Students: Loans
Shabana Mahmood: To ask the Secretary of State for Business, Innovation and Skills (1) what recent discussions he has had with (a) the Chancellor of the Exchequer, (b) student representatives, (c) higher education representative groups and (d) religious groups on the implementation of Sharia compliant student loans; and what the outcome was of those discussions; [115597]
(2) what plans he has to introduce student loans that are Sharia compliant. [115598]
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Mr Willetts: I met representatives of the National Union of Students (NUS) and the Federation of Student Islamic Societies (FOSIS) on 21 March 2011 and the chancellor and vice chancellor of the university of Bolton on 26 March this year to discuss the option of introducing an alternative finance version of student loans.
Officials in BIS have had meetings over the last year with officials from HM Treasury, student representatives, higher education representative groups and alternative finance experts, as part of an examination of whether an alternative finance student loan is feasible and likely to be taken up, if available.
This Department has identified a variant of the student loan system based on a Murabaha transaction that may prove attractive for those students who may prefer not to take up their entitlement to conventional loans. This system would in principle provide a student with the same level of financial support and produce identical repayments as conventional student loans. However there are several major issues still to be addressed concerning the use of a Murabaha for these purposes. These include the legislative basis for the system, and the VAT and tax treatment of the Murabaha.
Mr Marsden: To ask the Secretary of State for Business, Innovation and Skills what agreement he has made with the Chancellor of the Exchequer on carrying over funding allocated to 24+ advanced learner loans for the 2013-14 to the 2014-15 academic year in the event of the full allocation for 2013-14 not being taken up by adult learners. [115771]
Mr Hayes [holding answer 6 July 2012]: The Secretary of State for Business, Innovation and Skills, the right hon. Member for Twickenham (Vince Cable), has made no agreement with the Chancellor of the Exchequer on carrying over funding allocated to 24+ advanced learning loans for the 2013-14 to 2014-15 financial year, in the event of the full allocation for 2013-14 financial year not being taken up by adult learners.
The mechanisms by which Departments can carry over funding between financial years are set out in Managing Public Money, Chapter 2:
http://www.hm-treasury.gov.uk/d/consolidated_budgeting_guidance_201213.pdf
The Department for Business, Innovation and Skills has made no decision at this time on what, if any, Budget exchange requests might be made in 2013-14.
Work Experience
Kelvin Hopkins: To ask the Secretary of State for Business, Innovation and Skills how many interns work in his Department's press office. [116178]
Norman Lamb: BIS has no interns working in the press office.
Education
Children's Centres
Steve McCabe: To ask the Secretary of State for Education how many (a) children's and (b) Sure Start centres have closed in each of the last three years; and if he will make a statement. [116119]
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Sarah Teather: Children's centres and Sure Start centres are the same. It is for local authorities, in consultation with local communities, to determine the most effective way of delivering children's centre services to meet local need. Local authorities have duties under the Childcare Act 2006 to ensure sufficient provision of children's centres, and to consult before opening, closing or significantly changing services provided through children's centres.
At the end of June 2012, information supplied by local authorities on the Sure Start On database showed that there were 3,350 Sure Start Children's Centres. This represents a net reduction of 281 since April 2010 which is largely due to local reorganisations such as the merger of two or more centres.
There have been 16 outright closures.
Special Educational Needs
Mr Graham Stuart: To ask the Secretary of State for Education how many children with special educational needs were given an out-of-authority placement in each local authority in the most recent year for which figures are available. [115645]
Sarah Teather: The information requested is shown in the following table.
| Number of pupils(1, 2, 3, 4, 5, 6 )with a statement of special educational needs, resident in England and attending school outside their resident local authority, 2011, England | ||
| Number | ||
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| (1) Pupils living outside of England have been excluded. (2) Figures are based on the local authority of pupil residence. (3) Includes pupils who are sole or dual main registrations. Includes boarding pupils. (4) Includes nurseries, state-funded primary schools (including middle schools as deemed), primary academies, state-funded secondary schools (including middle schools as deemed), city technology colleges, secondary academies, and state-funded and non-maintained special schools. (5) Pupils with no identified special educational needs, school action and school action plus have been excluded from the table. (6) To put these figures in context, there were a total of 224,210 pupils with a statement of SEN in all schools in England in 2011. Source: School Census, 2011 | ||
Health
Abortion
Fiona Bruce: To ask the Secretary of State for Health (1) what progress the General Medical Council has made on investigating the doctors who were reported to have agreed to illegally perform abortions based on gender; [115832]
(2) whether the doctors who were found to be willing to sign abortion forms on the grounds of gender of the child have been suspended or whether they are still involved in providing abortion services. [115833]
Anne Milton: The Department understands that, as a result of recent media reports, a number of health professionals were referred to their regulator for investigation because of evidence uncovered.
The health regulators (including the General Medical Council as the regulator for doctors) are statutory bodies and have powers to investigate where complaints are made to them that the fitness to practise of professionals is in question. To date I understand that one doctor has been suspended and a further two had restrictions placed on their duties; this means that neither doctor is able to act as a certifying doctor nor take part in terminations.
As the health regulators are independent bodies, and as investigations are ongoing, the Department is unable to comment further at the present time.
Fiona Bruce: To ask the Secretary of State for Health what steps he is taking to determine how widespread gender abortion is in the UK. [115975]
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Anne Milton: Resolution 1829 (2011) from the Council of Europe called upon member states to collect various data on sex selection and implement a number of other measures. We are currently considering what research and data are available that might help us better explore this issue.
It is illegal for a practitioner to carry out an abortion for gender selection alone. A sex-linked inherited medical condition may be relevant to the certifying practitioner's consideration of whether a specific case meets section 1(1)(d) of the Abortion Act 1967 (as amended).
