Social Security Benefits
Jim Shannon: To ask the Secretary of State for Work and Pensions what the cost has been of administration of appeals against (a) disability living allowance, (b) incapacity benefit and (c) employment and support allowance decisions for each of the last three years. [80364]
Chris Grayling: The information requested is shown in the following table.
| Direct staff administration cost of appeals | |||
| £ million | |||
|
|
2008-09 | 2009-10 | 2010-11 |
| Source: Activity-based management system. | |||
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Figures shown cover the last three financial years for which final audited accounts are available. Employment support allowance (ESA) was introduced in October 2008. Existing incapacity benefit claimants began migrating to employment support allowance in the latter half of 2009-10.
Stephen Timms: To ask the Secretary of State for Work and Pensions if he will estimate the annual cost to the Exchequer of exempting households from the benefit cap for six months following exit from employment due to redundancy or the commencement of caring responsibilities. [83518]
Chris Grayling: The information that would enable us to make such an assessment is not available.
Stephen Timms: To ask the Secretary of State for Work and Pensions what recent estimate he has made of the cost to the public purse of excluding from the level of the overall benefit cap (a) child benefit, (b) child tax credit and (c) both benefits. [83519]
Chris Grayling: We estimate that the benefit cap will save £225 million in 2013-14 and £270 million in 2014-15 if it is introduced as announced in the 2010 spending review.
Analysis of the benefit cap is based on a very small sample using survey data, so any assessment of options to exempt certain categories of income or groups from the benefit cap is subject to significant uncertainty.
Estimates suggest that excluding child benefit from the calculation of the benefit cap may reduce these savings by around 40% to 50%, in both years.
Excluding child tax credit may reduce the savings by around 80% to 90%, in both years.
Excluding both child benefit and child tax credit would reduce the savings by around 90%, in both years.
State Retirement Pensions: Females
Mrs Laing: To ask the Secretary of State for Work and Pensions what recent representations he has received on his proposals for the state pension age for women. [82318]
Steve Webb: During the passage of the Pension Bill 2011 we listened to stakeholders, representative groups and individuals about the impact the proposed changes to state pension age would have on particular women. We therefore introduced an amendment so that state pension age will not reach 66 until October 2020.
As a consequence no woman will have an increase in her state pension age, against the previous legislated timetable, of more than 18 months and those women who would have experienced the largest delay in receiving their state pension will find this delay reduced by six months. This amendment reduces the savings on pensions and benefits expenditure from our original proposals by around £1 billion.
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We believe the amended timetable contained in the Pensions Act 2011 strikes a fair balance between addressing the concerns raised and maintaining fiscal sustainability.
Unemployment: Ex-servicemen
Mr Jim Murphy: To ask the Secretary of State for Work and Pensions (1) what support his Department provides to help those leaving the armed forces to find work; [83542]
(2) what (a) bespoke training and (b) advice his Department provides for veterans of the armed forces looking for work. [83543]
Chris Grayling: All former service personnel claiming jobseeker’s allowance (JSA) receive a flexible, personalised service and access to the full range of Jobcentre Plus service from day one.
This starts at the outset of the claim with an initial personal adviser meeting. The purpose of this is to discuss and agree some realistic and achievable job goals and steps that, if taken regularly, will offer the best chance of finding work. As part of this, the adviser provides information about, and access to, a range of additional support to help people improve job prospects. This includes support to overcome barriers that may make finding and keeping a job more difficult. Examples include specialist support for those with a health problem or disability or a skills need.
Thereafter, ex-service personnel receive ongoing support through regular jobsearch reviews and additional adviser contacts tailored to individual need. In addition, those unable to find work quickly can volunteer for early entry to the Work programme from the three-month point in their claim. Those with additional needs on employment and support allowance, incapacity benefit or income support can also volunteer for the Work programme at any point in their claim. The Work programme is the biggest single welfare to work programme this country has ever seen. It is built around the needs of individuals, targeting the right support at the right time, regardless of the benefit the claimant is in receipt of.
In terms of bespoke training, a skills screening is undertaken at the outset of the claim and where a need is identified, ex-service personnel are referred for further advice and guidance. Where appropriate, remedial provision is available from the Skills Funding Agency in England and the devolved Administrations in Scotland and Wales. Jobcentre Plus advisers work with the Skills Funding Agency or training providers in the devolved Administrations to arrange bespoke training for claimants where a need has been identified that, once addressed, will move the claimant closer to, or into, work.
In addition to the services outlined above, every Jobcentre Plus district has an armed forces champion. Their role is to ensure the support, advice and guidance offered reflects the needs of service leavers and the wider service community. The champions work in partnership with the armed forces community, support organisations and local and national employers to identify employment opportunities and specialist support for service leavers.
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Universal Credit
Stephen Timms: To ask the Secretary of State for Work and Pensions when he plans to determine the delivery model for universal credit. [83520]
Chris Grayling: Universal credit will be delivered by the DWP, through a predominantly online service, supported by telephone and face to face contact where appropriate. We are working collaboratively with existing delivery organisations to ensure that the delivery model takes full account of the needs of different claimant groups. The delivery model will be developed in greater detail in 2012 as a component of the overall design of the universal credit service.
Stephen Timms: To ask the Secretary of State for Work and Pensions whether his Department has assessed the universal credit programme against the National Audit Office’s list of common causes of project failure; and if he will place a copy of any such assessment in the Library. [83521]
Chris Grayling: The Office of Government Commerce’s paper on “Common Causes of Project Failure” is part of a suite of published best practice (including also “Causes of Confidence”) that officials have used to examine the standing of the universal credit programme, work that sits alongside advice from external experts and internal audit and assurance.
