Drugs: Babies

Nick de Bois: To ask the Secretary of State for Health pursuant to the answer of 8 November 2012, Official Report, columns 674-5W, on drugs: babies, how many babies were born showing neonatal withdrawal symptoms attributable to maternal use of illicit or therapeutic drugs in 2011-12; and if he will make a statement. [138570]

Dr Poulter [holding answer 21 January 2013]:In 2011-12 there were 1,118 finished admission birth episodes(1 )where the primary or secondary diagnosis(2) was P96.1 Neonatal withdrawal symptoms from maternal use of drugs of addiction.

It should be noted that ICD-10 code P96.1 includes neonatal withdrawal symptoms from maternal use of any drug that the mother is addicted to—for example heroin or analgesics. Therefore it is not possible to identify the specific drug the neonate is withdrawing from using ICD-10.

(1) Finished Admission (Birth) Episode (FAE)

A finished admission episode (FAE) is the first period of inpatient care under one consultant within one healthcare provider. FAEs are counted against the year in which the admission episode finishes. Admissions do not represent the number of in-patients, as a person may have more than one admission within the year. Birth episodes and 'other birth event' episodes were included in these counts.

(2 )Number of episodes in which the patient had a (named) primary or secondary diagnosis

The number of episodes where this diagnosis was recorded in any of the 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) primary and secondary diagnosis fields in a Hospital Episode Statistics (HES) record. Each episode is only counted once, even if the diagnosis is recorded in more than one diagnosis field of the record.

Note:

ICD-10 code used:

P96.1 Neonatal withdrawal symptoms form maternal use of drugs of addiction

Empty Property

Mr Chope: To ask the Secretary of State for Health pursuant to his answer of 15 January 2013, Official Report, column 698W, on health centres: Christchurch, for what reason the disposal of the Department's interest in the property has not yet taken place; and what the cost has been to his Department in empty property rates to date. [138794]

Dr Poulter: The surrender of the lease is dependent upon the landlord reaching an agreement with the proposed hotel operator and planning consent being obtained, both of which are outside the Department's control. This has taken longer than anticipated.

The total rates paid since 2000 are estimated to be £252,250.

Erectile Dysfunction: Drugs

Ms Abbott: To ask the Secretary of State for Health how many prescriptions of each type of drug for the treatment of erectile dysfunction were dispensed in (a) 2012 and (b) each of the last five years. [137866]

Norman Lamb: The number of prescription items dispensed for each medicine classified as used to treat erectile dysfunction, in the British National Formulary (BNF) section 7.4.5 “Drugs for erectile dysfunction”, is shown in the following table.

Number of prescription items for medicines used to treat erectile dysfunction, written in the UK and dispensed in the community, in England
BNF chemical name20072008200920102011January to September 2012(1)

Alprostadil

76,278

75,551

75,939

79,491

80,582

62,141

Apomorphine Hydrochloride

43

15

4

1

Dapoxetine Hydrochloride

5

6

6

Other Preparations(2)

199

192

12

8

25

Papaverine Hydrochloride

309

48

23

84

107

98

Papaverine Hydrochloride/Phentolamine

1

1

Papaverine Sulphate

5

Sildenafil (Erectile Dysfunction)(3)

1,112,228

1,185,434

1,232,875

1,276,062

1,279,472

958,444

Tadalafil

503,003

569,453

680,700

770,701

815,583

629,700

Vardenafil

146,478

153,324

155,669

156,351

165,359

131,483

Yohimbine Hydrochloride

143

126

171

181

75

57

Grand total

1,838,687

1,984,144

2,145,393

2,282,876

2,341,192

1,781,954

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22 Jan 2013 : Column 274W

‘—’ Indicates no prescription items. (1) Data for the full calendar year of 2012 is not yet available. (2) Includes Invicorp-1 injection solution auto-injector, Invicorp-2 injection solution auto-injector and Invicorp-2 injection solution 1 ml amp. (3) Does not include 'Revatio' as this should only be prescribed to treat pulmonary hypertension (BNF 2.5.1). Source: Prescription Cost Analysis (PCA) system. The Health and Social Care Information Centre, Prescribing and Primary Care Services.

