Diabetes: Orthopaedics

Mark Lancaster: To ask the Secretary of State for Health how many diabetes-related major amputations have been made (a) nationally and (b) in each primary care trust area in the last 10 years. [108555]

Paul Burstow: The Department does not collect this information centrally.

The National Diabetes Audit reports incidence of amputations for those practices participating in the audit. Information for 2005 to 2010 has been placed in the Library.

Food: Hygiene

Miss McIntosh: To ask the Secretary of State for Health what assessment he has made of the food hygiene regulations currently being negotiated; what assessment he has made of the effect they might have on UK producers; and if he will make a statement. [108113]

Anne Milton: The European Commission is expected to bring forward legislative proposals for amendments to the food hygiene regulations in summer 2012, based on information provided by competent authorities in member states and industry bodies. The proposals will then be subject to negotiation in the Council and Parliament under ordinary procedure. The Commission's intention is to simplify certain procedural aspects of the regulations, introduce risk-based controls for certain products such as gelatine and provide scope for potential future amendments in relation to controls at slaughterhouses and certain definitions such as mechanically separated meat.

The Food Standards Agency (FSA), which has policy responsibility in this area, is in regular contact with United Kingdom industry representatives about the development of the Commission's proposals. The FSA expects that there should be some benefit from a move to more risk-based controls for certain products, but this assessment will be reviewed following publication of the proposals, and where appropriate the proposals will be subject to consultation and impact assessment. Negotiating lines will be cleared with Ministers where necessary under established procedures.

Health Professions: English Language

Karen Lumley: To ask the Secretary of State for Health what steps his Department is taking to ensure that all NHS doctors and nurses can speak English. [108409]

Mr Simon Burns: It is the responsibility of employers to ensure that the health care professionals they employ are able to communicate safely and effectively with colleagues and patients.

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All non-European Economic Area health care professionals are required to demonstrate their knowledge of English before they are registered with the appropriate regulatory body.

Under the European directive 2005/36/EC on the recognition of professional qualifications it is not possible for the regulatory bodies systematically to test language competency of EU migrants wishing to register in the United Kingdom. However, it does not preclude regulatory bodies from taking fitness-to-practise action against a registrant where their knowledge of English is poor.

Departmental Staff

Mr Redwood: To ask the Secretary of State for Health how many full-time equivalent employees his Department employed in May 2010; and how many it employed in the latest period for which figures are available. [108163]

Mr Simon Burns: The information requested is shown in the following table.

  May 2010 April 2012
  Number Full-time equivalent Number Full-time equivalent

Civil servants total

2,651

2,570

2,352

2,271

Agency staff contractors total

834

795

313

305

Mr Redwood: To ask the Secretary of State for Health how many full-time equivalent employees have (a) left and (b) been recruited to his Department in the last two years. [108178]

Mr Simon Burns: The number of full-time equivalent civil servants who have left and been recruited are given in the following table:

Year ending Leavers Entrants

31 March 2011

212

179

31 March 2012

393

126

These figures include entrants and leavers who have transferred between Departments.

Meat: Contamination

Miss McIntosh: To ask the Secretary of State for Health what discussions he has had with (a) his European counterparts and (b) the European Commission on the decision to ban desinewed meat in the European Union; and if he will make a statement. [108114]

Anne Milton: The Food Standards Agency (FSA), which has policy responsibility in this area, has worked closely with the Foreign and Commonwealth Office on behalf of the United Kingdom Government in explaining to the Commission the full impact of its decision that desinewed meat (DSM) can no longer be produced from ruminant bones and that DSM made from poultry or pork bones should be labelled as mechanically separated meat.

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The FSA held urgent discussions with senior European Commission (EC) officials once the EC made its position known, securing an extension to the original five-day deadline for action. The FSA continues to pursue this matter with the EC, making the case for the UK interpretation, including scientific evidence to support that case.

Ministerial Policy Advisers

Ms Abbott: To ask the Secretary of State for Health whether any special advisers in his Department have been subject to disciplinary proceedings since May 2010. [108639]

Mr Simon Burns: No special advisers have been subject to disciplinary proceedings since May 2010.

