Health

Climate Change

Barry Gardiner: To ask the Secretary of State for Health what assessment he has made of the effects of climate change on expenditure under the NHS. [80447]

Mr Simon Burns: The Department has not made any specific cost assessments related to health services on the impact of climate change ahead of the outcomes from the climate change risk assessment (CCRA). The CCRA will provide a collaborative assessment across Government and help to prioritise areas of concern for consideration.

Departmental officials have been working closely with the Department for Environment Food and Rural Affairs (DEFRA) in their programme to develop a National CCRA. The conclusion to the first assessment will be laid before Parliament in early 2012 by DEFRA and will lead to the development of a National Adaptation Plan (NAP) in 2013.

Within individual and independent CCRA sector reports, of which Health is one and which will be made available alongside the CCRA, a monetary assessment has been made to inform the economic efficiency of decision making.

The national health service is a category one or category two responder under the Civil Contingencies Act (2004). Under these arrangements it is well placed to deal with the outcome of adverse weather events both in operational terms and in health care delivery. Climate change adaptation assessment and measures needed are the responsibility of individual health trusts.

Through the changes that are being proposed in the Health and Social Care Bill (2011) more and closer working relationships will be established at local government and public health level to address the impacts of climate change.

Ambulance Services: Warrington

Helen Jones: To ask the Secretary of State for Health what the estimated transfer time is for an emergency patient between Warrington and Chester (a) during the morning rush hour, (b) during the evening rush hour and (c) at other times of day. [80886]

Mr Simon Burns: This information is not collected centrally.

Information on local estimated transfer times for emergency patients may be obtained from North West Ambulance Service NHS Trust or, in the context of Cheshire and Merseyside vascular service review, Kathy Doran, chief executive of the Cheshire, Warrington and Wirral Primary Care Trust cluster board.

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Blood: Merseyside

Helen Jones: To ask the Secretary of State for Health (1) what assurances were given to the Cheshire and Merseyside Vascular Review that clinical concerns about a centre based at the Countess of Chester Hospital could be resolved; and what steps have been taken to resolve such concerns since they were raised; [80881]

(2) what information he has received on concerns expressed by clinicians at Arrowe Park Hospital about decisions made by the Cheshire and Merseyside Vascular Review; and if he will make a statement. [80882]

Mr Simon Burns: Vascular services across the national health service in England are being reviewed locally. This is in response to the growing clinical evidence base that provides a strong case for providing vascular surgery services in fewer more specialised centres or networks to achieve optimal patient outcomes.

Decisions about the provision of local health services, including vascular services, are a matter for the local NHS.

The Cheshire and Merseyside Vascular Review Project board is leading a review of vascular surgery services in Cheshire and Merseyside which will be subject to public consultation in due course.

Information on the proposed changes to vascular services in Cheshire and Merseyside can be obtained from Kathy Doran, chief executive of the Cheshire, Warrington and Wirral Primary Care Trust cluster board.

One letter has been received on concerns expressed by clinicians at Arrowe Park hospital about the Cheshire and Merseyside Vascular Review from my hon. Friend the Member for Wirral West (Esther McVey), in September 2011.

Helen Jones: To ask the Secretary of State for Health (1) where the two public engagement meetings for the Cheshire and Merseyside Vascular Review were held; what steps were taken to notify members of the public of those meetings; and how many people from each area attended each meeting; [80880]

(2) what matters were raised by the Cheshire and Merseyside Vascular Services Review about the clinical working at an arterial centre based at the Countess of Chester Hospital; following an application by the Countess of Chester Hospital and Wirral University Teaching Hospitals to form a South Mersey Vascular Network; [80884]

(3) what assessment he has made of the potential effects on other services at Warrington Hospital of the loss of vascular services; and if he will make a statement. [80885]

Mr Simon Burns: Vascular services across the national health service in England are being reviewed locally. This is in response to the growing clinical evidence base that provides a strong case for providing vascular surgery services in fewer more specialised centres or networks to achieve optimal patient outcomes.

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Decisions about the provision of local health services, including vascular services, are a matter for the local NHS. As such no assessment has been made by the Department.

The Cheshire and Merseyside Vascular Review Project board is leading a review of vascular surgery services in Cheshire and Merseyside which will be subject to public consultation.

Information on the public engagement carried out as part of the vascular service review, including details on the public engagement exercise, in Cheshire and Merseyside can be obtained from Kathy Doran, chief executive of the Cheshire, Warrington and Wirral Primary Care Trust cluster board.

Breast Cancer: Screening

David Morris: To ask the Secretary of State for Health what assessment he has made of the effect of proposed NHS reforms on breast cancer screening for disabled women. [80948]

Paul Burstow: Subject to the passage of the Health and Social Care Bill, from 1 April 2013 the NHS Commissioning Board will have responsibility for commissioning routine cancer screening programmes to a specification developed by Public Health England. We would not expect there to be any major changes to current arrangements for disabled women.

Women who use wheelchairs and are unable to access the mobile screening units are currently offered an alternative appointment in static units in hospitals at a time and date that is convenient to them. Disabled women are also offered longer appointment times to accommodate their individual needs and enable comprehensive screening by mammography. Additional assistance can be provided if necessary.

For women with learning difficulties, leaflets have also been produced to explain breast screening to help them make an informed choice whether or not to be screened. These leaflets are freely available to local screening services.

