Tessa Munt: To ask the Secretary of State for Health what criteria were used to determine the cancer drug fund budget for (a) radiotherapy and (b) chemotherapy for 2012-13; what account was taken of the respective cure rates of each form of treatment when setting the budgets; and if he will make a statement. [104668]
Paul Burstow: The £200 million we have made available to the national health service for the Cancer Drugs Fund in 2012-13 has been allocated amongst strategic health authorities (SHAs) using the national weighted capitation formula. This funding is for cancer drug treatments, including radiopharmaceuticals and it is for SHA regional clinically-led panels to make decisions on its use.
The clinical effectiveness of pharmaceutical and radiological treatments will vary according to factors such as the type and stage of disease.
Chronic Fatigue Syndrome
Mr Anderson: To ask the Secretary of State for Health what research his Department has commissioned on myalgic encephalomyelitis in the last three years. [104245]
Paul Burstow: The following projects funded by the National Institute for Health Research (NIHR) Research for Patient Benefit programme started in the last three years:
Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) interventions within the primary care setting: developing resources for support and self-management in primary care; and
Graded Exercise Therapy guided SElf-help Treatment (GETSET) for patients with CFS/ME: a randomised controlled trial in secondary care.
In addition, the NIHR is funding a clinician scientist award on evidence based prevention, identification and treatment of CFS/ME in children and young people.
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Mr George Howarth: To ask the Secretary of State for Health if he will publish each paper held by his Department on research evidence on myalgic encephalomyelitis in each of the last 20 years. [104435]
Paul Burstow: It has been a long-standing principle of governance for health and social care research that there should be open access to research findings in all therapeutic areas including chronic fatigue syndrome/myalgic encephalomyelitis, once these findings have been subjected to appropriate scientific review.
The Department's National Institute for Health Research (NIHR) has published a policy statement on open access to research. This is available on the NIHR website at:
www.nihr.ac.uk/research/Pages/Research_Open_Access_Policy_Statement.aspx
Mr George Howarth: To ask the Secretary of State for Health what programmes his Department has in place to raise medical awareness of myalgic encephalomyelitis. [104436]
Paul Burstow: The National Institute for Health and Clinical Excellence has published guidelines on the diagnosis and management of chronic fatigue syndrome/myalgic encephalomyelitis. There is also information available on the NHS evidence website, with a number of resources published by clinicians, charities and professional organisations.
Mr George Howarth: To ask the Secretary of State for Health whether his Department classifies myalgic encephalomyelitis as a neurological condition. [104437]
Paul Burstow: The Department classes chronic fatigue syndrome/myalgic encephalomyelitis as a long-term neurological disease of unknown cause.
Mr George Howarth: To ask the Secretary of State for Health how many people (a) were diagnosed with and (b) died from myalgic encephalomyelitis in each year since 2005. [104438]
Paul Burstow: This information is not available, as it is not collected centrally.
Mr George Howarth: To ask the Secretary of State for Health whether his Department considers the Perrin Technique to be an efficacious treatment for the symptoms of myalgic encephalomyelitis; and whether it is available as an NHS treatment. [104439]
Paul Burstow: Decisions on the commissioning of complementary and alternative therapies and treatments on the national health service are a matter for the NHS locally. The National Institute for Health and Clinical Excellence clinical guideline suggests there is insufficient evidence to demonstrate that complementary therapies are effective treatments for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) so do not recommend their use. However, the guideline acknowledges that some people with CFS/ME choose to use complementary therapies for symptom control and find them helpful.
It is the responsibility of individual clinicians to decide whether a particular treatment option is appropriate for an individual patient, in discussion with the patient and based on the available evidence.
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Colorectal Cancer
Stephen McPartland: To ask the Secretary of State for Health how many finished consultant episodes took place for (a) open and (b) laparoscopic excision of colorectal cancer in each NHS acute trust in England in each of the last 10 years for which data are available. [104237]
Paul Burstow: Tables of information concerning the number of finished consultant episodes for patients with a primary diagnosis of colorectal cancer and for those with an excision procedure of the colon and/or rectum have been placed in the Library.
These have been presented separately as open and laparoscopic procedures and been broken down by hospital provider. It should be noted that due to changes in the coding of trusts, 2003-04 to 2010-11 includes a greater number of providers than 2001-02 to 2002-03, including independent providers.
Note that these are counts of episodes not patients, as one patient may undergo several episodes in one spell or in separate spells.