NHS: Discrimination

Dr Poulter: To ask the Secretary of State for Health what arrangements are in place to ensure that boycotts, divestment and sanctions against Israel do not take place within the NHS. [108194]

Mr Simon Burns: The Equality Act 2010 makes it unlawful for service providers, providers of public functions and employers to discriminate on the grounds of a range of protected characteristics, including race, colour, nationality and ethnic or national origins. All local national health service organisations are subject to the provisions of the Act, including the public sector equality duty which requires them, in exercising their functions, to consider eliminating discrimination, harassment and other conduct prohibited under the Act, advance equality of opportunity and promote good community relations.

Dr Poulter: To ask the Secretary of State for Health what arrangements are in place to ensure that (a) political and (b) racial discrimination does not take place within the NHS. [108216]

Mr Simon Burns: There is no place for racial or political discrimination within the national health service. All staff in the NHS are required to treat colleagues and patients in a fair and non-discriminatory way. This is a guiding principle of the NHS, set out in the NHS constitution.

All NHS bodies are subject to the public sector equality duty under the Equality Act 2010, which makes discrimination on the grounds of race illegal.

Public appointments to NHS boards are made on merit and managed through a fair and open process, as required by the Commissioner for Public Appointments.

NHS: Equality

Mr Nicholas Brown: To ask the Secretary of State for Health what recent steps his Department has taken to tackle health inequalities. [108209]

Anne Milton: Tackling health inequalities is a Government priority, part of our wider focus on fairness and social justice.

We have taken steps to establish a framework to reduce health inequalities.

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In the Health and Social Care Act 2012, we have, for the first time ever, established legal duties on health inequalities for national health service commissioners and the Secretary of State for Health, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley). When applied, these will be:

The National Health Service Commissioning Board and clinical commissioning groups are under a duty to have regard to the need to reduce inequalities in access to, and the outcomes of, health care;

The Secretary of State has a wider duty to have regard to the need to reduce inequalities relating to the health service (including both national health service and public health, and relating to all the people of England);

The National Health Service Commissioning Board, clinical commissioning groups and Monitor have further duties around integration of health services, health-related services or social care services where they consider this would reduce inequalities; and

The Secretary of State, the National Health Service Commissioning Board and clinical commissioning groups have duties around health inequalities, concerning planning, reporting and assessment.

We have also taken steps to ensure that, once established, Public Health England will play a key role in tackling inequalities. This has been informed by the report of the independent review on health inequalities “Fair Society, Healthy Lives” (February 2010), which was led by Professor Sir Michael Marmot.

Ministers accepted the analysis and approach of the review and its key principles and recommendations, responding through the public health White Paper, “Healthy Lives, Healthy People” (November 2010), which adopted the review's life course framework, ensuring a focus for tackling the wider social determinants of health.

From 2013-14, the National Health Service Commissioning Board will allocate resources to Clinical Commissioning Groups in a way that supports the principle of securing equivalent access to national health service services relative to the prospective burden of disease and disability. The Board will have a duty to have regard to reducing inequalities in access to, and the outcomes from, health care. Furthermore, from 2013-14, the Department intends to allocate a ring-fenced public health grant, targeted for health inequalities, to upper-tier and unitary local authorities for improving the health and wellbeing of local populations.

To support development of evidence-based action on health inequalities, we have ensured that both the Public Health Outcomes Framework and the NHS Outcomes Framework have a strong focus on health inequalities.

University College London’s Institute of Health Equity, led by Professor Sir Michael Marmot and supported by the Department, will help England to strengthen its evidence-based approach to addressing health inequalities and support all parts of the health system through the practical application of knowledge and best practice.

Within a broad strategy to tackle health inequalities across the country, we are also addressing the health needs of those most vulnerable to poor health outcomes through the Inclusion Health programme.

NHS: Reorganisation

Caroline Nokes: To ask the Secretary of State for Health who will (a) fund and (b) have responsibility for commissioning (i) local and (ii) national enhanced services following the implementation of NHS reforms. [108092]

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Mr Simon Burns: The National Health Service Commissioning Board will be responsible for funding and commissioning all future primary medical services, including any nationally specified enhanced services under the general practitioner contract arrangements.

