms length body was not in existence or where the information could be obtained only at disproportionate cost.|
(2 )Denotes the Agency.
1. Figures may have come from various sources and so may not exactly match with accrual accounts.
2. Figures have been rounded to the nearest £1,000 and may include revenue and capital.
Pete Wishart: To ask the Secretary of State for Health what the expenditure on vehicles of (a) his Department and (b) each (i) non-departmental public body and (ii) executive agency for which his Department is responsible in each English region was in each of the last three financial years; and what the planned expenditure is in each case for 2010-11. 
Mr Simon Burns: The Department does not routinely offer lease cars to members of staff. However, NHS Connecting for Health, a programme managed by the Department's Director General and Chief Information Officer, does offer lease cars to some members of staff.
Also, a small number of employees who transferred into the core Department, who were previously employed by the Purchasing and Supplies Agency (PASA), an agency of the Department, had a business need for a lease vehicle. When PASA closed on 31 March 2010, there were 15 employees who continued with their lease agreements. Since the transfer date six individuals have returned their lease car. The Department meets the costs of the ongoing leases.
The following table shows the annual expenditure on the vehicles for NHS Connecting for Health for the last three years, and the total projected cost of the NHS Connecting for Health leases and the former PASA leases in 2010-11.
Figures are rounded to the nearest £1,000.
The Department has nine executive non-departmental bodies and one agency. Only one of the current non-departmental bodies, the Appointments Commission, incurs expenditure on vehicles as shown in the following table.
Figures are rounded to the nearest £1,000. Excludes mileage costs, lease costs only.
|Minister||May 2010||June 2010|
Pete Wishart: To ask the Secretary of State for Health what the cost was of pension contributions incurred by (a) his Department and (b) each (i) non-departmental public body and (ii) executive agency for which he is responsible in each of the English regions in each of the last three financial years; and what the planned expenditure is for 2010-11. 
Mr Simon Burns: The cost of employer pension contributions incurred for the last three years-and the predicted expenditure for the coming year-by the core Department, each of the Department's executive non-departmental public bodies and its executive agency: the Medicines and Healthcare products Regulatory Agency are shown in the following table.
|Title of organisation||2007-08 costs||2008-09 costs||2009-10 costs||2010-11 'planned expenditure'|
|(1 )Based on plans developed pre Arms Length Body review, now subject to review.|
(2 )HPA figures are as per the statutory entity at the time. The National Institute for Biological Standards and Control joined the HPA from 2009-10.
Pete Wishart: To ask the Secretary of State for Health what the monetary value was of (a) public opinion research and (b) public relations contracts awarded by his Department in each of the last five years in (i) London and (ii) each region of England. 
Mr Simon Burns: The Department's communications directorate commissioned regular tracking of public attitudes towards the national health service in England. As regional public opinion polling is carried out by strategic health authorities, we are unable to provide a breakdown by region.
|Tracking of public attitudes (excluding VAT) ( £ )|
Public relations companies have been contracted to support a very wide range of marketing and policy initiatives including major public health behaviour change programmes (such as tobacco control, sexual health, flu immunisation, obesity prevention, hand and respiratory hygiene and drug and alcohol harm reduction programmes) in addition to communicating to the NHS work force and supporting clinical campaigns. The work commissioned through public relations companies includes a wide range of marketing activity including: advertorials, newsletter production, conference and event management, research, creation of content and photography and stakeholder relations activity.
|Direct expenditure from Department of Health (excluding VAT)||Expenditure through Central Office of Information (excluding VAT)|
The above expenditure includes additional expenditure made directly by NHS Connecting for Health (part of the Department of Health), but excludes any expenditure by arm's length bodies and non-departmental public bodies.
All properties are in England. The amounts listed do not include VAT or serviced accommodation. Serviced accommodation costs cover all services in a building and it is not possible to break these costs down.