To protect patient confidentiality, figures between one and five have been replaced with “*” (an asterisk). Where it was still possible to identify numbers from the total an additional number (the next smallest) has also been replaced with an asterisk.
Stephen McPartland: To ask the Secretary of State for Health how many finished consultant episodes took place for other specified excision of rectum in each NHS acute trust in England in each of the last 10 years for which data are available. [104238]
Paul Burstow: Tables of information regarding the number of finished consultant episodes (FCEs) where the main or secondary operative procedure was recorded as specified excision of the rectum have been placed in the Library.
It should be noted that the number of FCEs does not represent the number of patients as an individual may have more than one period of hospital care involving this procedure in any given year.
To protect patient confidentiality, figures between one and five have been replaced with “*” (an asterisk). Where it was still possible to identify numbers from the total an additional number (the next smallest) has been also been replaced by an asterisk.
Complex Disability Equipment Clinical Reference Group
Mr Virendra Sharma: To ask the Secretary of State for Health what the (a) functions and (b) membership are of the Complex Disability Equipment Clinical Reference Group. [104637]
Paul Burstow: The role of the Clinical Reference Groups (CRG) including that for the Complex Disability Equipment CRG, is to support the transition of specialised services commissioning from the current arrangements to the new arrangements for commissioning which will be in place from April 2013.
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Professor Rajiv Hanspal (Consultant in Rehabilitation Medicine at Hillingdon Hospital and Stanmore Disablement Services Centre) is the Chair of the CRG. Other members of the Group are Carolyn Young, Keith Reid, Alan Woodcock, Lal Landham, Clive Thursfield, Venu Harilal, Fergus Jepson, Vicky Jarvis, Henry Lumley, Rosalind Ham, Kate Parkin (Muscular Dystrophy Campaign), Steve McNiece.
In addition the CRG can invite specialists to attend meetings of the Group to give specific advice.
Diabetes
Mr Mike Hancock: To ask the Secretary of State for Health if he will estimate the cost to the NHS of amputations due to diabetes (a) in Portsmouth, (b) in Hampshire and (c) nationally in each year since 2008. [R] [104427]
Paul Burstow: Information on the cost to the national health service of amputations due to diabetes is not collected centrally. However, the estimated England level gross expenditure on diabetes in acute care was £1.55 billion as reported through the programme budgeting data collection.
Mr Mike Hancock: To ask the Secretary of State for Health how many people have had amputations due to diabetes (a) in Portsmouth, (b) in Hampshire and (c) nationally in each year since 2008; and what steps he is taking to reduce the number of amputations. [R] [104428]
Paul Burstow: Hospital episode statistics do not distinguish amputations caused by diabetes from amputations due to other causes. The following results are based on the National Diabetes Audit (NDA) and shows the prevalence of recorded amputations for patients registered in the NDA in the given year i.e. the number of patients in the NDA per 100 patients who have had one or more amputations within the reporting period. Participation in the NDA was not mandatory before April 2011, so this information is approximate. We cannot state that the amputations were caused by the patients' diabetes.
| Number of registrations and prevalence of major and minor amputations in patients registered as having diabetes at practices participating in the National Diabetes Audit | |||
| Prevalence per 100 | |||
| Registrations | Major amputations | Minor amputations | |
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Mr Mike Hancock: To ask the Secretary of State for Health if he will estimate the proportion of amputations due to diabetes that could have been prevented; and if he will make a statement. [R] [104429]
Paul Burstow: NHS Diabetes document “Foot Care for People with Diabetes: The Economic Case for Change”, 2012 stated that with the implementation of multi-professional foot care teams, it is possible to prevent 80% of amputations in diabetics.
The Department is working closely with NHS Diabetes in implementing foot care networks. There are four networks already established and three more will be launched by May 2012. Network co-ordinators work with health care professionals and partner organisations to improve the quality of foot care services for people with diabetes across primary, community and acute settings.
Non-communicable Diseases
Mr Sanders: To ask the Secretary of State for Health if he will make a submission to the WHO/UN consultation on non-communicable diseases; and if he will place a copy of the submission in the Library. [104335]
Anne Milton: The Department, in consultation with the devolved Administrations, is actively participating in discussions on the development of a global, monitoring framework for the prevention and control of non-communicable diseases and will respond shortly to the second consultation. A copy of our response will be placed in the Library in due course. Departmental officials will also be attending the World Health Organization's consultation event on 26 April.