Alcoholic Drinks
Chris Ruane: To ask the Secretary of State for Health pursuant to the answer of 22 May 2012, Official Report, column 545W, on alcoholic drinks: young people, if he will assess the effects of trends in gross domestic product on alcohol consumption in people aged (a) 16 to 24, (b) 25 to 34, (c) 35 to 44, (d) 45 to 54, (e) 55 to 64, (f) 65 to 74 and (g) 75 to 84. [115791]
Anne Milton: The Department has assessed the overall relationship between trends in gross domestic product and the population’s alcohol consumption.
However, we have made no detailed assessment of the relation with trends in alcohol consumption by specific age groups. Consumption by age group is derived from survey data commissioned by the Health and Social Care Information Centre, or its predecessors. From 2005, there was a significant change in methodology with regard to the estimation of alcoholic strength and glass size, which means that consumption trends by age group from before 2005 cannot be estimated reliably. The Department has commissioned research to assess the feasibility of work to develop and apply a robust methodology for retrospective adjustment of trend data on alcohol consumption in England.
Alcoholic Drinks: Misuse
Chris Skidmore: To ask the Secretary of State for Health what the total number was of alcohol attributable hospital admissions in each year since 1997. [116087]
Anne Milton: The total number of admissions with an alcohol related primary or secondary diagnosis is given in the following table.
The estimates are based on the proportion of diseases and injuries that can be wholly or partially attributed to alcohol. The earliest year for which such estimates are available is 2002-03. Some of the observed increase is the result of improvements in the recording of secondary diagnoses.
| Estimated number of admissions(1) with an alcohol-related primary or secondary diagnosis, 2002-03 to 2010-11(2), Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector | |
| Alcohol-related admissions | |
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| (1) Alcohol-related admissions The number of alcohol-related admissions is based on the methodology developed by the North West Public Health Observatory, which uses 48 indicators for alcohol-related illnesses, determining the proportion of a wide range of diseases and injuries that can be partly attributed to alcohol as well as those that are, by definition, wholly attributable to alcohol. Further information on these proportions can be found at: www.nwph.net/nwpho/publications/AlcoholAttributableFractions.pdf The application of the NWPHO methodology has recently been updated and is now available directly from Hospital Episode Statistics (HES). As such, information about episodes estimated to be alcohol related may be slightly different from previously published data. (2) 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 national health service practice. For example, apparent reductions in activity may be due to a number of procedures which may now be undertaken to outpatient settings and so no longer include in admitted patient HES data. Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre | |
Alcoholic Drinks: Mothers
Tracey Crouch: To ask the Secretary of State for Health what estimate he has made of the number of alcohol-dependent mothers. [115692]
Anne Milton: The Adult Psychiatric Morbidity Survey (APMS) 2007 carried out by the National Centre for Social Research (NATCen) and commissioned by the Health and Social Care Information Centre collected data on mental health among adults aged 16 and over living in private households in England.
The Department's analysis of the survey data shows that 1,500 women were living in the same household as their son/daughter, step-son/daughter or their foster child. Of these mothers, 43 (3%) were mildly dependent on alcohol and none was moderately or severely dependent.
Alcohol dependence was assessed using the SADQ-C (Severity of Alcohol Dependence Questionnaire, community version). A SADQ-C score of 4-19 indicated mild dependence; a score of 20-34, moderate dependence; and a score of 35 or more, severe dependence.
A copy of the APMS 2007 has already been placed in the Library.
Antidepressants: Sexual Dysfunction
Chris Ruane: To ask the Secretary of State for Health with reference to the answer of 26 April 2012, Official Report, columns 1039-40W, on antidepressants, what assessment he has made of the decrease in libido and other sexual problems that result from the long-term use of antidepressants. [115794]
Mr Simon Burns: For information on what assessment has been made of the decrease of libido following long term use of antidepressants I refer the hon. Member to the written answer I gave him on 26 April 2012, Official Report, columns 1039-40W.
With regard to the risk of other sexual problems, the available preclinical and clinical trial data associated with the use of antidepressants were assessed at the
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time of licensing of all antidepressants, and where other sexual problems were found to be a side effect of an antidepressant this has been reflected in the product information for prescribers and included in the Patient Information Leaflet.
In the post licensing period, the safety of all antidepressants is subject to routine monitoring of reports of suspected adverse reactions from healthcare professionals and patients, and publications in the literature and any emerging data on the risk of sexual problems are carefully evaluated. Most recently in 2009, and then again in 2011, data were evaluated by the Medicines and Healthcare products Regulatory Agency relating to concerns raised by some patients that short and long term use of the selective serotonin reuptake inhibitor (SSRI) antidepressants may be associated with sexual dysfunction that persists even after the medication has been discontinued. Expert scientific and clinical advice was sought from independent scientific advisory committees who concluded that the available data were not sufficiently robust to demonstrate a causal association, particularly given that depression itself is known to affect sexual function, and therefore no updates to the advice provided in the product information were warranted.
The MHRA continues to keep the occurrence of decreases in libido and other sexual problems associated with antidepressant use under close review. Any new data will be carefully evaluated and, where supported by the data, appropriate regulatory action will be taken.
Breast Cancer
Mr Jim Cunningham: To ask the Secretary of State for Health (1) what steps his Department is taking to improve the early diagnosis of breast cancer among patients aged 74 years old and over; [115803]
(2) how many women had mastectomies aged (a) 49 years and under, (b) 50 to 59, (c) 60 to 69, (d) 70 to 79, (e) 80 to 89 and (f) over 90 years in each (i) cancer network and (ii) primary care trust area in each year since 1997; [115804]
(3) how many women undergoing surgery for breast cancer were offered immediate breast reconstruction surgery aged (a) 49 years and under, (b) 50 to 59, (c) 60 to 69, (d) 70 to 79, (e) 80 to 89 and (f) over 90 years in each (i) cancer network and (ii) primary care trust area in each year since 1997. [115805]
Paul Burstow: Between January and March this year, we provided £2.5 million to support 18 local cancer awareness projects led by the national health service in over 60 primary care trusts (PCTs). Seven of these projects targeted breast cancer in women over 70, as this is an area where survival rates are particularly poor. The evaluation of this work will inform the future work of the National Awareness and Early Diagnosis Initiative.