We also propose to transfer the funding attached to current local enhanced services (except where responsibility and resources pass to local authorities to meet their new public health functions) to clinical commissioning groups.

Clinical commissioning groups will be able to use their commissioning budgets to fund commissioning of community-based services, for which the provider might be a general practice where the service is outside the scope of the general practitioner contract and where the award of such contracts have been undertaken in line with safeguards to protect against any potential conflicts of interests.

Caroline Nokes: To ask the Secretary of State for Health when his Department expects to publish guidance on the (a) framework for and (b) scope of the quality premium. [108093]

Mr Simon Burns: We are continuing to discuss with stakeholders and professional bodies how payments to clinical commissioning groups for improving quality could be used to complement other quality improvement tools to encourage better services, improved outcomes for patients and reductions in health inequalities. Based on these discussions, we intend to develop proposals for wider engagement later this year, which will inform the content of regulations that will take effect from April 2013.

Pharmacy

Mr Barron: To ask the Secretary of State for Health (1) how much funding his Department allocated to services delivered by community pharmacies in each year since 2005; and if he will make a statement; [108097]

(2) how much has been reimbursed to his Department as a result of category M of the drug tariff; and if he will make a statement; [108098]

(3) when he plans to review the operation of category M of the drug tariff; and if he will make a statement. [108099]

Mr Simon Burns: The overall funding settlement under the community pharmacy contractual framework (CPCF), since its introduction in April 2005, for essential and advanced services, is shown in the following table:

  Overall CPCF funding settlement (£ billion)

2005-06

1.776

2006-07

1.911

2007-08

1.979

2008-09

2.213

2009-10

2.490

2010-11

2.486

2011-12

(1)2.526

(1) This does not include up to £55 million allocated for the new medicine service, introduced from October 2011.

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The reimbursement price paid by the national health service to community pharmacies for most generic medicines dispensed under NHS services are within Category M of the Drug Tariff. Through the reimbursement prices for Category M, the target margin of £500 million, at least, has been provided in each of the years towards the overall CPCF funding, set out above. Where excess margin above the target level is identified, Category M generic medicine reimbursement prices are adjusted accordingly. The CPCF, including medicine margin and Category M, was reviewed by the National Audit Office (NAO) in its report published in March 2010(1). As well as delivering at least the agreed CPCF funding, the NAO identified savings to the NHS of around £1.8 billion over the period 2005-06 to 2008-09.

(1) The “Community Pharmacy Contractual Framework and the retained medicine margin”, 30 March 2010 is available at:

www.nao.org.uk/publications/0910/community_pharmacy.aspx

The Department and Pharmaceutical Services Negotiating Committee are in discussion about the future funding arrangements for community pharmacy, taking account of:

the Cost of the Service Inquiry;

reviewing the medicine margin arrangements, informed by the recommendations of the NAO—such as extending the medicine margin survey beyond independent pharmacies to other pharmacy types, with a consistent approach on cost of service, and making more timely adjustments to medicine margin to reduce regulatory lag; and

reviewing the distribution of CPCF funding to incentivise and support high-quality and efficient services.

Mr Barron: To ask the Secretary of State for Health (1) how many pharmacies were established under the 100 hour exemption between April 2005 and April 2010; [108100]

(2) how many pharmacies have been established under the 100 hour exemption (a) in total and (b) within or attached to GP premises since April 2010; and if he will make a statement. [108101]

Mr Simon Burns: The number of pharmacies opened under the 100 hour exemption is provided as follows. Prior to 2008-09, this information was not collected centrally.

Number of 100 hour pharmacies opened in England
  Number

2008-09

450

2009-10

535

2010-11

689

Source: Table 8 of the “General Pharmaceutical Services Bulletin, 2001-02 and 2010-11”, published by the Health and Social Care Information Centre

Information is not collected centrally on the number of 100 hour pharmacies attached to general practitioner premises.

Prescriptions: Concessions

Mr Evennett: To ask the Secretary of State for Health how many people aged over 60 years received a free prescription in each of the last three years. [108203]

Mr Simon Burns: This information is not collected centrally.

