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Mr Gregory Campbell: To ask the Secretary of State for Health what steps the Government has taken in response to Lord Archer's report on the contamination of blood products; and if he will make a statement. 
Anne Milton: The majority of Lord Archer's recommendations are already in place in one form or another, although they have not necessarily been implemented exactly as Lord Archer recommended, in all cases. These include:
Recommendation 1- the Department has brought the Haemophilia Alliance - which is a United Kingdom wide partnership between patients, haemophilia doctors and others involved in their care - into the process of policy making on haemophilia issues;
Recommendation 2 - haemophilia patients and their partners are offered testing for any infectious condition, if deemed necessary by their clinician;
Recommendation 3 - blood donations are tested for syphillis, hepatitis B, HIV, hepatitis C, and Human T-Lymphotropic Virus. This list is kept under review by the Government's Advisory Committee on the Safety of Blood, Tissues and Organs ;
Recommendation 4 - general practitioner visits, counselling, physiotherapy and home nursing should be freely available in England under the national health service, where needed;
Recommendation 5 - the Government are funding the Haemophilia Society with £100,000 per annum over the next four years;
Recommendation 6 - the Government provide some financial support to those affected via the Macfarlane and Eileen Trusts and the Skipton Fund. They are not means tested, and are discounted for tax purposes and in calculating state benefits;
Recommendation 7 - the Government are currently considering the issue of access to insurance; and
Recommendation 8 - the Department is funding the UK Haemophilia Centre Doctors Organisation to identify any other patients who might have been infected. An interim report is expected in 2011, with a final report in 2012.
There are a small number of recommendations that have not been implemented. These primarily relate to aspects of the ex-gratia payments, free prescriptions in England, and access to insurance. I refer the hon. Member to the written ministerial statement I gave on 14 October, Official Report, column 30WS, announcing that I have instigated a review of these recommendations to see what more can be done.
Mr Baron: To ask the Secretary of State for Health (1) what proportion of patients diagnosed with each type of cancer following an admission to hospital in (a) each cancer network, (b) each primary care trust and (c) England was aged (i) 49 years and under, (ii) 50 to 59 years, (iii) 60 to 69 years, (iv) 70 to 79 years and (v) over 80 years in each of the last five years; 
(2) how many people who received any active treatment for each type of cancer in (a) each cancer network, (b) each primary care trust and (c) England were aged (i) 49 years and under, (ii) 50 to 59 years, (iii) 60 to 69 years, (iv) 70 to 79 years and (v) over 80 years in each of the last five years; 
(3) how many people who received any surgical treatment for each type of cancer in (a) each cancer network, (b) each primary care trust and (c) England were aged (i) 49 years and under, (ii) 50 to 59 years, (iii) 60 to 69 years, (iv) 70 to 79 years and (v) over 80 years in each of the last five years; 
(4) how many finished consultant episodes there were for patients with each type of cancer who were aged (a) 49 years and under, (b) 50 to 59 years, (c) 60 to 69 years, (d) 70 to 79 years and (e) over 80 years in (i) each cancer network, (ii) each primary care trust and (iii) England in each of the last five years. 
Paul Burstow: Information on the proportion of patients diagnosed with each type of cancer following an admission to hospital by cancer network, primary care trust (PCT) and nationally, who were aged 49 years and under, 50 to 59 years, 60 to 69 years, 70 to 79 years and over 80 years for each of the last five years cannot be provided in the format requested. Hospital episode statistics do not identify whether cancer had been diagnosed before or after admission.
Information on the number of finished consultant episodes where there was a primary diagnosis of cancer by age, both nationally and by PCT, can be provided, and has been placed in the Library. This information is not available at cancer network level.
Information on the number of people who received any surgical or active treatment for each type of cancer by cancer network, primary care trust and nationally who were aged 49 years and under, 50 to 59 years, 60 to 69 years, 70 to 79 years and over 80 years in each of the last five years cannot be provided in the format requested. Information on finished consultant episodes where there was a primary diagnosis of cancer and any named primary of secondary procedure or intervention can be provided at PCT level and for the age groups requested for the last five years. This information has been placed in the Library.
Dr Pugh: To ask the Secretary of State for Health who will replace primary care trusts as representatives on children's trusts following the implementation of the proposals contained in the NHS White Paper. 
The Department has specifically asked for views on how the proposals contained in "Equality
and Excellence: Liberating the NHS" might best fit with current duty to co-operate through children's trust arrangements.
Caroline Lucas: To ask the Secretary of State for Health on what date his Department's decision that people with myalgic encephalomyelitis should not give blood was (a) made and (b) implemented. 
Anne Milton: The UK Blood Services decision to permanently exclude from blood donation, anyone who reports that they have had Myalgic Encephalopathy/Chronic Fatigue Syndrome (ME/CFS) was made on 8 July 2010. The change to the donor selection guidelines will come into force on 1 November 2010. This change is being made on the grounds of donor safety, as ME/CFS is a relapsing condition. It brings practice for ME/CFS into line with other relapsing conditions or neurological conditions of unknown origin.
The change to donor selection criteria is being made following a recommendation by the UK Blood Services Standing Advisory Committee on the Care and Selection of Donors, and Joint Professional Advisory Committee.
Caroline Lucas: To ask the Secretary of State for Health with reference to the answer to the hon. Member for Stroud of 27 January 2010, Official Report, column 942W, on chronic fatigue syndrome, whether (a) the UK Blood Services and Health Protection Agency study of the prevalence of a rodent virus linked to myalgic encephalomyelitis and (b) his Department's risk assessment in respect of the study has been completed; and if he will make a statement. 