Information regarding the number of women offered immediate breast construction after breast cancer surgery is not routinely collected. The National Mastectomy and Breast Reconstruction Audit collected data on women having a mastectomy and immediate and delayed reconstruction surgery between 1 January 2008 and 31 March 2009. There are four audit reports and these are available on the NHS Information Centre website at:
www.ic.nhs.uk/mbrreports
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It is important to note that although all eligible English NHS trusts participated in the audit not all eligible cases were submitted to the audit, and not all of the cases submitted had complete clinical data. The audit only collected data on the surgeries described above; it did not include all breast cancer surgery, such as breast conservation surgery. Some women who initially have breast conservation surgery will have a further procedure, which may be a mastectomy with or without breast reconstruction.
The Second Annual Report reported that of cases submitted to the audit, 48% of mastectomy patients were offered immediate reconstruction. The audit collected data by NHS trust and cancer network.
Data concerning the number of women who had mastectomies aged 49 years and under, 50 to 59, 60 to 69, 70 to 79, 80 to 89 and over 90 years in each cancer network and PCT area in each year since 1997 cannot be provided in the format requested.
We have provided a count of finished consultant episodes (FCEs) for women with a main or secondary procedure of mastectomy and for women with a primary diagnosis of breast cancer and a main or secondary procedure of mastectomy by cancer network, PCT of residence and by age groups requested. FCEs should not be seen as a count of patients as the same person may have been admitted on more than one occasion. Cancer network data are not available prior to 2009-10 and data from 1997-98 to 2008-09 are provided at PCT level only. This information has been placed in the Library.
Cancer and Aortic Aneurysm
Grahame M. Morris: To ask the Secretary of State for Health what plans his Department has to continue to (a) monitor and (b) publish statistics on access to screening for (i) cervical cancer, (ii) bowel cancer, (iii) breast cancer and (iv) abdominal aortic aneurysm. [115951]
Paul Burstow: There are no plans to discontinue monitoring or publishing statistics for either the NHS Breast Screening Programme or the NHS Cervical Screening Programme. A draft statistical return for the NHS Bowel Cancer Screening Programme has been developed and NHS Cancer Screening Programmes is intending to pilot its usage later this year.
The Department does not currently collect data on abdominal aortic aneurysm (AAA) screening. After national roll-out is complete in March 2013, consideration will be given to the publication of AAA screening statistics.
Chronically Sick People: Witham
Priti Patel: To ask the Secretary of State for Health (1) how many patients there were with chronic medical conditions in (a) Witham Town and (b) Witham constituency in each of the last five years; [115903]
(2) what the number of people with multiple sclerosis was in (a) Witham Town and (b) Witham constituency in each of the last five years; [115904]
(3) what the number of people with myalgic encephalomyelitis was in (a) Witham Town and (b) Witham constituency in each of the last five years. [115905]
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Paul Burstow: Information is not available in the format requested.
‘Chronic medical conditions' is a very broad term that might apply to many different medical conditions. Information about patients with chronic medical conditions cannot be provided without further specification of the chronic conditions required.
Information about the number of hospital episodes with a primary diagnosis of multiple sclerosis or myalgic
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encephalomyelitis for residents of the Mid Essex primary care trust (PCT) area in the last five years is shown in the following table. This is not a count of the number of people with each condition in Mid Essex PCT as the same person might have been admitted on more than one occasion.
| Count of finished admission episodes (FAEs) with a primary diagnosis of multiple sclerosis or myalgic encephalomyelitis for residents of the Mid Essex PCT, 2006-07 to 2010-11 | |||||
| Diagnosis | 2006-07 | 2007-08 | 2008-09 | 2009-10 | 2010-11 |
| Notes: 1. An FAE is the first period of in-patient care under one consultant within one health care 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. 2. The primary diagnosis is the first of up to 20 diagnosis fields in the HES data set and provides the main reason why the patient was admitted to hospital, 3. The PCT contains the patient's normal home address. This does not necessarily reflect where patients were treated, as they may have travelled to another area for treatment. 4. HES 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 that may now be undertaken in out-patient settings and so no longer include in admitted patient HES data. 5. To protect patient confidentiality, figures between 1 and 5 have been replaced with "*". Where it was still possible to identify numbers from the total an additional number (the next smallest) has been replaced. 6. HES are compiled from data sent by more than 300 national health service trusts and 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 Statistic (HES) Information Centre for health and social care | |||||
Contraceptives: Walthamstow
Stella Creasy: To ask the Secretary of State for Health if he will assess the effect of restrictions in access to contraception services in Walthamstow on the healthcare of residents; and how he plans to ensure that all women of all ages in Walthamstow will have a choice of contraception. [116329]
Anne Milton: The Department is aware of concerns about access to contraception services in Walthamstow. We understand that the Waltham Forest Sexual Health Steering Group, which includes local general practitioners, primary care trust staff and local authority representatives is reviewing sexual health services locally. Sexual health is a priority of Waltham Forest health and wellbeing board who are developing a joint Clinical Commissioning Group-local authority strategy to improve the health of the local population.