In terms of assessments, these have been undertaken by the Department’s internal auditors and by the Major Project Authority, in line with the “Major Project approval and assurance guidance” published in April 2011. The most recent Major Project Authority assessment took place between 7 and 11 November 2011. The report from this assessment is confidential to the Senior Responsible Owner and the Major Project Authority and will not, therefore, be published.
Work Capability Assessment
Sheila Gilmore: To ask the Secretary of State for Work and Pensions pursuant to the answer to the hon. Member for North Tyneside of 24 October 2011, Official Report, column 8, on the Work Capability Assessment, whether he plans to publish the suggested descriptors for mental cognitive and intellectual function that his Department has received from Professor Harrington’s working group; and when any such publication will take place. [82392]
Chris Grayling: We currently have no plans to publish the report submitted by Professor Harrington to us on the mental, intellectual and cognitive descriptors.
Professor Harrington’s second independent review of the Work Capability Assessment has been published on 24 November. This contains a précis of the recommendations as well as an update on the current position regarding their consideration.
As the Government’s response to Professor Harrington’s second review—also published on 24 November—sets out, we are already engaging with the charities to revise the ESA50 questionnaire to take account of some of their recommendations. To further our evidence base, we are also considering developing a gold standard review during the first half of 2012.
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Church Commissioners
Churches: Community Relations
Gordon Henderson: To ask the hon. Member for Banbury, representing the Church Commissioners, what steps the Church Commissioners are taking to encourage churches to form closer links with their local communities. [82261]
Tony Baldry: The Church has two new initiatives which it has launched recently; the first is a research project into new mission projects. The Archbishops' Council and Church Commissioners have distributed £1 million as part of a nationwide move to help develop successful church growth projects in deprived areas. The £100,000 grants have been distributed to 10 projects across nine dioceses where existing activity has a proven track record of growth. The funds are part of a wider research and development programme, a key aim of which is to ensure projects are evaluated to provide evidence of what is proving effective.
A further £2 million in grants is being distributed next year. This overall £3 million for developing church growth in deprived areas is part of £12 million set aside by the Archbishops' Council and Church Commissioners for research and development work in 2011-13 and is in support of the strategic goals set out by the Archbishop of Canterbury in his November 2010 Presidential Address to the new General Synod.
The Church Commissioners and Archbishops' Council have for many years earmarked money specifically for mission development; while the details of this funding stream are new, it is part of the continuing commitment to ensure that the money generated by the historic endowment of the Commissioners is available to meet ‘opportunity’ as well as ‘need’.
Projects awarded funding for developing church growth in deprived areas (October 2011)
Diocese of Birmingham: A proposal to train Mission Apprentices combining structured training and mission experience in deprived parishes.
Diocese of Bradford: ‘Sorted’ Youth Evangelism Project—development of an existing successful youth evangelism project working with multi-cultural communities in deprived areas.
Diocese of Canterbury: ‘Ignite’ Project, Cliftonville—employing a missioner to replicate an established model of community ministry from a deprived neighbourhood into another area.
Diocese of Coventry: Mission Leadership—training and mentoring of young mission leaders, based in deprived parishes showing good levels of growth.
Diocese of Leicester: Eyres Monsell and New Parks Parish Development Project—a proposal to augment existing growth, using mission workers to help develop lay ministry in two Anglo-Catholic parishes with very high levels of multiple deprivation.
Diocese of Liverpool: Liverpool Cathedral Mission Project—using the Cathedral as a resource to support the replication of two, currently Cathedral-based, examples of Fresh Expressions into deprived parishes.
Diocese of Liverpool: St Andrew’s Clubmoor Mission Development—part-funding two posts to further develop mission and counselling work in an existing community and missional project with high levels of outreach into very deprived neighbourhoods.
Diocese of London: St Francis Dalgarno Way—development of mission activity in a fast-growing church plant through employment of a worker, targeting children and families in a deprived area with a high proportion of young people.
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Diocese of Sheffield: Pioneer Mission Training—funding for pump-priming training and bursaries for pioneer missioners in very deprived parishes.
Diocese of Worcester: St Barnabas Worcester, Tolladine Mission—scaling up a successful existing project based around a mission community in an area with pockets of exceptional multiple deprivation, by employing a mission leader full-time.
The Second initiative being the Near Neighbours project which is being administered by the Church Urban Fund in association with the Department for Communities and Local Government.
Near Neighbours aims to bring people together in communities that are religiously and ethnically diverse to foster greater understanding, build relationships of trust and working collectively to improve the local community.
This will be achieved by building on work already undertaken by churches and other faith groups through the twin streams of Social Action and Social Interaction. The projects are working collaboratively with the Christian Muslim Forum, the Hindu Christian Forum, the Council of Christians and Jews, the Nehemiah foundation, the Feast and Catalyst. The main focus for this work being in the cities of Leicester, Bradford, Burnley, Oldham, Birmingham and London. I have placed more information about the Near Neighbours project in the Library.
Health
Alcoholic Drinks: Misuse
Dr Wollaston: To ask the Secretary of State for Health what assessment he has made of any link between levels of alcohol duty fraud and the excessive consumption of alcohol. [82405]
Miss Chloe Smith: I have been asked to reply.
No assessment has been made of any link between levels of alcohol duty fraud and excessive alcohol consumption.