The figures above include rental costs of buildings, which are deemed surplus. Surplus property was returned to the Department for disposal or sublet until the end of the lease and is managed as part of the Department's retained estate. The main reason for the increase in rent paid for 2009-10 was the rationalisation in the arms length body sector estate and a number of properties becoming surplus and being managed as part of the Department's retained estate. The vacant properties are being actively marketed. The total costs for the Department's retained estate from 2005-06 to 2009-10 are as follows:.
Mr Jim Cunningham: To ask the Secretary of State for Health what steps he is taking to improve health care for people with rare diseases in response to the recommendations of the chief medical officer's annual report for 2009. 
Mr Simon Burns: The chief medical officer (CMO) produces an annual report on the state of public health, in which the CMO provides a wide range of policy recommendations on public health to the Government. His report for 2009, published in March 2010, included a section which addressed treatments for rare diseases.
The White Paper "Equity and Excellence-Liberating the NHS", published on 12 July 2010, includes our future intentions for the commissioning of specialised services. It proposes that highly specialised services which include the treatment of some rare diseases would in the future be commissioned by the National
Commissioning Board. The subsequent consultation and engagement paper "Liberating the NHS: commissioning for patients", published on 22 July 2010, is seeking views on a number of questions regarding the proposals on the future arrangement of national and regional specialised services.
Mr Simon Burns: The latest available National Health Service Workforce Census details the number of doctors employed in the NHS as at 30 September 2009. The following table shows the total number of doctors employed by the NHS in September 2009 and September 1997.
|(1) Excludes medical Hospital Practitioners and medical Clinical Assistants, most of whom are GPs working part time in hospitals.|
(2) Retainers were first collected in 1999 and have been excluded from the 2009 figure for comparability.
The NHS Information Centre for health and social care seeks to minimise inaccuracies and the effect of missing and invalid data but responsibility for data accuracy lies with the organisations providing the data. Methods are continually being updated to improve data quality. Where changes impact on figures already published, this is assessed but unless it is significant at national level figures are not changed. Impact at detailed or local level is footnoted in relevant analyses.
1. HCHS doctors as at 30 September each year.
2. GP data as at 1 October 1997 and 30 September 2009.
1. The NHS Information Centre for health and social care Medical and Dental Workforce Census
2. The NHS Information Centre for health and social care General and Personal Medical Services Statistics
There is more recent monthly data available for April 2010. It has not been included in the reply, as this would exclude some significant groups such as GPs. The monthly data also only includes staff on the Electronic Staff Record and therefore excludes primary care and bank staff.
To ask the Secretary of State for Health how many prisoners are in receipt of prescriptions for methadone; and what recent
assessment he has made of the effectiveness of (a) prescribing prisoners methadone and (b) abstinence programmes in reducing the level of drug addiction in prison. 
Mr Burstow: In 2009-10, a total of 60,067 prisoners received a clinical drug intervention. Of these, 36,323 received detoxification and 23,744 received a maintenance prescription for opioid dependency of either methadone or buprenorphine.
The Institute of Psychiatry and the National Centre for Social Research are carrying out an independent evaluation of drug treatment and the Integrated Drug Treatment System in prisons, including maintenance prescribing and detoxification programmes. The evaluation began in 2008 and is timetabled to be completed in 2011.
Laura Sandys: To ask the Secretary of State for Health (1) how many full-time equivalent epilepsy specialist nurses worked in the NHS (a) in each of the last 10 years and (b) at the latest date for which figures are available; what estimate he has made of the number of such nurses there will be in 2012; and if he will make a statement; 
Mr Burrowes: To ask the Secretary of State for Health what procedure for obtaining consent for the use of foetal tissue is in place; which organisation is responsible for overseeing the proper implementation of the consent procedure; how many complaints have been brought regarding the consent procedure in the last 10 years; and if he will make a statement. 
Anne Milton: The storage and use of foetal tissue for certain purposes including research is, like all other tissue from the living, subject to the requirement for "appropriate consent" in accordance with the Human Tissue Act 2004, i.e. it requires the consent of the woman from whom it was taken.
