Overseas Aid
Rushanara Ali: To ask the Secretary of State for International Development what steps his Department takes to monitor the effectiveness of poverty reduction programmes delivered by private sector development and funded through decentralised spending decisions. [117451]
Mr O'Brien: All of the Department for International Development's (DFID's) programmes—including private sector programmes funded through country offices—are subject to a rigorous monitoring process. DFID uses a value for money framework to assess the effectiveness and efficiency of all projects, with specific indicators determined on a case-by-case basis. All proposals for DFID funding must be accompanied by a business case. This is the main record of the proposal, summarising value for money considerations and intended results. Indicators for tracking effectiveness are included in the logical framework, which is an annex to the business case. DFID's monitoring and evaluation processes include an annual review against the indicators in the logical framework and require an assessment of whether a project remains good value for money. The project database (projects.dfid.gov.uk/) provides access to business cases, logical frameworks and annual reviews.
Further information on how we measure progress against our objectives is available on the DFID website
http://www.dfid.gov.uk/About-us/How-we-measure-progress/
Alison McGovern: To ask the Secretary of State for International Development what criteria will be used to evaluate the performance of each of his Department's proposed cash-on-delivery aid programmes; and who will evaluate those programmes. [117935]
Mr O'Brien:
We have designed three payment by results (PBR) (also known as cash on delivery) pilots and independent evaluation is built in to each of these to learn from this innovative approach. The evaluations
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are tailored to the individual pilots. The key criterion to evaluate performance is whether PBR leads to additional results. In addition the evaluations will look at how PBR works, in order that we can apply lessons to future design and implementation.
Independent contractors are hired to evaluate each of our pilots: Cambridge Education for our Ethiopia pilot and the Liverpool Associates in Tropical Health for our pilot in northern Uganda. We are in the process of contracting an independent evaluator for our Rwanda pilot.
Alison McGovern: To ask the Secretary of State for International Development what estimate he has made of the likely cost of each of his Department's proposed cash-on-delivery aid programmes. [117936]
Mr O'Brien: The cost of each of the Department for International Development's payment by results (also known as cash on delivery) pilot programmes is as follows:
| Programme | Total programme cost £ million |
| (1)Up to £1.5 million per programme. | |
As we only pay for results, the final cost of each pilot will depend upon the results achieved.
The cost of each of these pilots is relatively small to allow us to test payment by results and understand how it works before we scale it up.
South Sudan
Mr Jim Cunningham: To ask the Secretary of State for International Development what assistance the Government are giving to the Government of South Sudan on (a) malnutrition and (b) hygiene. [117621]
Mr O'Brien: The UK is committed to helping deliver health care to the people of South Sudan. Our development goals in South Sudan over the next three years will give over 469,000 people access to clean water and sanitation; help 250,000 people get enough food to eat; and enable 2 million people receive life-saving health care and nutrition. In addition, the UK is a key supporter of the current humanitarian response in South Sudan, contributing £15 million to the Common Humanitarian Fund which will help to provide clean water for 130,000 people. We have also allocated £10 million to the World Food Programme to help feed 100,000 people through the hunger gap period this year.
In the health facilities supported by the UK's contribution to the Basic Services Fund, we run programmes to educate people about the importance of hygiene; 23,000 people were reached in 2010-11. This programme is also extended to children attending local schools.
Sub-Saharan Africa
Sir Tony Cunningham: To ask the Secretary of State for International Development what his policy is on support or funding for low-cost private schools in Sub-Saharan Africa. [117011]
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Mr O'Brien: The UK Government take a pragmatic, non-ideological stance on how services should be delivered. The Department for International Development (DFID) supports private sector education providers where we believe they will increase choice, equity, value for money, and learning outcomes. Support to non-state education providers complements the UK's extensive support to public sector delivery of education. In Nigeria, for example, we are researching the educational choices of low income parents, with a view to improving low-cost private education alongside existing UK support to reform the public education sector. We are also currently developing a low-cost private sector education programme in Kenya.
From 2011-15, the UK will support 9 million children in primary school, over half of whom will be girls, and 2 million in lower secondary school. In addition, DFID has launched a new Girls' Education Challenge, which will galvanise innovation in the non-state sector to support up to an additional 1 million of the world's poorest girls through a full cycle of schooling.
UN Women
Rushanara Ali: To ask the Secretary of State for International Development (1) what discussions he has had with his overseas counterparts on encouraging the international community to meet the resource and funding shortage for UN Women; [117595]
(2) what recent assessment he has made of the performance of UN Women against the four priorities set out in the Multilateral Aid Review; and what consequent decisions he has taken on the level of future UK funding for that organisation; [117596]
(3) against which criteria his Department plans to assess the performance of UN Women in advance of taking a decision on whether to continue funding that organisation beyond 2015; [117597]
(4) what his policy is on future UK financial support for UN Women. [117598]
Mr O'Brien: The Multilateral Aid Review (MAR) identified four key priority reform areas for UN Women: delivery of programmes at country level; results management; transparency; and cost effectiveness. The Department for International Development will review progress against these reform priorities in 2013. This review will determine the level of funding for 2013-14 and 2014-15. In addition, we regularly monitor progress with UN Women on follow-up to the MAR.
We will continue to fund UN Women up till 2015, based on its ability to perform, but beyond that no decision has been taken.
The UN Women annual report notes that in 2011, contributions to UN Women totalled $235 million, representing a 33% increase from 2011. Despite missing its 2011 funding targets this shows a real commitment to UN Women by other donors. We continue to work closely with UN Women and other donors to ensure it is as effective an organisation as it can be.
Health
NHS: Financial Stability
16. Sarah Newton: To ask the Secretary of State for Health what steps he is taking to ensure the financial sustainability of NHS organisations. [117295]
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Mr Lansley: We are working directly with all NHS trusts to enable them to achieve foundation trust status, in the main by April 2014. To achieve foundation trust status will mean NHS trusts have achieved sustainable, high levels of clinical quality and financial governance.
Reconfiguration: South-east London
17. Clive Efford: To ask the Secretary of State for Health what the cost was to South London Healthcare NHS Trust of the delay in implementing the proposals contained in the “A Picture of Health” consultation on the reconfiguring of local health services in south-east London. [117297]
Mr Simon Burns: Implementation of “A Picture of Health” has not been subject to delay. Between May and December 2010, NHS London carried out a thorough review of the proposals against the Secretary of State’s “four tests” that all reconfiguration schemes must meet.
NHS Walk-in Centres
18. Mr Crausby: To ask the Secretary of State for Health how many NHS walk-in centres have (a) closed and (b) reduced their opening hours since May 2010. [117298]
Mr Simon Burns: Since 2007, the local NHS has been responsible for NHS walk-in centres. It is for primary care trusts to decide locally on the availability of these services. No information is held centrally.
PFI Contracts
20. Karen Lumley: To ask the Secretary of State for Health if he will estimate the proportion of the PFI negotiations agreed prior to 2010 that have led to unsustainable contractual obligations being placed on NHS hospitals. [117300]
Mr Lansley: From 2012-13, we are providing the seven worst affected trusts with PFI scheme access to a £1.5 billion support fund over a period of 25 years directly from the Department.
Patient Outcomes
Simon Hughes: To ask the Secretary of State for Health what progress the NHS is making in improving outcomes for patients; and if he will make a statement. [117299]
Mr Lansley: Since last December, we have published data against 34 indicators in the NHS Outcomes Framework. Where trend data are available, the majority of indicators suggest performance has been maintained or improved. This includes MRSA infections down by 25% and C difficile infections down by 17% in 2011-12 compared with 2010-11.
Absenteeism
John Pugh: To ask the Secretary of State for Health what the absenteeism rate was in his Department in each of the last three years. [116660]
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Mr Simon Burns: The total number and the average number of days lost to sickness in the Department, for each of the last three calendar years, are shown in the following table:
| Calendar year | Total number of (working) absence days due to sickness | Average working days lost per staff year due to sickness |
Cancer
Nic Dakin: To ask the Secretary of State for Health (1) what assessment his Department has made of the effects of removing its support services from cancer networks on the delivery of their functions; [116638]
(2) what assessment has been made of the effects on existing cancer networks of the restructuring of clinical networks; [116639]
(3) what funding from the main NHS programme budget was allocated to cancer networks in (a) 2009-10, (b) 2010-11 and (c) 2011-12. [116652]
Paul Burstow: Funding to support cancer networks is mainly provided through what is called the Strategic Health Authority (SHA) bundle. In addition to funding from the bundle, networks receive funding from other sources, such as their constituent primary care trusts or from one or more of their provider trusts. The amounts included in the SHA bundle for cancer networks for 2009-10, 2010-11, 2011-12 and 20012-13 can be found in the following table.
| Cancer Network Funding (£ million) | |
These allocations are based on estimates of the funding required to deliver cancer networks. However, it is for each SHA to determine how the total amount they receive in the SHA bundle is allocated to specific services, such as cancer networks, taking into account the needs of local populations.