Fast Food

Kerry McCarthy: To ask the Secretary of State for Health what assessment he has made of the recent findings by the International Study of Asthma and Allergies in Childhood on the connection between fast food and asthma or allergies; and if he will make a statement on the implications for public health policy. [138158]

Anna Soubry: This study adds to the evidence base linking dietary factors and the risk of conditions such as asthma and eczema. The development of these conditions is affected by a wide range of factors (e.g. environmental and genetic factors), all of which need to be considered.

The Department will continue to keep the evidence on this issue under review.

Health

Lyn Brown: To ask the Secretary of State for Health whether public health budgets were ring-fenced when responsibilities were transferred to local authorities. [138160]

Anna Soubry: Public health budgets have been ring-fenced. A number of conditions have been placed on how they can be used and local authorities will be required to report on how they have spent their grants at the end of each financial year. Any underspends will need to be placed into a public health reserve.

The conditions and reporting arrangements were published alongside the allocations announcements on 10 January. A copy of the grant conditions, and the associated documentation on the reporting arrangements, has been placed in the Library.

Health Services

Mr Barron: To ask the Secretary of State for Health what his assessment is of the data on achievement, exceptions and prevalence for the Quality and Outcomes Framework recently published by the Health and Social Care Information Centre. [137650]

Dr Poulter: Practices continue to maintain high levels of achievement against the Quality and Outcomes Framework (QOF) in England; achieving 96.9% of the points available; compared to 94.7% in the previous year. The main reason for the small increase in average points achievement is technical, due to a change in the allocation of points between QOF areas.

The overall exception rate for practices in England increased slightly on the previous year by 0.2 % to 5.6%. As part of our proposed reform to the GP contract we will ask the NHS Commissioning Board to carry out further work during 2013; in consultation with the General Practitioners Committee, to replace ill-defined general codes for exceptions with specific codes to record accurately the clinical reason for an exception of a patient.

Reported prevalence has generally remained stable with some small increases for chronic conditions, which is to be expected.

The QOF has brought improvements in patient care, but we need to go further and faster. This is why we have sent proposals to the British Medical Association for changes to the GP contract to drive up standards for all patients. We want the contract to reflect the most up-to-date expert guidance and excellent standards of care.

Nick de Bois: To ask the Secretary of State for Health when information on the Commissioning for Quality and Innovation frameworks for prescribed specialised services will be published. [138201]

Anna Soubry: The Commissioning for Quality and Innovation (CQUIN) framework was introduced nationally in 2009 and is intended to ensure that a proportion of core national health service funding is explicitly directed to the achievement of measurable improvements in the quality and experience of commissioned care.

CQUIN schemes for directly commissioned specialised services in 2013-14 have been informed both by national priorities (for example the provision of clinically led, networked care) and by the work of Clinical Reference Groups (CRGs), which have been established to enable active clinical engagement in national work in support of the commissioning of specialised services.

The CQUIN approach for specialised services in 2013-14, for which documentation will be completed by the beginning of February, includes a range of service specific schemes. This enables commissioning staff within the future area teams of the NHS Commissioning Board to tailor the negotiation of CQUIN targets with local providers within a consistent national framework.

Nick de Bois: To ask the Secretary of State for Health when the NHS Commissioning Board plans to publish (a) the final commissioning specification for blood and marrow transplantation and (b) the Manual for Prescribed Specialised Services. [138203]

Anna Soubry: A public consultation is currently under way in respect of a range of draft service specifications and commissioning policies covering the prescribed specialised services falling within the NHS Commissioning Board's direct commissioning responsibilities from 1 April 2013.

The consultation is intended to support the completion of these commissioning ‘products’ which will, for the first time, describe a consistent set of national requirements for all commissioned providers of specialised services.

22 Jan 2013 : Column 275W

The documents build on work previously undertaken at a local level, and on the recommendations of a range of organisations (including Royal Colleges, patient representative groups and National Institute for Health and Clinical Excellence) which in many cases have themselves also been subject to broad stakeholder engagement and/or public consultation.

