Incinerators: Health Hazards

Richard Burden: To ask the Secretary of State for Health (1) with reference to the answer to the then hon. Member for Chesterfield of 30 November 2009, Official Report, column 539W, on incinerators: health hazards, whether his Department has assessed the effect on public health of emissions from functioning incinerators since the date of that answer; [49717]

(2) what research his Department has (a) commissioned and (b) evaluated on the effects on public health of emissions from incinerators since 2008. [49742]

Anne Milton: The Department has not assessed the effect on public health of emissions from incinerators since the date of the written answer in November 2009, nor has it commissioned or evaluated research into the effects on public health of emissions from incinerators since 2008. The Health Protection Agency (HPA) published a report of its review of the latest scientific evidence on the health effects of modern municipal waste incinerators in September 2009. The report concludes that while it is not possible to rule adverse health effects out completely, any potential damage from modern, well run and regulated incinerators is likely to be so small that it would be undetectable. The HPA report also advises that since any possible health effects are likely to be very small, if detectable, studies of public health around modern, well managed municipal waste incinerators would yield no useful information.

Macular Degeneration: Drugs

Glyn Davies: To ask the Secretary of State for Health when he expects to publish the results of the IVAN trial of alternative treatments for the inhibition of vascular endothelial growth factor in age-related choriodal neovascularisation funded by his Department. [49946]

Mr Simon Burns: Year one follow-up findings are expected in late 2011 or early 2012. The final report of the trial is expected to be published in 2014.

Medical Records: Living Wills

Dr Huppert: To ask the Secretary of State for Health what progress is being made on amendments to the NHS Summary Care Record System that will enable the

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addition of living wills and Lasting Powers of Attorney to a record; and whether such amendments will enable supporting information concerning a patient's wishes to be included on their records. [50062]

Mr Simon Burns: The purpose of the summary care record (SCR) is to provide the minimal information required to support safe care in urgent and emergency situations.

The main recommendation of a review of the content of the SCR, which was led by Sir Bruce Keogh and reported in October 2010, 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.

We firmly believe that it is for patients to decide if any additional information should be included in their SCR.

Supported by appropriate professionals, patients wanting to add information pertaining to their wishes as expressed in living wills or a lasting power of attorney are already free to do so.

Medical Treatments Abroad

Greg Mulholland: To ask the Secretary of State for Health how many NHS patients were treated overseas in each country for each type of condition in each of the last three years; and what the cost to the NHS of such treatment was. [49807]

Anne Milton: To identify details of the number of national health service patients treated for each type of condition, in each overseas country, and the cost of each treatment, in each of the last three years would incur disproportionate cost.

Monitor

Graeme Morrice: To ask the Secretary of State for Health what his estimate is of (a) levels of expenditure by Monitor on staff and (b) the number of staff to be employed by Monitor in each of the next five years. [50285]

Mr Simon Burns: We do not currently hold information centrally on estimated numbers of staff for Monitor, and its associated expenditure on staff, in each of the next five years. The Government's estimate of Monitor's future annual budget was set out in the impact assessment published alongside the Health and Social Care Bill (19 January 2011) and quoted a figure of £72 million, by 2015-16.

The Department has continued to refine these estimates since the impact assessment was published, and I refer the hon. Member to the written answer I gave the hon. Member for Easington (Grahame M. Morris) on 8 February 2011, Official Report, column 167W.

NHS: Competition

Graeme Morrice: To ask the Secretary of State for Health what estimate he has made of the cost to his Department of regulating health competition in each category of expenditure in each of the next five years. [50284]

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Mr Simon Burns: The impact assessment, published alongside the Health and Social Care Bill, estimates the annual running costs of Monitor at £72 million by 2015-16. At this stage, we do not hold information centrally on estimated annual running costs for Monitor, or an estimated breakdown of expenditure, for each of the next five years. The Bill proposes that Monitor would be responsible for regulating competition in relation to health care services. It would be for Monitor to decide how to prioritise the use of its resources in pursuit of its overarching duty to protect and promote patients’ interests. Monitor would be accountable to Parliament for its expenditure and would be expected to demonstrate value for money through its annual reports.