HM Revenue and Customs have recently renewed their strategy to tackle alcohol duty fraud. The Department of Health aims to publish the Government’s strategy for reducing harm from alcohol in the coming months.
Ambulance Services: Rural Areas
Dr Poulter: To ask the Secretary of State for Health what steps his Department is taking to ensure adequate ambulance resources are available to rural counties. [82397]
Mr Simon Burns: It is the responsibility of individual ambulance trusts to ensure that adequate ambulance resources are available to all patients in their area, taking into account the local geography.
Clinical quality indicators for the ambulance service came into effect from April 2011 and require each ambulance trust to publish the median time to treatment, the 95th centile time to treatment and 99th centile time to treatment for immediately life-threatening (category A) calls. The requirement to publish these data, and in particular the 95th centile and 99th centile time to treatment, will ensure that trusts must demonstrate an excellent service to all patients, whether the incident occurs in a rural or urban setting.
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Ambulance Services: Standards
Dr Poulter: To ask the Secretary of State for Health what steps his Department is taking to monitor ambulance response times (a) at a sub-regional level and (b) in Norfolk, Suffolk and Cambridgeshire. [82398]
Mr Simon Burns: The NHS Operating Framework provides for central performance management of the A8 and A19 ambulance response time targets at strategic health authority level.
It is for local commissioners to monitor performance at the sub-regional level.
Appointments Commission
Mr Lammy: To ask the Secretary of State for Health what guidance is issued on the content of vacancies advertised on the Appointments Commission website. [82370]
Mr Simon Burns: The Appointments Commission agrees the content of the vacancies on its website with the organisation seeking to fill the post.
No central guidance has been issued to the Appointments Commission on the subject apart from the Commissioner for Public Appointments’ Code of Practice on Ministerial Appointments to Public Bodies, which includes some requirements in relation to the advertisement of posts that fall within the Commissioner's remit.
Brain Cancer: Health Services
John Mann: To ask the Secretary of State for Health what steps he is taking to ensure that those affected by a brain tumour receive early diagnosis and treatment. [83550]
Paul Burstow: On 12 January 2011, we published “Improving Outcomes: A Strategy for Cancer”. The strategy sets out an ambition to save an additional 5,000 lives every year by 2014-15 through earlier diagnosis of cancer and improved access to screening and radiotherapy.
To support earlier diagnosis of cancer, the Government have committed over £450 million over the next four years, which includes provision for the funding of awareness activity and measures to support general practitioners (GPs) to diagnose cancer earlier. The measures include funding increased GP access to diagnostic tests, including magnetic resonance imaging to support the diagnosis of brain tumours.
The strategy also sets out our commitment to work with a number of rarer cancer-focused charities to assess what more can be done to encourage appropriate referrals to secondary care for earlier diagnosis. Departmental officials have already met with a number of these charities, including two brain tumour charities, with the aim of identifying some of the barriers to early diagnosis and to discuss potential solutions. This will inform our future work in this area.
We are currently investigating a possible new metric around the proportion of cancer diagnosed through emergency routes, as there is a relationship between the route to diagnosis and survival rates. We know that a
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large proportion of brain tumours are diagnosed through emergency routes and so encouraging diagnosis through other routes would help deliver earlier diagnosis.
Child Protection
Craig Whittaker: To ask the Secretary of State for Health what assessment he has made of recommendations in the intercollegiate document, “Safeguarding children and young people: roles and competences for health care staff” relating to competences and training of health care professionals. [83109]
Anne Milton: A stocktake of safeguarding training for national health service staff undertaken by the Department in 2009 identified a need for greater clarity about what training should be received and how frequently.
The updated intercollegiate document “Safeguarding children and young people: roles and competences for health care staff” was developed by 14 Royal Colleges and health professional bodies and published in September 2010. It provides a clear framework which identifies the competences required for all health care staff and focuses upon the education and training needed to enable them to acquire and maintain the necessary knowledge and skills.
“To protect children and young people from harm, all health staff must have the competences to recognise child maltreatment and to take effective action as appropriate to their role. They must also clearly understand their responsibilities, and should be supported by their employing organisation to fulfil their duties.”
In response to the stocktake and the intercollegiate document, the Department, strategic health authorities and other stakeholders have worked together to produce a training matrix, to be published online shortly. This will describe learning outcomes, map existing training courses, and outline training pathways for different professional groups, and will complement the intercollegiate document.
Craig Whittaker: To ask the Secretary of State for Health (1) what steps he plans to take to ensure that health and wellbeing boards prioritise safeguarding activity in their local areas; [83110]
(2) what (a) legislative and (b) other steps he plans to take to (i) protect and (ii) enhance the roles of named and designated professionals for safeguarding. [83111]
Anne Milton: Health and wellbeing boards will have an important role in facilitating partnership arrangements for organisations involved in the delivery of health and care. They should ensure that the needs of vulnerable groups are reflected through joint strategic needs assessments and joint health and wellbeing strategies, which will inform the commissioning of services by clinical commissioning groups and local authorities.
The Department of Health is working with local government to support a National Learning Network with early implementer health and wellbeing boards and stakeholders to understand how boards can be effective, including for vulnerable children and adults.
National health service bodies have a statutory duty to make arrangements to safeguard and promote the welfare of children, and are statutory members of local
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safeguarding children boards. These duties will transfer to the new organisations under the Health and Social Care Bill.
In response to a recommendation in Professor Eileen Munro’s review of child protection, the Department of Health and the Department for Education published on 31 October a work programme, co-produced with key partners, to ensure that effective arrangements to safeguard children are central to the health reforms.