We have already made clear that there is an important role for clinical networks, such as cancer networks, in the reformed national health service. The cancer networks are a clear example of how this way of working delivers improved outcomes for patients. That is why we announced in May 2011 that we would continue to fund cancer networks in 2012-13 and that the NHS Commissioning Board (NHS CB) would fund and host a number of strengthened strategic clinical networks in the new health system. Strategic clinical networks will be supported through network support teams covering 12 defined geographical areas. The use of shared support teams, with dedicated clinical leads, will ensure that the available resources for strategic clinical networks are used to maximum effect.
It is expected that cancer networks will be able to make a significant contribution to driving improvements in outcomes for patients in the new health system and will made a significant contribution to achieving the goals set out in the Cancer Outcomes Strategy.
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A review of clinical networks is currently under way to consider the functions, structures and governance that will mostly effectively support commissioners to deliver improved quality and outcomes in the future. The NHS CB Authority will publish its recommendations for clinical networks later in the summer.
Julie Hilling: To ask the Secretary of State for Health (1) if he will ensure that data collected by the forthcoming National Cancer Patient Experience Survey is published by equality group within tumor types; [117482]
(2) what progress his Department has made in providing information to commissioners on (a) the age profile of local cancer populations, (b) the outcomes and experiences of local patients by age and (c) how their performance compares with other areas; and if he will make a statement. [117483]
Paul Burstow: A major focus of activity for the National Cancer Intelligence Network (NCIN) has been the development and publication of comparative information or “profiles”. Profiles for general practitioner practices, commissioners and individual multidisciplinary teams mean that cancer services and outcomes can be benchmarked across the treatment pathway.
The NCIN has also published a range of data reports that are providing valuable insight into cancer patient outcomes across England. These have included data on surgical resection rates, 30-day post-operative mortality after colorectal surgery, and pancreatic cancer trends in younger people. Wherever possible, all NCIN reports are published broken down by equality characteristic. All new datasets include gender, socio-economic deprivation and age, including older people and children, teenagers and young adults.
The National Report of the 2010 Cancer Patient Experience Survey, published in December 2010, recorded the views of over 67,000 cancer patients treated across 158 trusts against over 50 scored questions. A key part of disseminating the 2010 results has been benchmarking the performance of trusts against one another. At the bespoke trust level, reports display the results for each question in the survey benchmarked against other trusts and also benchmarks by teams within trusts where numbers allowed.
The fieldwork for the National Cancer Patient Experience Survey 2011-12 is finished and analysis is under way. Data collected from the 2011-12 National Cancer Patient Experience Survey will be published by equality group within cancer-type groupings where sufficient numbers allow, and a report will be placed on the website of our survey supplier Quality Health.
The 2011 survey will show who has really improved and where further action is required. National and trust level reports are expected to be published later this summer.
Cancer: Drugs
Dr Wollaston: To ask the Secretary of State for Health (1) how many patients in each parliamentary constituency have received access to drugs through the Cancer Drugs Fund since its creation; [117097]
(2) how many patients (a) under the age of five, (b) between the age of five and 10 and (c) between the age
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of 10 and 16 years have received access to drugs through the Cancer Drugs Fund since its creation; and what the total cost for this treatment has been. [117199]
Paul Burstow: Information on patients funded through the Cancer Drugs Fund is not collected at parliamentary constituency level. Information on the age of patients who have received cancer drugs is also not collected.
Cancer: Older People
Annette Brooke: To ask the Secretary of State for Health (1) what progress has been made on the work led by his Department, the National Cancer Equality Initiative and Macmillan Cancer Support to test new approaches to clinical assessment for older patients; [117859]
(2) what steps his Department is taking to encourage multidisciplinary teams to undertake patient-level equity audits; and if he will make a statement. [117860]
Paul Burstow: We are working with Macmillan Cancer Support and Age UK on a £1 million programme to improve cancer care for older people. The programme will help us to deliver improved outcomes by ensuring that older people’s needs are properly assessed and met.
The programme consists of 14 pilot sites across the country to improve intervention rates for people over 70 with cancer. The pilots are introducing new ways of assessing an older person for cancer treatment, offering short-term practical support for older people undergoing cancer treatment and addressing any age discrimination in cancer services by identifying and meeting the training needs of all professionals working with older people.
To date, over 500 people have received assessment as part of the project. The effectiveness and feasibility of this intervention is currently being evaluated. The pilots will report back in September 2012 and the final report and recommendations will be published in December 2012.
“Improving Outcomes: A Strategy for Cancer”, published on 12 January 2011, said that multidisciplinary teams (MDTs) are being encouraged to embed equalities into clinical practice. The National Cancer Action Team (NCAT) and the National Cancer Intelligence Network have been developing patient characteristics profiles for breast and bowel cancer MDTs, and NCAT will be working with cancer networks to develop MDT equity audits. We are aware of good progress being made by Lancashire and South Cumbria Cancer Network, who will be working closely with local clinicians to refine their patient characteristics profiles. Good practice will be shared through other cancer networks and the National Cancer Equality Initiative.
As part of their National Cancer Peer Review Programme self-assessment, under the key theme of structure and function of the service, MDTs are requested to comment on how many patients by equality characteristic (race, age and gender) they diagnosed/treated in the previous year.
Care Homes
Alison McGovern: To ask the Secretary of State for Health (1) what steps he plans to take to ensure uniform standards are achieved in the delivery of social care nationwide; [117251]
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(2) what plans he has to improve the regulation of private care homes; and whether his plans include the setting of standards in staff training. [117254]
Paul Burstow: The Care Quality Commission (CQC) is the independent regulator of health and adult social care providers in England. It has 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, have to be registered with the CQC and meet the 16 registration requirements setting out the essential levels of safety and quality.
Failure to comply with the requirements is an offence, and under the 2008 Act, the CQC has a wide range of enforcement powers that it can use if the provider is not compliant.
The registration requirements include a requirement for the registered person to have suitable arrangements in place to ensure that persons employed for the purpose of carrying on the regulated activity are appropriately supported in relation to their responsibilities, to enable them to deliver care and treatment to service users safely and to an appropriate standard including by receiving appropriate training, professional development, supervision and appraisal.
The CQC is responsible for developing and consulting on its methodology for assessing whether providers are meeting the registration requirements and published its “Guidance About Compliance” in March 2010.
Our White Paper, draft Bill and progress report mark the most significant Government action in over 60 years to fix a system that is fragmented, confusing and of variable quality and provision. The White Paper introduces new tools to help deliver better quality services and to improve the care that people experience, including greater transparency, with new provider quality profiles and the piloting of new care audits. It also clarifies what quality in care and support means, by setting out principles, standards, roles and responsibilities for driving up the quality of care.
Alison McGovern: To ask the Secretary of State for Health what steps he plans to take to ensure that changes in local council social care budgets do not affect the supply of residential care homes. [117252]
Paul Burstow: The level of residential care provision is not determined solely by local council social care budgets. The supply of care home places is governed principally by demand, which comes from both public commissioners, such as local councils and the national health service, and private purchasers of services.
According to the Care Quality Commission, there are approximately 18,000 care and nursing homes in England, with around 460,000 places, at present. We are informed by the NHS Information Centre that, during 2010-11 (the latest available data) the number of people receiving permanent council-supported residential care was 213,000. A further 72,000 received short-term residential care during the year.
The remainder of places are purchased by those who fund their own care. The Department does not collect information on occupancy levels in care homes.
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However, independent analysts, such as Laing and Buisson, estimate there to be a national vacancy rate of around 10% in the sector at present. The Department does not envisage or expect that there will be a shortage of places.
The Government have allocated an additional £7.2 billion by 2014-15 to councils to support the delivery of social care, plus an additional £300 million from the Care and Support White Paper. This funding, together with an ambitious programme of efficiency, should enable councils to protect people’s access to services and deliver new approaches to improving their care.