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Primary Care Trusts: Equality

Mr Nicholas Brown: To ask the Secretary of State for Health what principal conclusions he has drawn from his Department's publication, Equality Impact Assessment for Primary Care Trust Resource Allocations 2011-12. [108208]

Mr Simon Burns: The principal conclusion from the Equality Impact Assessment is that the public sector equality duties under the Equality Act 2010 were met for allocations to primary care trusts in 2011-12. The Equality Impact Assessment was published on the Department's website in December 2010 and is available at:

www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_122617.pdf

Radiotherapy

Mr Baron: To ask the Secretary of State for Health (1) when he expects to make a decision on the level at which radiotherapy services will be commissioned in the new NHS structure; [108542]

(2) what steps his Department is taking to ensure access for all suitable patients to (a) intensity-modulated radiation therapy, (b) image-guided radiation therapy and (c) other new and emerging radiotherapy technologies; [108543]

(3) whether the metrics in the 2007 National Radiotherapy Advisory Group report still apply; and what progress his Department is making on meeting these targets; [108544]

(4) what steps he is taking to ensure that patients have access to high-quality radiotherapy services with an appropriate number of fractions. [108545]

Paul Burstow: From April 2013, services will be commissioned either by clinical commissioning groups or by the NHS Commissioning Board. No final 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.

In ‘Improving outcomes: A Strategy for Cancer’, published on 12 January 2011, we said that ensuring that patients have access to high-quality modern radiotherapy techniques can deliver improved patient outcomes and that it was the Department's aspiration to ensure that intensity-modulated radiotherapy was available in at least one centre per cancer network. This has now been achieved.

The National Radiotherapy Implementation Group (NRIG) is planning to publish a report on image-guided radiotherapy, setting out protocols for its use. This report will be available on the National Cancer Action Team (NCAT) website, and NCAT will be providing an IGRT training programme for radiotherapy centres. NRIG is tasked with providing national support to local teams to implement national radiotherapy policy and to keep new and emerging radiotherapy techniques under review.

The National Radiotherapy Advisory Group (NRAG) report ‘Radiotherapy: developing, a world class service for England’, published in 2007, made a range of recommendations to improve and expand radiotherapy

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services in England. These included the extension of the 31-day cancer waiting time standard to include all radiotherapy treatments, the establishment and collection of the national radiotherapy dataset (RTDS) and that the number of radiotherapy fractions being delivered should be increased from 30,000 per million population per annum (as it stood at the time of the NRAG report) to 40,000 by 2010-11.

The 31-day standard for all radiotherapy treatment has since been introduced and the RTDS is now in its second full year of data collection. Analysis of the RTDS shows that there were approximately 34,500 fractions per million head of population per annum in 2009-10. However, the data collection also suggests that NRAG had overestimated the number of fractions delivered at that time so the baseline was in fact lower than 30,000 per million per annum. The Cancer Outcomes Strategy made the commitment to undertake a detailed analysis of the RTDS data to ensure that the metrics in the NRAG report remain meaningful and current. NRIG has been tasked with undertaking that analysis, including a review of progress, and is due to report by the autumn.

NRIG has undertaken a major piece of work to bring together the experts to agree radiotherapy decision trees based on best practice prescribing of radiotherapy fractions. A toolkit has recently been made available to commissioners and providers of radiotherapy services to enable them to make assessments of local practice against agreed best practice. These assessments should inform demand planning and discussions about variations in services locally.

Redundancy

Mr Redwood: To ask the Secretary of State for Health how many of his Department's employees have been made redundant in the last two years. [108073]

Mr Simon Burns: The Department has made fewer than five permanent employees redundant in the last two years. As part of departmental restructuring and ‘downsizing', 278 permanent staff have left the Department over the last two years on voluntary exits.

Thalidomide

Guto Bebb: To ask the Secretary of State for Health what discussions he has had with Ministers in the Welsh Government on the continuation of the thalidomide health grant beyond 2012. [108811]

Paul Burstow: Departmental officials have been in regular contact with officials from the devolved Administrations and will continue to work closely with them on this issue.