The consultation period closes on 25 January, and will enable consideration of any further amendments that might be required prior to formal adoption. Publication of the agreed 2013-14 service specifications, including the specification covering blood and marrow services, is expected in March.

The Manual for Prescribed Specialised Services was published on the NHS Commissioning Board's website in November 2012 at:

http://www.commissioningboard.nhs.uk/files/2012/12/pss-manual.pdf

and describes the prescribed specialised services that the Board will commission from April 2013. A final version of the manual will be published in March 2013.

Nick de Bois: To ask the Secretary of State for Health what representations he and the NHS Commissioning Board have received on the timeline for the consultation on the specialised commissioning service specifications. [138205]

Anna Soubry: Representations in respect of the consultation timeline have been received from the following organisations:

The Gender Identity Research and Education Society

The National Association of LINks Members

The Association of the British Pharmaceutical Industry

The Association of British Healthcare Industries.

The consultation closes on 25 January. Responses to the consultation will be carefully analysed before the NHS Commissioning Board formally adopts the final service specifications for inclusion in contracts with providers from 2013-14. Publication of the 2013-14 service specifications is expected in March 2013.

Nick de Bois: To ask the Secretary of State for Health when guidance outlining the national Individual Funding Request process for prescribed specialised services will be published. [138206]

Anna Soubry: A suite of ‘generic’ (non service-based) NHS Commissioning Board commissioning policies has been developed to support the delivery of future direct commissioning responsibilities. This includes draft operating guidance outlining the national Individual Funding Request (IFR) process, which will be administered by four area teams (one in each region) from April.

The draft IFR guidance is currently being reviewed by the clinical and commissioning teams within the NHS Commissioning Board and guidance is being sought on the potential for wider engagement prior to the policies being finalised. A final publication date has consequently not yet been confirmed. An interim process will be published, to enable area teams to ensure that individual funding requests continue to be considered in a timely manner during the transition period.

22 Jan 2013 : Column 276W

Nick de Bois: To ask the Secretary of State for Health when guidance outlining the national Individual Funding Request cohort policy process for prescribed specialised services will be published. [138207]

Anna Soubry: A suite of 'generic' (non service-based) NHS Commissioning Board commissioning policies has been developed to support the delivery of future direct commissioning responsibilities. This includes draft operating guidance outlining the national Individual Funding Request (IFR) process, which will be administered by four area teams (one in each region) from April.

The draft IFR guidance is currently being reviewed by clinical and commissioning colleagues within the board and guidance is being sought on the potential for wider engagement prior to the policies being presented for ratification. A final publication date has consequently not yet been confirmed. An interim process will be published for guidance in the meantime, to enable area teams to ensure that individual funding requests continue to be considered in a timely manner during the transitionary period.

Dr Wollaston: To ask the Secretary of State for Health what representations his Department has received on reform of the Quality and Outcomes Framework in the last 12 months. [138231]

Dr Poulter: The Department has received four letters from Members of Parliament with suggestions from their constituents for reforms to the Quality and Outcomes Framework (QOF), including two letters calling for new indicators for vitamin D and obesity. We received one letter from the National Obesity Forum calling for new indicators on obesity.

We have also received seven letters from Members of Parliament enclosing letters from general practitioners (GPs) and a letter from the General Practitioners Committee, expressing concern at the Government's proposed changes to QOF as part of the GP contract for 2013-14.

In addition, ‘The management of diabetes services in the NHS’, a report by the National Audit Office, referred to problems with the QOF, including that it did not incentivise GP practices to exceed upper thresholds of achievement. The report was the subject of a Public Accounts Committee hearing in June 2012.

Health Services: Greater London

Nick de Bois: To ask the Secretary of State for Health what representations he has received on progress of the delivery of the Independent Reconfiguration Panel in respect of the Barnet, Enfield and Haringey Clinical Strategy; and if he will make a statement. [137822]

Anna Soubry: My right hon. Friend the Secretary of State for Health and Health Ministers have received a number of representations from the London borough of Enfield, other interested stakeholders, and members of the public regarding progress in respect of the Barnet, Enfield and Haringey Clinical Strategy generally, and its implementation.