Anne Milton: There has been a consistent failure of independent European and American studies to confirm the original American study that described the detection of xenotropic murine leukemia virus-related virus (XMRV), a virus related to rodent viruses, in patients with chronic fatigue syndrome, sometimes referred to as myalgic encephomyelitis. An expert subgroup of National Expert Panel for New and Emerging Infections (NEPNEI) met in May 2010, to consider all available evidence about XMRV and conduct a risk assessment. The subgroup concluded that XMRV can infect humans but there is currently no evidence that it causes human disease and that on the evidence before the group, no public health action is required at this time. Since the subgroup meeting in May there has been no new scientific evidence that would change the conclusions of the subgroup but they are keeping it under review.
The Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO), on the basis of current evidence does not recommend further measures at present but wishes to continue to monitor the situation. The NHS Blood and Transplant and Health Protection Agency study group concur with the views expressed both by NEPNEI and SaBTO but also recognise the need for further research on the prevalence of XMRV in the United Kingdom. In a recent unpublished pilot study conducted by the group a series of 540 randomly selected English blood donors were screened for XMRV and none were found to be infected.
Bridget Phillipson: To ask the Secretary of State for Health what plans he has to publish his Department's clinical strategy on chronic obstructive pulmonary disease; and if he will make a statement. 
Mr Simon Burns: The Department is currently reviewing the responses received to its consultation on a strategy for services for chronic obstructive pulmonary disease in England and will make an announcement in due course on the publication of any final strategy.
Mr Simon Burns: A consultation was held earlier this year on a draft strategy for services for chronic obstructive pulmonary disease in England, closing on 6 April 2010. The Department is currently considering the responses received and will be taking these into account when shaping the final strategy. In advance of publication of the final strategy, the Department is doing some preparatory work with the development of communities of practice at a local level and the initiation of pilots working with NHS improvement.
Sammy Wilson: To ask the Secretary of State for Health how many of the recommendations made by Lord Archer in the report of his inquiry into contaminated blood products his Department has implemented. 
Anne Milton: Some of Lord Archer's recommendations are already in place in one form or another, although they have not necessarily been implemented exactly as Lord Archer recommended, in all cases. These include:
Recommendation 1-The Department has brought the Haemophilia Alliance-which is a United Kingdom wide partnership between patients, haemophilia doctors and others involved in their care-into the process of policy making on haemophilia issues;
Recommendation 2-Haemophilia patients and their partners are offered testing for any infectious condition, if deemed necessary by their clinician;
Recommendation 3-Blood donations are tested for syphilis, hepatitis B, HIV, hepatitis C, and Human T-Lymphotropic Virus. This list is kept under review by the Government's Advisory Committee on the Safety of Blood, Tissues and Organs ;
Recommendation 4-General practitioner visits, counselling, physiotherapy and home nursing should be freely available in England under the NHS, where needed;
Recommendation 5-The Government are funding the Haemophilia Society with £100,000 per annum over the next four years;
Recommendation 6-The Government provide some financial support to those affected via the MacFarlane and Eileen Trusts and the Skipton Fund. They are not means tested, and are discounted for tax purposes and in calculating state benefits;
Recommendation 7-The Government are currently considering the issue of access to insurance; and
Recommendation 8-The Department is funding the UK Haemophilia Centre Doctors Organisation to identify any other patients who might have been infected. An interim report is expected in 2011, with a final report in 2012.
There are a small number of recommendations that have not been implemented. These primarily relate to aspects of the ex-gratia payments, free prescriptions in England, and access to insurance. I refer the hon. Member to the written ministerial statement i gave on 14 October 2010, Official Report, column 30WS, announcing that I have instigated a review of these recommendations to see what more can be done.
Anne Marie Morris: To ask the Secretary of State for Health what recent representations he has received on the adequacy of dementia services available to people living in (a) South Devon and (b) Newton Abbot constituency. 
Dr Pugh: To ask the Secretary of State for Health who will be responsible for ensuring the provision of NHS dental services in areas of shortage after the implementation of the proposals contained in the NHS White Paper. 
Mr Simon Burns: Primary care trusts are currently responsible for commissioning sufficient primary care dentistry to meet local demand. Under the proposals set out in the White Paper 'Equity and Excellence: Liberating the NHS', the NHS Commissioning Board would, subject to the outcome of consultation and parliamentary approval, take on responsibility for commissioning primary care dentistry and, if locally required, increasing those services to meet demand.
|(1) Figures for 2009-10 include costs up to the end of September 2010.|
Luciana Berger: To ask the Secretary of State for Health how many interns his Department has engaged in the last 12 months; and how many were (a) unpaid, (b) remunerated with expenses only and (c) paid at the rate of the national minimum wage or above. 
Mr Simon Burns: In 2009-10, the Department recruited three apprentices, three student candidates from the Cabinet Office Summer Development and Placement Schemes, 10 analytical students and three financial student placements from universities and three Government Economics Service Summer Placement Scheme students. All are paid at the Department's minimum administrative officer pay scale for 2009-10.
Work experience placements are unpaid (expenses are reimbursed) and are arranged by local business units. Information on these placements is not held centrally and it would incur disproportionate costs to collect the information requested.
Paul Burstow: In July 2008, the National Institute of Health and Clinical Excellence (NICE) issued a review of its guidance on insulin pump therapy, which is supported by a costing template and separate guidance on the commissioning of insulin pump services. Implementation of the NICE guidance is the responsibility of commissioners and/or providers.