The Human Tissue Authority has a general function under the Act to superintend compliance with the consent requirements of the Act and codes of practice, one of which covers the subject of consent. There is not a specific procedure for complaints about the consent process and any complaint about consent would be dealt with in accordance with the general complaints procedures of the organisation concerned. Information on any complaints that may have been made is not collected centrally.
Anne Milton: The Food Standards Agency has monitored the effectiveness of its consumer campaigns, and the reductions in average population daily salt intakes as a result of the overall salt reduction programme.
Evaluation of the four-phase campaign suggests that the number of consumers claiming to make a special effort to cut down the amount of salt in their diet has increased by one-quarter. Of those who are doing so by checking the label, the increase has been 200%; there has been a 1,000% increase in awareness of the six grams (g) a day message; and there has been a 72% increase in the number of all adults looking at the label to find out the salt content.
John Mann: To ask the Secretary of State for Health (1) what representations he has received from Burson-Marsteller on the recent decisions by his Department to change the remit of the Food Standards Agency; 
Mr Meacher: To ask the Secretary of State for Health what projects on public attitudes to pesticides the Food Standards Agency has funded since 1997; what the (a) topic, (b) start date, (c) cost and (d) project code was of each such project; who the main contractor was in each case; and which such projects have been completed. 
Anne Milton: The following research has been commissioned in relation specifically to public attitudes to pesticides. All projects were completed and the final reports can be found at the web links provided:
Consumer Concern Over the Use of Pesticides to Grow Food (Define Solutions)-commissioned via the Central Office of Information (COI) (COI ref: 260602). Duration of the project was January 2004 to March 2004; the total cost was £29,370.
Consumer Information Needs Regarding Pesticides (Forum Qualitative)-commissioned via COI (COI ref: 269197). Duration of the project was December 2005 to August 2006; the total cost was £53,550.
Consultancy Services to Assist in the Preparation of a Strategy to Minimise Pesticide Residues in Food (ADAS Consulting). Project code PAU 154; Duration of the project was March 2003 to August 2003; the total cost was £63,856.
Jon Cruddas: To ask the Secretary of State for Health what plans he has for the level of funding for research into the causes and treatments of food allergies following the restructuring of the Food Standards Agency. 
There has been no indication that the FSA budget will be unaffected by the Government's October spending review. The FSA is committed to ensuring that its policies are based on sound science and evidence, and is assessing future priorities, including the research programmes. The FSA is considering different models for funding research and is already exploring potential collaborative co-funding resources to help support its research objectives.
Jon Cruddas: To ask the Secretary of State for Health what mechanisms he plans to put in place to ensure that people with food allergies can access ingredients information when buying food and eating out after the transfer of responsibility for food labelling and provision of information in restaurants and takeaways to his Department. 
The responsibility for food allergy and food intolerance, including labelling and the provision of allergen information, is remaining in the Food Standards Agency (FSA), as this is a food safety matter. There will not be any change in the current legal provisions for food allergen labelling following the transfer of responsibility
for general food labelling (ie labelling that is not safety or nutrition labelling) to Department for Environment, Food and Rural Affairs (DEFRA).
There will be close co-operation between DEFRA the FSA and the Department to support ongoing negotiations on the proposed Food Information Regulation. This regulation will incorporate existing provisions on the labelling of allergenic ingredients in pre-packed foods and is expected to introduce new requirements to provide allergen information for foods sold unpackaged, including in catering.
Jon Cruddas: To ask the Secretary of State for Health what steps his Department is taking to improve guidance on weaning to parents of young babies in order to prevent food allergies from developing; and if he will make a statement. 
Anne Milton: Research is ongoing as there is considerable scientific uncertainty about introducing allergenic foods in the infant diet and whether this reduces the risk of developing a food allergy in later childhood.
The Department's advice is that infants should be breastfed exclusively for around the first six months, as breast milk provides all the nutrients a baby needs. Thereafter, parents can introduce more solid foods alongside breastfeeding for the first year.