22 Jan 2013 : Column 277W

Health: Disadvantaged

Lyn Brown: To ask the Secretary of State for Health what steps his Department is taking to tackle health inequality. [138188]

Anna Soubry: Tackling health inequalities is a Government priority as part of its wider focus on fairness and social justice. We have established a framework aimed at reducing health inequalities.

In the Health and Social Care Act 2012, we have, for the first time ever, established specific legal duties on health inequalities for national health service commissioners and my right hon. Friend the Secretary of State for Health Commencing on 1 April 2013:

The NHS Commissioning Board and clinical commissioning groups will be under a duty to have regard to the need to reduce inequalities in access to, and the outcomes of, healthcare.

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

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

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

The NHS Mandate to the NHS Commissioning Board, published on 13 November 2012, recognises that there are longstanding and unjustifiable inequalities in access to services, in the quality of care, and in health outcomes for patients and reaffirms the Government's commitment to holding the board to account for discharging its legal duties as regards to these health inequalities.

We have also taken steps to ensure that, once established, Public Health England will play a key role in tackling inequalities. This has been informed by the independent review of health inequalities “Fair Society, Healthy Lives”, (February 2010), which was led by Professor Sir Michael Marmot. The Government accepted the key principles and recommendations, responding through the public health White Paper, “Healthy Lives, Healthy People” (November 2010).

The NHS Commissioning Board has a budget of £95.6 billion to deliver the mandate. Within this overall funding, it has allocated £65.6 billion to local health economy commissioners for 2013-14, a real terms increase of 0.6% compared to 2012-13 baselines.

Local authorities will take the lead for improving the health of their local population and reducing health inequalities. The ring-fenced grants totalling £2.7 billion and £2.8 billion have been allocated to local authorities for 2013-14 and 2014-15 to spend on public health services for their local populations. These grants have been targeted using a formula commissioned by the Secretary of State from the independent Advisory Committee on Resource Allocation. One of the aims of this formula is to contribute to reducing health inequalities.

Both the Public Health Outcomes Framework and the NHS Outcomes Framework have a strong focus on addressing health inequalities, providing mechanisms to monitor progress.

The University College London Institute of Health Equity, led by Professor Sir Michael Marmot and supported

22 Jan 2013 : Column 278W

by the Department, will help England to strengthen its evidence-based approach to addressing health inequalities, and support all parts of the health system through the practical application of knowledge and best practice.

Finally, within a broad strategy to tackle health inequalities across the country, we are also addressing the health needs of those most vulnerable to poor health outcomes through the Inclusion Health programme. The initial focus of the programme is on the health outcomes of homeless, Gypsies and Travellers, sex workers, and vulnerable migrants.

Ibuprofen

Nick de Bois: To ask the Secretary of State for Health how many prescriptions have been dispensed for the use of ibuprofen in England in each of the last five years; and what the annual cost to the Exchequer was of such prescriptions. [138677]

Norman Lamb: Information on the number of ibuprofen prescription items, dispensed in the community, with the net ingredient cost, in each of the most recently available five years, is as follows:

Prescription items for ibuprofen written in the United Kingdom and dispensed in the community, in England(1,2)
 Number (thousand)Net ingredient cost (£000)

2007

5,885.5

21,520.9

2008

6,168.4

19,398.1

2009

6,474.1

20,275.3

2010

6,618.5

20,154.2

2011

6,675.4

20,580.5

(1) Does not include items dispensed in hospitals, including mental health trusts, or private prescriptions. (2) Does not include preparations that contain both ibuprofen and other chemicals, in combination, which are relatively small in number. Source: Prescription Cost Analysis (PCA) system. The Health and Social Care Information Centre, Prescribing and Primary Care Services.