Drugs: Prices
Mark Lancaster: To ask the Secretary of State for Health if he will consider only publishing the drug tariff online in the future; and if he will make a statement. [105345]
Mr Simon Burns: The drug tariff sets out payments to dispensing contractors for providing national health service pharmaceutical services. Not all contractors can readily access the drug tariff online whilst dispensing without disrupting their workflow. Therefore, for the immediate future, contractors will continue to have the choice whether to use the paper copy or the online version. We will continue to reassess the situation with the possibility of publishing the drug tariff solely online in due course.
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General Practitioners
Dr Huppert: To ask the Secretary of State for Health if he will ensure that the partners in the Woodlands Surgery in Cambridge will not be personally liable for a prospective lease on new premises, and that in the event of closure, resignations or lack of financial viability, the NHS will take over responsibility for the lease. [105059]
Mr Simon Burns: NHS Cambridge has advised departmental officials that the general practitioners at the Woodlands Surgery have received sufficient reassurances about their concerns and are now discussing lease terms with the company which will develop the new premises.
Health Education
Chris Ruane: To ask the Secretary of State for Health what Government expenditure has been incurred in advertising to warn the public about dangers from (a) smoking, (b) alcohol, (c) illegal drugs and (d) the impact of media violence on children in each year for which data are available. [105297]
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Anne Milton: The following tables show the Government's advertising expenditure(1) about the dangers from smoking, alcohol, illegal drugs and the impact of media violence on children for each year for which data are available.
A total budget figure for the 20012-13 financial year cannot be provided at this stage as detailed planning for some campaigns is underway and advertising media allocations have not been finalised.
Neither the Department of Health or the Home Office have incurred advertising expenditure warning the public about the dangers of the impact of media violence on children.
(1) Advertising spend is defined as covering only media spend (inclusive of agency commissions but excluding production costs, Central Office of Information (COI) commission and VAT). All figures exclude advertising rebates and audit adjustments and therefore may differ from COI official turnover figures. All figures are rounded to the nearest £10,000. These figures do not include the Department's recruitment/classified advertising costs and ad hoc spend under £10,000. These figures may include occasional minor spend through COI by national health service organisations, to supplement national campaigns in their area. While this expenditure has been excluded as far as possible so that this chart reflects central departmental spend, it would incur disproportionate cost to validate that every item of NHS expenditure has been removed.
| 1999-2000 to 2004-05 | ||||||
| Campaign expenditure (£ million) | ||||||
| 1999-2000 | 200-01 | 2001-02 | 2002-03 | 2003-04 | 2004-05 | |
| (1 )From 2006-07 Department of Health contribution to campaign run jointly with Home Office). (2) ( )Since 2003, all spend on illegal drugs campaigns has been administered and funded jointly by the Department of Health, the Home Office and the Department for Education. From 2003, these figures include expenditure from all three departments. | ||||||
| 2005-06 to 2011-12 | |||||||
| Campaign expenditure (£ million) | |||||||
| 2005-06 | 2006-07 | 2007-08 | 2008-09 | 2009-10 | 2010-11 | 2011-12 (1) | |
| (1) All expenditure for 2011-12 is being reconciled so may be subject to change. (2 )From 2006-07 Department of Health contribution to campaign run jointly with Home Office. (3) Since 2003, all spend on illegal drugs campaigns has been administered and funded jointly by the Department of Health, the Home Office and the Department for Education. From 2003, these figures include expenditure from all three departments. | |||||||
Health Services: Detention Centres
Mr Virendra Sharma: To ask the Secretary of State for Health what steps Public Health England (a) have taken and (b) will take with the UK Border Agency and immigration removal centres to ensure (i) continuity of care for those undergoing treatment and (ii) access to screening and evidence-based treatment while in detention. [104353]
Anne Milton: All immigration removal centres (IRCs) undertake a medical assessment of individuals detained on their admission, including screening questions about mental health, current and past health history, screening for infectious diseases, and a first night risk assessment. All treatment and medication are provided upon the guidance of the centre doctor. There is access to on-site primary health care services and, through these services access to secondary health care services.
Where secondary health care appointments cannot be kept because of removal from the United Kingdom and it is deemed important by the centre health care team that the individual detainee should be followed up on return to their country of origin, the detainee is provided with a letter to pass to those responsible for providing health care there.
Public Health England will not be operational until April 2013. The detail of their role and responsibilities in this area, together with that of other organisations in the new public health system (e.g. NHS Commissioning Board), is currently being considered.