As part of that programme, work is in hand to develop an accountability framework for the NHS contribution to safeguarding children, setting out more detail on the proposed new arrangements. This will be tested with national and local stakeholders. It will set the framework for development both within the NHS and in local partnership arrangements, including the opportunities offered by the introduction of health and well-being boards. It will also inform development plans for designated and named professionals, to ensure professional leadership and expertise in safeguarding children are retained in the NHS system.
In May, the Department of Health published a “Statement of Government Policy on Adult Safeguarding”, a copy of which has been placed in the Library, announcing our intention to bring forward legislation to put safeguarding adults boards on a stronger, statutory footing, better equipped both to prevent abuse and to respond when it occurs. In the meantime, organisations should continue to follow the statutory guidance on adult safeguarding set out in No Secrets, with local social services authorities taking the lead on ensuring the co-ordination of adult safeguarding activity.
Departmental Audit
Mr Thomas: To ask the Secretary of State for Health how many internal audits have taken place (a) in his Department and (b) in the non-departmental bodies for which his Department is responsible in the last 12 months; and if he will make a statement. [82543]
Mr Simon Burns: The internal audit assurance work undertaken in the Department in the 12-month period covering 2010-11 was 44.
The following table shows how many internal audits have taken place in the non-departmental bodies (NDPBs) for which the Department is responsible in the 12-month period covering 2010-11.
| NDPB | Number of internal audits that took place in 2010-11 |
| (1) Includes one follow-up audit (reviewing recommendations made in previous five). | |
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Official Photographs
Mr Thomas: To ask the Secretary of State for Health how many official photographs have been taken of (a) Ministers and (b) senior officials in his Department for use in Government publications since May 2010; how many staff of his Department are expected to undertake photography of the ministerial and senior leadership team as part of their duties; and if he will make a statement. [82572]
Mr Simon Burns: Each Minister has an official photograph, as do the most senior members of staff, which are used, for example, in departmental publications. No member of staff is expected to undertake photography of the ministerial and senior leadership team as part of their duties.
Food Standards Agency
Mr McCann: To ask the Secretary of State for Health which companies have been prosecuted by the Food Standards Agency since 2007 in respect of which no further legal proceedings are active; what the reasons were for prosecution in each case; and what penalty was imposed. [82614]
Anne Milton: The Food Standards Agency (FSA) is the enforcement authority for food hygiene and food safety legislation at approved meat plants and at dairy production holdings. The FSA has provided details of all prosecutions undertaken by them in England, Wales and Northern Ireland since 2007 and by Procurators Fiscal in Scotland following a report submitted by the FSA in the same period. A copy has been placed in the Library.
Health Services: Prisons
Mr Jim Cunningham: To ask the Secretary of State for Health what level of access prisoners have to (a) prescription medicines and (b) psychiatric care. [82658]
Paul Burstow: Offenders are entitled to expect, and receive, the same quality of treatments and services from the national health service as anyone else. All prisons have access to on-site health care teams, which can treat most mental health problems and issue prescriptions required by prisoners.
When mental health treatment cannot be delivered in prison settings, prisoners can be transferred to secure NHS facilities outside of the prison service for treatment under the Mental Health Act. If other health problems cannot be dealt with fully at the prison where the sentence is being served, a prisoner may be moved to another prison where different facilities are available. Alternatively, a specialist may be called in or a prisoner may be taken to an outside NHS hospital but will remain in the custody of the Prison Service.
Mr Jim Cunningham: To ask the Secretary of State for Health what funding he provided for prison health care in each of the last three years. [82659]
Paul Burstow: In 2009-10, the Department allocated £234.85 million to fund national health service prison health care in England. In 2010-11, £294.18 million was allocated and in 2011-12, £369.13 million was allocated.
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This increased spending follows the Department's provision in 2010-11 of an extra £44.5 million funding for Integrated Drug Treatment Service (IDTS) in prisons in England. In 2011-12, the Department also contributed over £108 million for IDTS, after it assumed responsibility for funding all other substance misuse treatment interventions in prisons and children and young persons' secure settings from the Ministry of Justice.
Health Services: Standards
Charlotte Leslie: To ask the Secretary of State for Health what research his Department has undertaken on the effect of continuity of care on patient health and well-being outcomes; and if he will place any such research in the Library. [82426]
Mr Simon Burns: The National Institute for Health Research Service Delivery and Organisation (SDO) Programme has funded an extensive portfolio of research on continuity of care, including its relation to outcomes. Details of this portfolio, and the final reports of completed projects are available on the SDO website at:
www.sdo.nihr.ac.uk/projlisting.php?srtid=6
Health Services: Weather
Luciana Berger: To ask the Secretary of State for Health what estimate he has made of the cost to the NHS arising from physical illness or mental health problems which are caused or exacerbated by people living in cold homes. [83587]
Anne Milton: Indoor temperatures during winter can have a clear impact on health. It has been estimated that the annual cost to the national health service of treating winter-related disease due to cold housing is £859 million. The total costs to the NHS of poor health due to cold housing are unknown.
Health: Finance
Mr Byrne: To ask the Secretary of State for Health what the public health budgets in (a) Birmingham, (b) Newcastle, (c) Wakefield, (d) Manchester, (e) Leeds, (f) Liverpool, (g) Coventry, (h) Bristol, (i) Sheffield, (j) Bradford, (k) Leicester and (l) Nottingham will be in each of the next five years. [82743]
Mr Simon Burns: The Secretary of State for Health, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), has asked the Advisory Committee on Resource Allocation (ACRA), an independent committee including general practitioners, national health service managers, public health experts and academics, to develop a formula for the allocation of the ring-fenced public health grant to local authorities (LAs). ACRA’s recommendations and indicative ‘shadow’ allocations to LAs for 2012-13 will be published in due course. These allocations will enable LAs to support local planning and provide the opportunity to give the Department feedback on the allocation process before it is finalised and they become formally responsible for the delivery of public health services. Actual allocations to LAs for 2013-14 will be made towards the end of next year.