Parents should avoid giving children under six months allergenic foods, such as peanuts, nuts, seeds, fish, shellfish, wheat-and other cereals that contain gluten (for example, rye, oats, barley). Information on breastfeeding, weaning, and foods to avoid during weaning is available at:
Mr Simon Burns: We do not wish to be unduly prescriptive about the size of general practitioner commissioning consortiums. There have been widespread variations in the size and population coverage of primary care trusts (PCTs), which are currently responsible for commissioning national health service healthcare services, and there is no evidence to suggest a single 'right' size. The NHS Commissioning Board will, however, need to satisfy itself that consortiums are of sufficient size to manage financial risk effectively. The consultation document on new NHS commissioning arrangements "Liberating the NHS: Commissioning for patients", published on 22 July, seeks views on whether there should be a minimum or maximum population size for GP commissioning consortiums. A copy of the document has already been placed in the Library.
Andy Burnham: To ask the Secretary of State for Health what (a) research and (b) other evidence on the capacity of GPs to commission services was used in preparation of his Department's recent White Paper. 
Mr Simon Burns:
The White Paper, "Equity and Excellence: Liberating the NHS" published on 12 July 2010, sets out our proposals for transforming the quality of commissioning by devolving decision-making to local
consortiums of general practitioner (GP) practices. "Liberating the NHS: Commissioning for patients", published on 22 July, provides further details on these proposals. There is a body of evidence both from this country and internationally about the importance of involving clinicians in commissioning decisions.
An analytical strategy was published alongside the White Paper. This set out that, between now and the legislation that will give effect to the proposals, the Department will be developing the analytical framework to give a picture of the likely effects of the White Paper.
The Department will publish an impact assessment covering the proposals for GP commissioning alongside or shortly after its response to the consultation process. The Department will use the consultation period to inform the development of the impact assessments to ensure that a wide ranging and robust analysis is undertaken.
Mr Barron: To ask the Secretary of State for Health whether GP consortiums will be entitled to refuse to offer patients clinically appropriate drugs or treatments which have been approved by the National Institute for Health and Clinical Excellence under the proposals in the NHS White Paper. 
Mr Simon Burns: The White Paper 'Equity and Excellence: Liberating the NHS', published on 12 July 2010, sets out our proposals for transforming the quality of commissioning by devolving decision-making to local consortiums of general practitioner practices.
We will be considering this issue as we develop the detail of the new commissioning arrangements but we remain committed to ensuring that patients can access drugs and treatments recommended in National Institute for Health and Clinical Excellence technology appraisals.
|Primary care trusts (PCTs)||NHS Plan general practitioners (GPs) per 100,000 population|
| Note: NHS Plan GPs per 100,000 population is calculated using mid-year 2006 resident population data with the permission of the Office for National Statistics. Source: NHS Factsheets-Department of Health Care and Health Information Portfolio (CHIP) briefing system.|
Mr Simon Burns: The Government's White Paper "Equality and Excellence: Liberating the NHS", published on 12 July, set out proposals for putting local consortiums of general medical practitioners in charge of commissioning services to best meet the needs of local people, supported by an independent national health service commissioning board.
We have now launched a consultation and engagement process on how we should implement these proposals. "Liberating the NHS: commissioning for patients" published on 22 July, which provides more detail on proposed arrangements and seeks views. Both publications have already been placed in the Library.
NHS chief executive Sir David Nicholson has also written to the chief executive community setting out plans for managing the transition to the new arrangements. His letter set out the initial steps that are being taken at a national level to ensure the NHS continues to deliver for today while designing a new system for tomorrow. It provides a framework within which strategic health authorities can lead this process regionally, and sets out some initial actions that commissioners and providers need to take as part of state of readiness for 2012. It is available from the Department's website at:
Mrs Main: To ask the Secretary of State for Health what recent estimate he has made of the number and proportion of residents of St Albans constituency who (a) are registered with a GP and (b) have access to an NHS dentist. 
|Primary care trust (PCT)||GP registered patients|
1. The GP Census collection contains data by trust level only. St Albans Constituency is contained within and served by Hertfordshire PCT. Hertfordshire PCT was created in April 2010 through the merging of two PCTs. These two PCTs, East and North Hertfordshire PCT and West Hertfordshire PCT, were in existence at the time of the census and so data has been shown for each of these, with a cumulative total to reflect the number of registered patients in Hertfordshire PCT.