Cancer

Mr Anderson: To ask the Secretary of State for Health what assessment he has made of the findings in respect of cancer survival rates in the recent paper by Professor Colin Pritchard and Dr Tamas Hickish; and if he will make a statement. [80689]

Paul Burstow: “Comparing cancer mortality and GDP health expenditure in England and Wales with other major developed countries from 1979 to 2006”, published in the British Journal of Cancer (BJC), reported that mortality rates from cancer in England and Wales fell significantly between 1979 and 2006, a time during which the national health service spent proportionally less on health care than other countries included in the study.

We know that England has a good track record on reducing cancer mortality, especially in men under 75. This is largely related to falls in smoking prevalence in the previous two decades and has little to do with levels of NHS expenditure. However, looking at cancer mortality rates does not provide a good way of assessing NHS

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performance as it is an indicator of both incidence and of survival. Survival rates are a much more effective way of assessing NHS performance as they show how good the NHS is, compared with other countries, in diagnosing and treating people with cancer.

In terms of cancer survival rates, we know that we are lagging behind other countries. In “Improving Outcomes: A Strategy for Cancer” we have set out the ambition to be as good as the European average and save an additional 5,000 lives per year by 2014-15.

A copy of the BJC paper has been placed in the Library.

Cancer: Wigs

David Morris: To ask the Secretary of State for Health what steps are being taken to improve the standard of NHS wigs provided to people undergoing chemotherapy. [80946]

Anne Milton: The NHS Supply Chain has negotiated a national agreement for the provision of wigs to the national health service; this includes a patient satisfaction form which must be signed by the patient before the NHS releases payment. NHS organisations are not mandated to use this agreement and can choose to make their own supply arrangements. In these cases, they must ensure the quality of services is appropriate.

Care Homes

Hilary Benn: To ask the Secretary of State for Health what the total number of care home places was in each local authority area in each of the last 15 years. [80601]

Paul Burstow: Information on the numbers of care and nursing homes and places has been collected by several organisations during the period from 1996 to the present day.

Until 2002, residential care homes were registered by individual local authorities and nursing homes were registered by local health authorities. The NHS Information Centre for Health and Social Care holds registration data collected from these organisations for the period until 2001.

The Information Centre has provided information on numbers of care and nursing homes and places, broken down by local authority and health authority areas for the years ending 31 March 1997 to 2001. This has been placed in the Library.

From 2002, care and nursing homes were registered by the National Care Standards Commission (NCSC), the first national regulator of adult social care services. The NCSC was replaced in 2004 by the Commission for Social Care Inspection (CSCI), which was replaced in 2009 by the present regulator, the Care Quality Commission (CQC).

We are informed by CQC that it can provide data on numbers of care homes and places for the period from 2004, when the Commission for Social Care Inspection (CSCI) was established as the regulator of adult social care. CQC has access to statistical data collected by CSCI. However, CQC cannot provide data for the years 2002-04, when homes were registered by the NCSC, as it is unable to confirm its accuracy.

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CQC has provided information, showing numbers of care and nursing homes and places by local authority area for the period 31 March 2004 to 31 October 2011. This has been placed in the Library.

Hilary Benn: To ask the Secretary of State for Health how many people were waiting to be discharged from hospital because of a shortage of community care facilities in each local authority area in the latest period for which figures are available. [80602]

Paul Burstow: The latest information on the numbers of delayed transfer of care awaiting a care package in their own home and awaiting community equipment and adaptions is shown in a table which has been placed in the Library.

Charlie Elphicke: To ask the Secretary of State for Health what estimate he has made of the number of people in nursing homes in (a) Kent and (b) England in (i) 2008-09, (ii) 2009-10 and (iii) 2010-11. [80693]

Paul Burstow: Data on the number of adults—aged 18 and over—whose care is funded either partially or wholly by councils with adult social services responsibilities (CASSRs) is collected and published by the NHS Information Centre for Health and Social Care.

Information on the numbers of care and nursing home residents who fund their own care is not collected centrally.

The following table shows the number of people aged 18 and over who were in nursing homes in Kent and England as at 31 March 2009 and 31 March 2010, whose care was funded partially or wholly by CASSRs. Provisional data for the year ending 31 March 2011 are due to be published on 30 November 2011.

Number of adults—aged 18 and over—in nursing homes as at 31 March

2009 2010

Kent

1,515

1,490

England

60,775

58,805

Note: Figures for Kent and England rounded to the nearest five. Source: Adult Social Care-Combined Activity Return (ASC-CAR)

Karen Lumley: To ask the Secretary of State for Health what estimate he has made of the number of people in nursing homes in (a) Redditch and (b) England in (i) 2008-09, (ii) 2009-10 and (iii) 2010-11. [81266]

Paul Burstow: Data on the number of adults—aged 18 and over—whose care is funded either partially or wholly by councils with adult social services responsibilities (CASSRs) are collected and published by the NHS Information Centre for Health and Social Care. The Information Centre does not collect data on numbers of care and nursing home residents in Redditch. Data are collected for Worcestershire, which includes Redditch.

Information on the numbers of care and nursing home residents who fund their own care is not collected centrally.