Responsibility for commissioning health care in IRCs transferred from the UK Border Agency (UKBA) to the Department on 1 April. However, responsibility for clinical services will remain with the UKBA until such time as national health service commissioning is in place, with current arrangements remaining in force. Under the Health and Social Care Act 2012, responsibility for commissioning all offender health care in England
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will pass from primary care trusts to the NHS Commissioning Board in April 2013. The Commissioning Board will then work with criminal justice agencies and clinical commissioning groups, with advice from local public health teams, to commission health care for people of all ages detained in settings including IRCs.
Legal Costs
Mr Thomas: To ask the Secretary of State for Health how much his Department spent on fees for legal work in (a) 2010-11 and (b) 2011-12; and if he will make a statement. [104568]
Mr Simon Burns: Expenditure figures on legal services and legal consultancy work for the core Department taken from the central procurement system for the two financial years 2010-11 and 2011-12 are shown in the following table along with the same expenditure data provided by Connecting for Health for the same periods:
| £ | ||
| 2010-11 | 2011-12 | |
This includes expenditure on internal legal advice obtained through a service level agreement with the Department for Work and Pensions.
Please note that the increase in legal spend for NHS Connecting for Health is associated with the proceedings with Fujitsu and Computer Sciences Corporation (CSC).
Following termination of the Local Services Provider contract with Fujitsu in May 2008, the Department is in formal Arbitration proceedings. This has reached a critical stage in the process where evidence gathering, witness statements and submissions to the Arbitration panel ahead of the September 2012 hearing have increased the external legal effort and therefore the costs.
The CSC external legal costs have increased due to activities associated with the negotiation and agreement of an Interim Agreement and Final Agreement, regarding the deployment of Lorenzo software in the North, Midlands and East of England.
Mental Health Services
Mr Thomas: To ask the Secretary of State for Health what the level of spending was on mental health services in (a) 2010-11 and (b) 2011-12; what this represented as a proportion of total expenditure in each primary care trust service in each year; and if he will make a statement. [105295]
Paul Burstow: The data requested for 2011-12 are not currently available. They are expected to be available later in the year. Total national expenditure on mental health was £11.91 billion in 2010-11. The following table shows mental health expenditure for each primary care trust (PCT) in 2010-11, and the percentage of total spend that this represents.
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| PCT | Mental health expenditure (£000) | Mental health as a proportion of total expenditure (%) |
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| Notes: 1. These figures include PCT, Department of Health, strategic health authority and special health authority expenditure. The table sets out the level of mental health expenditure for PCTs in 2010-11 and shows this value as a proportion of total PCT expenditure. 2. Calculating programme budgeting data is complex and not all health care activity or services can be classified directly to a programme budgeting category or care setting. When it is not possible to reasonably estimate a programme budgeting category, expenditure is classified as ‘other: Miscellaneous’. GP contract expenditure cannot be reasonably estimated at disease specific level and is separately identified as a subcategory of 'Other' expenditure (category 23A). Source: Annual PCT programme budgeting financial returns. | ||
Multiple Sclerosis: Palliative Care
Mr Jim Cunningham: To ask the Secretary of State for Health (1) what palliative treatment is available on the NHS to people diagnosed with multiple sclerosis; [104859]
(2) if he will take steps to increase the provision of palliative treatments for patients diagnosed with multiple sclerosis who are in receipt of benefits and cannot afford to pay for nabiximols and other drugs; [104860]
(3) whether his Department was consulted by NHS Coventry's Area Prescribing Committee on their decision not to fund nabiximols in Coventry and Warwickshire. [104861]
Paul Burstow: The National Institute for Health and Clinical Excellence (NICE) has published a clinical guideline on the management of multiple sclerosis (MS) in primary and secondary care in the national health service. The guideline provides comprehensive evidence-based information on the benefits and limitations of the various methods of diagnosing, treating and caring for people with MS. This helps health professionals and patients decide on the most appropriate treatment, including palliative care. People with neurological conditions nearing the end of their life should have access to a range of palliative care services as and when they need them—to control symptoms, offer pain relief, and to meet any personal needs they may have.
NICE is currently updating this clinical guideline on MS, and nabiximols are one of the new interventions being considered. In the absence of NICE technology appraisal guidance on a drug, it is for the local NHS to make funding decisions based on the available evidence and an individual patient's circumstances. As nabiximols fall into this category, it would not be appropriate for the Department to be consulted on a local decision of this sort.
NHS: Innovation
Adam Afriyie: To ask the Secretary of State for Health on what day in 2012-13 he will launch the pilot of the Specialised Services Commissioning Innovation Fund. [105069]
Mr Simon Burns:
Development of the detailed operating arrangements is under way, which will be tested later this year, ahead of the Specialised Services Commissioning
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Innovation Fund being fully operational from 1 April 2013. It is too early to give a specific date when these arrangements will be piloted.