2. Data is for the number of GP patient registrations shown on the annual GP Census collection as at 30 September 2009. However, this is not resident population data and in fact may be higher than resident population in the given areas due to factors such as multiple registrations and GP systems not being fully up-to-date. Owing to this, proportions of numbers registered (and not registered) cannot be accurately calculated by dividing the numbers presented here by resident population statistics.
3. The numbers shown here represent GP patient registrations to national health service GPs only
4. Data Quality:
The NHS Information Centre for health and social care seeks to minimise inaccuracies and the effect of missing and invalid data but responsibility for data accuracy lies with the organisations providing the data. Methods are continually being updated to improve data quality where changes impact on figures already published. This is assessed but unless it is significant at national level figures are not changed. Impact at detailed or local level is footnoted in relevant analyses.
The Information Centre for health and social care.
With regard to dental access, under the new dental contractual arrangements introduced on 1 April 2006, patients do not have to be registered with an NHS dentist to receive NHS care. The closest equivalent measure to 'registration' is the number of patients receiving NHS dental services ('patients seen') over a 24 month period.
Information on the number and proportion of patients seen in the previous 24 months, in England, is available in Table Dl and D2 of Annex 3 of the NHS Dental Statistics, Quarter 3: 31 December 2009 report. Information is available at quarterly intervals, from 31 March 2006 to 31 December 2009 and is provided by PCT and by strategic health authority.
Mr Chope: To ask the Secretary of State for Health pursuant to the answer of 8 June 2010, Official Report, column 112W, on health centres: Christchurch, what progress he has made in the discussions to achieve an early disposal of his Department's interest in the former health centre at Saxon Square, Christchurch. 
Harriett Baldwin: To ask the Secretary of State for Health (1) whether he has taken note of the comments on the Health Professions Council on the Government's Your Freedom website; and if he will make a statement; 
Anne Milton: The Council for Healthcare Regulatory Excellence, which is responsible for the scrutiny and quality assurance of the nine health care professions regulators in the United Kingdom, recently published its annual performance review. In respect of the Health Professions Council (HPC) it commented that the HPC
"is a well organised, efficient and cost-effective regulator. This has helped it maintain a good performance during a year which saw it assume responsibility for two further professions..."
The Government are currently considering their overall approach to the regulation of health and social care workers, including the legislative framework. No firm decisions have been made. We will of course take note of any comments we receive including comments from the Government's Your Freedom website.
Mr Barron: To ask the Secretary of State for Health what proportion of his Department's expenditure on health staffing costs related to (a) nurses, (b) doctors, (c) all clinical staff, (d) all non-clinical staff and (e) managers in the most recent financial year for which figures are available. 
Mr Simon Burns: The following table indicates our estimates of the proportion of the total pay bill allocated to each of the requested staff groups in 2008-09, which is the latest year for which figures are available.
|Proportion of 2008-09 pay bill (percentage)|
1. It is not possible to precisely split pay bill between clinical and non-clinical categories. The 'clinical staff' proportion will be an over-estimate in the above analysis. This is because the financial data are collectively reported for unqualified nurses, healthcare assistants and support workers, and the cost of this group has been treated as a 'clinical' cost. In addition, the total cost of ambulance staff is reported with no indication of the clinical and non-clinical cost elements, and has likewise been treated as 'clinical staff'. As a result, the non-clinical costs will be under-estimated.
2. Around 0.4% of pay costs are for non-medical staff with an unknown classification.
3. The pay bill includes all employees of NHS trusts, primary care trusts (PCTs), strategic health authorities and foundation trusts in England. It excludes agency staff, contractors' employees, general practitioners (GPs) and other GP practice staff.