Mr Simon Burns: Eligibility for national health service treatment is not established until an individual funding request is approved. In certain circumstances, such as where the decision-making process is flawed through undue delay or the decision is clearly irrational, primary care trusts may consider making an ex gratia payment in accordance with the principles outlined in "Managing Public Money" available at:
Andrew Griffiths: To ask the Secretary of State for Health if he will direct the National Treatment Agency for Substance Misuse to adhere to the guidance on long-term sobriety issued by the National Institute for Health and Clinical Excellence. 
Anne Milton: We expect all national health service organisations to take final guidance from the National Institute for Health and Clinical Excellence (NICE) fully into account when deciding what treatments to give people. However, NICE guidance does not replace the knowledge and skills of individual health professionals who treat patients.
Andrew Griffiths: To ask the Secretary of State for Health what estimate he has made of the number of people in England who were prescribed methadone and benzodiazepines in the latest year for which figures are available. 
Mr Simon Burns: Data for the number of people receiving substitute prescribing interventions for substance misuse in England for the period 2009-10 are in the following table. Information to enable this figure to be broken down in relation to specific medications is not collected. However, the figure does include those receiving methadone or buprenorphine substitute treatment.
| Source: National Drug Treatment Monitoring System.|
The following table shows the prescription items of methadone and benzodiazepines dispensed in England. There is no information available on the number of people who were prescribed these items or the reason for prescription. Since drugs can be prescribed to treat more than one condition, for example methadone can be used as a cough suppressant or analgesic as well as for treating substance misuse, it is not possible to separate the different conditions which a drug was prescribed for.
|British National Formulary chemical name||Prescription items (Thousand)|
| Source: Prescription Cost Analysis.|
Andrew Griffiths: To ask the Secretary of State for Health what estimate he has made of (a) the number of people who were prescribed (i) methadone hydrochloride mixture and (ii) buphenorphine/subutex for opiate dependence, (b) the average dose prescribed of each type of medication and (c) the average cost to the public purse of prescribing each type of medication for one patient in the latest year for which figures are available. 
Anne Milton: The National Drug Treatment Monitoring System collects information on the number of people receiving substitute prescribing interventions for substance misuse in England, but does not distinguish between methadone and other drugs such as buprenorphine which are also recommended for the treatment of drug misuse by the National Institute for Health and Clinical Excellence. The number of adults receiving substitute prescribing in their latest treatment journey was 153,632 in 2009-10.
Data are not collected on the number of people who were prescribed methadone hydrochloride mixture and buphenorphine/subutex. However, Drug Misuse and Dependence: UK Guidelines on Clinical Management (2007) does indicate that there is a consistent finding of greater benefit from maintaining patients on a daily dose between 60 and 120 milligram (mg) of methadone; and that doses of between 12 and 16mg and up to 32mg in exceptional cases) would seem appropriate for long-term prescribing.
Information about the annual cost of prescribing methadone or buprenorphine for opiate dependence in specialist drug treatment is not collected. However, in 2007-08 a one-off unit cost exercise was carried out by the National Treatment Agency for Substance Misuse, assessed the average cost of prescribing interventions (including methadone and buprenorphine) per individual per day, during that year. The exercise calculated the cost of specialist prescribing at £6.81 per day, which included dispensing and keyworking costs but not the costs of psychosocial or other support interventions received by the individual at the same time
Andrew Griffiths: To ask the Secretary of State for Health what estimate he made of the number of people who had been on a continuous (a) methadone and (b) buprenorphine/subutex prescription for (i) 12 to 24, (ii) 24 to 48 and (iii) 48 months or more in the latest year for which figures are available. 
Anne Milton: The National Drug Treatment Monitoring System (NDTMS) collects information on the number of people receiving substitute prescribing interventions for substance misuse in England, but does not distinguish between methadone and other drugs such as buprenorphine which are also recommended for the treatment of drug misuse by the National Institute for Health and Clinical Excellence (NICE). NICE recommends that substitute prescribing should always be accompanied by psychosocial interventions.
In addition, Drug Misuse and Dependence: UK Guidelines on Clinical Management (2007) state that any decision to maintain a patient on long-term prescribing should be an active one agreed between the clinician and patient, reviewed at regular intervals, and part of a broader programme of care-planned social and psychological support.
Drug addiction is a long-term chronic relapsing condition, which may require treatment over an extended period. The numbers of people in a continuous period of substitute prescribing for the time periods requested are as follows.
|Latest continuous period of prescribing|
|Less than 12 months||%||1-2 years||%||2-4 years||%||4 years+||%||Total|
Statistics from the NDTMS 1 April 2009 - 31 March 2010
Bridget Phillipson: To ask the Secretary of State for Health what plans he has to introduce a national plan for all patients assessed as requiring access to an epilepsy specialist nurse; what his policy is on the future of epilepsy specialist nurses; and if he will make a statement. 
Paul Burstow: We have no plans to introduce a national plan for all patients assessed as requiring access to an epilepsy nurse. It is the responsibility of local health bodies to commission services to meet the needs of those living with epilepsy, this includes the recruitment of specialist nurses where appropriate.
The National Service Framework for Long-term Conditions is the key tool for delivering the Government's strategy to support and improve services for those living with long-term neurological conditions, including epilepsy.
Mr Simon Burns: The White Paper "Equity and Excellence: Liberating the NHS" set out our proposals to devolve power and responsibility for commissioning services to local consortia of general practitioner (GP) practices.