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Heart Diseases
Glyn Davies: To ask the Secretary of State for Health what his policy is on the publication of a quality standard for atrial fibrillation. [82761]
Mr Simon Burns: The National Institute for Health and Clinical Excellence (NICE) jointly with the National Quality Board recently ran an engagement exercise on the development of a library of NICE Quality Standard topics for the national health service. The list of proposed Quality Standard topics published as part of this exercise included atrial fibrillation. The engagement exercise closed on 14 October 2011.
Further information on the engagement exercise can be found at:
www.nice.org.uk/getinvolved/currentniceconsultations/NQBEngagement.jsp
An announcement on next steps will be made once the responses have been analysed.
Glyn Davies: To ask the Secretary of State for Health what plans he has to appoint a National Clinical Director for heart disease and stroke. [82760]
Mr Simon Burns: Future arrangements for the provision of senior clinical advice are being discussed as part of developing the role of the NHS Commissioning Board.
Hepatitis
Mr Amess: To ask the Secretary of State for Health what plans he has to improve data collection on hepatitis C at (a) a local and (b) national level; and if he will make a statement. [R] [83019]
Anne Milton: The proposed establishment of Public Health England will bring together in a single organisation the Health Protection Agency with its laboratory surveillance systems, the Public Health Observatories with experience in using hospital episode statistics and the National Treatment Agency for Substance Misuse which oversees drug treatment and harm reduction services for people who inject drugs, who are at greatest risk of acquiring hepatitis C. This will provide opportunities for improvement of hepatitis C data collection at both local and national levels.
Statutory reporting of hepatitis C by diagnostic laboratories testing human samples came into force in October 2010, which will also help improve the completeness of hepatitis C surveillance.
Mr Amess: To ask the Secretary of State for Health what plans he has to designate a lead public health observatory to take responsibility for improving the quality and timeliness of information available on hepatitis C services; and if he will make a statement. [R] [83020]
Anne Milton: Public health observatories contribute to planning, commissioning and development of a range of health services. While all nine public health observatories have a lead responsibility, there are no plans to designate a lead observatory for hepatitis C services.
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The Health Protection Agency (HPA) is responsible for surveillance of hepatitis C virus infection and works closely with the public health observatories and the National Treatment Agency for Substance Misuse in providing information on and for the prevention, treatment and monitoring of hepatitis C.
The establishment of Public Health England will offer opportunities to strengthen capabilities of the existing information on the burden of hepatitis C, by bringing together HPA laboratory and real time surveillance systems and the public health observatories.
Mr Virendra Sharma: To ask the Secretary of State for Health what steps his Department is taking to ensure equal access to treatment for patients infected with hepatitis C. [78214]
Anne Milton: I refer the hon. Member to the answer I gave him on 3 November 2011, Official Report, column 745W.
HIV Infection
Andrew Rosindell: To ask the Secretary of State for Health what is being done to assist early diagnosis of HIV. [83137]
Anne Milton: Increasing the offer and uptake of HIV testing in a variety of health care settings, both primary and secondary, is important to reduce undiagnosed HIV. We are considering the findings of the “Time to Test” report, published by the Health Protection Agency in September this year, which assessed the feasibility and acceptability of routinely offering HIV testing in eight pilot projects that were funded by the Department. We are also funding a three-year project by the Medical Foundation for AIDS and Sexual Health (MedFash) to produce an interactive tool to support GPs and primary care staff in offering HIV testing.
The Department continues to fund targeted programmes of work for the groups most at risk of HIV in the United Kingdom and these highlight the importance of HIV testing. Additionally, in February 2011, the National Institute of Health and Clinical Excellence published its recommendations on increasing the offer of HIV testing to men who have sex with men and black African communities, which we welcome.
Andrew Rosindell: To ask the Secretary of State for Health what steps are being taken to increase awareness of HIV. [83138]
Anne Milton: This year, the Department has invested £2.9 million in a national programme of HIV prevention for men who have sex with men and African communities, the groups most at risk of HIV in the United Kingdom. Raising levels of awareness and knowledge will be key elements of the Government's new Sexual Health Policy Framework, which is currently being developed.
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NHS Consultants
Shabana Mahmood: To ask the Secretary of State for Health what impact assessment has been undertaken on the effect on the UK's research performance of changes to clinical excellence awards; and if he will make a statement. [83017]
Mr Simon Burns: In 2011, the Review Body on Doctors' and Dentists' Remuneration led a United Kingdom wide review of compensation levels and incentives for national health service consultants. The review included the Clinical Excellence and Distinction Award Schemes. Their report is currently being considered by Ministers. No impact assessment has been undertaken.
Human Papillomavirus: Vaccination
Andrew Rosindell: To ask the Secretary of State for Health what assessment he has made of the effectiveness of human papillomavirus vaccines against cervical cancer. [83136]
Anne Milton: In 2008, the Joint Committee on Vaccination and Immunisation (JCVI)—the independent experts that advise the Government on vaccination—completed a detailed assessment of the effectiveness of the human papillomavirus vaccination against cervical cancer.