Alison McGovern: To ask the Secretary of State for Health if he will extend the protection offered to local authority arranged care recipients under the Human Rights Act 1998 to care recipients who are self-funded. [117255]
Paul Burstow: The Government's view is that all providers of publicly arranged health and social care services, including private and voluntary sector providers, should consider themselves to be bound by the duty imposed by section 6 of the Human Rights Act 1998, and not to act in a way which is incompatible with a convention right.
Any amendment to the Human Rights Act in relation to third sector and private providers of home care, to specify explicitly that they are subject to the section 6 duty, risks casting doubt about the interpretation of the Human Rights Act in other sectors. Each time specific provision is made with respect to a particular type of body, we weaken the applicability of the general test and raise doubt about all those bodies that have not been specified explicitly in the legislation.
The Government have established a Commission to look at how human rights are protected in the United Kingdom to see if things can be done better and in a way that reflects our traditions. The Commission is due to report by the end of this year.
I and my noble Friend, the Parliamentary Under-Secretary of State (Earl Howe), are to host a round table discussion on 19 September, at which we will seek the views of key partners and stakeholders to establish how, both individually and collectively, we will work to promote and protect peoples' human rights in health and social care services.
The round table will be a one-off event, hosted by the Department, to facilitate a discussion on the promotion and protection of the human rights of people using social care services. It will look at how Government strategy on adult social care contributes to improvements in this area.
Partners present at the round table will identify what actions they are taking to deliver improvements in the promotion and protection of human rights. The event will focus upon the principal aim of preventing abuse of people's human rights, rather than concentrating on routes of redress once abuse has actually occurred.
The Department will consider any recommendations made on the day and will continue to work closely with key stakeholders in this area.
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Care Homes: Fees and Charges
Esther McVey: To ask the Secretary of State for Health (1) what information his Department holds on whether private care homes in receipt of registered nursing care contributions payments reflect such payments in the level of fees payable by self-funding residents; [116942]
(2) what the average weekly cost is to the NHS of NHS-funded nursing care contributions paid to residents in private nursing homes; and what steps his Department takes to monitor whether such homes use those contributions for the purpose of patient care; [116943]
(3) whether private care homes in receipt of registered nursing care contribution payments are reflecting such payments in the fees charged to self-funding residents. [117731]
Paul Burstow: National health service-funded nursing care is the funding contribution provided by the NHS to homes providing nursing to support the provision of nursing care by a registered nurse for those assessed as eligible. Once the need for such care is agreed, it is the responsibility of primary care trusts to pay a flat rate contribution towards these costs.
Currently, the weekly flat rate is £108.70. However, those people assessed prior to October 2007 as being eligible for the higher rate contribution continue to qualify for this higher rate payment, currently £149.60, unless their nursing needs have diminished or ceased.
The home must provide a written contract or statement of terms and conditions to the resident, or the resident's family, setting out how much the NHS is contributing to the nursing care of the individual concerned and how this payment reduces the fees being paid for private care. It should include the care and services covered by the fee, the level of the fees and any additional services available at extra cost. Such contracts and the charges made by care homes are a matter between providers and purchasers of care. The Department does not monitor these centrally.
Care Homes: Vetting
Steve Rotheram: To ask the Secretary of State for Health what plans he has to create an offence of not undertaking full Criminal Records Bureau checks on staff working with vulnerable people in care homes. [117879]
Paul Burstow: Providers of care homes in England are required to register with the Care Quality Commission and to meet a series of registration requirements that set the essential levels of safety and quality. Failure to comply with the essential levels is a criminal offence. Under the requirement relating to workers, service providers must have available an enhanced criminal records check for all eligible staff.
In addition, it is a criminal offence to knowingly employ a person to work with adults in a care home who is barred by the Independent Safeguarding Authority (ISA). The ISA bars people automatically if they commit the most serious criminal offences and considers a person's criminal record when making its barring decisions.
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Carers
Alison McGovern: To ask the Secretary of State for Health whether he plans to place requirements on the NHS Commissioning Board to improve patient support for carers whose health is affected by their caring duties. [117248]
Paul Burstow: “Our NHS care objectives: A draft mandate to the NHS Commissioning Board” was published for consultation on 4 July. The draft mandate emphasises the importance of identifying and meeting the needs of carers, and proposes a specific objective asking the board to improve support for carers (objective 15). Annex B to the draft mandate proposes some key measures for assessing progress on the objectives, and asks for evidence that carers are supported to look after their health and well-being (annex B, page 10). The mandate will be published in the autumn of this year, and the NHS Commissioning Board will have a legal obligation to seek to meet the objectives it sets out.
The consultation closes on 26 September. Copies of the consultation documents have already been placed in the Library, and can be found at:
www.mandate.dh.gov.uk
Clinical Trials: Older People
Annette Brooke: To ask the Secretary of State for Health what steps his Department is taking to address inequalities in access to clinical trials amongst those aged 65 and over; and if he will make a statement. [117861]
Mr Simon Burns: The Department will continue to work with partner organisations to ensure that when researchers design a clinical trial and settle the inclusion criteria, they take account of equality legislation.
The national Age and Ageing Specialty Group which is part of the National Institute for Health Research Clinical Research Network (CRN) continues to raise the issue of arbitrary upper-age cut offs in clinical trials to help ensure those aged 65 and over are offered entry to CRN-hosted trials wherever appropriate. To highlight the importance of this, members of the group have recently published in the journal “Age and Ageing” a guide to good practice in recruiting older people into clinical research.
Community Health Services: Suffolk
Mr Reed: To ask the Secretary of State for Health (1) what assessment he has made of the decision to award Suffolk community health services to Serco; and whether experience of operating county-wide community health services was a qualifying criterion for organisations wishing to provide such services; [117808]
(2) if he will assess the comparative costs of the (a) current provider of Suffolk community health services and (b) Serco bid for those services; [117809]
(3) whether NHS Suffolk undertook any public consultation regarding the transfer of Suffolk community health services from the NHS to the private sector. [117810]
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Mr Simon Burns: The awarding of the contract to provide Suffolk community health services is a local decision by Suffolk Primary Care Trust (PCT), assured by the Strategic Health Authority, NHS Midlands and East. Therefore, the Department has not made an assessment of this decision. It is the responsibility of Suffolk PCT to ensure that the contract provides good value for money.
Suffolk PCT did not undertake a public consultation because there will be no change to services. Patients will continue to receive the same high quality care.
Consultants
Chris Skidmore: To ask the Secretary of State for Health what the cost was of external consultancy for each public body for which his Department is responsible in the latest period for which figures are available; for which projects such consultancy was commissioned; and what the cost of each project was. [117146]
Mr Simon Burns: The Department submits a monthly consultancy spend tracker report to Cabinet Office Government Procurement which captures total spend information on consultancy together with information on new contracts let or extended by the Department and the arm's-length bodies and agencies for which it is responsible. This consultancy expenditure in May 2012 by the Department's arm's-length bodies and agencies is set out in the following table. The figures are based on the definition of consultancy services provided by Cabinet Office Government Procurement (formerly the Office of Government Commerce). Information on the individual projects against which this expenditure is incurred and on the spend for each project is not available. To provide that information would incur a disproportionate cost.
| Arm's-length body or agency | Expenditure in May 2012 (£) |
Dialysis Machines
Gordon Henderson: To ask the Secretary of State for Health what steps he is taking to improve services for dialysis patients. [117284]
Mr Simon Burns:
The Department and the NHS leadership team have funded development of a patient decision aid to support patients in making an informed decision with their clinician about which method of
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treatment for renal failure is best for them, including various options for dialysis. Patients should be able to change modality if a different approach becomes more appropriate.
National health service providers of dialysis services are encouraged to have regard to the Quality Standard for Chronic Kidney Disease in Adults produced by the National Institute for Health and Clinical Excellence and published in March 2011. The Quality Standard describes the high quality, cost-effective care that will best improve care for dialysis patients. Additionally, NHS Kidney Care is leading a number of projects aimed at embedding good practice into local services.
Workplace Flour
John McDonnell: To ask the Secretary of State for Health what assessment his Department has made of the extent, causes, treatment and prevention of health conditions arising from exposure to flour in the workplace. [115712]
Chris Grayling: I have been asked to reply on behalf of the Department for Work and Pensions.
The Health and Safety Executive is responsible for the assessment of the extent, cause and prevention of occupational health conditions. Treatment is not within HSE's area of competence.