A number of supporting documents were published and in particular "Liberating the NHS: Commissioning for Patients" invited views on a number of areas of the commissioning agenda. The engagement exercise closed on 11 October and the Department is now analysing all of the contributions received.
Many of the proposals require primary legislation and are subject to the approval of Parliament. A Health Bill is to be introduced in this parliamentary session and will set out further detail about the duties and functions of commissioning consortia.
Dr Pugh: To ask the Secretary of State for Health who will be responsible for monitoring the performance of GPs and ensuring that their skills are kept up to date and adequately revalidated after the implementation of the proposals contained in the NHS White Paper. 
Mr Simon Burns: The public has the right to expect that their doctor is professionally up to date and fit to practise. Revalidation, which is currently being tested in the national health service, will be built on existing local processes of regular appraisal and effective clinical governance. The intention is that every five years, a revalidation recommendation will be made by a doctor's responsible officer to the General Medical Council. From 1 January 2011, subject to parliamentary approval, general practitioners will relate to a responsible officer in the primary care organisation that holds the performers list on which the individual doctor is included as a practitioner of primary medical services. The arrangements for nominating or appointing responsible officers in primary care following the proposed changes to NHS architecture set out in "Equity and excellence: Liberating the NHS" are currently being considered by Ministers and officials.
Dr Pugh: To ask the Secretary of State for Health who will be responsible for ensuring that GPs follow best practice on (a) dementia diagnosis and treatment and (b) drug prescription after the implementation of the proposals contained in the NHS White Paper. 
Paul Burstow: General practitioner (GP) consortia will be expected to involve relevant health and social care professionals from all sectors in helping design care pathways or care packages for people with dementia that achieve more integrated delivery of care, higher quality and more efficient use of resources. This will create an effective dialogue across all health, and where appropriate, social care, professionals.
To support GP consortia in their commissioning decisions, the Government will also create an independent NHS Commissioning Board. The Commissioning Board will set commissioning guidelines based on the quality standards which have already been developed by the National Institute for Health and Clinical Excellence for dementia.
Mr Simon Burns: Local enhanced services are commissioned by primary care trusts (PCTs) to meet local health needs and are funded from PCT revenue allocations. Therefore, decisions on funding of local enhanced services in 2011-12 are a matter for individual PCTs based on local priorities and not the Department of Health.
Paul Burstow: The creation and expansion of mutuals, co-operatives, charities and social enterprises is a priority for the Government. The Government want to enable these groups to have much greater involvement in the running of public services.
Miss McIntosh: To ask the Secretary of State for Health (1) what arrangements were made to consult GP practices before the decision to close minor injury services at the Lambert Hospital in Thirsk and St Monica's Hospital in Easingwold was (a) taken and (b) made public; 
(2) what assessment he has made of the effect on GP practices of the planned closures of minor injury services at (a) the Lambert Hospital in Thirsk and (b) St Monica's Hospital in Easingwold. 
Mr Simon Burns: This is a local matter for North Yorkshire and York Primary Care Trust. The Secretary of State has made no assessment of the effect on general practitioner (GP) practices of the planned closures of minor injuries units at the Lambert Hospital, Thirsk, and St Monica's Hospital, Easingwold.
This Government are committed to devolving power to local communities-to the people, patients, general practitioners and councils who are best placed to determine the nature of their local national health service services.
focus on improving patient outcomes;
consider patient choice;
have support from GP commissioners; and
be based on sound clinical evidence.
The Department expects all reconfiguration schemes to be informed by local decisions, driven by clinical professionals, and grounded in firm clinical evidence by recognising the views of the community.
Mr Simon Burns: The independent Advisory Committee on Resource Allocation (ACRA), which oversees the development of the primary care trust (PCT) revenue allocation funding formula, has considered the impact of rurality on a number of occasions and concluded that the only adjustment necessary is the Emergency Ambulance Cost Adjustment, to reflect the additional cost of providing emergency ambulance services in rural areas. No further adjustment is made to reflect rurality.
ACRA is to continue to provide independent advice to the Secretary of State on the funding formula for the allocation of national health service resources during the transition to the NHS Commissioning Board. ACRA has been asked to consider looking again at the impact of rurality on unavoidable differences on costs as part of its future work programme.
Alison Seabeck: To ask the Secretary of State for Health (1) what guidance his Department has issued to procurement hubs on the weighting to be applied to price when commissioning a contract for the supply of implantable cardiac devices; 
|Activity in English national health service hospitals and English NHS commissioned activity in the independent sector|
|Insertion of pacemaker|
|SHA of residence||2005-06||2004-05|
|Insertion of pacemaker|
|SHA of residence||2008-09||2007-08||2006-07|
1. Finished Consultant Episode (FCE)-A FCE is a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which they end. Figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year.
2. Number of episodes with a (named) main or secondary procedure:
The number of episodes where the procedure (or intervention) was recorded in any of the 24 (12 from 2002-03 to 2006-07 and four prior to 2002-03) procedure fields in a Hospital Episode Statistics (HES) record. A record is only included once in each count, even if the procedure is recorded in more than one procedure field of the record. Note that more procedures are carried out than episodes with a main or secondary procedure. For example, patients under going a 'cataract operation' would tend to have at least two procedures-removal of the faulty lens and the fitting of a new one-counted in a single episode.