NHS: Negligence
Margaret Hodge: To ask the Secretary of State for Health (1) how many medical negligence cases for (a) maternity, (b) obstetrics and (c) paediatrics were settled; and how much was paid out in each of the last five financial years by (i) Barking, Havering and Redbridge University hospitals, (ii) Barts and The London, (iii) Newham University Hospital and (iv) Whipps Cross University hospital NHS Trusts; [105001]
(2) which 10 NHS trusts in England had the highest compensation bills for medical negligence on (a) obstetrics, (b) paediatrics and (c) maternity in each of the last five years; and how much was paid out by each. [105002]
Mr Simon Burns: The information requested has been placed in the Library and was provided by the NHS Litigation Authority (NHSLA).
Data do not separately cover maternity because the NHSLA does not code this separately from obstetrics in its claims database. The amounts paid in a given year may include payments on settlements made in that year as well as payments made against settlements agreed in earlier years, for example where there are ongoing annual payments.
NHS: Reorganisation
Grahame M. Morris: To ask the Secretary of State for Health pursuant to the answer of 7 February 2011, Official Report, column 114W, on the NHS: re-organisation, what recent estimate he has made of the likely cost of redundancy payments following the proposed abolition of (a) primary care trusts and (b) strategic health authorities under the provisions of the Health and Social Care Act 2012. [104326]
Mr Simon Burns: The impact assessment, published alongside the Health and Social Care Bill, estimated that the redundancies resulting from the modernisation will cost £810 million. The estimate for total redundancy costs related to staff employed in primary care trusts is £634 million, and the estimate for strategic health authorities is £84 million.
This upfront cost will result in a £1.5 billion saving per year by 2014-15, which is a one-third reduction in the administrative spending across the system. The upfront costs of the modernisation will be more than recouped from the cost-savings by the end of 2012-13.
The impact assessment is available at:
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsLegislation/DH_123583
A copy has already been placed in the Library.
Palliative Care
Mr Robin Walker: To ask the Secretary of State for Health what arrangements are being made for the commissioning of children's palliative care services in Worcestershire following the introduction of NHS reforms; and what representations his Department has received on this matter. [104450]
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Anne Milton: The majority of clinical interventions will be commissioned by Clinical Commissioning Groups (CCGs) although for some services, a collaborative, or in a small number of cases, a national approach may be appropriate. We expect that most children's palliative care services will therefore be commissioned by CCGs.
The Department has received recent correspondence from my hon. Friend on behalf of Acorns, a provider of children's palliative care services in Worcestershire.
Parliamentary and Health Service Ombudsman
Mark Pawsey: To ask the Secretary of State for Health what the cost was of the Parliamentary and Health Service Ombudsman in each of the last five financial years. [104659]
Mr Simon Burns: The Parliamentary and Health Service Ombudsman is independent of Government and accountable to Parliament through the Public Administration Select Committee. Their annual reports, including financial information are available online at:
www.ombudsman.org.uk/about-us/publications/annual-reports
Plastic Surgery
Rosie Cooper: To ask the Secretary of State for Health (1) what steps he is taking to ensure the safety of patients undergoing intradermal filler procedures; [105162]
(2) when his Department plans to publish its guidelines on (a) who can prescribe intradermal fillers, (b) who can administer intradermal filler procedures and (c) the level of appropriate professional training required. [105164]
Mr Simon Burns: The materials used in intradermal fillers used for medical purposes are regulated under the European Union's medical devices directives. The possibility of further regulation for these procedures, including the regulation of the practitioners who can administer dermal fillers, will be considered as part of Sir Bruce Keogh's review into cosmetic interventions.
Rosie Cooper: To ask the Secretary of State for Health (1) which groups the NHS Medical Director will be consulting as part of his review of the cosmetic surgery industry; and if he will publish a schedule of planned consultations; [105165]
(2) when the NHS Medical Director expects to consult the British Association of Dermatologists as part of his review of the regulation of the cosmetic surgery industry. [105166]
Mr Simon Burns: All organisations with an interest in the review by the NHS Medical Director will be given the opportunity to submit evidence. An announcement will be made in the near future.