A copy of the JCVI statement has been placed in the Library.
Liver Diseases
Mr Amess: To ask the Secretary of State for Health what the timetable is for the publication of the National Liver Strategy; and if he will make a statement. [R] [83021]
Mr Simon Burns: Professor Martin Lombard, National Clinical Director for Liver Disease, is currently leading work with national health service and public health stakeholders to ensure that the response to the rising demand for liver disease services is adequate and supports improvement against the NHS Outcomes Framework and the public health Outcomes Framework (which is expected for publication in the autumn). No publication date for the liver disease strategy has yet been identified.
Mr Amess: To ask the Secretary of State for Health what recent assessment he has made of the merits of a national audit of hepatology services; and if he will make a statement. [R] [83022]
Mr Simon Burns: A census of the medical workforce of consultant gastroenterologists and hepatologists was undertaken in order to assess the current capacity and infrastructure for delivery of liver services in England, and these data are available to subscribers on the NHS Liver Network website.
A copy of “A Census of Medical Workforce and Infrastructure for Liver Disease Strategy: Summary of Findings (Final 2011)” has been placed in the Library.
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Mayors: Powers
Mr Byrne: To ask the Secretary of State for Health with reference to the Government’s consultation on mayoral powers, entitled “What can a mayor do for your city? A consultation” and the Open Public Services White Paper, what assessment he has made of powers of his Department which could be devolved to elected mayors. [82587]
Mr Simon Burns: As the consultation paper makes clear, the approach we are proposing is to look to the cities themselves to come forward with their own proposals for decentralising services and power to the city mayor.
Medical Equipment
Mr Sanders: To ask the Secretary of State for Health if he will make it his policy to require the National Institute for Health and Clinical Excellence to consider the costs and benefits to wider society of new and existing medical devices in addition to clinical and economic cost-effectiveness when conducting technology appraisals. [82559]
Mr Simon Burns: We have no plans to do so. The National Institute for Health and Clinical Excellence is currently carrying out a review of its ‘Guide to the Methods of Technology Appraisal’ and the economic perspective taken in the development of technology appraisal guidance is being considered as part of this review process.
Further information on the review process is available at:
http://www.nice.org.uk/aboutnice/howwework/devnicetech/technologyappraisalprocessguides/GuideToMethodsTA201112.jsp
Subject to the Health and Social Care Bill currently before Parliament, the National Institute for Health and Care Excellence will, when it is established, be able to take wider societal factors into account in its work where appropriate.
Mental Health
Simon Kirby: To ask the Secretary of State for Health what assessment his Department has made of the findings of the Shaping our Age report by WRVS on loneliness. [82395]
Anne Milton: The Department welcomes the Shaping our Age report by WRVS on loneliness and has noted its findings.
The engagement exercise, Caring for Our Future: Shared ambitions for care and support, was launched on 15 September 2011, and will last until early December. This engagement exercise will cover among its six themes prevention, integration, quality, personalisation, shaping local services, and financial services.
After the engagement exercise, we will set out our response to the Dilnot Commission in the spring, with full proposals for reform of adult social care in a White Paper and progress report on funding reform.
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Mental Health Services: Voluntary Organisations
Mr Jim Cunningham: To ask the Secretary of State for Health what assessment he has made of the involvement of the voluntary sector in mental health treatment. [82657]
Paul Burstow: There is already a plurality of providers of mental health services, including many from the private and voluntary sectors. The Government want to go further to ensure that patients and service users will be able to choose ‘any qualified provider' in certain community and mental health services. It is for commissioners to decide locally which services are appropriate for this approach, following engagement with patients.
Providers must pass a standard qualification process to ensure they meet the appropriate quality standards. The Department has assessed mental health as potentially suitable for any qualified provider, as the needs of individuals are very diverse and a range of innovative approaches may be necessary for ensuring that even the most excluded can be helped to get the care and support they need. The Department has engaged with the mental health voluntary sector while developing the ‘any qualified provider' policy.
NHS: Pay
Luciana Berger: To ask the Secretary of State for Health what estimate he has made of the number of NHS staff that will have their pay grade down-banded in the next two financial years. [83586]
Mr Simon Burns: No such estimate has been made.
It is for the national health service locally to decide on the number and pay band of the staff they need to provide high quality, safe and effective services for patients.
NHS: Standards
John Mann: To ask the Secretary of State for Health what timetable his Department has set for implementation and monitoring of its Improving Outcomes guidance over the next two years. [83551]
Paul Burstow: “Improving Outcomes: A Strategy for Cancer”, published on 12 January, sets out actions to tackle preventable cancer incidence, raise public awareness of the signs and symptoms of cancer, support general practitioners to diagnose cancer earlier, expand our cancer screening programmes and introduce new screening technologies, to improve the quality and efficiency of cancer services and to deliver outcomes which are comparable with the best in Europe.
The strategy is backed by over £750 million of additional funding over the spending review period up to 2014-15. While many of the initiatives we have set out will be implemented during this time, others will take longer. For example, it is not anticipated that flexible sigmoidoscopy screening will be full incorporated into the bowel screening programmes until 2016.
Annual reports will be published to measure progress on implementation and on improving cancer outcomes and we are planning to publish the first report this winter. The annual reports will assess progress in implementation against a range of metrics.
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Pancreatic Cancer
Mr Buckland: To ask the Secretary of State for Health how many people were diagnosed with pancreatic cancer in (a) the Swindon and Marlborough NHS Trust and (b) all NHS trusts in England in (i) 2008, (ii) 2009, (iii) 2010 and (iv) so far in 2011. [83610]
Mr Hurd: I have been asked to reply.