Exposure to flour in the workplace (through inhalation and skin contact) can lead to a variety of health conditions including occupational contact dermatitis, and occupational asthma. In recent years, the majority of new cases of respiratory disease where flour was the suspected cause were occupational asthma. Further information on the extent of these conditions is available on the Health and Safety Executive's website at:
http://www.hse.gov.uk/statistics/causdis/asthma.htm
http://www.hse.gov.uk/statistics/causdis/dermatitis/index.htm
Prevention of health conditions arising from exposure to flour dust and their long-term consequences depends on reducing the risk of exposure and on the early recognition of harm. Guidance on minimising exposure to flour dust can be found at:
http://www.hse.gov.uk/asthma/bakers.htm
Similarly, guidance on simple measures to prevent work-related contact dermatitis can be found at:
http://www.hse.gov.uk/catering/dermatitis.htm
Fractures: Older People
Annette Brooke: To ask the Secretary of State for Health if he will include the prevention of fragility fractures in older people in his mandate to the NHS Commissioning Board. [R] [117858]
Paul Burstow:
Our “NHS care objectives: A draft mandate to the NHS Commissioning Board” was published for consultation on 4 July. The draft mandate focuses on the ultimate outcomes of care that matter to patients and professionals, based on the NHS Outcomes Framework. The draft proposes to set the board stretching ambitions to improve against each of the five domains of the framework. Although we propose that the mandate avoids singling out specific clinical conditions or patient
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groups, in order to promote local autonomy and avoid distorting clinical priorities, the prevention of fragility fractures is relevant to several of the care objectives.
Because serious fragility fractures are a recognised factor in early mortality, prevention is relevant to achieving the objectives set in Domain 1—Preventing people from dying prematurely. Because osteoporosis is a chronic and progressive long-term condition and good management can help prevent fragility fractures, prevention is relevant to Domain 2—Enhancing quality of life for people with long-term conditions. Because fragility fractures can occur in hospitals and other care settings, prevention is relevant to Domain 5—Treating and caring for people in a safe environment and protecting them from avoidable harm.
The consultation on the draft mandate closes on 26 September. Copies of the consultation documents have already been placed in the Library, and can be found at:
www.mandate.dh.gov.uk
General Practitioners: Telephone Services
Mr Ainsworth: To ask the Secretary of State for Health what steps he has taken since January 2012 to ensure that GP surgeries adhere to his Department's direction prohibiting the use of telephone numbers that charge patients more than the equivalent cost of calling a geographical number to contact the NHS. [117661]
Mr Simon Burns: The Department issued further guidance on 23 February 2012 clarifying directions issued to national health service bodies in December 2009 on the cost of telephone calls. These directions and guidance prohibit the use of telephone numbers which charge people more than the equivalent cost of calling a geographical number to contact any part of the NHS. Where NHS bodies are charging people more, all reasonable steps should be taken to rectify this.
Health Services: Equality
Annette Brooke: To ask the Secretary of State for Health if his Department will issue guidance to ensure that all professional regulatory organisations review and, if necessary, revise their standards, codes of conduct and education programmes to advance equality and to ensure that age discriminatory behaviour is identified as unacceptable; and if he will make a statement. [117862]
Anne Milton: The health and care professions regulatory bodies are statutory bodies which are independent of Government. The Secretary of State for Health, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), has no powers to direct the way that they undertake their functions. However, the Government intend to commence provisions of the Equality Act later this year which will prohibit age discrimination in the provision of services. Under the Equality Act, the health professions regulators will be under a duty to eliminate age discrimination and advance equality of opportunity for older people. We would expect these duties to be reflected in the way that the professional regulators undertake all of their functions, including those in respect of setting standards for regulated professionals.
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Health Services: Older People
Alison McGovern: To ask the Secretary of State for Health what assessment he has made of the effect of GP commissioning on the provision of hospital services for older people. [117214]
Mr Simon Burns: The Health and Social Care Act 2012 provides for Clinical Commissioning Groups (CCGs) to become responsible for commissioning the majority of NHS services. CCGs will be required to involve other local health and social care professionals to understand the needs of local populations and how to work with their local populations to design care pathways and services that meet those needs.
Health and wellbeing boards will also provide the vehicle to enable local authorities to work in partnership with CCGs and other community partners to deliver meaningful joint health and wellbeing strategies which will in turn set the local framework for commissioning of health, social care and public health, maximising the opportunities for integrating health and social care.
This should mean that groups such as older users of hospital services experience health and care services that are better joined up and better meet their needs as individuals.
Alison McGovern: To ask the Secretary of State for Health what steps he expects the NHS Commissioning Board to take to ensure continuous and open communication between consultants and other medical staff and an older person's next of kin or representative. [117215]
Paul Burstow: The NHS Commissioning Board is subject to a legal obligation to publish guidance on information sharing. Best clinical practice would be to share information appropriately with all who have a “need to know”.
It may also be helpful to explain that an independent panel of experts chaired by Dame Fiona Caldicott is conducting a review of information governance on behalf of the Secretary of State for Health, the right hon. Member for South Cambridgeshire (Mr Lansley). The Review Panel will report its findings and make recommendations to the Secretary of State for Health. The review is considering the sharing of information with third parties. One of the topic areas is the communication of patient information between consultants and medical staff (and social care staff) and next of kin, representatives or carers.
More information can be found at the following link:
www.caldicott2.dh.gov.uk
Alison McGovern: To ask the Secretary of State for Health what measures he plans to propose to foster the development of positive perceptions of older people in his White Paper on social care. [117231]
Paul Burstow: The White Paper “Caring for our future: reforming care and support” was published in July 2012, following a public engagement in 2011. The need for people who receive care and support—the majority of whom are older people—to be treated with dignity and respect was a key message from the engagement, and this has been reflected by the policies in the White Paper.
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In addition to the White Paper, the Government intend to bring in a ban of age discrimination in the provision of goods and services, from October this year. There will be no exceptions to the ban in health and social care, aside from a statutory exception that allows, for example, free prescriptions. The aim is to ban unjustifiable age discrimination against people aged 18 and over when accessing services and in the exercise of public functions. Harassment related to age and victimisation is also banned. Adults of all ages will benefit from better access to services and for the first time people will have a legal right to redress from the courts if they are unjustifiably discriminated against because of age.
In July 2011, the Equality Delivery System (EDS) was made available to the national health service. The purpose of the EDS is to drive up equality performance and embed equality into mainstream NHS business. It has been designed to help NHS organisations—in the current and new NHS structures—to meet the requirements of the public sector Equality Duty, as well as equality aspects of other duties.
Health Services: Social Services
Alison McGovern: To ask the Secretary of State for Health what steps he expects the NHS Commissioning Board to take to ensure joined-up service provision between providers of social care and the NHS. [117216]
Paul Burstow: The Health and Social Care. Act 2012 places a duty on the Board concerning promoting integration in the way in which services are provided, where this will lead to better outcomes and reduce inequalities.
“Our NHS care objectives: A draft mandate to the NHS Commissioning Board” was published for consultation on 4 July. The draft mandate emphasises the importance of integrated care, and proposes a specific objective asking the Board to ensure that the new commissioning system promotes and supports the integration of care (including through joint commissioning) around individuals, particularly people with dementia or other complex long-term needs (objective 13). Annex B to the draft mandate proposes some key measures for assessing progress on the objectives, and asks for evidence, for example that the Board has provided leadership and practical support for clinical commissioning groups on commissioning integrated services or that patients report more integrated care—to be measured by a new indicator in the NHS Outcomes Framework. The mandate will be published in the autumn of this year, and the NHS Commissioning Board will have a legal obligation to seek to meet the objectives it sets out. The consultation closes on 26 September. Copies of the consultation documents have already been placed in the Library, and can be found at:
www.mandate.dh.gov.uk
Later this year, the Government will publish a framework, co-produced with partners across the new health and care system (including the NHS Commissioning Board, Monitor, local government, patients, people who use services, and carers), that will support the removal of barriers to making evidence-based integrated care and support the norm over the next five years.