Prostate Cancer
Stephen McPartland: To ask the Secretary of State for Health what the mean length of stay for patients undergoing (a) open, (b) laparoscopic and (c) robotically-assisted excision of the prostate was in each NHS acute trust in England in each of the last 10 years. [104242]
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Paul Burstow: This information is not available in the format requested. Information concerning the mean length of stay for patients undergoing open, laparoscopic and robotically-assisted excisions of the prostate that took place in each national health service acute trust in England from 2006-07 to 2010-11 and mean length of stay for patients undergoing excisions of the prostate that took place in each NHS trust from 2001-02 to 2005-06 has been placed in the Library.
Prior to 2006-07, it is only possible to identify whether an excision of the prostate took place as coding does not identify the method by which the excision was carried out. From 2006-07 onwards a series of codes were introduced to allow the identification of the means of excision.
Stephen McPartland: To ask the Secretary of State for Health how many (a) open, (b) laparoscopic and (c) robotically-assisted excisions of the prostate took place in each NHS acute trust in England in each of the last 10 years. [104243]
Paul Burstow: This information is not available in the format requested. Information concerning the number of finished consultant episodes for open, laparoscopic and robotically-assisted excisions of the prostate that took place in each national health service acute trust in England from 2006-07 to 2010-11 and the number of excisions of the prostate that took place in each NHS trust from 2001-02 to 2005-06 has been placed in the Library.
Prior to 2006-07, it is only possible to identify whether an excision of the prostate took place as coding does not identify the method by which the excision was carried out. From 2006-07 onwards a series of codes were introduced to allow the identification of the means of excision.
Mr Laurence Robertson: To ask the Secretary of State for Health what progress has been made on establishing a quality standard for the treatment of prostate cancer; and if he will make a statement. [105221]
Paul Burstow: We have asked the National Institute for Health and Clinical Excellence (NICE) to develop a quality standard on prostate cancer, as part of a library of approximately 170 NHS quality standards. NICE is preparing this quality standard alongside an update of its existing clinical guideline on prostate cancer. NICE currently expects to complete the update of its prostate cancer guideline in late 2013.
Radiotherapy
Caroline Dinenage: To ask the Secretary of State for Health (1) if he will take steps to ensure clinical commissioning groups have dedicated plans for replacing existing linear accelerators to deliver treatment as they reach the end of their working life; [104400]
(2) by what means radiotherapy treatment will be commissioned after April 2013. [104401]
Paul Burstow:
From April 2013, radiotherapy services will either be commissioned by Clinical Commissioning Groups or by the NHS Commissioning Board. No final
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decisions have yet been taken on which services will be directly commissioned by the board. Work is in hand to define the list of services for direct commissioning and Ministers expect to be in a position to confirm those services in the summer.
Individual national health service trusts are responsible for replacing capital equipment, such as linear accelerators, that is at the end of its useful working life. We expect trusts to plan strategically and manage their capital expenditure to ensure that they can replace high value equipment. It is up to trusts to prioritise their investments.
One of the cancer Peer Review Measures requires local organisations to agree an equipment replacement programme with their cancer networks in order to avoid the life of a linear accelerator extending beyond the recommended 10 years. This measure is assessed as part of the Cancer Peer Review Programme.
Tariff pricing includes depreciation for capital equipment and therefore contributes the cash to fund capital expenditure. Trusts have the ability to build up cash reserves from income to fund high value equipment. Depreciation charges should be enough to cover like for like replacement, depreciation on equipment and buildings comes to £2.1 billion per year. There is capital money in the system for new machines where these are needed.
Commissioners have a role in ensuring that quality standards are maintained and patients have access to the latest recommended technology.
‘Improving Outcomes: A Strategy for Cancer’, published in January 2011, sets out our commitment to expand radiotherapy capacity by investing over £150 million in additional funding over the next four years. This will support increased utilisation of existing equipment, establish new services to increase capacity in some areas and ensure that all high priority patients with a need for proton beam therapy treatment get access to it abroad.
Caroline Dinenage: To ask the Secretary of State for Health whether he plans to publish the national tariff for radiotherapy in April 2013. [104402]
Mr Simon Burns: For 2012-13, the use of currencies (the unit of health care for which payment is made) for external beam radiotherapy has been mandated. Non-mandatory tariff prices have been published however these are indicative and commissioners and providers can agree local pricing.
We will make a decision later this year whether to introduce mandatory tariffs for 2013-14, based on feedback about the non-mandatory prices for 2012-13.