4. Foundation trusts do not submit a breakdown of their pay bill by staff group. This has been estimated.
2008-09 Trust, PCT and SHA Financial Returns and Foundation Trust Annual Reports.
a qualified nurse is estimated at £40,100 per full-time equivalent, and
a doctor is estimated at £98,700 per full-time equivalent.
These estimates have been derived by taking the average earnings per full-time equivalent from the Quarterly Earnings Survey for January-March 2010, published by the NHS Information Centre for health and social care, and estimating the additional employer costs of national insurance and pension contributions.
Mr Simon Burns: The latest annual national health service work force census shows that at 30 September 2009 there were 140,897 doctors, 417,164 qualified nurses, 725,579 professionally qualified clinical staff, 706,417 non-clinical staff, the majority of whom are support to clinical staff, and 44,661 managers and senior managers working in the NHS in England.
|NHS Hospital and Community Health Service (HCHS) and General Practice work force as at 30 September, England-2009|
1. "Professionally qualified clinical staff" includes all doctors, qualified nursing staff, qualified scientific, therapeutic and technical staff and qualified ambulance staff.
2. "Non clinical staff" includes support to clinical staff, infrastructure support staff, other practice staff and other non-medical staff with unknown classifications.
3. In this instance monthly data have not been provided as they exclude significant groups that have been requested (e.g. primary care).
As from 21 July 2010 The Information Centre has published experimental, provisional monthly NHS work force data based on staff on the electronic staff record (ESR). Note that these do not include primary care staff (e.g. GPs and their staff) or bank staff however they do include locum doctors (not included in the annual work force census). This information is available from September 2009 onwards at the following website:
Mr Barron: To ask the Secretary of State for Health whether GP consortiums will be entitled to take any unspent part of their (a) commissioning budget and (b) management allowance as profit under the proposals in the NHS White Paper. 
Mr Simon Burns: Within commissioning budgets, general practitioner (GP) consortiums will receive a maximum management allowance to reflect the management costs associated with commissioning. Consortiums will be free to decide how to use this management allowance to carry out commissioning activities.
With the exception of this management allowance the consortium's commissioning budget must be used exclusively for the commissioning of patient care. It will be distinct from the income that GP practices earn under their primary medical care contract, from which they both meet their practice expenses, and derive their personal income.
Health outcomes for patients will depend both on the quality of services that GP practices provide and on the quality of GP commissioning. We therefore propose, subject to discussion with the British Medical Association and the profession, that a proportion of GP practice income should be linked to the outcomes that practices achieve collaboratively through commissioning consortiums, and the effectiveness with which they manage national health service financial resources.
'Liberating the NHS: Commissioning for patients', published on 22 July, sets out further information on the intended arrangements for GP commissioning, providing the basis for fuller engagement with primary care professionals and the public.
Clive Efford: To ask the Secretary of State for Health when he expects the implementation of the Southeast London Healthcare Trust 'A Picture of Health' programme to be completed; and if he will make a statement. 
Mr Simon Burns: This is a matter for the local national health service. The Secretary of State for Health has outlined four tests that decisions on NHS service changes must meet. Change must improve patient outcomes; consider patient choice; have support from general practitioner commissioners; and be based on sound clinical evidence. The NHS in South East London will need to make sure any plans for change have local support and meet these tests.
Glenda Jackson: To ask the Secretary of State for Health who will be responsible for delivering (a) health and (b) mental health services in prisons (i) during and (ii) after the implementation of the changes in commissioning services proposed in his Department's White Paper. 
Mr Burstow: Primary care trusts are responsible for delivering healthcare services in prisons during the White Paper consultation period and until the health Bill is passed. Once this is enacted, the national health service commissioning board will be responsible for commissioning prison health services and will work with criminal justice agencies and general practitioner consortia to determine the most appropriate arrangements for prison health services.
Mr Sanders: To ask the Secretary of State for Health pursuant to the answer of 14 July 2010, Official Report, column 786W, on hospitals: admissions, what the 10 most common reasons are for which patients of each healthcare (a) provider and (b) commissioner were transferred from residential care to hospital care in the latest period for which figures are available. 