3. OPCS-4 Codes:
The OPCS-4 codes used to identify the procedures are:
(I). Insertion of pacemaker
K60.1 Implantation of intravenous cardiac pacemaker system NEC
K60.5 Implantation of intravenous single chamber cardiac pacemaker system
K60.6 Implantation of intravenous dual chamber cardiac pacemaker system
K60.7 Implantation of intravenous biventricular cardiac pacemaker system
K60.8 Other specified cardiac pacemaker system introduced through vein
K60.9 Unspecified cardiac pacemaker system introduced through vein
K61.1 Implantation of cardiac pacemaker system NEC
K61.5 Implantation of single chamber cardiac pacemaker system
K61.6 Implantation of dual chamber cardiac pacemaker system
K61.7 Implantation of biventricular cardiac pacemaker system
K61.8 Other specified other cardiac pacemaker system
K61.9 Unspecified other cardiac pacemaker system
4. Assessing growth through time:
HES figures are available from 1989-90 onwards. Changes to the figures over time need to be interpreted in the context of improvements in data quality and coverage (particularly in earlier years), improvements in coverage of independent sector activity (particularly from 2006-07) and changes in NHS practice. For example, apparent reductions in activity may be due to a number of procedures which may now be undertaken in outpatient settings and so no longer include in admitted patient HES data.
5. SHA/PCT of residence:
The strategic health authority (SHA) or primary care trust (PCT) containing the patient's normal home address. This does not necessarily reflect where the patient was treated as they may have travelled to another SHA/PCT for treatment.
6. Data quality:
HES are compiled from data sent by more than 300 NHS trusts and 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.
Hospital Episode Statistics (HES), The NHS Information Centre for health and social care
To ask the Secretary of State for Health what recent assessment his Department has made of the effects of needle exchange and drug substitution therapy
programmes on levels of HIV infection amongst injecting drug users. 
Anne Milton: The overall prevalence of HIV among injecting drug users (IDUs) is currently estimated to be 1.5% in the United Kingdom-one of the lowest rates among this population in the western world.
The introduction of needle exchange, opioid substitution therapy and abstinence based drug treatment in the 1980s, and the sustained investment in these services since then will have contributed to this.
The National Institute for Health and Clinical Excellence (NICE) guidance on needle and syringe programmes (NSPs) states that, overall, needle and syringe programmes were cost effective in reducing HIV incidence and prevalence among IDUs.
The United Nations Offices of Drug Control are clear that countries that do not commission methadone/needle exchange programmes have substantially higher rates of HIV and Hepatitis C infection among injecting drug users than the UK.
Health Protection Agency, Unlinked Anonymous Monitoring Survey of Injecting Drug Users in contact with specialist services, (July 2010) NICE, Needle and syringe programmes: guidance, February 2010
Mr Simon Burns: Before responding to the consultation on national health service car parking charges, departmental officials met with representatives of Macmillan Cancer Support, the Patients Association, Which? and Age UK.
Mr Simon Burns: Provisional Hospital Episode Statistics (HES) data show that there were 16,924,370 finished consultant episodes in English NHS Hospitals and English NHS commissioned activity in the independent sector in the 12 months from July 2009 to June 2010.
Stephen McPartland: To ask the Secretary of State for Health what the (a) procedure and (b) timetable is for approval of the outline business case for phase 4 of the Lister Hospital, Stevenage; and if he will make a statement. 
Mr Simon Burns: The Department received the outline business case for phase 4 of redevelopment of the Lister Hospital, Stevenage on 5 October and is carrying out a review to ensure that the scheme is affordable, deliverable and demonstrates value for money. After the Department's review is completed, the scheme will require HM Treasury's approval before a recommendation for approval can be made to proceed to full business case. A decision will be announced in due course.
Mr Laurence Robertson: To ask the Secretary of State for Health what his Department's strategy is for reducing the number of deaths resulting from lung diseases; and if he will make a statement. 
Mr Simon Burns: The Department is committed to improving outcomes for patients. For lung disease the two main areas the Department is focussing on are lung cancer and the respiratory diseases chronic obstructive pulmonary disease and adult asthma.
We have announced a £10.75 million campaign for three of the biggest killer cancers, including lung cancer, to raise awareness of signs and symptoms and encourage people with persistent symptoms to present to their general practitioner. Being diagnosed at an early stage of the disease increases the chance of being successfully treated for lung cancer.
With respiratory disease the Department is currently reviewing the responses received to its consultation on a strategy for services for chronic obstructive pulmonary disease in England, which contained a chapter on adult asthma, and will make an announcement in due course.
Mr Simon Burns: The main recommendation of the recent review of the content of the summary care record (SCR), led by Sir Bruce Keogh, was that the core information should only include a patient's medications, allergies, and adverse reactions. Any additional information beyond this should only be added to the SCR with the explicit consent of the patient. This would therefore preclude the automatic inclusion of a patient's advance decision.
The four UK Health Departments fund sufficient foundation programme training places to meet the expected output of UK medical schools. However, applicants from non-UK medical schools are also able to apply.
To date, all eligible applicants to the foundation programme have secured a place. However, for the programmes commencing in 2011 there has been a large number of applicants from non-UK medical schools, which means for the first time there are more applicants to the foundation programme than there are places.
The latest predictions from the UK foundation programme office are that all eligible applicants to the foundation programme in 2011 will be offered a foundation programme post as places become available due to failed finals and graduates deciding to do other things.