The table shows the number of people aged 18 and over who were in nursing homes in Worcestershire and England as at 31 March 2009 and 31 March 2010,

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whose care was funded partially or wholly by CASSRs. Provisional data for the year ending 31 March 2011 are due to be published on 30 November 2011.

Number of adults—aged 18 and over—in nursing homes as at 31 March

2009 2010

Worcestershire

860

790

England

60,775

58,805

Note: Figures are rounded to the nearest 5. Source: Adult Social Care—Combined Activity Return (ASC-CAR).

Change4Life

Keith Vaz: To ask the Secretary of State for Health what the budget of the Change4Life scheme is for 2011-12; and if he will make a statement. [80464]

Anne Milton: The budget for the Change4Life scheme for 2011-12 is £8.5 million, as approved by the Efficiency and Reform Group in March 2011. Details of how this will be used are within the “Change4Life Three Year Social Marketing Strategy”, published on 13 October 2011, a copy of which has already been placed in the Library.

Cystic Fibrosis

Bob Russell: To ask the Secretary of State for Health (1) when he expects the national tariff for cystic fibrosis to be implemented; [80890]

(2) what analysis has been conducted into applying the market forces factor for the draft national tariff for cystic fibrosis; and if he will make a statement; [80891]

(3) what consideration he has given to discounting drug costs from the market forces factor in relation to the draft national tariff for cystic fibrosis; and if he will make a statement. [80892]

Mr Simon Burns: The Department is collaborating closely with the Cystic Fibrosis Trust, Specialist Commissioning Group Commissioners, clinicians and providers on developing a tariff for cystic fibrosis (CF) which will deliver high quality CF care.

We have recently consulted on proposed tariffs with a number of national health service organisations, including CF specialist providers and national CF commissioning leads.

Through this ‘sense check’ exercise we have sought views on the proposal to introduce a mandatory year-of-care CF tariff. We are currently reviewing responses before deciding if the CF tariff can be introduced on a mandatory or non-mandatory basis from April 2012.

The prices shared at sense check were adjusted to take account of the market forces factor (MFF). The intention is that MFF would be applied to the CF tariff if it were introduced, as it is applied to all mandatory tariffs.

Drugs costs are reflected in the proposed year-of-care tariff; therefore, as MFF is applied to the tariff, it would also apply to the drugs costs that are reflected in the tariff price. The calculation of the MFF takes account of the fact that some health care related costs do not vary geographically.

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Dementia: Research

Chris Skidmore: To ask the Secretary of State for Health how much his Department spent on dementia research in each financial year since 1997-98. [80398]

Paul Burstow: Annual expenditure figures are shown in the following table:

Department of Health expenditure on dementia research

£ million

1997-98

0.4

1998-99

3.2

1999-2000

1.0

2000-01

4.7

2001-02

2.9

2002-03

1.6

2003-04

1.1

2004-05

19.0

2005-06

18.3

2006-07

22.8

2007-08

22.2

2008-09

18.4

2009-10

12.7

2010-11

18.6

The figures for the years from 1997-98 to 2003-04 relate to national research programme expenditure. They do not include the part of the research and development allocations made annually at that time to national health service providers and spent on dementia research. That information was not collected prior to 2004-05.

Design Services

Dan Jarvis: To ask the Secretary of State for Health what contracts his Department has awarded for design services since May 2010; and what information his Department holds on the location of such companies. [80184]

Mr Simon Burns: In the relevant period; the Department's Communications Directorate has not awarded any contracts for design services.

To trawl the Department and its related agencies to establish whether any other contracts for design services have been awarded would incur disproportionate costs.

Dan Jarvis: To ask the Secretary of State for Health how much his Department has spent on design in respect of (a) logos, (b) buildings, (c) advertising, (d) stationery and (e) campaigns in the last year for which figures are available. [80203]

Mr Simon Burns: The Department has not changed its logo or stationery since 1999, therefore no money was spent on design of logos or stationery in 2010-11.

No money was spent on building design during the same year.

The Department does not hold data on money spent specifically on the design elements relating to advertising and campaigns. The information could be obtained only at disproportionate cost.

The Department's total advertising expenditure in 2010-11 was £4,230,478.

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Departmental Food

Laura Sandys: To ask the Secretary of State for Health how much his Department spent on food procurement in each year from 1997 to 2011. [80317]

Mr Simon Burns: The Department has spent the following amounts on food and beverages since October 2004. No data are available prior to that date:

£
Year (1) Total Food Beverages

2004-05

832,117.14

554,744.76

277,372.38

2005-06

833,411.13

555,607.42

277,803.71

2006-07

796,003.72

530,669.15

265,334.57

2007-08

877,529.83

585,019.88

292,509.95

2008-09

830,226.72

553,484.48

276,742.24

2009-10

692,759.81

461,839.87

230,919.94

2010-11

452,293.00

301,528.66

150,764.34

Total

5,314,341.35

3,542,894.22

1,771,447.13

(1 )The financial year is October to September.

Diabetes

Mr Sanders: To ask the Secretary of State for Health if he will make it his policy to include an indicator to incentivise a pre-diabetic register in the 2012-13 Quality Outcomes Framework. [R] [80253]

Mr Simon Burns: The prioritisation of potential indicators for inclusion in the quality and outcomes framework (QOF) is the responsibility of the National Institute for Health and Clinical Excellence and its independent primary care QOF Indicator Advisory Committee.