The information requested falls within the responsibility of the UK Statistics Authority. I have asked the authority to reply.
Letter from Stephen Penneck, dated November 2011:
As Director General for the Office for National Statistics, I have been asked to reply to your Parliamentary Question asking how many people were diagnosed with pancreatic cancer in (a) the Swindon and Malborough NHS trust and (b) all NHS trusts in England in (i) 2008, (ii) 2009, (iii) 2010 and (iv) so far in 2011 (83610).
The latest available figures for newly diagnosed cases of pancreatic cancer (incidence) are for the year 2009. Please note that the number of pancreatic cases may not be the same as the number of people diagnosed with cancer, because one person may be diagnosed with more than one cancer.
ONS does not publish figures on cancer incidence by NHS trust. NHS hospital trusts are commissioned by primary care organisations to provide health services. Whilst primary care organisations have geographical boundaries, hospital trusts do not. For this reason figures on cancer incidence by primary care organisation have been provided instead.
Swindon and Malborough NHS trust is situated in Swindon primary care organisation. In (i) 2008 and (ii) 2009 there were 20 and 14 newly diagnosed cases of pancreatic cancer respectively in Swindon primary care organisation.
The table provides the number of newly diagnosed cases of pancreatic cancer in each primary care organisation in England (Table 1) for the years (i) 2008 and (ii) 2009.
A copy of Table 1 has been placed in the House of Commons Library.
Patients: Nutrition
Andrew George: To ask the Secretary of State for Health what steps he is taking to improve the provision of basic hydration and nutrition to all NHS patients regardless of age, gender or diagnosis; and if he will make a statement. [82368]
Mr Simon Burns: All providers of regulated activities are required by law to have policies in place that protect people from the risks of inadequate nutrition and dehydration. The Care Quality Commission (CQC) can take action if these requirements are not being met. The Department welcomes the CQC's announcement that its recent Dignity and Nutrition Inspection programme will be followed up with a further focused inspection of 50 hospitals in the new year (2012).
It is for health and social care providers to develop local nutrition and hydration policies and there are a number of best practice resources and guidelines available to help them do this. These include the National Institute for Health and Clinical Excellence clinical guideline to help the national health service identify patients who are malnourished or at risk of malnutrition, and the “Essence of Care” benchmarking system which includes “food and drink”. The relevant links are as follows:
http://guidance.nice.org.uk/CG32
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www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_119969
While national initiatives can stimulate thinking and offer guidance on best practice, local boards, nurse leaders (including community team leaders) ward sisters and matrons, are key to setting and maintaining excellent standards of hydration and nutrition in their clinical areas.
Primodos
Nick de Bois: To ask the Secretary of State for Health what recent representations he has received on the drug Primodos; and if he will make a statement. [82414]
Mr Simon Burns: During the last 12 months, the Department has had five inquiries from Members of Parliament and 21 direct inquiries from members of the public about the drug Primodos.
The Medicines and Healthcare products Regulatory Agency (MHRA) is the Government agency responsible for regulating medicinal products and medical devices to ensure they comply with agreed standards of quality, safety and efficacy. The MHRA has also received 12 inquiries directly from members of the public.
A campaigner met with departmental and MHRA officials on 6 December 2010 and 18 January 2011.
Primodos first became available in the United Kingdom in 1959. Primodos contained norethisterone acetate (10 mg) and ethinylestradiol (0.02 mg), to diagnose pregnancy. One tablet was given to women on two consecutive days.
The Committee of Safety of Medicines (CSM—which is now the Commission for Human Medicines), kept the issue of hormone pregnancy tests (HPTs) under review throughout the late 1960s and 1970s.
In 1975 the evidence for an association with congenital defects was inconsistent. However, in view of the emergence of alternative methods of diagnosing pregnancy, CSM took the precautionary step of advising that there was little justification for the continued use of HPTs, including Primodos. In 1978 it was voluntarily discontinued by the manufacturer (Schering) for commercial reasons.
The current position is that, as far as we are aware, no scientific evidence is available that conclusively proves the existence of a causal link between the use of Primodos and congenital abnormalities.
Primary Care Trusts: Finance
Mr Spellar: To ask the Secretary of State for Health pursuant to the answer of 29 June 2011, Official Report, columns 876-7W, how much his Department has (a) spent to date and (b) allocated for future expenditure for (i) redundancy payments, (ii) pay in lieu of notice and (iii) additional payments to pensions schemes for staff in primary care trusts. [82769]
Mr Simon Burns: The 2010-11 NHS (England) Summarised Accounts report expenditure of £221 million in respect of “Termination benefits” in primary care trusts (PCTs) in 2010-11. This comprises redundancy payments and pay in lieu of notice. They also report a cost of £2 million for “Other pension costs” which includes additional payments to pension schemes.
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The impact assessments published alongside the Health and Social Care Bill entering the House of Lords in September 2011 estimated the costs of modernising the national health service and reducing administration costs. This included an estimate of £634 million redundancy costs for PCT staff associated as a result of the reforms. These redundancy costs include redundancy payments, pay in lieu of notice and payments to pension schemes. So we expect £411 million extra redundancy costs in PCTs on top of those stated in the 2010-11 accounts.
There is no money centrally allocated for redundancy costs in PCTs: it is all managed locally. The Operating Frameworks for the NHS in England 2011-12 and 2012-13 required PCTs to hold 2% of their revenue allocation for non-recurrent expenditure, including the redundancy costs associated with modernising the NHS. This equates to £1,600 million in 2011-12 and, potentially, a similar sum in 2012-13. Not all of this resource will be required for redundancy costs.