Cabinet Office

Economic Activity

Mr Frank Field: To ask the Minister for the Cabinet Office what the economic activity rates are for (a) men and (b) women in each age decile group; and what assessment has been made of trends in these rates in the last 30 years. [108307]

Mr Hurd: The information requested falls within the responsibility of the UK Statistics Authority. I have asked the authority to reply.

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Letter from Stephen Penneck, dated May 2012:

As Director General for the Office for National Statistics, I have been asked to reply to your Parliamentary Question asking what the economic activity rates are for (a) men and (b) women in each age decile group; and what assessment has been made of trends in these rates in the last 30 years. [108307]

The information requested is shown in the table. Estimates prior to 1993 are not available. In accordance with the International Labour Organisation (ILO) definition, people are classed as economically active if they are either in employment or unemployed. The estimates are derived from the Labour Force Survey (LFS) and are not seasonally adjusted. As with any sample survey, estimates from the LFS are subject to a margin of uncertainty.

Seasonally adjusted economic activity rates by age are published in Table 12 of the monthly Labour Market Statistical Bulletin which is available on the National Statistics website via the following link:

http://www.ons.gov.uk/ons/dcp171778_264236.pdf

Employment

Andrew Stephenson: To ask the Minister for the Cabinet Office how many people were employed in the manufacturing sector in (a) Lancashire, (b) the North West and (c) England in (i) 1997 and (ii) the latest year for which figures are available. [108981]

Mr Hurd: The information requested falls within the responsibility of the UK Statistics Authority. I have asked the authority to reply.

Letter from Stephen Penneck, dated May 2012:

As Director General for the Office for National Statistics, I have been asked to reply to your Parliamentary Question asking how many people were employed in the manufacturing sector in (a) Lancashire, (b) the North West and (c) England in (i) 1997 and (ii) the latest year for which figures are available. [108981]

Annual statistics on the number of employees are available from the ONS release Business Register Employment Survey (BRES) at:

www.ons.gov.uk

The following table contains the latest statistics available, which show the number of employees in the Manufacturing industry for Lancashire, the North West and England in 1997 and 2010.

  1997 2010

Lancashire

130,800

71,500

North West

532,200

301,100

England

3,532,700

1,999,800

The 1997 employee estimates shown above are taken from the Annual Employment Survey (AES) and the 2010 estimates come from BRES. The AES is a forerunner survey to BRES and differs in several ways, most notably in the method of data collection and in estimation methodology. Furthermore the estimate for Lancashire in 1997 is based on pre-1995 administrative boundaries. Comparisons between the figures from the two years should therefore be made with caution.

Fuel Oil: Kilmarnock

Cathy Jamieson: To ask the Minister for the Cabinet Office what estimate has been made of average household expenditure on heating fuel bills in Kilmarnock and Loudoun constituency in each of the last 10 years for which figures are available. [108899]

Mr Hurd: The information requested falls within the responsibility of the UK Statistics Authority. I have asked the Authority to reply.

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Letter from Stephen Penneck dated May 2012:

As Director General for the Office for National Statistics, I have been asked to reply to your Parliamentary question to the Minister for the Cabinet Office, asking what estimate has been made of average household expenditure on heating fuel bills in Kilmarnock and Loudoun in each of the last 10 years for which figures are available. (108899)

The Living Costs and Food Survey (LCF), which is a sample survey covering approximately 5,000 households in the UK, collects data on expenditure on gas, electricity and other fuels. Unfortunately, estimates of household expenditure at parliamentary constituency level are not available due to small sample sizes.

Risk Assessment

Mr Thomas: To ask the Minister for the Cabinet Office what strategic or transitional risk registers in

22 May 2012 : Column 670W

each area of policy are held by his Department; and if he will make a statement. [107481]

Mr Maude: Within the Cabinet Office each business group is accountable for managing its own risks and responsible for both maintaining its associated risk registers and ensuring that its business plans and all projects, programmes or activities which deliver departmental strategic or corporate objectives include the review of associated risks and that any mitigating actions are implemented.

Risk registers are kept and maintained as is appropriate, at working level. A list of all risk registers used within the Department and its NDPBs is not held centrally.