Retirement
Mr Thomas: To ask the Secretary of State for Health how many staff of his Department retired in (a) 2010-11 and (b) 2011-12; how many such staff were taking early retirement in each such year; and if he will make a statement. [104566]
Mr Simon Burns: For the purposes of this parliamentary question, the Department defines retirement as happening when a member of staff decides to leave our employment at or after the pension age for their pension scheme. For the majority of the Department's civil servants pension age is 60. The following table gives this information.
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| April to March each year | Civil servants in grades administration officer to grade 6 (AO-G6) | Senior civil servants | Total |
The Department has also approved a number of voluntary exits since March 2010. Of those who have left, the information about those who have chosen to access their pension before their normal retirement age is given in the following table. This group were at least minimum pension age, which is the earliest point an individual can access their pension benefits.
| Civil servants in grades AO to G6 | Senior civil servants | Total | |
There have also been four medical retirements in 2010-11—three at grades AO to G6 and one senior civil servant.
Skin Cancer
Mrs Siân C. James: To ask the Secretary of State for Health how much funding his Department has allocated to public health campaigns aimed at raising awareness of skin cancer in (a) 2010-11 and (b) 2011-12. [104293]
Paul Burstow: SunSmart is the national skin cancer prevention campaign run on behalf of the United Kingdom Health Departments by Cancer Research UK. In 2009-10, the Department provided £615,000 to the campaign and for 2011-12 we have contributed £500,000.
In 2011-12 this money has supported the production and distribution of educational materials, a schools campaign, helped local providers working on skin cancer prevention and delivered a major targeted marketing campaign in conjunction with the popular music festival ‘T4 on the Beach’.
Cancer Research UK is also currently running ‘R UV Ugly’, a campaign funded by a £150,000 Third Sector Investment Programme grant from the Department, to raise awareness of the dangers of sunbeds and the benefits of skin checks. The campaign is being run in partnership with SK:n who are providing free ultraviolet scans in their clinics across the UK.
Social Services
Fiona Bruce: To ask the Secretary of State for Health whether personalised care budgets can be used to purchase care from a local authority and not solely from an independent provider. [105222]
Paul Burstow:
Personal budgets are intended to enable the personalisation of social care services by allocating a budget to people. Personal budgets do not have a legislative basis and describe a management arrangement operated by local authorities. A direct payment is one way in which the individual can choose to take that
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money in order to meet their needs, but personal budgets do not have to involve a cash exchange with the service user.
A personal budget can be taken by an individual in the following different ways:
as a direct (cash) payment; held by the individual. Direct payments were established in law in 1996;
as an account held and managed by the council in line with the individual's wishes; or as an account placed with a third party (provider) and called off by the individual;
or as a mixture of these approaches.
If an individual prefers to receive local council services to meet some of their assessed care needs, the council may agree to offer a combination of direct payments and services.
Personal budget holders can still choose to receive services provided by their council. Alternatively, the budget can be held by a third party acting on behalf of the service user—such as an individual carer, provider, trust or specialist broker. However the personal budget is deployed, the same principles remain:
the individual has been informed about a clear, upfront allocation of funding;
there is an agreed care plan making clear what outcomes are to be achieved with that money; and
the individual can use the money in ways and at times of their choosing.
Thalidomide
Naomi Long: To ask the Secretary of State for Health (1) what considerations he has given to continuing the thalidomide health grant beyond 2012; [104284]
(2) if he will consider making his Department's thalidomide health grant permanently available and linking increases in the grant to the consumer prices index. [104451]
Paul Burstow: The Thalidomide Grant is a three-year pilot, running from April 2010 until March 2013, to explore how the health needs of Thalidomide survivors can best be met in the longer term and how such a scheme might be applied to other small groups of geographically dispersed patients with specialised needs.
Departmental officials met with members of the National Advisory Council to the Thalidomide Trust in June 2010, to discuss their evaluation of the first year. Further meetings will be held to discuss years two and three and we will consider the future of the grant further into the pilot.
We expect to receive an evaluation report on the second year from the National Advisory Council shortly; a meeting will then be arranged in response to that report to discuss progress.