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Hospitals: Waiting Lists
Mr Ainsworth: To ask the Secretary of State for Health how many NHS patients in (a) Coventry, (b) the west midlands and (c) England waited longer than 18 weeks for treatment in each of the last five years. [117689]
Mr Simon Burns: The information requested is shown in the following table:
| Number of patients who waited longer than 18 weeks to start treatment | ||||
| Provider name | 2008-09 | 2009-10 | 2010-11 | 2011-12 |
| Notes: Data are available from 2008-09. Includes patients who commenced treatment on admitted and non admitted pathways. Source: Department of Health Unif/2 data collection - referral to treatment waiting time statistics | ||||
Latest data for April 2012 show that 94.6% of admitted patients and 98.1% of non-admitted patients in Coventry Teaching PCT started their treatment within a maximum of 18 weeks of referral.
Learning Disability: Sussex
Nicholas Soames: To ask the Secretary of State for Health how many adults are registered as having a severe learning disability in (a) Mid Sussex constituency and (b) West Sussex. [117008]
Paul Burstow: This information is not held centrally.
NHS Commissioning Board
Nic Dakin: To ask the Secretary of State for Health what discussions he had with the Cabinet Secretary before appointing Mr Naguib Kheraj to the NHS Commissioning Board. [117291]
Mr Lansley: None. All public appointments to the Commissioning Board, including Mr Kheraj's, were made in accordance with the code of practice issued by the Commissioner for Public Appointments. Candidates were put through due diligence checks and all of the appointments were made on merit.
Jack Dromey: To ask the Secretary of State for Health what progress he has made on incorporating the recommendations of the national neuromuscular work plan into the NHS Commissioning Board set-up; and if he will make a statement. [117296]
Paul Burstow: The workplan will support a national approach to the commissioning of specialised neuromuscular services.
We will set out an initial list of nationally commissioned services this summer, which will be subject to consultation with the Commissioning Board before subsequently being confirmed in regulations.
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NHS: Fees and Charges
Mrs Ellman: To ask the Secretary of State for Health whether NHS hospitals are offering self-funding services whereby patients are charged for NHS care that could not otherwise be received; and how many patients have been charged for such services. [117722]
Mr Simon Burns: The Department is not aware of any evidence to suggest that trusts are charging for NHS services.
Trusts are, however, permitted to charge private patients for services which are not available on the national health service. They have always been allowed to do this.
The principle that NHS services should be free at the point of use, based on clinical need and not an individual's ability to pay, has underpinned the NHS since its establishment in 1948. This principle is enshrined in the NHS Constitution, and reaffirmed in the Health and Social Care Act 2012.
NHS: Finance
Chris Skidmore: To ask the Secretary of State for Health how many reviews into the financial position of NHS trusts his Department commissioned in each financial year since 1997; what the cost was of each such report; and if he will publish each such report. [117145]
Mr Simon Burns: This information is not available in the format requested. However, since 2003 the Department has commissioned historic due diligence reviews on the financial position of national health service trusts who are applying for NHS foundation trust status. The number of reviews and the total cost in each year from 2003, is shown in the following table. The historic due diligence reports and working capital reviews are held by individual NHS trusts and not by the Department.
In 2011 the Department commissioned McKinsey and Co to review the financial position of 22NHS trusts who had private finance initiative schemes, which might effect the ability to achieve NHS foundation trust status. The cost of this review was £240,000.
| Number of NHS trusts | Amount (£) | |
| Note: A number of contracts may not have been completed in the relevant year and some work may not have been finished where NHS trusts have deferred from the application process. Therefore, the total cost of the work may be less than stated. | ||
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NHS: Innovation
Chi Onwurah: To ask the Secretary of State for Health (1) when he plans to develop and publish an innovation scorecard to track compliance with the National Institute for Health and Clinical Excellence technology appraisals; and if he will make a statement; [117796]
(2) with reference to his Department's publication, “Innovation, Health and Wealth: accelerating adoption and diffusion in the NHS”, when he plans to launch the innovation pipeline project. [117797]
Mr Simon Burns: “Innovation Health and Wealth: accelerating adoption and diffusion in the NHS” was published on the 5 December 2011 and we are making good progress on all recommendations.
The NHS Confederation, Association of the British Pharmaceutical Industry and the Association of British Healthcare Industries launched the Innovation Pipeline Project in February 2012.
Development of the innovation scorecard is under way with a wide range of stakeholders. The first release will be published in September 2012.
NHS: Property
Graham Jones: To ask the Secretary of State for Health (1) what discussions he has had with PropCo on future rent levels for NHS properties; [117402]
(2) what safeguards he plans to put in place to protect hospitals from high rent increases after the transfer of NHS property assets to PropCo. [117403]
Mr Simon Burns: The Department is currently developing lettings policies that NHS Property Services Ltd will adopt once operational. These will be published in due course, so that new organisations that will become tenants of NHS Property Services as of 31 March 2013 will understand the terms and conditions of their leases, including rent levels.
Existing tenants of primary care trusts already in occupation of property that is due to transfer to NHS Property Services on 31 March 2013 will remain on the terms and conditions of existing leases and tenancy agreements in the first instance. It is likely that NHS Property Services will conduct periodic rent reviews, as is the standard practice within the property management sector.
NHS: Standards
Alison McGovern: To ask the Secretary of State for Health whether the NHS Commissioning Board's objectives will include the specification of dignified care as a key objective. [117210]
Mr Simon Burns: The Government's ambition is for a national health service which provides high quality, safe and effective care, treating patients with compassion, dignity and respect.
The Government will set objectives in a mandate to the NHS Commissioning Board that the board must seek to achieve, and the outcomes in the NHS Outcomes Framework will be at its core.
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The Government published a draft mandate for consultation on 4 July, which makes it clear that treating patients with dignity and respect is key to achieving the improved outcomes for which the board will be held to account, particularly when improving patient experience of care.
Building on the board's duty in the Health and Social Care Act 2012 to promote the NHS Constitution, the draft mandate also contains an objective asking the board to uphold, and where possible, improve performance on the rights and pledges for patients in the NHS Constitution. Among these rights is the right to be treated with dignity and respect.
As the draft mandate makes clear, the importance of treating patients and staff with dignity and respect touches on the very purpose of the health service described in the Constitution—to support people:
“at times of basic human need, when care and compassion are what matter most.”
Alison McGovern: To ask the Secretary of State for Health what steps he plans to take to ensure the achievement of dignity in care is reflected in funding for hospitals. [117211]
Paul Burstow: The Department is responsible for the allocation of resources to primary care trusts (PCTs). It is for PCTs to decide their priorities for investment locally—including funding for hospitals—taking into account both local and national priorities.
In terms of departmental policy, the standard national health service contract incorporates a number of obligations around dignity in care, including general requirements relating to good health and care practice through compliance with Care Quality Commission (CQC) essential standards of quality and safety. The NHS Operating Framework reinforces the need for high quality, dignified and compassionate care, and sets it as one of four key priorities for the NHS in 2012-13. The framework establishes the introduction of the NHS Safety Thermometer Commissioning for Quality and Innovation (CQUIN) goal. This provides NHS organisations with a financial incentive to measure harm from pressure ulcers, falls, urinary tract infections in patients with catheters, and new treatment for venous thromboembolism. The CQUIN goal will help fulfil the commitment made to publish outcomes data on pressure ulcers, and supports wider work to deliver higher quality care to patients.
From 2013, the NHS Commissioning Board (NHSCB) will be responsible for the future allocation of resources to clinical commissioning groups, and the Department will make a ring-fenced public health grant to local authorities for their new public health responsibilities. On 4 July 2012, the Department published a draft mandate to the NHSCB. This includes a number of NHS care objectives—setting out the expectations for the health service of the Secretary of State for Health, the right hon. Member for South Cambridgeshire (Mr Lansley). At the heart of the care objectives are a series of standards that broadly cover the range of work the NHS does:
preventing premature deaths—helping people live longer;
supporting people with a long-term condition to look after themselves;
supporting people through their recovery from episodes of ill health or injury;
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making sure that people have a positive experience of care in the NHS; and
treating people in a clean, safe, environment and protecting them from unnecessary harm.
The Department is now seeking public feedback on the draft care objectives. The consultation period will run from 4 July to 26 September. Responses will help to inform the final care objectives, which will be published in autumn 2012, before they officially come into force in April 2013.
Alison McGovern: To ask the Secretary of State for Health what assessment he has made of the potential effect on quality of service provision of his decision to make Monitor the economic regulator of the health and social care sector. [117247]
Mr Simon Burns: Monitor’s overarching duty will be to protect and promote the interest of patients by promoting NHS services that are economic, efficient and effective, and maintains or improves the quality of services. Improving the value for money of NHS services will support commissioners’ in driving quality improvements in NHS services for patients.