Mr Umunna: To ask the Secretary of State for Health (1) how many community treatment orders were made under the Mental Health Act 1983 in respect of people in each ethnic group in the last five years; 
Paul Burstow: The information requested about community treatment orders and contact with secondary mental services has been placed in the Library. Further information and the statistics that we have on compulsory inpatient admissions are available on the NHS Information Centre's website at:
Mr Simon Burns:
We are aware of no recent representations on the opening times of minor injury units, other than that made by my hon. Friend during the Westminster Hall debate on accident and emergency
services on 14 September. South West Strategic Health Authority has been made aware of my hon. Friend's concerns.
George Hollingbery: To ask the Secretary of State for Health what steps have been taken to implement the March 2010 recommendation of the South Central Commissioning Group to fund a neuromuscular care advisor for families in Hampshire; on what date he expects an appointment to be made; and what the reason is for the time taken to make the appointment. 
Anne Milton: The activity data returns on speech and language therapy were discontinued from April 2005. The available information is published in "NHS Speech and Language Therapy Services, Summary Information for 2004-05, England". This document has already been placed in the Library.
Dr Pugh: To ask the Secretary of State for Health what statutory duties are placed upon (a) strategic health authorities and (b) primary care trusts; and who will be responsible for discharging such duties in 2014. 
Mr Simon Burns: Strategic health authorities (SHAs) and primary care trusts (PCTs) have a large number of legal duties. Most of these are statutory functions of the Secretary of State that have been delegated through regulations and directions under the National Health Service Act 2006.
Broadly, PCTs are currently responsible for the commissioning of most national health service services, while SHAs act as regional headquarters of the NHS, providing management and direction to PCTs and NHS trusts.
The White Paper "Equity and excellence: Liberating the NHS", which proposed that SHAs and PCTs should be abolished, gave a commitment to establish more autonomous NHS institutions, with transparent duties and responsibilities. It proposed that, in future, consortia of general practices should be responsible for commissioning
the majority of NHS services, supported by a national NHS Commissioning Board. PCTs' current responsibilities for public health improvement would transfer to local authorities.
The Department does not collect data from NHS foundation trusts. Where an NHS trust obtains foundation trust status part way through any year, the data provided are only for the part of the year the organisation operated as an NHS trust.
The definition of consultancy services in the NHS Manual for Accounts was revised in 2009 to ensure consistency with Cabinet Office definitions for central Government. Consequently, the definition includes the provision of advice far a broad range of services including, legal, information technology, property and human resources.
Mr Simon Burns: The Department does not collect accounting information from individual hospitals. The information requested has been placed in the Library in respect of primary care trusts and national health service trusts.
Mark Lancaster: To ask the Secretary of State for Health (1) what estimate he has made of the monetary value of debt recovered by debt collectors on behalf of the NHS in respect of each (a) hospital and (b) primary care trust in each of the last five years; 
Mr Simon Burns: The Department does not collect accounting information from individual hospitals. The information for primary care trusts and national health service trusts for the last three years (2007-08 to 2009-10) has been placed in the Library. Information for 2005-06 and 2006-07 is not available in the format requested.
Dr Pugh: To ask the Secretary of State for Health what estimate his Department has made of the expected level of savings that will arise from the implementation of the proposals contained in the NHS White Paper in (a) 2011-12, (b) 2012-13, (c) 2013-14 and (d) 2014-15. 
Mr Simon Burns: The White Paper "Equity and Excellence: Liberating the NHS" laid out proposals for fundamental changes to the ways that the national health service is structured and run. The Government have said that the NHS management costs of the new system must be 46% lower than the current system, and that the overall administration costs of the health service must be 33% lower, by the end of the next spending review period (2014-15).
Caroline Lucas: To ask the Secretary of State for Health how many full-time equivalent staff were employed by the NHS as (a) hospital consultants, (b) general practitioners, (c) registered nurses, (d) administrative and clerical workers, (e) managers, (f) executive directors, (g) managers involved in commissioning at primary care trusts, care trusts and health authorities, (h) other staff supporting managers involved in commissioning at primary care trusts, care trusts and health authorities, (i) finance staff and (j) managers and support staff directly involved in performance management in each year since 1995. 
Mr Simon Burns: The following tables show full-time equivalent staff employed by the NHS for the aforementioned staff groups (a) to (e) as at 30 September 1995 to 2009. Information for September 2010 will not be published until March 2011.
|NHS hospital and community health service and general practice work force as at 30 September each year|
(1) GP data as at 1 October 1995-99, 30 September 2000-09.
(2) GP retainers were first collected in 1999 and have been omitted for comparability purposes.
(3) GP full-time equivalent (FTE) data for 1999 to 2005 have been estimated using the results from the 1992-93 GMP Workload Survey. From 2006 onwards GP FTE has been collected and therefore may not be fully comparable with previous years; we are currently evaluating the accuracy of this data.
(4) Nursing and midwifery figures exclude students on training courses leading to a first qualification as a nurse or midwife. Bank staff are included.
The NHS Information Centre for health and social care Medical and Dental Workforce Census
The NHS Information Centre for health and social care General and Personal Medical Services Statistics
The NHS Information Centre for health and social care Non-Medical Workforce Census
HM Treasury Public Expenditure Statistical Analyses 2010 Tables 9.11 and 9.15.
Liz Kendall: To ask the Secretary of State for Health how many NHS staff have participated in the mutually agreed resignation scheme; and what the average redundancy payout has been since its introduction. 
Mr Simon Burns: The national mutually agreed resignation scheme was launched on 2 September 2010. It is open to staff for a time-limited period. The national scheme closes at the end of October/early November. It will not be until toward the end of the year, when the scheme is evaluated, that the total numbers and costs are known.