Tuberculosis
Mr Virendra Sharma: To ask the Secretary of State for Health (1) what resources (a) are available and (b) will be made available for housing of tuberculosis patients as recommended by the National Institute for Health and Clinical Excellence's guidance on tuberculosis in hard-to-reach groups; [104303]
(2) with reference to the National Institute for Health and Clinical Excellence's public health guidance 37, Identifying and managing tuberculosis
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among hard-to-reach groups, published in March 2012, what funding he plans to allocate to implement screening and treatment of latent tuberculosis for substance misusers and ex-prisoners; [104513]
(3) whether he plans to expand Find and Treat mobile screening services in (a) London and (b) other metropolitan areas with an incidence of tuberculosis of over 40 people per 10,000 population; [104514]
(4) if he will implement the recommended ratio of one full-time equivalent case manager per 40 tuberculosis incident cases requiring regular case management, and one per 20 incident cases requiring enhanced case management. [104516]
Anne Milton: The commissioning and provision of tuberculosis (TB) services is a matter for local national health service organisations and their partners, such as local authorities, to determine according to local needs and circumstances. We would expect them to take into account the recommendations made in the recent guidance from the National Institute for Health and Clinical Excellence, ‘Identifying and managing tuberculosis among hard-to-reach groups’, when planning and commissioning such services.
The NHS and public health system reforms will provide opportunities for more integrated planning and commissioning of services for TB through health and wellbeing boards, and collaborative working by clinical commissioning groups, providers and local authorities, supported by the NHS Commissioning Board and Public Health England.
Mr Virendra Sharma: To ask the Secretary of State for Health what steps he is taking to ensure adequate and timely tuberculosis screening and treatment for prisoners. [104355]
Paul Burstow: The Department and the Health Protection Agency published guidance for prison staff to improve the detection of infectious diseases, including tuberculosis (TB), in prisons, “Prevention of infection and communicable disease control in prisons and places of detention” in August 2011. A copy of this publication has been placed in the Library and is available online at:
www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1309970446427
Eight prisons in England have been equipped with digital x-ray machines and related information technology systems to improve detection of infectious TB earlier in the course of imprisonment and to reduce the risk of onward transmission.
The National Institute for Health and Clinical Excellence published good practice guidance “Identifying and managing tuberculosis among hard-to-reach groups” in March aimed at raising awareness, identifying and managing TB in hard-to-reach groups, including the homeless, prisoners and vulnerable migrants. A copy of this publication has been placed in the Library and is available online at:
www.nice.org.uk/nicemedia/live/13683/58591/58591.pdf
Under the Health and Social Care Act 2012, responsibility for commissioning offender health care passes from primary care trusts to the national health service Commissioning Board (NHSCB) in April 2013. From this date, the NHSCB will commission services
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for prisoners of all ages and secure the same access to health and social care services and appropriate to their needs in line with the standards set for the rest of the population.
Mr Virendra Sharma: To ask the Secretary of State for Health what steps his Department is taking to address reports of discrimination against and exclusion of individuals with tuberculosis by some social services agencies. [104638]
Paul Burstow: Local authorities (LAs) are specified in Schedule 19 of Equality Act 2010 and as such, are covered by the general equality duty in relation to all of their functions. This means that in the exercise of their functions, LAs must have due regard to the need to eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Act and advance equality of opportunity between people who share a protected characteristic and those who do not.
Disability is defined as a protected characteristic under the Act as a physical or mental impairment which has a substantial and long-term adverse effect on people's ability to carry out normal day-to-day activities. The Department considers that people with tuberculosis (TB) are very likely to fall within this definition and should therefore enjoy the protections afforded by the legislation.
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The National Knowledge Service—Tuberculosis, provided by the Health Protection Agency, has published a range of resources aimed at improving the knowledge and understanding of TB among those who may work with people at risk of the disease. These include hostels for the homeless and services for substance misusers, asylum seekers and children.
The Department has funded TB Alert, the national TB charity, to raise public and professional awareness of TB.
Vacancies
Mr Thomas: To ask the Secretary of State for Health how many job vacancies there were for (a) staff posts and (b) senior Civil Service posts in his Department on 31 March (i) 2010, (ii) 2011 and (iii) 2012; and if he will make a statement. [104567]
Mr Simon Burns: The Department does not hold information, in the form requested, for 31 March 2010 and 2011 so has provided information on the numbers of vacancies advertised in each of these respective financial years. We are able to provide details on job vacancies as at 31 March 2012. These are set out in the following tables.
The Department introduced recruitment controls in November 2009, to establish the affordability and suitability of all posts for recruitment, internally and externally. Since the announcement of the civil service recruitment freeze on 24 May 2010, controls have been tightened.
| Senior civil servants | Civil servants in grades administration officer to grade 6 | |||
| External (1) | Internal (2) | External (1) | Internal (2) | |
| (1 )Excludes secondments into the Department (2 )Includes trawls across other Government Departments | ||||
| Senior civil servants | Civil servants in grades AO to G6 | |||
| External | Internal | External | Internal | |