Dental Services: Children
Mr Mike Hancock: To ask the Secretary of State for Health (1) what estimate his Department has made of the cost per child of providing a yearly dental check in school via a mobile clinic or visiting dental professional; [115689]
(2) what steps his Department has taken to encourage preventative measures for dental disease in children under 16 years; [115690]
(3) how much his Department spent on treating dental disease in children under 16 years in the last year. [115691]
Mr Simon Burns: The cost of a child seeing a dentist for check ups and any associated treatment is met locally from services commissioned by primary care trusts and will vary according to location and dental needs. We do not hold central information on individual treatment costs. Total spend on dentistry is not broken down by age.
The Government are committed to improving oral health, particularly of children. A new dental contract that promotes a more preventative approach to care will be introduced and elements of that contract, including a preventative care pathway, are being trialled in 70 dental practices.
In advance of a new contract all dentists are being encouraged to adopt a preventative approach as set out in “Delivering Better Oral Health—an evidence-based toolkit for prevention” published jointly by the Department and the British Association for Community Dentistry. Rates of dentists prescribing high concentration fluoride toothpaste and mouthwash, both key indicators of a more preventative approach, are rising.
Other initiatives focus on good self care, reaching out to children who are not seeing a dentist regularly. “Brushing for life” is a campaign that delivers oral health advice to parents and their children in community settings such as Sure Start centres and child health clinics.
Diabetes
Mr Sanders: To ask the Secretary of State for Health when he plans to publish a diabetes action plan; and if he will make a statement. [R] [115784]
Paul Burstow: I refer the hon. Member to the answer given on 2 July 2012, Official Report, column 515W.
Rushanara Ali: To ask the Secretary of State for Health what recent progress he has made on (a) reducing the cost of diabetes to the NHS and (b) improving the quality of life of people affected by diabetes. [115992]
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Paul Burstow: We take the view that the best means of the national health service getting value from diabetes care—both in reducing waste and in improving the quality of care—is by encouraging NHS providers and commissioners to use data to identify areas of practice where improvements can be made. For this reason the Department supports the National Diabetes Audit and the In-Patient Audit together with the “NHS Atlas of Variation in Healthcare for People with Diabetes”. All provide robust data that aid the identification of areas of best practice.
One result has been improvements year in year in the delivery of services such as the retinopathy-screening programme and delivery in primary care of the nine diabetes care processes. A suite of tools and materials are also available from NHS Diabetes to local healthcare organisations to help drive improvements.
In addition, work is in hand to develop best practice tariffs that encourage NHS providers to adopt best practice in clinical care for people with diabetes. The first was in paediatric diabetes medicine and was introduced in 2011-12.
Diabetes: Witham
Priti Patel: To ask the Secretary of State for Health what the number of people with diabetes was in (a) Witham Town and (b) Witham constituency in each of the last five years. [115902]
Paul Burstow: Information is not available in the format requested. Information about the number of people with diabetes is available at primary care trust (PCT) level as patient register data from the Quality and Outcomes Framework (QOF). Information from the diabetes patient register for the last five years in Mid Essex PCT, which covers Witham, is shown in the following table.
| Mid Essex PCT diabetes register (ages 17+) | |
| Number | |
| Notes: 1. The disease register for diabetes in QOF does not include patients below the age of 17. 2. QOF was introduced as part of the new General Medical Services (GMS) contract on 1 April 2004. Participation by general practices in QOF is voluntary, but participation rates are high and most Personal Medical Services (PMS) practices also take part. 3. The QOF information was derived from the QMAS, a national information technology system. QMAS uses data from general practices to calculate individual practices' QOF achievement. 4. QMAS captures the number of patients on the various disease registers for each practice. This can be used to calculate measures of disease prevalence, expressing the number of patients on each register as a percentage of the number of patients on practices' lists. 5. Patients will contribute to the figures in QOF only if they are registered with a general practice participating in QOF. Not all practices participate in QOF and some participate only in parts (especially PMS practices, which are paid under different arrangements for providing services that are part of QOF for GMS practices). Most indicators in QOF have rules that allow for patients to be excluded (e.g. patient refuses treatment) and so the denominator for a given indicator may be less than the number of patients on the register for that disease. Source: The Quality Management Analysis System (QMAS) database | |
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Electronic Cigarettes
Ms Abbott: To ask the Secretary of State for Health what information his Department holds on the number of people who smoked electronic cigarettes in each of the last five years; what assessment his Department has made of the potential health effects compared to smoking; and what requirements govern the smoking of electronic cigarettes in enclosed public places. [115606]
Mr Simon Burns: Available data from a recent (2012) survey carried out by Action on Smoking and Health suggest that up to 650,000 smokers are currently using electronic cigarettes, with perhaps as many as 2,000,000 United Kingdom smokers having tried them on at least one occasion.
Electronic cigarettes are caught by the provisions of the General Product Safety Directive and associated regulations. Some electronic cigarettes have been tested by local authority trading standards departments and have been found to pose a potential danger to consumers. The available data suggest that there can be great variability in the content of electronic cigarettes, both in the amount of nicotine present and also in relation to other potentially toxic substances.
Electronic cigarettes are not currently regulated as medicines, which are required to meet appropriate standards of safety, quality and efficacy. In March 2011, the Medicines and Healthcare products Regulatory Agency (MHRA) published the outcome of a public consultation on whether to bring all nicotine containing products within the medicines licensing regime. The response to consultation suggested there was strong support for MHRA regulation. The response to consultation also highlighted the need for further information to inform a decision and the MHRA is coordinating further scientific and market research with a view to a final decision on the application of medicines regulation in spring 2013.
The smoke-free legislation governing smoking in public places applies to tobacco or other lit products. If an e-cigarette does not involve combustion, smoke-free legislation is not applicable.