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NHS: Expenditure

John Healey: To ask the Secretary of State for Health if he will estimate the outturn expenditure of the NHS in England in each of the last five financial years on a basis directly comparable with the estimate he has made for its outturn expenditure in 2010-11. [50056]

Mr Simon Burns: The following table sets out the last five years' expenditure on a basis that is directly comparable to the estimate of the Department's latest forecast outturn of expenditure that was included in the 2011 Budget report.

Outturn (£ billion)

2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 (1)

NHS resource

72.8

76.7

82.3

88.8

95.6

99.5

Depreciation

-0.5

-1.0

-0.7

-1.0

-1.2

-1.1

NHS resource minus depreciation

72.3

75.7

81.6

87.8

94.4

98.4

NHS capital

2.1

2.9

3.8

4.2

5.0

4.5

Total NHS

74.4

78.6

85.4

92.0

99.4

102.9

(1) Estimated outturn

The figures for 2005-06 to 2009-10 are taken from the Core Tables on page 125 of the Department of Health's 2009-10 Resource Account (HC208).

The figures provided are after having adjusted for the technical classification changes arising from the implementation of the Alignment (or ‘Clear Line of Sight’) legislation—the Constitutional Reform and Governance Act 2010.

The 2010-11 figure is the estimated NHS outturn for 2010-11 that was published on page 48 of the 2011 Budget (HC836).

The estimated outturn for 2010-11 includes a forecast underspend of £0.65 billion. The Department's underspend for 2009-10 was £1.6 billion.(2)

(2 )The 2009-10 underspend figure is based upon the previous classification method.

NHS: Finance

John Healey: To ask the Secretary of State for Health what allocations were included in the estimate for NHS (a) Resource and (b) Capital Departmental Expenditure limits for 2010-11 in the June 2010 Budget but not in the limits in the 2010 comprehensive spending review; and what the monetary value is of each such allocation. [50055]

Mr Simon Burns: The question refers to the difference in figures quoted in the June 2010 Budget and in the 2010 comprehensive spending review. The differences are due to categorisation and financial currency of the numbers.

Table 2.2 in June Budget 2010 reports figures for 2010-11 of £101.5 billion for Health of which NHS England is £99.5 billion on Resource Departmental Expenditure Limit (DEL). The difference in figures is Personal Social Services (PSS) centrally funded services, PSS grants and Food Standards Agency (FSA). Both figures included depreciation of £1.1 billion.

The baseline 2010-11 figure in Spending Review Statistical Annex Table A5 of £98.7 billion excludes depreciation (£1.1 billion), but includes £0.3 billion of additions to the NHS baseline by HM Treasury to reverse inter-departmental transfers of funding—this procedure is followed to avoid funding either not being counted or counted twice in spending review bids.

PSS and FSA expenditure is shown separate to NHS funding in the spending review tables.

Table 2.2 in June Budget 2010 reports figures for 2010-11 of £4.9 billion for Health of which NHS England is £4.7 billion on capital DEL. The difference in figures is capital funding for Personal Social Services.

The baseline 2010-11 figure in Spending Review Statistical Annex Table A6 of £5.1 billion, is higher than the £4.7 billion again due to HM Treasury action to reverse inter-departmental transfers of funding.

Surgery

Frank Dobson: To ask the Secretary of State for Health how many internal operations were carried out on NHS patients in each year since 1996-97. [50114]

Mr Simon Burns: The information is not held in the format requested. Hospital Episodes Statistics (HES) data do not have categories of ‘internal operations’. However, we have provided a count of finished consultant episodes (FCEs) with a named main procedure or intervention for the years 1996-97 to 2009-10. It should be noted that these figures do not represent the number of patients as a person may have more than one procedure or intervention within a given year.

Activity in English national health service hospitals and English NHS commissioned activity in the independent sector is shown in the following table.