Liz Kendall: To ask the Secretary of State for Health what estimate he has made of the average cost to the public purse of making redundant (a) managers, (b) senior managers and (c) non-clinical staff employed under the NHS Agenda for Change terms and conditions. 
Mr Simon Burns: Redundancy payments for national health service staff depend on factors such as earnings and length of service. As such, the exact costs of redundancies depend on the characteristics of the affected staff.
£90,000 per full-time equivalent for managers and senior managers;
£35,000 per full-time equivalent for administrative and clerical staff; and
£40,000 per full-time equivalent for maintenance and works staff.
Dr Pugh: To ask the Secretary of State for Health what estimate his Department has made of the cost to the public purse of redundancies arising from the implementation of the structural reorganisation proposed in the NHS White Paper. 
Mr Simon Burns: The White Paper "Equity and Excellence: Liberating the NHS" laid out proposals for fundamental changes to the ways that the national health service is structured and run. The Department has not yet produced robust costings of the redundancies arising from the implementation of the structural reorganisation. This is because the precise costs of the transition to the new system, including the costs of redundancies, will not be known until the new organisations that will underpin the new system have been designed in more detail.
A number of consultations on how the new organisations should be designed have been published, and once the results of this are known we will publish the costs of moving to the new system in an Impact Assessment. However, we have made it clear that the running costs of the new system will be lower than the running costs of the current system.
Mr Simon Burns: The White Paper Equity and Excellence: Liberating the NHS set out that the Secretary of State for Health would hold the new NHS Commissioning Board to account for the delivery of better health outcomes through a NHS Outcomes Framework. This framework will include a set of around 30 indicators which will be used to measure the progress of the national health service as a whole in delivering better outcomes through the treatment activity for which it is responsible. Information against the indicators within the framework will be made publicly available.
More details on the proposals are set out in the consultation document Transparency in outcomes - a framework for the NHS. The 12-week consultation period on the proposals closed on Monday 11 October 2010.
Recruitment to the Foundation Programme in 2011 has been discussed at the Medical Education England Medical Programme Board and a press release was issued by the UK Foundation Programme Office on 10 September explaining the position.
Chi Onwurah: To ask the Secretary of State for Health what the per capita health allocation was for North of Tyne primary care trust in the latest period for which figures are available; and whether he has made an estimate of the effect on the per capita allocation for North of Tyne primary care trust of the application of the Combined Age Related Needs and Additional formula. 
Mr Simon Burns: The following table provides the allocation per head received by North Tyneside primary care trust (PCT) for the years 2008-09, 2009-10 and 2010-11, and the England averages for those years.
| Note: Allocations are not always comparable between years because of changes to baseline funding. Source: Finance, Planning and Allocations Division, Department of Health.|
The Combining Age Related and Additional Needs (CARAN) formula replaced the Allocation of Resources to English Areas formula as the needs component for the prescribing and hospital and community health services elements of the formula (with the exception of mental health) used for PCT revenue target allocations from 2009-10. It is estimated that the impact of this formula change alone would have been to move North Tyneside PCT further above or less below target by 1.8%. When combined with changes to other components of the formula the overall effect was to move the PCT from at target at the end of 2008-09 to 1.5%, under target at the start of 2009-10.
However, the actual allocations PCTs receive depend on a combination of both the distance from the target set by the funding formula, and how quickly PCTs are moved towards their target allocation (the pace-of-change policy). Therefore, it is not possible to distinguish the individual impact of any formula change, including CARAN, on PCTs' actual per capita allocations.
To ask the Secretary of State for Health what steps his Department is taking to implement the recommendations of the report on High impact for nursing and midwifery: the essential
collection by the NHS Institute for Innovation and Improvement. 
Anne Milton: The NHS Institute for Innovation and Improvement developed the High Impact actions for Nursing and Midwifery as the nursing and midwifery response to the quality, innovation, productivity and prevention (QIPP) challenge against eight key areas. The Institute's The Essential Collection is the subsequent examples of how the national health service has already responded. The NHS has taken these eight areas and identified ways of improving quality whiles reducing costs.
The Essential Collection shows how nurses and midwives can deliver high quality care across these key areas, demonstrating the potential for even greater contribution to prevention, innovation, productivity and best use of resources. The Department along with the strategic health authorities will be co-producing a set of outcome indicators to measure achievements against these High Impact Actions in response to Government policy. This work will be available in due course.
Much of the High Impact Action work is already embedded across the NHS with support from the Department, and three of the areas: pressure ulcers, falls and urinary tract infections, have featured in the recent consultation Liberating the NHS: Transparency in Outcomes.
Mr Blunkett: To ask the Secretary of State for Health what plans he has for the (a) number and (b) location of approved nurse training places to current providers in the next three years; and if he will make a statement. 
Mr Simon Burns: It is currently the responsibility of strategic health authorities (SHAs) to commission nurse education and training. SHAs base their workforce planning on assessment of their local NHS organisations. It is the local national health service organisations that are best placed to determine workforce needs, including demand and location of approved nurse training programmes.
The White Paper "Equity and Excellence: Liberating the NHS", a copy of which has already been placed in the Library, signalled a new approach to workforce planning, education and training. Individual health care providers will be responsible for developing their current workforce by promoting staff engagement and partnership working, ensuring continued professional development and providing support to improve staff health and wellbeing.