Mr Burstow: We are unable to provide the information in the format requested as a breakdown of reasons for admissions from residential care at provider and commissioner level would risk patient confidentiality.
However, the following tables show finished admission episodes by strategic health authority of commissioner where the primary diagnosis (the main reason the patient was admitted to hospital) was one of the top 20 primary diagnoses for patients transferred from residential care to hospital care nationally in 2008-09. This is not a count of patients as a patient may be admitted to hospital more than once within the year.
|Strategic health authority of commissioner (SHA code)|
|Primary diagnosis||Diagno sis code||Total||North East (Q30)||North West (Q31)||Yorkshir e and Humber (Q32)||East Midlands (Q33)||West Mid lan ds (Q34)|
|Strategic health authority of commissioner (SHA code)|
|Primary diagnosis||Diagnosis code||Total||East of England (Q35)||London (Q36)||South East Coast (Q37)||South Central (Q38)||South West (Q39)||Scotland/ Wales (S/Q99 )||Not know n (Y)|
1. A finished admission episode (FAE) is the first period of inpatient care under one consultant within one healthcare provider. FAEs are counted against the year in which the admission episode finishes. Admissions do not represent the number of inpatients, as a person may have more than one admission within the year.
2. The strategic health authority of commissioner (SHA code) field identifies the strategic health authority (SHA) in which the commissioner is located.
3. The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and 7 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.
4. This list of 20 diagnoses is the top 20 primary diagnoses for finished admission episodes where patients were transferred from residential care to hospital nationally in 2008-09.
5. The admission source field contains a code which identifies where the patient was immediately prior to admission. The following codes for admission source were used to classify patients as being transferred from residential care to hospital treatment:
54 = NHS run nursing home, residential care home or group home
65 = Local authority Part 3 residential accommodation: where care is provided (from 1996-97)
69 = Local authority home or care (1989-90 to 1995-96)
85 = Non-NHS (other than Local Authority) run residential care home (from 1996-97)
86 = Non-NHS (other than Local Authority) run nursing home (from 1996-97 to 2006-07)
Hospital Episode Statistics (HES), The NHS Information Centre for health and social care
Glenda Jackson: To ask the Secretary of State for Health who will be responsible for maintaining (a) accident and emergency, (b) maternity, (c) paediatric and (d) trauma departments at hospitals in North London during the implementation of the commissioning of changes proposed in his Departments White Paper. 
Mr Evennett: To ask the Secretary of State for Health how many people resident in the London borough of Bexley received NHS funding for IVF and IVI treatment in the last 12 months for which figures are available; and how many such people received funding for more than one course of treatment. 
Mr Burstow: The independent Commission on the Funding of Care and Support has been asked to make recommendations on how to achieve an affordable and sustainable funding system for care and support for all adults in England. However, the long term future of the Independent Living Fund, which operates across the United Kingdom, will be considered and settled as part of the forthcoming spending review.
Anne Milton: The High Impact Action (HIA), "Keeping Patients Nourished" was launched last year. This work, which is led by the chief nurses from the 10 strategic health authorities with input from various partner organisations including the Department, identified that keeping patients nourished, especially older people, was a priority area of care upon which nurses and midwives could facilitate progress. Support materials have been made available to help nurses deliver this HIA.
Laura Sandys: To ask the Secretary of State for Health what percentage of older people in hospital were malnourished (a) on admission and (b) at discharge in the latest period for which figures are available. 