General Practitioners
Mr Spellar: To ask the Secretary of State for Health what restrictions have been placed on appointments of lay members to health commissioning boards; and for what reason any such restrictions have been made. [116339]
Mr Simon Burns: The Health and Social Care Act 2012 requires that every clinical commissioning group (CCG) must have a governing body. The Government Response to the NHS Future Forum report committed to each governing body having at least two lay members, one with a lead role in championing patient and public involvement, the other with a lead role in overseeing key elements of governance such as audit, remuneration and managing conflicts of interest. This is to ensure that there is independent oversight of the governance arrangements of CCGs, including systems for managing conflicts of interest and checks and balances for the stewardship of public money.
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The 2012 Act provides for regulations to specify requirements as to membership of governing bodies. The National Health Service (Clinical Commissioning Group) Regulations 2012, laid before Parliament on 26 June, therefore require that each governing body must have at least two lay members. The first lay person must have qualifications, expertise or experience such as to enable the person to express informed views about financial management and audit matters. The second must be someone who has knowledge about the area specified in the CCG's constitution such as to enable the person to express informed views about the discharge of the CCG's functions.
The regulations also prevent certain individuals from counting as lay members if they would not be able to provide independent oversight. This includes members or employees of NHS organisations/employees of local authorities, employees of the Department and certain health care professionals. A full list of individuals excluded is laid out in schedule four of the regulations.
Health Education
Grahame M. Morris: To ask the Secretary of State for Health from which of his Department's budgets national public health advertising campaigns are funded; and whether he has any plans to change this. [116015]
Anne Milton: The External Relations Directorate within the Department is allocated a single budget from which all public health campaigns are funded.
The launch of Public Health England in April 2013 may mean some administrative changes in the funding of national public health campaigns.
Health Services: Coventry
Mr Ainsworth: To ask the Secretary of State for Health how many (a) nurses and (b) doctors were employed by the NHS in the Coventry Primary Care Trust area in each of the last five years. [116206]
Mr Simon Burns: The information requested is not available in the format requested. Data held by the National Health Service Information Centre for health and social care for the number of doctors and nurses providing NHS primary care within the Coventry Primary Care Trust (PCT) area in each of the last five years is shown in the following table:
| Number (headcount) | |||||
| As at 30 September each year | 2007 | 2008 | 2009 | 2010(1) | 2011(1) |
Both University Hospitals Coventry and Warwickshire NHS Trust and Coventry and Warwickshire Partnership NHS Trust employ doctors and nurses within the Coventry
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PCT area. NHS Information Centre data for the total number of doctors and nurses employed by these organisations (not just those within the Coventry PCT area) is shown in the following tables:
| University Hospitals Coventry and Warwickshire NHS Trust | |||||
| Number (headcount) | |||||
| As at 30 September each year | 2007 | 2008 | 2009 | 2010(1) | 2011(1) |
| Coventry and Warwickshire Partnership NHS Trust | |||||
| Number (headcount) | |||||
| As at 30 September each year | 2007 | 2008 | 2009 | 2010(1) | 2011(1) |
| (1) The new headcount methodology is not fully comparable with data for years prior to 2010, due to improvements that make it a more stringent count of absolute staff numbers. Further information on headcount methodology is available in the Census publication. Headcount totals are unlikely to equal the sum of components. (2) Includes Hospital and Community Health Services doctors and general practitioners (GPs). (3) Excludes medical hospital practitioners and medical clinical assistants, most of whom are GPs working part time in hospitals. (4) Nursing and midwifery figures exclude students on training courses leading to a first qualification as a nurse or midwife. (5) Practice staff counts for 2011 represents an improvement in data collection processes and comparisons with previous years should be treated with caution. Source: National Health Service Information Centre for health and social care | |||||
Herbal Medicine: Regulation
Heather Wheeler: To ask the Secretary of State for Health what discussions he and Ministers in his Department have had with the Medicines and Healthcare products Regulatory Agency on enforcement of the Directive on Traditional Herbal Medicines since it was introduced; and if he will make a statement. [115699]
Mr Simon Burns: The Medicines and Healthcare products Regulatory Agency regularly updates Ministers on a wide range of regulatory issues, including matters relating to the implementation of the Directive on Traditional Herbal Medicinal Products.
Mental Illness
Chris Ruane: To ask the Secretary of State for Health (1) if he will establish an inquiry into the (a) increase in the number of prescriptions for anti-depressant drugs and (b) lack of take-up of mindfulness-based therapy for repeat episode depression; [115957]
(2) what assessment his Department has made of the (a) effects and (b) cost of untreated mental illness on the severity of concurrent physical illness; [116190]
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(3) what estimate his Department has made of the proportion of those with (a) mental and (b) physical illnesses who were treated for their condition in each of the last five years; [116191]
(4) what proportion of ill health among the under 65s was (a) mental and (b) physical illness in each of the last five years; and how much funding was given to each in each year. [116192]
Paul Burstow: People living with significant or persistent mental illness have significantly reduced health and quality of life and live on average 10 to 20 years less than those with no mental illness.
We do not collect figures on the proportion of those with mental and physical illnesses treated for their condition. However, the Government has made its commitment to achieving parity of esteem between physical and mental health explicit in the Health and Social Care Act 2012.
The NHS Outcomes Framework 2012-13 (December 2011) sets out the outcomes and corresponding indicators that will be used to hold the NHS Commissioning Board to account for the outcomes it delivers through commissioning health services from 2012-13. Reducing premature death in people with serious mental illness is identified as an improvement area.
The NHS Operating Framework for 2012-13 (November 2011) includes a particular focus on improving the physical health care of those with mental illness to reduce excess mortality.
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One of the six shared objectives of the Government's mental health strategy, ‘No Health Without Mental Health’, in February 2011 is that more people with mental health problems will have good physical health and that fewer people with mental health problems will die prematurely.
The Public Health White Paper highlights the physical health inequality for people with mental illness as a public health concern which needs to be addressed.