Paul Burstow: Lifestyle behaviours such as smoking, the harmful use of alcohol, drug misuse, poor diet and nutrition, being overweight and physical inactivity are acknowledged risk factors for a number of chronic diseases and conditions such as oesophageal cancer.
Later this year, the Department will publish a public health White Paper setting out details of its strategy for improving public health and reducing the risk factor associated with developing conditions such as oesophageal cancer.
Mr Simon Burns: The NHS (Pharmaceutical Services) Regulations 2005, as amended, set out the requirements for granting applications to join a primary care trust's pharmaceutical list. These are regularly reviewed. A review of progress on reforms in England to the "Control of Entry" system for national health service pharmaceutical contractors was undertaken in 2006 and a report published later that year. Officials also have regular meetings with primary care trust representatives who are members of the Community Pharmacy Regulations and Guidance User Group.
The regulations are also being reviewed as part of the work of the Advisory Group on the NHS (Pharmaceutical Services) Regulations. The group is currently helping the Government devise revised market entry regulations based on pharmaceutical needs assessments. Progress on their work can be found at:
Ian Mearns: To ask the Secretary of State for Health how many hospital bed days there were for (a) chronic obstructive pulmonary disease and (b) all respiratory diseases in (i) Gateshead and (ii) England in the latest period for which figures are available. 
For patients treated in Gateshead Primary Care Trust (PCT) (regardless of place of residence), there were 4,905 bed days with a primary diagnosis of chronic obstructive pulmonary disease (COPD) (defined as ICD-10 codes J40 to J44 inclusive). For patients resident in Gateshead PCT (but treated anywhere in the English NHS), there were 4,612 bed days with a primary diagnosis of COPD. Overall, there were 878,218 bed days for this primary diagnosis in 2008-09.
For patients with a primary diagnosis of respiratory disease (defined as ICD-10 codes J00 to J99 inclusive), there were 23,807 bed days for patients treated in Gateshead PCT, or 24,075 bed days for patients resident in Gateshead PCT. Overall, there were 4,249,216 bed days for these primary diagnoses in 2008-09.
Mr Simon Burns: The purpose of the NHS Health Check programme is to identify an individual's risk of heart disease, stroke, kidney disease and diabetes. The tests used in the NHS Health Check are based on economic modelling undertaken by the Department to ensure it is clinically and cost effective. We continue to keep the components of the NHS Health Check under review as new evidence emerges.
Natascha Engel: To ask the Secretary of State for Health (1) what assessment his Department has made of trends in the level of sexually transmitted infections in people over the age of 50 years; 
Anne Milton: For a number of years, diagnosis of sexually transmitted infections (STIs) in people aged over 44 years (data on those aged 50 and over are not separately published), attending genitourinary medicine (GUM) clinics in England have increased. However, diagnoses have increased in all age groups and young people aged 15 to 24 remain the group most affected by STIs.
For HIV, the age distribution of people living with this infection in the United Kingdom is changing, with older age-groups increasing both in number and proportion.
In the UK in 2009, almost one in five individuals accessing HIV-related care were aged 50 years and older, compared to one in seven individuals in 2005 and one in 10 in 2000. This increase is partly explained by the improved life expectancy of adults infected in their 20s, 30s and 40s, as well as those diagnosed soon after infection in the over 50s.
It is for local areas to decide which information and services should be commissioned to meet the needs of their local populations. However, quick access to GUM services is important to reduce the spread of infections and we are seeing more people coming forward for testing. In May 2005, only 45% were offered an appointment to be seen within 48 hours. In July 2010, 99.9% were offered an appointment to be seen within 48 hours. This means that more people are being tested and therefore having infections detected, including those aged over 50. It also means that more people than ever before are getting the information and advice they need.
We know that more needs to be done to ensure all people regardless of age get the right information and advice at the right time to make responsible choices, and we are considering how we can tackle these issues. Later this year we will publish the Public Health White Paper which will set out a cross-government strategy for public health and plans for the new public health service.
|Number and proportion of individuals living with diagnosed HIV aged = 50 years accessing HIV-related care in the UK and England, 2000-09|
|Individuals accessing HIV care aged = 50 years (number)||Individuals accessing HIV care (number)||Proportion of individuals aged = 50 years (%)||Individuals accessing HIV care aged = 50 years (number)||Individuals accessing HIV care (number)||Proportion of individuals aged = 50 years (%)|
| Note: Excludes patients with age group not reported; these individuals represent <0.01% of records. Source: Health Protection Agency, Survey of Prevalent HIV Infections Diagnosed (SOPHID).|
|Number and proportion of new HIV diagnoses among individuals aged =50 years in the UK and England, 2000-09, data to end of June 2010|
|Individuals newly diagnosed aged =50 years (number)||New HIV diagnoses (number)||Proportion of individuals newly diagnosed aged =50 years (%)||Individuals newly diagnosed aged =50 years (number)||New HIV diagnoses (number)||Proportion of individuals newly diagnosed aged =50 years (%)|
| Notes: 1. Patients may live with HIV for many years before they are diagnosed. Therefore new diagnosis data do not necessarily reflect recently acquired infections. 2. Regions presented represent place of diagnosis, not place of residence. There is evidence that a substantial proportion of individuals are diagnosed outside of their PCT of residence. Source: Health Protection Agency, HIV and AIDS New Diagnoses and Death Database.|
|Diagnoses of chlamydia, gonorrhoea, syphilis, genital herpes and genital warts in patients over 44 years as a percentage of all diagnoses made in genitourinary medicine clinics in the UK, 2000-09|
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