Total FCEs

1996-97

5,911,350

1997-98

5,908,250

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1998-99

6,468,404

1999-2000

6,530,852

2000-01

6,509,425

2001-02

6,435,022

2002-03

6,612,582

2003-04

6,772,074

2004-05

6,847,589

2005-06

7,215,286

2006-07

7,888,074

2007-08

8,606,493

2008-09

9,274,423

2009-10

9,747,584

Notes: 1. A finished consultant episode (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. Main procedure or intervention—The first recorded procedure or intervention in each episode, usually the most resource intensive procedure or intervention performed during the episode. It is appropriate to use main procedure when looking at admission details, (eg time waited), but a more complete count of episodes with a particular procedure is obtained by looking at the main and the secondary procedures. 3. Hospital Episode Statistics (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. 4. HES are compiled from data sent by more than 300 NHS trusts and primary care trusts 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); Outpatients, The NHS Information Centre for health and social care

Tattooing

Mr Knight: To ask the Secretary of State for Health pursuant to the answer of 16 March 2011, Official Report, column 452W, on tattoos, whether it is his Department's policy to fund the removal of tattoos on the NHS. [49784]

Anne Milton: Tattoo removal may be available on the national health service, according to local primary care trust policies, if a clinician considers that an individual patient's health requires it.

International Development

Botswana: Charities

Mr Gregory Campbell: To ask the Secretary of State for International Development if he will provide advice to UK charities operating in Botswana on the use of terminology in publications that does not cause offence to sections of the local population. [50253]

Mr O'Brien: The Department of International Development is willing to provide advice on terminology and other issues, where it is appropriate to do so, to UK charities funded by the Department.

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Developing Countries: Agriculture

Andrew George: To ask the Secretary of State for International Development what proportion of his Department's commitment to agriculture and food security made at the G8 L'Aquila summit has been disbursed to date; and what plans his Department has for the use of the remaining funds before 2012. [49936]

Mr O'Brien: The Department for International Development (DFID) is on track to meet its commitments on global food security and agriculture made at the 2009 L'Aquila summit. In the first year of this pledge, DFID had disbursed 32% of its total commitment of £1.1 billion.

The recent bilateral and multilateral aid reviews have set out the results which DFID will deliver in the next four years. In summary, it is envisaged that we will stop 10 million more children going hungry and ensure a further four million people have enough food throughout the year. We anticipate working on food security in a small number of countries including Ethiopia, (South) Sudan, Zimbabwe and Burma. We will also continue to support multilateral agencies with a mandate on food and nutritional security. Agriculture will continue to be a major focus for DFID's Research and Evidence Division, which has increased its support for agriculture by 60% over the last three years.

Developing Countries: Tuberculosis

Nic Dakin: To ask the Secretary of State for International Development what assessment his Department has made of the effects on its provision of projects to (a) treat and (b) prevent maternal tuberculosis of the absence of an indicator for the incidence of maternal tuberculosis in the maternal health strategy. [49723]

Mr O'Brien: The Department for International Development (DFID) supports national health plans and where countries put in place specific systems to monitor TB, we will support this. Where TB is a high risk and common complication of pregnancy, we would expect to invest in that. The monitoring and evaluation framework in the “Choices for women” Framework for Results cannot be all-inclusive given the many aspects of reproductive, maternal and newborn health that we expect to support in the countries where we work. We must balance our need for accurate data to measure progress whilst not creating additional reporting burdens for countries or parallel monitoring systems.

The framework is clear that strong health systems are needed to deliver reproductive, maternal and newborn health services and that the expansion of coverage of the proven interventions and services that women and newborns need, particularly under the “continuum of care” is a priority. This includes screening for TB.

Sudan: Israel

Guto Bebb: To ask the Secretary of State for International Development whether he has had discussions with his Israeli counterpart on the provision of assistance by Israel to refugees from Sudan. [49850]

Mr Andrew Mitchell: We have held no discussions with the Government of Israel on this matter.