The Advisory Committee met on 8 June 2011 and recommended that the QOF diabetes register indicator should be amended to include other types of diabetes. These recommendations have been accepted into the general practitioner contract for 2012-13. These recommendations do not include patients who are classified as pre-diabetic.

Disability: Children

Grahame M. Morris: To ask the Secretary of State for Health which organisation will be responsible for designing care pathways and shaping local services for disabled children. [80525]

Anne Milton: Subject to passage of the Health and Social Care Bill, clinical commissioning groups will be responsible for commissioning services for children and young people with a disability or complex needs. They will work in partnership with the Health and Wellbeing Boards that will be a forum for local commissioners across the NHS, local government, elected representatives, and representatives of HealthWatch to agree how to improve the health and wellbeing of the people in their area including children and young people. We expect that the National Commissioning Board (NHSCB) will have responsibility for the direct commissioning of a number of services from April 2013. Included within those services will be services for people with rare conditions which are currently commissioned at both a national and regional level as described in the Specialised National Definitions Set.

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We have proposed that when commissioning children's services, both the NHSCB and Clinical Commissioning Groups will also seek advice from paediatricians, nurses and other clinical professionals with expertise across a range of areas. There will be senior clinical leadership for children's services within the NHS Commissioning Board providing advice and support to commissioners.

Also the special educational needs and disability pathfinders, set up to test some of the proposals set out in the Green Paper “Support and Aspiration—A new approach to SEN” will have a key role to play in shaping and improving services for children and young people with a disability.

Grahame M. Morris: To ask the Secretary of State for Health what plans he has to ensure that information and support is provided to disabled children and young people and their families on the way in which reforms to the NHS will affect them. [80526]

Anne Milton: The Government has asked the NHS Future Forum to continue its conversations with professionals, service users and the public, including parents, about how to modernise the national health service.

As part of this process, it has produced information materials that can be used by local groups to consider how these changes will affect them locally. Clinical Commissioning Groups and Health and Wellbeing Boards will also have a key role to play in ensuring that they provide information that takes account of their local population.

We recognise that for specific groups, more tailored information may be required. Where this is identified as being the case, we will consider how best this should be done.

Grahame M. Morris: To ask the Secretary of State for Health what steps he is taking to ensure that clinical commissioning groups will meet the needs of disabled children and young people with high-cost and low-incidence conditions. [80527]

Mr Simon Burns: The arrangements we are proposing for commissioning would see clinical commissioning groups (CCGs) led by local clinicians responsible for coordinating the commissioning of complex or low volume services; including those for disabled children and young people. CCGs will have the flexibility to enter into collaborative arrangements. They can for example adopt a lead commissioner/CCG model and develop risk-pooling arrangements to commission services.

CCGs will have support to take on their role—general practitioners will be working with their clinical colleagues to draw on their expertise when designing care for patients. CCGs will also receive expert support and advice from clinical networks and senates on the design and delivery of services.

The NHS Commissioning Board will be responsible for commissioning specialised services. We anticipate that the list of these services including specialised services for children, will be based closely on the current Specialised Services National Definition Set.

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Grahame M. Morris: To ask the Secretary of State for Health what assessment he has made of the merits of the NHS Commissioning Board establishing a Clinical Network for children with responsibility for developing care pathways for disabled children and young people. [80528]

Anne Milton: Clinical networks will support the NHS Commissioning Board and clinical commissioning groups to design pathways of care and shape services, based on a wide-range of multi-disciplinary input. Proposals for the role of clinical networks will be developed after the completion of a review of clinical networks which is engaging with a wide range of stakeholders to assess how the functions and range of networks can most effectively support commissioners.

Grahame M. Morris: To ask the Secretary of State for Health what steps he plans to take to improve health services for disabled children. [80529]

Anne Milton: The Government are committed to improving the lives of children and young people who are disabled and to providing more support for their families and carers. This is reflected in this year’s operating framework, where we identify disabled children as a specific group that the national health service should pay particular attention to.

Subject to the passage of the Health and Social Care Bill, the NHS and public health reforms also provide a significant opportunity for improving the range and quality of services available to children and young people with disabilities and complex needs. The role of health and well being boards will be to examine the health needs of their local population and to design a joint health and wellbeing strategy to meet those needs. Clinical commissioning groups and local authorities’ commissioning plans will be informed by the local joint health and well-being strategy—including services for children with disabilities. The local services will be judged against the health outcomes and many of the indicators within the NHS and public health outcomes frameworks, either directly or indirectly require improvements in services for children and young people.

The Department of Health also worked closely with the Department for Education in the development of the Government’s Green Paper “Support and Aspiration—A new approach to SEN” published in March 2011.

As announced in the Green Paper, 20 pathfinders covering 31 local authorities and primary care trust clusters have been appointed to test the ambition of the proposals. This will include testing various elements to improve the current system including a new single assessment process with a single education, health and care plan along with the option of a personal budget. The pilots will run initially for 18 months.