We have commissioned the Royal College of Psychiatrists to lead work on how to achieve “parity of esteem between mental health and physical health in practice”. This work, involving leading Royal Colleges, professional associations, charities and others, will consider what specific actions are needed to realise the Government's consistently articulated aim of ensuring mental health is on a par with physical health. As part of this, they will be examining all aspects of mental health and health care, from the complexities of co-morbidity between physical and mental health, to the attitudes and behaviour of mental health professionals, providers, commissioners and the public. The group will report in the autumn.
The programme budget data in the following table include children and adolescent services (CAMHS) as well as substance misuse, organic mental disorders, psychotic disorders and other. The data in the latter categories are for all adults.
| Programme budgeting estimated England level gross expenditure for mental health disorders and total gross expenditure | |||||
| £ billion | |||||
| 2006-07 | 2007-08 | 2008-09 | 2009-10 | 2010-11 | |
| Source: Programme Budget Data | |||||
The Department collects data on the patients in contact with mental health services under the Mental Health Act 2007. The total numbers of those patients are shown in the following table:
| Patients detained under the Mental Health Act 1983 and patients on supervised community treatment by Mental Health Act 2007 mental category at 31 March, 2011 | |||||
| England all NHS facilities | 2006-07 | 2007-08 | 2008-09 | 2009-10 | 2010-11 |
| Source: KP90: Health and Social Care Information Centre | |||||
The mental health minimum dataset collects data on the number of patients accessing adult and elderly secondary mental health services and these data are presented in the following table:
| Number of people using adult and elderly NHS secondary mental health services, 2006-07 to 2010-11 | |||||
| 2006-07 | 2007-08 | 2008-09 | 2009-10 | 2010-11 | |
| Source: Health and Social Care Information Centre mental health minimum dataset | |||||
We do not have figures for the overall investment in physical ill health, early indication of the total NHS spend reported a cash increase of 3.02% between 2010-11 and 2011-12 compared to a 1.2% cash increase adult working age mental health services. There was a 1.0% increase in investment of the provision of direct services in the year 2011-12, a direct benefit to patients.
We will not be establishing such inquiries.
NHS Litigation Authority
Mr Slaughter: To ask the Secretary of State for Health on what date and with what organisations the NHS Litigation Authority has had meetings to discuss a new system for clinical negligence claims in the last three years. [115672]
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Mr Simon Burns: The NHS Litigation Authority has discussed a potential new system for dealing with lower monetary-value clinical negligence claims with stakeholders as shown in the following table.
Table showing dates of meetings that have taken place to discuss a new system for clinical negligence claims in the last three years:
NHS: Inspections
Fiona Bruce: To ask the Secretary of State for Health whether he proposes that the Care Quality Commission will continue to make unannounced inspections of (a) hospitals, (b) care homes, (c) abortion clinics and (d) other health providers for the purpose of raising standards; and if he will make a statement. [115834]
Mr Simon Burns: The Care Quality Commission (CQC) is the independent regulator of health and adult social care providers in England and has a key responsibility in the overall assurance of essential levels of safety and quality of health and adult social care services. Under the Health and Social Care Act 2008 all providers of regulated activities, including national health service and independent providers, must register with the CQC and meet a set of essential requirements of safety and quality.
The CQC is responsible for developing and consulting on its methodology for assessing whether providers are meeting the registration requirements.
Under the 2008 Act, the CQC can make short, focused unannounced site visits with direct observations of care at any time. The CQC has recently introduced a new regulatory model that will see most social care, independent health care services and NHS hospitals inspected at least once a year. CQC will inspect dental services at least once every two years.
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NHS: Reorganisation
Mr Ainsworth: To ask the Secretary of State for Health what estimate he has made of the costs of NHS reorganisation in (a) Coventry, (b) Coventry North East constituency, (c) the West Midlands and (d) England. [116256]
Mr Simon Burns: National health service bodies are constantly in the process of reorganisation to modernise services and improve value for money. We do not monitor the cost of all local reorganisations.
Nutrition
Chris Ruane: To ask the Secretary of State for Health pursuant to the answer of 18 June 2012, Official Report, columns 805-6W, on nutrition, for what reasons expenditure for the Change4Life advertising campaign was reduced in 2010-11 and 2012-13 as compared to 2009-10. [115790]
Anne Milton: We have been progressively scaling back the amount of taxpayers’ money spent on Change4Life overall, including media spend, and have looked to others to increase support.
The contribution, mainly in kind, from our national partners and selected media partners has increased over the same period in line with expectations—60-40%.
Tracker results for the Change4Life brand show key brand values have been maintained.
Change4Life continues to maintain a high level of trust with the public.
Grahame M. Morris: To ask the Secretary of State for Health what plans he has for funding allocations for Change4Life in (a) the North East and (b) England in each of the next five years. [116014]
Anne Milton: Change4Life is an England wide campaign and covers the north east region. No English region has been specifically allocated a portion of the campaign budget.
On October 2011. a three year social marketing strategy for Change4Life was approved. This information is contained in “Change4Life Three Year Social Marketing Strategy” which has already been placed in the Library.
Activity in future financial years is subject to change including approval from the Efficiency and Reform Group at Cabinet Office.
Obesity
Chris Skidmore: To ask the Secretary of State for Health what the total number was of finished admission episodes involving patients with an obesity related illness in each year since 1997. [116086]
Anne Milton: The NHS Information Centre has provided a count of finished admission episodes (FAEs(1)) with a primary diagnosis of obesity(2), for the years 1997-98 to 2010-11(3). This information is provided in the following table:
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| FAEs | |
| (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 inpatients, as a person may have more than one admission within the year. (2) Primary diagnosis. The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was admitted to hospital. The ICD-10 codes used to identify obesity is as follows: E66—Obesity (3) 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 national health service 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. Note: Additional information Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector. Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre | |
Palliative Care
Jim Dobbin: To ask the Secretary of State for Health what steps he is taking to ensure the preferences of all people at the end of life are recorded and shared between health and social care providers; and how commissioners will be encouraged to develop systems to record the end-of-life preferences of their local populations. [116106]
Paul Burstow: The Department's End of Life Care Strategy emphasises the importance of establishing people's preferences and wishes about their end-of-life care. It advocates the process of care planning, including advance care planning, as a mechanism for doing this. Advance care planning aims to clarify a person's wishes in the event of a future, anticipated deterioration in their condition, with attendant loss of capacity to make decisions and/or ability to communicate wishes to others.