The impact assessment for the Health and Social Care Act 2012 assesses the impact of Monitor’s new role as sector regulator for the NHS. A copy has already been placed in the Library and is available on the Department’s website at:
www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_129917.pdf
Nutrition
Chris Ruane: To ask the Secretary of State for Health what (a) research and (b) trials his Department has (i) commissioned and (ii) evaluated on the potential effects of diet on the incidence of anti-social behaviour; and what the outcomes were of such research or trials. [111647]
Mr Blunt: I have been asked to reply on behalf of the Ministry of Justice.
The National Offender Management Service (NOMS) has responsibility for providing instructions to all prisons on the provision of meals for prisoners. The most recent guidelines are contained within Prison Service Instruction 44/2010, Catering Meals for Prisoners which became effective from 1 October 2010.
NOMS has not funded any research into the relationship between diet and the issues mentioned in the question. However NOMS has been supportive towards the charity "Natural Justice" which has conducted research into the effects of nutritional supplements on the behaviour of young offenders.
This research was conducted in 1996 at HMYOI Aylesbury and was reviewed by Home Office researchers who concluded that while the results showed a positive effect on behaviour, the numbers involved were too small to make the drawing of wider conclusions possible. The study did not follow up with the trainees once they were released so the question of whether re-offending was affected was not considered.
Additionally in 2009 (reported in the Journal Science) a further three-year research study commenced led by Professor John Stein in three UK prisons: Hindley,
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Greater Manchester; Lancaster Farms, Lancashire; and Polmont, Falkirk (Scotland). This study was not commissioned by NOMS but has been in part supported by £1.4 million from the charitable foundation the Wellcome Trust. The results of this study are subject to academic evaluation prior to publication of findings.
Currently NOMS has no plans to fund research or trials relating to diet and behaviour.
Palliative Care
Mr Leech: To ask the Secretary of State for Health what assessment his Department has made of the monetary value to the NHS of the contribution of informal carers for people at the end of life; and what plans he has to improve support for carers of people at the end of life. [117101]
Paul Burstow: We are very much aware of and greatly value the significant contribution that carers make to the care of those at the end of life. There is scope for debate about how best to put a financial value on this care but there can be no doubt about its huge value to those who receive care and to the wider community.
No assessment has been undertaken by the Department, but some external organisations have made estimates of the monetary value of carers' contribution. However, formal services would not need to replace every hour of unpaid care: for example, carers may include among hours of unpaid care time spent with the cared-for person, in case they should need help, but undertaking other activities. It does not include a valuation of the long-term impacts of intensive caring on the carer's own health and well-being or on the carer's career prospects and life-time earnings and pensions.
The Care and Support White Paper, together with the draft Care and Support Bill, which the Government published on 11 July, set out the Government's plans for transformation of care and support. This is a historic step forward in relation to carers as the draft Bill, for the first time, includes provision for a new duty on local authorities to meet carers’ eligible needs for support. This will put them on the same footing as the people they care for.
We think that there is much merit in providing free health and social care in a fully integrated service at the end of life and this is reflected in the White Paper. This was acknowledged in the independent Palliative Care Funding Review report and we will use the evaluation of the eight palliative care funding pilot sites to gather the data to inform this.
Pharmacy
Kate Hoey: To ask the Secretary of State for Health (1) pursuant to the answer of 21 June 2012, Official Report, column 1106W, on Guy's and St Thomas' NHS Foundation Trust: pharmacy, whether funding NHS bodies receive from his Department provides each trust with a budget allocation to reimburse actual pharmacy VAT costs incurred; and whether this allocation provides equality to an NHS provider when pharmacy services are market tested; [117711]
(2) what steps he is taking to ensure that NHS pharmacy services provided within NHS hospitals can compete with private providers who are eligible for a VAT exemption. [117712]
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Mr Simon Burns: National health service organisations' VAT costs are recognised in the public funding they receive. The NHS' spending settlement covers any VAT costs it incurs in the same way that it covers any other cost.
The Department currently allocates funding, to all primary care trusts through recurrent revenue allocations. Once allocated, it is for individual primary care trusts to decide how their budgets are invested to meet the health care needs of their local populations, taking account of local and national priorities. This would include the provision of out-patient dispensing, whether provided in-house or outsourced.
Any decision to outsource the out-patient pharmacy service would be a matter for local decision making which would be patient centred.
School Milk
Chris Skidmore: To ask the Secretary of State for Health how many settings in each local authority area claiming for the cost of free milk through the nursery milk scheme claimed more than 90p per pint in the latest period for which figures are available; and what the (a) highest and (b) median cost per pint for milk was in each local authority. [117150]
Anne Milton: The Department does not hold information centrally on the number of settings in each local authority (LA) area that claimed more than 90p per pint of free nursery milk in 2011-12. However we are able to provide figures as follows for the total number of settings that claimed more than 90p per pint in June 2012.
Cost claimed by the child care settings in providing free nursery milk in the month of June 2012—more than 90p per pint
Number of child care settings—8,962
Information is not held centrally on the highest and median cost per pint of milk in each LA geographical area.
Steroid Drugs
Jo Swinson: To ask the Secretary of State for Health (1) what recent steps his Department has taken to inform the public of the health risks of anabolic steroids; how much has been spent to that end in the last 12 months; and if he will make a statement; [117852]
(2) how many people in each region (a) aged under 18 years and (b) in total were treated for poisoning by steroid in each of the last five years. [117853]
Anne Milton: Information and advice about anabolic steroids, including the health risks associated with using anabolic steroids, is provided by FRANK and NHS Choices. It is not possible to breakdown the FRANK or NHS Choices budget to show the cost of providing information on a particular subject such as anabolic steroids.
When used in clinical practice, doctors prescribing a course of anabolic steroids are expected to discuss potential side effects and to draw patients' attention to the additional information contained in the Patient Information Leaflet.
The information in the following tables show counts of finished admission episodes by strategic health authority (SHA) of residence, for primary diagnoses of poisoning by steroids for all ages and for under 18-year-olds for 2006-07 to 2010-11.
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| Finished admission episodes(1) with a primary diagnosis of steroid poisoning(2), by SHA residence(3), under 18 and all ages, 2006-07 to 2010-11(4) | ||||||
| Activity in English national health service hospitals and English NHS commissioned activity in the independent sector | ||||||
| Under 18 | ||||||
| Strategic health authority of residence | 2006-07 | 2007-08 | 2008-09 | 2009-10 | 2010-11 | |
| Activity in English national health service hospitals and English NHS commissioned activity in the independent sector | ||||||
| All ages (including unknown) | ||||||
| Strategic health authority of residence | 2006-07 | 2007-08 | 2008-09 | 2009-10 | 2010-11 | |
| (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. ICD10 codes used: T38.5 Poisoning by other estrogens and progestogens (includes Antineoplastic, estrogen hormone steroids) T38.7 Poisoning by androgens and anabolic congeners (includes Anabolic steroids, Androgenic steroid, Antineoplastic, hormone steroids) (3) SHA/PCT of residence The strategic health authority (SHA) or primary care trust (PCT) containing the patient's normal home address. This does not necessarily reflect where the patient was treated as they may have travelled to another SHA/PCT for treatment. (4) Assessing growth through time HES figures are available from 1989-90 onwards. Changes to the figures over time need to be interpreted in the context of improvements in data quality and coverage (particularly in earlier years), improvements in coverage of independent sector activity (particularly from 2006-07) and changes in NHS practice. For example, apparent reductions in activity may be due to a number of procedures which may now be undertaken in outpatient settings and so no longer include in admitted patient HES data. Data quality: HES are compiled from data sent by more than 300 NHS trusts and PCTs in England and from some independent sector organisations for activity commissioned by the English NHS. The NHS Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies. While this brings about improvement over time, some shortcomings remain. Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre | ||||||
Thalidomide
Jim Dobbin: To ask the Secretary of State for Health with reference to the answer of 19 October 2011, Official Report, column 1042W, on thalidomide, how many prescriptions were issued for each product in each of the last three years. [117201]
Mr Simon Burns: Thalidomide is listed in the British National Formulary as a possible treatment for leprosy and untreated multiple myeloma. The table shows the actual number of prescription items dispensed in the community for Thalidomide in each of the last three calendar years.
| Thalidomide prescription items written in the United Kingdom and dispensed in the community in England(1) | |
| Number | |
| (1) Does not include items dispensed in hospitals, including mental health trusts, or private prescriptions. Source: Prescription Cost Analysis (PCA) system | |
Jim Dobbin:
To ask the Secretary of State for Health (1) with reference to the answer of 19 October 2011, Official Report, column 1042W, on thalidomide, how
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the off-label prescription of thalidomide is monitored and controlled; and what scientific evidence has been provided in product licence applications to the Medicines and Healthcare products Regulatory Agency to demonstrate the safety and efficacy of these products; [117202]
(2) how many product licences have been issued for the manufacture or supply of each of these products; to which companies; and how patients are informed that the products contain thalidomide; [117203]
(3) how many products containing thalidomide or thalidomide analogue compounds are licensed for use; and what the product names are. [117204]
Mr Simon Burns: The distribution and supply of thalidomide are strictly controlled throughout the European Union in order to ensure that patients, both male and female, cannot receive the product without observing appropriate safeguards against pregnancy. In the United Kingdom, the Pregnancy Prevention Programme for thalidomide involves the restriction of supply to specifically registered pharmacies that have agreed to abide by the programme. The Pregnancy Prevention Programme is required to be implemented regardless of whether thalidomide is prescribed for the authorised indication (multiple myeloma), or for an unauthorised indication.