Doctors: Pay

Mark Lancaster: To ask the Secretary of State for Health what the average salary is of a junior doctor in (a) the UK and (b) Milton Keynes. [81013]

Mr Simon Burns: Pay is a devolved matter. I am therefore not able to provide the average salary for a

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junior doctor in the UK. The mean total earnings for junior doctors in England (from April to June 2011) are tabled as follows:


£

Foundation year 1/House officer

32,300

Foundation year 2/Senior house officer

41,200

Registrar Group

55,800

These figures are published every quarter by the NHS Information Centre in "NHS Staff Earnings Survey" and are available on their website at:

www.ic.nhs.uk/statistics-and-data-collections/workforce/nhs-staff-earnings/nhs-staff-earnings-april--june-2011

The information for salaries of junior doctors in Milton Keynes will be held locally by individual employers, and the hon. Member may wish to approach each employer to obtain this information. We do not collect and validate this information centrally.

Drugs: Misuse

Mr Jim Cunningham: To ask the Secretary of State for Health what steps his Department is taking to reduce the number of deaths arising from an overdose of illegal drugs. [81309]

Anne Milton: The Government published their drug strategy in December 2010 which aims to prevent drug use, interrupt drug supply and help more people to recover from drug dependence.

Data published by the Office for National Statistics in August show that deaths from drug misuse, including overdose, fell by 5% between 2009 and 2010, from 1,731 to 1,625.

Health Services: Overseas Visitors

Chris Skidmore: To ask the Secretary of State for Health how many visitors to the UK had more than one unpaid debt to the NHS of £1,000 or more in each of the five years preceding the changes in regulations that came into force on 31 October 2011. [80237]

Anne Milton: The Department does not hold this information. However, as part of the evaluation of a policy to amend the immigration rules to allow an outstanding debt to the national health service to be a reason to refuse a new visa or extension of stay to a person subject to immigration control, the Department estimated that around 3,600 people each year incur unpaid debts to the NHS of £1,000 or more.

We are developing processes to ensure these data are available to the UK Border Agency to deliver this commitment.

Mark Lancaster: To ask the Secretary of State for Health (1) how much owed by foreign nationals for NHS treatment was (a) recovered and (b) unrecovered in each of the last five years; [81015]

(2) what arrangements are in place to recover money owed by foreign nationals for NHS treatment; [81016]

(3) whether he intends to bring forward proposals to change the system of recovering money owed by foreign nationals for NHS treatment. [81017]

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Anne Milton: Entitlement to free national health service hospital treatment is based on ordinary residence in the United Kingdom or exemption from charges under the NHS (Charges to Overseas Visitors) Regulations 2011. These regulations place a duty on NHS bodies providing treatment to charge those overseas visitors who are not exempt and recover the charge from them. Many use debt collection agencies to aid this process.

As of 31 October 2011, an outstanding debt to the NHS of £1,000 or more is a reason for immigration officers normally to refuse a new visa or extension of stay to a person subject to immigration control. The Department is now finalising guidance to the NHS on how to share information with the UK Border Agency to facilitate this. Further, the Department is currently reviewing access to the NHS by overseas visitors, including how to establish more effective processes across the NHS to recover charges.

The following table shows the total audited income from overseas visitors under non-reciprocal arrangements and total audited losses, bad debt and claims abandoned for overseas visitors for each of the last five years, for England. As well as foreign nationals who are not ordinarily resident in the UK, these data include UK nationals who are not ordinarily resident here. The data do not include moneys owed that hospitals are still in the process of attempting to recover.

£

Income from overseas visitors under non-reciprocal arrangements Bad debts and claims abandoned in respect of overseas patients

2006-07

15,182,925

5,046,763

2007-08

18,167,000

6,468,751

2008-09

17,541,000

5,204,856

2009-10

17,127,000

6,967,780

2010-11

23,333,000

6,773,733

Note: We do not collect data from NHS foundation trusts so figures exclude these sites. Source: NHS Trust Audited Summarisation Schedules.

Heart Diseases: Ethnic Groups

Andrew Gwynne: To ask the Secretary of State for Health what steps he plans to take to increase patient take-up of cardiac rehabilitation among (a) women and (b) black, Asian and minority ethnic groups. [80860]

Mr Simon Burns: The National Audit of Cardiac Rehabilitation Annual Statistical Report 2011 suggests that there may be little difference in the take-up of cardiac rehabilitation (CR) between different ethnic groups, although women may be under-represented in these programmes.

Several steps are being taken to improve the provision and take-up of CR services for all eligible patients. Among the resources available to help commission cardiac rehabilitation services are the Department's Commissioning Pack for Cardiac Rehabilitation and the National Institute of Health and Clinical Excellence's Guide for Commissioners on Cardiac Rehabilitation Services. These, alongside the National Audit of Cardiac Rehabilitation funded through the British Heart Foundation, and the NHS improvement work to support implementation of the commissioning pack, will help

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ensure that commissioners have the information they need to take account of the specific needs of all patients eligible for cardiac rehabilitation in their commissioning decisions.

IVF

David Morris: To ask the Secretary of State for Health what steps his Department is taking to ensure equality of access to IVF treatment. [80947]

Anne Milton: Primary care trusts are fully aware of their statutory commissioning responsibilities and the need to base commissioning decisions on clinical evidence and discussions with local general practitioner commissioners, secondary care clinicians and providers. The national health service deputy chief executive, David Flory, wrote to primary care trust commissioners on 11 January 2011 to highlight to those involved in commissioning fertility services the importance of having regard to the National Institute for Health and Clinical Excellence fertility guidelines, including the recommendation that up to three cycles of in vitro fertilisation are offered to eligible couples where the woman is aged between 23 and 39.