Psychiatric Nurses: Manpower
Dan Rogerson: To ask the Secretary of State for Health how many community psychiatric nurses are employed per thousand residents in each (a) mental health NHS trust and (b) foundation trust area. [82341]
Mr Simon Burns: It is not possible to give the number of community psychiatric nurses per thousand residents in each mental health national health service trust and foundation trust. The last NHS Information Centre annual work force census showed that there were 16,138 full-time equivalent qualified nursing, midwifery and health visiting staff employed in this nursing speciality as at 30 September 2010.
Self-harm
Jo Swinson: To ask the Secretary of State for Health (1) what assessment he has made of the adequacy of statistics on acts of self-harm by (a) boys and (b) young men; and if he will make a statement; [83424]
(2) how many (a) males and (b) females for each age under 25 years have committed acts of self-harm in each of the last 10 years; [83425]
(3) what estimate he has made of the prevalence of self-harm amongst (a) boys and (b) young men; and if he will make a statement. [83426]
Anne Milton: While figures are collected on the number of hospital admissions and the number of accident and emergency (A&E) attendances for self-harm, it is not possible to determine the overall number of people that commit self-harm. Hospital figures would only reflect those cases that require hospital treatment and would not include those treated in a primary care setting or those who do not seek/require medical attention.
The following tables show total finished in-patient admission episodes for males and females for each age under 25 and of A&E attendances for intentional self-harm for 2007-08 to 2009-10.
The prevalence of self-harm is difficult to estimate. “The Adult psychiatric morbidity in England (2007)” survey holds information related to adult self-harm broken down by gender and age and reports that:
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“There was no significant difference in the overall prevalence of self-harm between men and women. However, young women were more likely than young men to report having ever deliberately harmed themselves: 17.0% of women aged 16-24 reported this behaviour, compared with 7.9% of men in the same age group. This variation by sex was not evident in subsequent age groups.
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This corresponds with data from other sources about changes to the sex ratio in the occurrence of self-harm across the lifecycle.”
In November 2011, the National Institution for Health and Clinical Excellence published guidelines on “Self Harm (longer term management)”.
| Total finished in-patient admission episodes (1) for intentional self-harm (2) by sex (including unknown) and age (under 25) for each year 2001-02 to 2010-11. Additionally, total A&E attendances for intentional self-harm (3) by sex (including unknown) and age (under 25) for each year 2007-08 to 2009-10 | |||||||||||
| Activity in English NHS Hospitals and English NHS commiss i oned activity in the independent sector | |||||||||||
| In-patients | |||||||||||
| Sex | Age | 2010-11 | 2009-10 | 2008-09 | 2007-08 | 2006-07 | 2005-06 | 2004-05 | 2003-04 | 2002-03 | 2001-02 |
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| Accident and emergency | ||||
| Sex | Age | 2009-10 | 2008-09 | 2007-08 |
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| (1) Finished admission episodes A finished admission episode (FAE) is the first period of inpatient care under one consultant within one healthcare provider. FAEs are counted against the year in which the admission episode finishes. Admissions do not represent the number of in-patients, as a person may have more than one admission within the year. (2 ) Cause codes A supplementary code that indicates the nature of any external cause of injury, poisoning or other adverse effects. Only the first external cause code which is coded within the episode is counted in Hospital Episode Statistics (HES). ICD10 Cause codes used for Intentional self-harm are X60-84 and Y87.0 (3 ) A&E Patient Group A code that indicates the reason for the A&E episode. Group 30 indicates those admitted for intentional self-harm A&E Treatment Treatment is any intervention that takes place during an A&E attendance. For the financial year 2007-08, providers had the option of using one of three different treatment classifications of codes; A&E treatment codes, OPCS-4 and READ-5. For more information on these, visit HESonline www.hesonline.nhs.uk From April 2008, all providers are mandated to use the A&E classification of treatment codes. Analysis of treatment based on A&E HES data are produced using A&E treatment codes unless stated otherwise. Providers are able to submit unlimited number of treatments for each attendance, however, only the first 12 treatment codes are available in HES. Analysis on treatment in A&E HES is based on the primary treatment code submitted, unless stated otherwise. The coverage and quality of treatment data available in 2007-08 A&E HES is poor and therefore great caution is needed before interpreting this in any way. Further information on the quality and coverage of treatment data are available in the 2007-08 A&E HES publication, which is available on HESonline www.hesonline.nhs.uk A&E data quality HES are compiled from data sent by a number of NHS providers across England. The NHS Information centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seek to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain. Accident and Emergency HES data available for the year 2007-08, which covers attendances reported between April 2007 and March 2008. The A&E HES data for 2007-08 is the first record level national A&E attendance data to be available within HES. The current coverage and quality of A&E data in HES is poor and for this reason the dataset has been labelled as 'experimental'. Allowing access to this data will also help stimulate discussion and encourage trusts to improve quality for subsequent releases. The 2007-08 A&E HES publication addresses some of the key data quality and coverage issues. This report is available on HESonline www.hesonline.nhs.uk 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. Data quality HES are compiled from data sent by more than 300 NHS trusts and primary care trusts (PCTs) in England and from some independent sector organisations for activity commissioned by the English NHS. The NHS Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies. While this brings about improvement over time, some shortcomings remain. Source: Hospital Episode Statistics (HES), The NHS Information Centre for health and social care. | ||||