Prescriptions can be dispensed in the UK only if they are accompanied by a dedicated Prescription Authorisation Form. The prescription authorisation form requires the indication for treatment with thalidomide to be recorded.
The Medicines and Healthcare products Regulatory Agency (MHRA) has put in place measures to ensure that the maximum treatment duration for one prescription is four weeks for women of childbearing potential. Prescriptions can only be dispensed within seven days of the date of the prescription, and women who are capable of becoming pregnant must provide evidence of a recent negative pregnancy test prior to receiving each new prescription.
According to the terms of the Marketing Authorisation for Thalidomide, Celgene, the Marketing Authorisation Holder is required to conduct regular audits to confirm compliance with the requirements of the Pregnancy Prevention Programme. Audits are conducted annually based on the information recorded on the prescription authorisation forms. Pharmacies registered to supply thalidomide return the information in their prescription authorisation forms to the Marketing Authorisation Holder, who then collates and analyses the data supplied. The data are then compiled into a report, which is sent to the MHRA for information and comment. One of the items analysed during the conduct of the annual pharmacy audit is the indication for treatment with thalidomide. This allows the MHRA to monitor the nature and extent of prescription for unlicensed indications.
As with all marketing authorisation applications, before thalidomide was granted a licence and became available in the UK they were fully evaluated in relation to the appropriate standards required in the relevant European Rules and Regulations on Medicinal Products. Data submitted in support of the application demonstrated that the safety and efficacy of the product were satisfactory in the claimed indication and patient population.
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There is only one authorised product available in the UK that contains thalidomide (Thalidomide Celgene 50mg Capsules, MA holder: Celgene Europe Ltd, Middlesex, UK).
Marketed products are clearly labelled on both the outer container and in the patient information leaflet supplied with the medicine to provide the name of the active ingredient in addition to any brand name given to the product.
Given that there is an obligation for the patient to sign an informed consent form and to be counselled as to the risks of thalidomide with every prescription, and that it must be recorded that counselling has taken place, it should not be possible for patients to receive Thalidomide Celgene in the UK without being aware that the product contains thalidomide.
Mr Jim Cunningham: To ask the Secretary of State for Health (1) what steps his Department is taking to ensure that its cost data capture the costs of thalidomide needs nationwide; [117820]
(2) what steps his Department is taking to ensure that standards in home care for thalidomiders are consistently high and at a specialist level. [117821]
Paul Burstow: Our expectation is that good quality home care should be available to anyone that needs it. 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, have to register with the CQC and meet a set of 16 safety and quality registration requirements.
The 16 requirements reflect the essential levels of safety and quality of care that people should be able to expect, and are built around the main risks inherent in the provision of health and adult social care services.
The CQC is responsible for developing and consulting on its methodology for assessing whether providers are meeting the registration requirements and published its “Guidance About Compliance” in March 2010.
Failure to comply with the requirements is an offence, and under the 2008 Act, the CQC has a wide range of enforcement powers that it can use if the provider is not compliant.
Trade Unions
Chris Skidmore: To ask the Secretary of State for Health how many trade union representatives worked at each public body for which his Department is responsible on a full-time basis in each financial year since 1997-98; what the salary was for these full-time representatives in each year; and what the total cost to his Department was in each case. [117147]
Mr Simon Burns:
Information provided by the Department's 20 public bodies indicated that between 1997-98 and 2006-07, there were no full-time trade union representatives, though one public body did not have available information for the years 2005-06 to
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2006-07. Information for the years from 2007-08 is set out in the following table, using salary bandings of £5,000.
As with other personal data, the Department's disclosure of the details of this type of information is subject to data protection legislation and standing instructions from the Cabinet Office that, where numbers of individuals are five or fewer in a particular category, the figures are not released to prevent individuals being personally identified directly or in combination with other published information. In this instance, the aggregation of data acts to protect the identity and privacy of individuals.
| Number of trade union representatives that worked on a full-time basis | Salary range | Total cost range | |
Foreign and Commonwealth Office
Absenteeism
John Pugh: To ask the Secretary of State for Foreign and Commonwealth Affairs what the absenteeism rate was in his Department in each of the last three years. [116662]
Mr Bellingham: The total number of working days lost through short and long-term sick absence, for the financial years 2010-11 and 2011-12, are published in the Annual Departmental Report produced by the Foreign and Commonwealth Office (FCO), which can be accessed via:
http://www.fco.gov.uk/en/publications-and-documents/publications1/annual-reports/departmental-report/
The figures for the last three years are:
| Number | |
The total number of days lost through sick absence in 2009-10 was 27,804. The figures for 2009-10 and 2010-11 include absences in FCO Services. FCO Services is now a Trading Fund of the FCO. The 2011-12 figure excludes FCO Services absences.
Bahrain
Richard Burden: To ask the Secretary of State for Foreign and Commonwealth Affairs for what reasons he did not support the joint statement on Bahrain proposed at the recent UN Human Rights Council; and if he will make a statement. [116952]
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Alistair Burt: The UK remains concerned about the human rights situation in Bahrain and continues to raise this regularly with the Bahraini Government at the most senior levels.
We did not sign up to the joint statement because we did not consider it appropriate at this stage to raise Bahrain under agenda item 4. While we agree with the substance of the Swiss-led statement, item 4 is reserved for highlighting situations of the most serious concern for human rights, and the UK does not believe that the situation in Bahrain is currently comparable with the situation in the other countries raised under this item, such as Syria. A number of other countries, including the US and other EU member states, agreed with this assessment and did not sign the statement.
The UK made its concerns clear when we raised human rights in Bahrain under item 10 at the HRC. We noted that while progress has been made in a number of areas, much more must be done to address the continuing failings and to ensure the recommendations of the National Commission of Inquiry are implemented in full. In particular, we called on the Bahraini Government to ensure that the postponed visit of the Special Rapporteur on Torture goes ahead as soon as possible. As a long- standing ally the UK will continue to support Bahrain in this work.
Burma
Rushanara Ali: To ask the Secretary of State for Foreign and Commonwealth Affairs if he will press the Government of Burma to establish an independent inquiry, with international assistance, into the violence in Arakan state in that country. [117535]
Mr Jeremy Browne: We are deeply concerned by the recent violence in Rakhine (Arakan) state. We are aware that the Burmese authorities have opened an inquiry into the recent violence. We will monitor this closely and will urge the Burmese Government to ensure that that inquiry is able to work in a transparent manner and that its findings are balanced and credible.
Rushanara Ali: To ask the Secretary of State for Foreign and Commonwealth Affairs if he will urge the Government of Burma to stop the violence and persecution of Rohingyas in Arakan state in that country. [117549]
Mr Jeremy Browne: The recent inter-communal violence in Rakhine state in western Burma has highlighted both the fragility of the situation in Burma, and drawn further and much needed attention to the plight of the Rohingya. I issued a statement on 10 June which expressed deep concern about the situation and urged all groups to open a dialogue to end the violence.
On 12 June our ambassador met Burmese President Thein Sein. The ambassador emphasised our deep concern about the hostilities in Rakhine state, and urged him to make every effort to resolve the situation peacefully.
On 22 June officials from our embassy in Rangoon raised our concerns over the lack of regular humanitarian aid access to Rakhine state and the closure of the border with Bangladesh with the Burmese Ministry of Foreign Affairs.