Additionally, we support Infertility Network UK, a leading patient support organisation, to develop and promote standardised access criteria and to work in partnership with commissioners to encourage good practice in the provision of fertility services.

James Paget Hospital: Sick Leave

Brandon Lewis: To ask the Secretary of State for Health how many days NHS staff at the James Paget University hospital have taken sick leave in each year since 2006. [81033]

Mr Simon Burns: Information on the sickness absence for national health service staff at the James Paget University Hospital NHS Foundation Trust, April 2009 to June 2011 is in the following table:

Sickness absence at the James Paget University Hospital NHS Foundation Trust
Period Absence (days)

April 2009 to March 2010

37,730

April 2010 to March 2011

34,295

April 2011 to June 2011

8,365

Notes: 1. Figures are rounded to the nearest five. 2. Figures are for national health service staff only and do not include bank staff or locums. 3. While a low number of recorded sickness absence days generally represents a low level of sickness absence it can also represent under reporting. 4. The NHS Information Centre did not publish sickness absence data prior to April 2009. Source: NHS Information Centre for Health and Social Care—Processed using data taken from the Electronic Staff Record Data Warehouse

Maternity Services: Finance

Chris Skidmore: To ask the Secretary of State for Health how much and what proportion of spending by the NHS was on maternity care in each financial year between 1997-98 and 2010-11. [80223]

Anne Milton: Expenditure on the purchase of secondary maternity care by primary care trusts (PCTs) for 1997-98 to 2010-11 is set out in the following table.

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Net NHS expenditure

£000 Percentage

1997-98

1,043,881

3.10

1998-99

1,096,158

3.06

1999-2000

1,080,520

2.77

2000-01

1,258,219

2.94

2001-02

1,324,780

2.79

2002-03

1,256,757

2.41

2003-04

1,350,286

2.18

2004-05

1,544,838

2.30

2005-06

1,677,204

2.26

2006-07

1,616,777

2.05

2007-08

1,786,896

2.06

2008-09

1,968,563

2.16

2009-10

2,407,090

2.46

2010-11

2,532,350

2.64

Note: The figures are taken from the audited NHS (England) Summarised Accounts for 1997-98 to 2010-11, which are publicly available. The figure is for secondary health care only; we have no information relating to primary health care expenditure on maternity services.

Medicine: Prices

Stephen McPartland: To ask the Secretary of State for Health (1) what stakeholder involvement there will be in establishing the weightings for disease severity, level of unmet need and innovation to be used in any future value-based pricing scheme for medicines; [80374]

(2) what progress he has made in developing a value-based pricing system for medicines; and what steps he is taking to ensure a system is in place from 2014. [80375]

Mr Simon Burns: The Government's response to the consultation on a new value-based pricing system for branded medicines was published on 18 July. In it, we set out our intention that value-based pricing will apply to new active substances placed on the market from 1 January 2014, however, the vast majority of branded medicines already on the market before 2014 will be considered by the successor arrangements to the current Pharmaceutical Price Regulation Scheme.

As we take forward our work in this area, we intend to collaborate with external experts and stakeholders, to ensure that the value-based pricing system is clear, robust and transparent, and that industry, patients, clinicians and all others who have an interest can understand how valuations are made in the new system.

Mental Health

Mr Charles Walker: To ask the Secretary of State for Health (1) what plans his Department has to support the development of step down and community services for people requiring discharge from secure mental health services; [80454]

(2) if he will assess the recommendations in the Centre for Mental Health's report on unlocking pathways to secure mental health care; [80455]

(3) plans to divide commissioning responsibilities for (a) medium and low secure mental health services and (b) step-down and community forensic mental health services between the National Commissioning Board and clinical commissioning groups. [80458]

15 Nov 2011 : Column 818W

Paul Burstow: “Pathways to unlocking secure mental health care” published by the Centre for Mental Health in April 2011 makes 12 recommendations for the national health service to improve quality, innovation, productivity and prevention within secure mental health services. The report recognises that the NHS is already actively working to address several of the recommendations.

Secure mental health services are currently being commissioned as a specialised service by the four clusters of specialised commissioning groups in England. This means that standardised specifications, quality standards, quality payments and prices are being developed for secure mental health services, which will put in place the consistent framework the report calls for.

Some of the specialised commissioning groups are already changing the balance of investment and reinvesting in step down facilities. For example, in the north west and south west there are good examples of reinvestment in step down facilities to enable the whole system to operate more effectively.

The Department of Health and the National Offender Management Service have consulted and published a response on a pathway approach for offenders with personality disorder and commissioners are already changing the balance of investment in these services to enable earlier identification, progression and support in the community when appropriate for increased numbers of offenders. Commissioning for outcomes and involvement of service users is being embedded in every stage of the pathway.

Although plans for the future commissioning of secure mental health services are still in development, it is probable that they will be commissioned by the NHS Commissioning Board and continue to be commissioned as a ‘specialised’ service.

Forensic Payment by Results is also under development. Commissioning as a specialised service will allow the NHS to focus on outcomes, pathways and quality.

Current work on ‘integrated care’, or pathways, has looked specifically at barriers to ensuring that the patients receive the right care at the right time and that the new commissioning architecture does not put any new barriers in the way. This work has focused specifically on pathways into and out of specialised mental health services, which includes secure services.