The strategy advocated the establishment of locality registers both to support this process and to enable effective recording and sharing of this information. After successful piloting, the registers (now more accurately named Electronic Palliative Care Co-ordination Systems (EPaCCS)) are being set up across the country with support from the National End of Life Care Programme.
An Information Standard for co-ordination of care at the end of life (2012) has been agreed to ensure national consistency of key information through a core data set, and is available at:
www.isb.nhs.uk/library/standard/236
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Implementation of EPaCCS is also an important strand of the Quality, Innovation, Productivity and Prevention (QIPP) end-of-life care workstream, and the Department's QIPP digital team are working with implementers of systems to help identify and address technical challenges, such as how to support the involvement of social care.
Jim Dobbin: To ask the Secretary of State for Health what steps he is taking to improve the integration of health and social care services to enable more people to die at home if they wish to do so. [116107]
Paul Burstow: Provisions in the Health and Social Care Act 2012 place statutory duties on the NHS Commissioning Board, clinical commissioning groups, local authorities (through health and wellbeing boards) and Monitor to encourage integrated working at all levels.
The NHS Outcomes Framework, the Adult Social Care Outcomes Framework and the Public Health Outcomes Framework together support the Government's desire to improve integration of services. Domain Four of the NHS Outcomes Framework, ensuring that people have a positive experience of care, includes an indicator assessing the experience of end-of-life care.
The spending review and 2011-12 NHS Operating Framework announced details of non-recurrent primary care trust (PCT) allocations for social care, totalling £648 million in 2011-12 and £622 million in 2012-13. The funding, allocated to PCTs, and then transferred to local authorities, was for investment in social services to benefit health and improve overall health gain. PCTs were expected to work with local authorities to agree jointly on appropriate areas for social care investment and the outcomes expected.
The independent Palliative Care Funding Review, which was commissioned by the Department and reported in 2011, highlighted the importance of effective integration between health and social care services at the end of life. The Department is funding eight pilots over two years which will test all the review's recommendations, and will include both health and social care services.
The Department is also supporting roll-out of electronic palliative care Co-ordination Systems (EPaCCS), which capture key information about people's care, including their expressed preferences about where they want to be cared for and die, and make these instantly accessible to relevant staff across care settings and organisations. Currently, EPaCCS systems focus on communication between health professionals and organisations. However, integrating social care is recognised as important, and some early implementers of systems are considering how to overcome technical and other challenges.
Prostate Cancer
Grahame M. Morris: To ask the Secretary of State for Health what steps his Department is taking to improve research into the causes, diagnosis and treatment of prostate cancer. [115952]
Paul Burstow: The Department is fully committed to high quality clinical and applied research into the causes, diagnosis and treatment of cancer.
The Department's National Institute for Health Research (NIHR) welcomes funding applications for research into any aspect of human health, including prostate
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cancer. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the scientific quality of the proposals made.
The United Kingdom has the highest national per capita rate of cancer trial participation in the world. The NIHR Clinical Research Network (CRN) is currently hosting 35 trials and other well-designed studies in prostate cancer that are in set-up or recruiting patients. Details can be found on the UK CRN portfolio database at:
http://public.ukcrn.org.uk/search
In August 2011, the Government announced £800 million investment over five years in a series of NIHR biomedical research centres and units. This includes £61.5 million funding for the Royal Marsden/Institute of Cancer Research Biomedical Research Centre, which has a research theme on prostate cancer.
The NIHR funds 15 experimental cancer medicine centres across England in close partnership with Cancer Research UK. Prostate cancer is included within the disease focus of 11 of these centres.
Royal College of General Practitioners
Jim Dobbin: To ask the Secretary of State for Health pursuant to the answer of 26 June 2012, Official Report, column 234W, on the Royal College of General Practitioners (RCGP), if he will place in the Library a copy of each presentation made by the two drug policy officials who attended the RCGP conference. [116104]
Anne Milton: The Royal College of General Practitioners has. published several of the presentations made at its May 2012 conference on its website, including the slide presentation on the misuse of prescribed medications, but not the slide presentation on payment by results for drug and alcohol recovery:
www.rcgp.org.uk/courses__events/going_for_gold_2012/presentations_and_audio.aspx
The slide presentation on payment by results for drug and alcohol recovery has been placed in the Library.
It is important that anyone accessing these documents be aware that each slide presentation was intended to supplement an oral presentation rather than exist as a standalone document.
School Milk
Catherine McKinnell: To ask the Secretary of State for Health what plans he has to promote the uptake of free nursery milk. [116265]
Anne Milton: The Nursery Milk scheme has been running since the 1940s and we believe that awareness of the scheme is high, with over 50,000 childcare providers currently registered with the Nursery Milk Reimbursement Unit. The Department is currently consulting on a range of options for reforming the operation of the scheme, looking at making it more efficient—as well as improving its value for money, while ensuring that all children under five attending a childcare setting for more than two hours a day continue to be entitled to receive free milk. The consultation will further raise the profile of the scheme and offer an opportunity for childcare providers to give their thoughts on improving the operation of the scheme.