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We remain concerned about the humanitarian situation in Rakhine state and will continue to monitor this closely.
Rushanara Ali: To ask the Secretary of State for Foreign and Commonwealth Affairs what discussions he has had on the situation in Arakan state, Burma with his counterparts in other EU member states and in the US. [117552]
Mr Jeremy Browne: We are deeply concerned by the recent violence in Rakhine (Arakan) state. We regularly discuss the ethnic conflict in Burma and the specific issues affecting the Rohingya with our European and US colleagues. We are set to discuss the matter further at senior official level in Brussels on 18 July.
Rushanara Ali: To ask the Secretary of State for Foreign and Commonwealth Affairs what discussions he has had on the situation in Arakan state, Burma with his counterparts in Bangladesh and India and in members states of the Association of South East Asian Nations. [117553]
Mr Jeremy Browne: We regularly raise the ethnic conflict in Burma and the specific issues affecting the Rohingya with countries in the region, including the Association of South East Asian Nations (ASEAN), India and Bangladesh.
Our high commissioner in Dhaka raised this issue with the Government of Bangladesh as part of an EU demarche in late June and officials from our high commission have continued to discuss it with the Bangladesh authorities since.
We acknowledge Bangladesh's efforts in dealing with development and humanitarian issues in Cox's Bazar district over several decades and understand the challenges accepting further refugees would cause. We continue to urge Bangladesh to continue to provide treatment for individuals displaced from Burma in need of emergency medical care.
In our meetings with ASEAN member states we continue to stress the important role that ASEAN and its members have in both supporting the reform process and resolving ethnic conflict in Burma. In particular, we have called on ASEAN member states to draw upon their own experiences to assist Burma's transition to democracy.
Diplomatic Service
Nic Dakin: To ask the Secretary of State for Foreign and Commonwealth Affairs how many UK (a) ambassadors and (b) high commissioners are female. [117195]
Mr Bellingham: The Foreign and Commonwealth Office (FCO) has 38 heads of post who are female. This includes 26 ambassadors and high commissioners. The remainder are heads of subordinate posts.
The FCO produces an annual Equality report which can be accessed at:
http://www.fco.gov.uk/en/publications-and-documents/publications1/annual-reports/equality-report
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Ethiopia
Jeremy Corbyn: To ask the Secretary of State for Foreign and Commonwealth Affairs what recent assessment he has made of the freedom of the press in Ethiopia. [117486]
Mr Bellingham: We are concerned about the increasing restrictions on the freedom of the press in Ethiopia, including recent convictions of journalists under the anti-terrorism legislation. We have raised these concerns with the Ethiopian Government at the highest level, including most recently on 12 July when I met with the Ethiopian Deputy Prime Minister. Other developments have also made the operating environment for the press more difficult, including the passing of a law in July that restricts the ratio of advertising to news coverage.
Iran
Alec Shelbrooke: To ask the Secretary of State for Foreign and Commonwealth Affairs what reports he has received on Iranian activity at the Parchin facility. [117570]
Alistair Burt: In the annex to its November 2011 report, the International Atomic Energy Agency (IAEA) states that it had been provided with information which indicates that Iran “constructed a large explosives containment vessel in which to conduct hydrodynamic experiments” at Parchin. It also received information alleging that Iran “was conducting high explosive testing” at the site. As the IAEA report details,
“hydrodynamic experiments [...] which involve high explosives in conjunction with nuclear material or nuclear material surrogates, are strong indicators of possible weapon development.”
At the same time as it continues to deny the Agency access, we are concerned that Iran is now undertaking sanitisation work at Parchin. The IAEA's most recent report of 25 May 2012 referred to a letter dated 2 May 2012 in which the Agency reiterated its request for early access to a specified location within the Parchin site. In the same letter, the Agency informed Iran that satellite imagery had shown that
“at this location, where virtually no activity had been observed for a number of years, the buildings of interest to the Agency are now subject to extensive activities that could hamper the Agency's ability to undertake effective verification.”
In line with an IAEA Board of Governors resolution adopted on 18 November 2011, we continue to call on Iran to provide the Agency with “access to all relevant information, documentation, sites, material and personnel in Iran” in order to address the international community's concerns about the possible military dimensions to its nuclear programme.
Alec Shelbrooke: To ask the Secretary of State for Foreign and Commonwealth Affairs what reports he has received of the access of International Atomic Energy Agency inspectors to the Parchin facility in Iran. [117571]
Alistair Burt: In its November 2011 resolution, the International Atomic Energy Agency (IAEA) Board of Governors calls on Iran to provide the Agency with
“access to all relevant information, documentation, sites, material and personnel in Iran.”
Since then, the IAEA has in successive reports reiterated its request for access to Parchin, including most recently in its report of 25 May 2012. In response to the agency's
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request in May, Iran stated that access would not be possible until agreement had been reached on a structured approach to clarify all outstanding issues. Despite the agency's efforts, Iran has so far failed to finalise agreement to such a structured approach, and continues to deny the agency the access it needs to be able to assure the international community that there are no ongoing activities relevant to the development of a nuclear explosive device.
Iraq
Mr Jim Cunningham: To ask the Secretary of State for Foreign and Commonwealth Affairs what assessment his Department has made of reports that the Iraqi Government has been refusing to allow Iraqis who left as refugees to return to Iraq. [117620]
Alistair Burt: The British Government continue to make returns to Iraq on a case by case basis and Iraqis who have failed to establish an asylum claim can and do return voluntarily.
Kashmir
Steve Baker: To ask the Secretary of State for Foreign and Commonwealth Affairs what assessment he has made of the allegations of human rights abuses made in the Channel 4 documentary, Kashmir's Torture Trail; and if he will make a statement. [117788]
Alistair Burt: We are aware of the Channel 4 documentary on Kashmir. We monitor developments in Kashmir closely and regularly raise concerns about the human rights situation on both sides of the Line of Control. The UK has consistently called for an end to all external support for violence in Kashmir. Prime Minister Singh has made it clear that human rights abuses by security forces in Kashmir will not be tolerated. We note that the Indian Government decided to allow the UN Special Rapporteur on extrajudicial, summary or arbitrary executions to pay a fact-finding visit to Kashmir last March. We are following the investigations of the Jammu and Kashmir State Human Rights Commission. We welcome the initiative by Prime Minister Singh to appoint three interlocutors to engage with a wide range of interested parties to help resolve the situation in Indian-administered Kashmir. The Indian Government have recently published the interlocutors' report, which sets out a range of confidence building measures, including addressing human rights concerns. I understand that the Indian Government will take a decision on how to implement the report after a period of consultation.
The long-standing position of the UK is that it is for India and Pakistan to find a lasting resolution to the situation in Kashmir, one which takes into account the wishes of the Kashmiri people. It is not for the UK to prescribe a solution or to mediate in finding one. We welcome the positive steps being taken by Pakistan and India to build trust and confidence.
Mexico
Kerry McCarthy: To ask the Secretary of State for Foreign and Commonwealth Affairs what discussions his Department has had with authorities in Mexico on the recent presidential election and public demonstrations against the result; and if he will make a statement. [117931]
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Mr Jeremy Browne: Foreign and Commonwealth Office staff in London and at our embassy in Mexico City are closely monitoring the situation following the election and are in contact with the relevant authorities. The provisional results of the presidential election were announced on 2 July, with Enrique Peña Nieto gaining the most votes. The final result will be ratified by the independent Electoral Tribunal by 6 September. To date the Electoral Tribunal has pronounced itself satisfied with the electoral process. This followed a recount of around half of all ballot boxes in response to a request from one of the other presidential candidates. The UK and Mexico have an excellent bilateral relationship built on mutual understanding and respect, and we look forward to working with the new administration, once it is confirmed, on a wide range of bilateral and international issues.
Middle East
Simon Kirby: To ask the Secretary of State for Foreign and Commonwealth Affairs what assessment he has made of recent reports of rocket fire from the Sinai peninsula into Israel. [117338]
Alistair Burt: We are not aware of any confirmed reports of rocket fire from the Sinai peninsula into Israel. However, the British Government remain concerned about the security situation in the Sinai and we regularly raise this issue with the Egyptian authorities.
On 22 June, I issued a statement expressing concern the escalation of violence around southern Israel and Gaza, including indiscriminate rocket fire into southern Israel.
The UK continues to urge all parties to exercise restraint and prevent civilian casualties and loss of life.