Morecambe Bay Hospitals NHS Trust: Complaints

David Morris: To ask the Secretary of State for Health what assessment he has made of the system for complaints in Morecambe Bay NHS Trust. [80953]

Mr Simon Burns: National health service organisations are responsible for managing local NHS complaints. Under the NHS Complaints Procedure, all NHS organisations must have in place a complaints procedure. The ‘NHS Constitution: the NHS belongs to us all’ (March 2010) also sets out the rights of patients who wish to complain about the NHS.

However, the Department plans to review the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 in 2014, in response to the Health Committee report into Complaints and Litigation published in June 2011.

15 Nov 2011 : Column 819W

NHS

Helen Jones: To ask the Secretary of State for Health what his policy is on the level of consideration that should be given to patient access, including access by public transport, in any review of NHS service provision. [80883]

Mr Simon Burns: In line with the Government's commitment to devolve power to communities, decisions about national health services locally are essentially a matter for the local NHS. People, patients, general practitioners (GPs) and councils are best placed to determine the nature of their local NHS services.

We have outlined four new, strengthened criteria that decisions on NHS service changes are expected to meet. They must demonstrate strengthened public and patient engagement; consider patient choice; have support from GP commissioners; and be based on sound clinical evidence. Patient access issues should be taken into account as part of this process.

Mike Freer: To ask the Secretary of State for Health what the cost to the NHS was of revalidating an individual (a) NHS and (b) non-NHS practitioner in the latest period for which figures are available. [81185]

Anne Milton: Revalidation is not currently in place for health care practitioners. Medical revalidation is currently being piloted and assessed throughout the United Kingdom with a view to implementation in late 2012.

NHS: Disclosure of Information

Sir Peter Bottomley: To ask the Secretary of State for Health if he will instruct each part of the NHS to lift any gagging restrictions on (a) present and (b) former NHS staff that (i) have and (ii) have had the effect of withholding from the public and the media information, evidence or justified concerns about levels of care in the NHS. [81029]

Anne Milton: The Public Interest Disclosure Act 1998 provides that any clause or term in a contract, or other agreement between a worker and their employer, is void in so far as it purports to preclude the worker from making a protected disclosure.

Health Service Circular 1999/198 made it clear that local national health service trusts should have in place policies and procedures which prohibit confidentiality “gagging” clauses in contracts of employment which seek to prevent the disclosure of information in the public interest, which includes information, evidence or justified concerns about levels of care in the NHS.

Sir Peter Bottomley: To ask the Secretary of State for Health in what circumstances a suspended NHS (a) manager, (b) clinician and (c) other employee is prevented from talking with colleagues and former colleagues by the NHS. [81030]

Mr Simon Burns: The exclusion from work of national health service employees, and any conditions related to that exclusion, will be a matter for NHS employers in

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accordance with locally agreed disciplinary and grievance procedures taking into account the circumstances of each individual case.

Sir Peter Bottomley: To ask the Secretary of State for Health which NHS trusts have settled an employment tribunal claim before determination with a confidential agreement restricting the release of information on (a) low standards of clinical care and (b) the number of failures noticed by the Care Quality Commission on essential quality and safety standards in each of the last five years. [81038]

Mr Simon Burns: The Department does not hold this information. The Department does not routinely monitor the use of confidentiality clauses in compromise agreements. The Department's guidance, contained within the health circulars HSC 2004/001 for National Health Service managers and HSC 1999/198 for all employees, does not prevent the use of confidentiality clauses per se. However, it does state that NHS employers must consider with their legal advisers whether such a clause is necessary in the circumstances of each case and that if such a clause is included within a particular agreement that it complies with their various statutory obligations regarding the treatment of confidential information, including the Public Interest Disclosure Act 1998.

Before an employee considers signing a compromise agreement, which may or may not contain a confidentiality clause, the employer is required to pay for the employee to have independent legal advice on the terms of the agreement.

NHS: Employment Tribunals Service

Sir Peter Bottomley: To ask the Secretary of State for Health if he will make it his policy to require NHS Trusts to seek ministerial approval before appealing an adverse employment tribunal decision. [80937]

Mr Simon Burns: The Government do not plan to introduce a policy to require national health service trusts to seek ministerial approval before appealing an adverse employment tribunal decision. The decision to appeal is a matter for local determination.

NHS: Pensions

Rachel Reeves: To ask the Secretary of State for Health what proportion of (a) male and (b) female active members of the NHS Pension Scheme earn up to £15,000 but have a full-time equivalent salary of more than £15,000. [81291]

Mr Simon Burns: Estimates based on data extracted from the electronic staff record in March 2011 show the following information:

(a) Of those who are estimated to be members of the NHS Pension Scheme, around 80% of female Hospital and Community Health Services staff who earn less than £15,000 per year have full-time equivalent pay of more than £15,000.

(b) Of those who are estimated to be members of the NHS Pension Scheme, around 50% of male Hospital and Community Health Services staff who earn less than £15,000 per year have full-time equivalent pay of more than £15,000.