Anne Milton: The information is shown in the following table. The top figure shows the total amount of hospital episodes regardless of the condition, and is included to put the malnutrition figures into context.
|Table to show count and percentage of admissions( 1) and discharges (last episode of care)( 2) in hospital where there was a primary or secondary diagnosis( 3) of malnutrition( 4) for people aged 65 and over in 2008-09|
|Total finished admission episodes||Total in year discharge episodes|
|(1) Finished admission episodes A finished admission episode (FAE) is the first period of inpatient care under one consultant within one health care provider. FAEs are counted against the year in which the admission episode finishes. Admissions do not represent the number of inpatients, as a person may have more than one admission within the year. (2 ) Discharge A discharge episode is the last episode during a hospital stay (a spell), where the patient is discharged from the hospital or transferred to another hospital. (3 ) Number of episodes in which the patient had a primary or secondary diagnosis The number of episodes where this diagnosis was recorded in any of the 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) primary and secondary diagnosis fields in a Hospital Episode Statistics (HES) record. Each episode is counted only once, even if the diagnosis is recorded in more than one diagnosis field of the record.|
(4) ICD10 Clinical Codes The ICD-10 codes for Malnutrition are: E40.X Kwashiorkor E41.X Nutritional marasmus E42.X Marasmic kwashiorkor E43.X Unspecified severe protein-energy malnutrition E44 Protein energy malnutrition of moderate and mild degree E45.X Retarded development following protein energy malnutrition E46 Unspecified protein energy malnutrition 025 Malnutrition in pregnancy. Note: Data quality Hospital Episode Statistics (HES) are compiled from data sent by more than 300 national health service trusts and primary care trusts (PCTs) in England and from some 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. While this brings about improvement over time, some shortcomings remain. Source: Hospital Episode Statistics (HES). The NHS Information Centre for health and social care.
Dr Huppert: To ask the Secretary of State for Health what restrictions his Department places on the (a) services, (b) treatments and (c) medications which may be provided to patients through (i) GPs and (ii) other NHS facilities. 
Mr Simon Burns: Under their terms of service, general practitioners (GPs) are allowed to prescribe any product, including any unlicensed product or product not licensed for a particular indication (often known as 'off-label' prescribing), which they consider to be a medicine necessary for the treatment of their patients under the national health service, subject to two provisos. These are, firstly, that the product is not included in schedules 1 or 2 to the NHS (General Medical Services Contracts) (Prescription of Drugs etc) Regulations 2004, otherwise known as the 'Selected List Scheme', and secondly, GPs are prepared to justify any challenges to their prescribing by their primary care trust.
Tracey Crouch: To ask the Secretary of State for Health whether his proposals to incentivise health providers to reduce numbers of emergency re-admissions will apply to re-admissions of mental health patients. 
Mr Burstow: The non-payment for readmissions announced in the 'Revision to the Operating Framework for the NHS in England in 2010-11' (page 12) applies to acute trusts providing physical health care. A copy has already been placed in the Library.
The reason it will not apply to mental health trusts is that we are implementing a payment system for mental health services in 2012-13 that covers both in-patient and community care. Under this system, a mental health provider will be paid for a person's care for a time period (for example six months), and that payment will cover the costs of all care given, such as an inpatient stay, contact with a community mental health team and psychological therapies.
Jonathan Reynolds: To ask the Secretary of State for Health what mechanisms are in place to ensure that the advisory guidelines on the identification and handling of deceased patients are followed in each hospital. 
Anne Milton: "Care and Respect in Death, Good Practice Guidance for NHS Mortuary Staff", was published by the Department in 2006. It sets out eight key principles of good practice, and practical guidance based on them. It provides a basis for, but does not replace, the detailed standard operating procedures which every mortuary must have in place, and which will be adapted to local and individual circumstances. As it is advisory guidance, we would expect the national health service to have regard to it, but we do not monitor compliance. This is consistent with the principle set out in "Equity and excellence: Liberating the NHS" that we should be clear about what the NHS should achieve; we should not prescribe how it should be achieved.
Harriett Baldwin: To ask the Secretary of State for Health whether he plans to instruct the National Institute for Health and Clinical Excellence to develop a national strategy for motor neurone disease. 
Mr Simon Burns: We have no such plans. The quality requirements contained in the national service framework (NSF) for long-term conditions set out standards for care for people with neurological conditions, including motor neurone disease (MND). The NSF covers all aspects of care from assessment, through diagnosis, treatment and support, to end of life decisions and palliative care and makes specific reference to addressing the needs of people with rapidly progressing conditions such as MND, where services need to respond quickly.
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