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In addition, the Department provides guidance on its website explaining the way in which the scheme is currently administered. Information about the scheme is also available on the Nursery Milk Reimbursement Unit's website at:
www.nurserymilk.co.uk
Suicide
Stuart Andrew: To ask the Secretary of State for Health pursuant to the answer of 2 July 2012, Official Report, column 527W, on suicide, on what date his Department expects to publish the new suicide prevention strategy for England. [116412]
Paul Burstow: We currently plan to publish on 10 September to coincide with the International Association for Suicide Prevention's World Suicide Prevention Day.
Thalidomide
Cathy Jamieson: To ask the Secretary of State for Health how many people affected by thalidomide there were in (a) the UK, (b) Scotland, (c) each local authority area in Scotland and (d) each health board area in Scotland in the most recent period for which figures are available. [116320]
Paul Burstow: The Thalidomide Trust supports 435 people in the United Kingdom whose health has been affected by thalidomide. This breaks down per country as follows:
| UK beneficiaries by country | |
| Country | Number |
Further disaggregated information regarding people living in Scotland who have been affected by thalidomide is a matter for the Scottish Parliament as health is a devolved responsibility.
Defence
Afghanistan
Cathy Jamieson: To ask the Secretary of State for Defence how many (a) serving personnel and (b) Armed Forces veterans have taken or are taking legal action against his Department for (i) injuries, (ii) wounds and (iii) disease they claim are attributable to service in Afghanistan. [116130]
Mr Robathan: The number of common law personal injury compensation claims attributable to service in Afghanistan was 224 as at 30 June 2012. The claims database does not distinguish between serving personnel and armed forces veterans nor is it possible to identify separately, injuries, wounds and diseases. Such claims are recorded as personal injuries.
Cathy Jamieson: To ask the Secretary of State for Defence whether he plans to set up an investigation into the health of Afghanistan veterans similar to that undertaken in relation to Gulf War veterans. [116131]
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Mr Robathan: In 2003, the Ministry of Defence commissioned research into the health of military personnel deployed to Iraq. In 2006, the study was extended for a further three years and broadened to include all subsequent Iraq deployments as well as deployments to Afghanistan. The research programme follows a cohort of over 20,000 serving and former members of the armed forces. In 2010, the study was extended for a further three years to maintain the database and further explore the data obtained in phases 1 and 2.
Apache Helicopters
Mr Ellwood: To ask the Secretary of State for Defence (1) when he plans that the Apache helicopter will be upgraded to utilise the Brimstone missile system; [116028]
(2) what plans he has to marinise the Apache helicopter; [116029]
(3) what the total number of Apaches in use is; and how many are earmarked for upgrade. [116030]
Peter Luff: The Army Air Corps currently operates a fleet of 67 Apache helicopters. The number of aircraft to be upgraded through the Capability Sustainment Programme will be decided at the main investment decision, which is currently planned for 2014.
While not originally designed as a maritime helicopter, the Ministry of Defence (MOD) has modified and cleared the Apache to support operations from the maritime environment as demonstrated from HMS Ocean on Operation Ellamy. The modifications included wet-sealing the aircraft to resist corrosion and modifying the windscreen wipers to include a solution to disperse sea spray. We are also currently in an assessment phase to fit flotation equipment to increase safety when operating over water.
The Apache is currently armed with variants of the Hellfire missile which are due to go out of service in 2021-22. The MOD will look at various options as a replacement to this capability. The successor to Brimstone, the 50kg class Spear Capability 2 Block 3 missile, will be one of the options considered as a replacement.
Armed Forces: Injuries
Mr Holloway: To ask the Secretary of State for Defence what steps he has put in place to diagnose mild traumatic brain injury in infantry soldiers. [115304]
Mr Robathan: A multi-disciplinary team providing a military clinical ‘centre of excellence' for the diagnosis and treatment of mild traumatic brain injuries is based at the Defence Medical Rehabilitation Centre Headley Court.
All personnel, including infantry soldiers, are diagnosed by Defence Medical Services in the same way. Individuals will be assessed by medical staff if, as a result of any incident, they are taken to a medical facility; if they contact medical staff with symptoms of illness; or if their chain of command recommends a medical consultation. This approach is reinforced through education, training and by generally raising awareness of mild traumatic brain injuries among troops, their commanders and medical staff to ensure they all remain alert to this risk.
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After their return from an operational theatre, the Defence Medical Services also conduct selective screening of all personnel seen at Headley Court where there is a history of injury that might put them at risk of mild traumatic brain injury. In addition, all personnel who may be at risk of mild traumatic brain injury admitted to the Royal Centre for Defence Medicine in Birmingham and personnel who report to their primary care services with a history suggestive of mild traumatic brain injuries, should be referred to the Defence Medical Rehabilitation Centre multi-disciplinary team.
We also continue to conduct research into the area of traumatic brain injury with Defence Science and Technology Laboratory, the Defence Medical Rehabilitation Centre, the national health service and King's College London, as well as in collaboration with the US and other NATO partners in order to develop clinical diagnosis and management as well as future improvements in force protection equipment and practices.
Armed Forces: Redundancy
Gordon Banks: To ask the Secretary of State for Defence where the 4,000 personnel recently served with redundancy notices were serving when issued with such notices. [115462]
Mr Robathan [holding answer 5 July 2012]:The number of armed forces personnel recently issued with redundancy notices is 3,800. The selection of an individual for redundancy cannot be assumed to imply that the post they occupy on the date of notification is no longer required and as such the geographical distribution of redundancy notices is not a valid basis for assumptions about the future distribution of military posts.
The following table details the geographical serving location of those personnel when the notices were issued:
| Location | Royal Navy | Army | RAF |
| ‘—’ Denotes zero or rounded to zero. Note: Figures have been rounded to the nearest 10, except for numbers ending in 5 which are rounded to the nearest 20 in order to prevent systematic bias. | |||