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NHS: Sexual Offences

Jim Shannon: To ask the Secretary of State for Health how many (a) male and (b) female victims of sexual abuse aged (i) up to 16, (ii) between 16 and 40 and (iii) over 40 have received NHS treatment arising from that abuse in each of the last 10 years. [80384]

Anne Milton: Information is not available in the form requested as data on this treatment are not collected

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centrally. However, information on admissions for 'sexual assault by bodily force' is recorded and figures are provided in the table. This does not include people treated in accident and emergency, out-patients or primary care settings and does not reflect the number of people who have been abused, as the same person may have been admitted more than once.

Count of finished admission episodes with a cause code of Y05 in England, 2010-11 to 2001-02
Activity in English NHS hospitals and English NHS commissioned activity in the independent sector

2010-11 2009-10 2008-09 2007-08 2006-07 2005-06 2004-05 2003-04 2002-03 2001-02

Male

                   

Under 16

13

6

9

12

10

10

7

6

4

4

16 to 40

92

93

60

68

86

91

79

44

40

42

Over 40

33

20

25

19

26

16

21

13

9

7

Unknown

3

0

0

0

0

0

0

0

0

0

Total

141

119

94

99

122

117

107

63

53

53

                     

Female

                   

Under 16

28

28

21

18

14

22

21

23

18

19

16 to 40

96

66

74

68

72

79

65

60

33

41

Over 40

31

31

16

11

25

19

22

13

13

7

Unknown

2

1

1

0

0

0

1

1

1

2

Total

157

126

112

97

111

120

109

97

65

69

Source: Hospital Episode Statistics (HES), The NHS Information Centre for health and social care.

NHS: Solar Power

Caroline Flint: To ask the Secretary of State for Health if he will estimate the potential cost to hospitals, surgeries and other NHS buildings that were planning to install photovoltaic solar systems arising from the proposed reductions in feed-in tariffs. [81085]

Mr Simon Burns: The Department does not collect data from the national health service on the installation of photovoltaic (PV) solar systems under the feed-in tariffs (FITs) scheme or otherwise that would enable such an estimate to be provided.

Decisions on the use of the FIT scheme will continue to be made by individual NHS trusts and at an individual site/building level. NHS trusts also have the opportunity to participate in the current Department for Energy and Climate Change Consultation on feed-in tariffs for solar PV up until the 23 December 2011.

Orphan Drugs

Mr Barron: To ask the Secretary of State for Health (1) what applications for (a) specialised services and (b) orphan and ultra orphan therapies have been received by the Advisory Group for National Specialised Services; [80224]

(2) when he expects the Advisory Group for National Specialised Services to make a recommendation to Ministers on services for atypical haemolytic uremic syndrome; and if he will make a statement; [80225]

(3) when he plans to make a decision on the commissioning of specialised services for atypical haemolytic uremic syndrome; and if he will make a statement. [80226]

Mr Simon Burns: The Advisory Group for National Specialised Services (AGNSS) received 29 outline applications for services to be considered for inclusion in the national arrangements for specialised services in 2012-13 and has received six drug therapies for consideration. AGNSS will be finalising its recommendations to Ministers on those specialised services to be commissioned nationally at its meeting on the 8 December 2011.

Following that meeting Ministers will consider the recommendations made by AGNSS. Decisions on those recommendations are expected in early 2012.

Paramedical Staff

Mr Anderson: To ask the Secretary of State for Health what estimate he has made of the number of NHS paramedic posts which have been lost in the last 12 months. [80554]

Mr Simon Burns: Information on the number of paramedics employed is collected and reported in the NHS Information Centre annual census.

The most recent data available show that there has been an increase of 589 (headcount) employed in the past 12 months, with 10,089 (headcount) employed in 2009 and 10,678 (headcount) in 2010, the date of the last annual census.

School Fruit and Vegetable Scheme

Zac Goldsmith: To ask the Secretary of State for Health what plans his Department has for the future funding of the School Fruit and Vegetable Scheme. [80373]

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Anne Milton: The School Fruit and Vegetable Scheme is continuing.

For the financial year 2012-13, the Department will continue to manage the service level agreement with NHS Supply Chain on behalf of primary care trusts, who will contribute to the scheme in proportion to their overall allocations.

Smoking: Motor Vehicles

Diana Johnson: To ask the Secretary of State for Health how much his Department plans to spend on campaigns to reduce smoking in cars in the presence of children in each of the next three years. [81089]

Anne Milton: £15 million has been allocated for tobacco control marketing and communications activity during 2011-12. The Department is currently developing a national campaign to remind smokers of the harms of second hand smoke and to encourage them to change their behaviour to protect children and non-smokers. This activity is planned to run in spring 2012 and the

15 Nov 2011 : Column 824W

exact budget for this campaign has not yet been confirmed. Marketing budgets have not been agreed beyond March 2012.

Strokes

Mr Cox: To ask the Secretary of State for Health what steps he is taking to maintain the supply of products for the prevention of a transient ischaemic attack which meet National Institute for Health and Clinical Excellence guidelines. [81036]

Mr Simon Burns: The Department works closely with manufacturers and other representatives of the medicines supply chain to ensure that patients get the medicines they need, when they need them.

We have no reason to believe that companies supplying the medicines recommended for the treatment and prevention of transient ischaemic attack in accordance with National Institute for Health and Clinical Excellence guidance (aspirin, clopidogrel and modified release dipyridamole) are not able to meet current demand from United Kingdom patients.