Influenza

Andy Burnham: To ask the Secretary of State for Health what steps he is taking to ensure that the NHS is prepared for an influenza epidemic. [138434]

Anna Soubry [holding answer 21 January 2013]: We are taking a range of measures to ensure that the NHS is able to respond flexibly to varying levels of flu, including an epidemic. These measures include:

publishing a seasonal flu plan to assist local National Health Service organisations in developing robust and flexible operational plans;

providing the NHS with guidance on the flu immunisation programme and use of antivirals;

running an assurance process with strategic health authority and primary care trust clusters to ensure adequate plans are in place for the flu season;

running a targeted national communications campaign to promote improved uptake of flu vaccine in clinical risk groups;

liaising with flu vaccine manufacturers to help ensure security of supply;

holding a central strategic reserve of flu vaccine to address any serious supply issues;

providing updated information to NHS commissioners and providers via the Department's monthly Vaccine Update bulletin; and

22 Jan 2013 : Column 279W

monitoring levels of flu and vaccine coverage throughout the season.

Andy Burnham: To ask the Secretary of State for Health what proportion of general practitioner patients have received a vaccination against influenza in each primary care trust area since September 2012. [138435]

Anna Soubry [holding answer 21 January 2013]: Information about the proportion of patients registered with a general practitioner that have received vaccination against influenza in each primary care trust area from 1 September 2012 to 31 December 2012 is available on the Department's website at:

http://immunisation.dh.gov.uk/category/data-and-statistics/

A copy of this information has been placed in the Library.

Mr Jamie Reed: To ask the Secretary of State for Health how many influenza vaccinations were available for those with egg allergies in (a) the Cumbria Primary Care Trust area and (b) Copeland local authority area in winter (i) 2011-12 and (ii) 2012-13 to date. [138515]

Anna Soubry [holding answer 21 January 2013]: The Department does not hold this information. The number of influenza vaccines produced for each general practitioner (GP) practice depends on the quantities they have requested for production directly with the manufacturers, at least 10 months before the influenza season begins. GPs are reminded of this process regularly throughout the year through Vaccine Update and the chief medical officer letters, which the Department circulates.

This has been the procedure for ordering all influenza vaccine for many years and is not a recent change.

Mr Jamie Reed: To ask the Secretary of State for Health whether his Department has issued new guidelines for the application of influenza vaccines to those with egg intolerances in the last 12 months. [138563]

Anna Soubry [holding answer 21 January 2013]:Updated guidance on the application of influenza vaccine in those with egg allergy was published by the Department on 24 August 2012, as an update to the “Green Book—Immunisation against infectious disease”. The guidance can be found on page 203 of chapter 19, which is available on the Immunisation channel of the Department's website at:

http://immunisation.dh.gov.uk/green-book-chapters/chapter-19/

Mr Jamie Reed: To ask the Secretary of State for Health what safeguards are in place to ensure that people with egg intolerances will have access to safe influenza vaccinations in the winter of 2013-14. [138564]

Anna Soubry [holding answer 21 January 2013]: For 2013-14, the NHS Commissioning Board will be responsible for commissioning certain public health services, including the seasonal influenza immunisation programme, as part of the published agreement between the Board and the Department. The published service specification for

22 Jan 2013 : Column 280W

this programme states that locally commissioned services should immunise the target population following the guidance in “Immunisation against Infectious Disease” (The Green Book), which includes specific information on the immunisation of individuals who have egg allergy and may be at increased risk of reaction to influenza vaccines.

NHS Direct

Frank Dobson: To ask the Secretary of State for Health what the official satisfaction ratings for NHS Direct were in each year since its introduction. [138467]

Anna Soubry [holding answer 21 January 2013]:Official satisfaction ratings for NHS Direct in each year since 2008 is given in the following table:

 Average patient satisfaction rating (percentage)

2008-09

93

2009-10

91

2010-11

93

2011-12

93

Source: NHS Direct National Health Service Trust Annual Report and Accounts

Official satisfaction ratings are not available as an annual figure between 2002-07, but were collected monthly by NHS Direct between 2002-06. The information from the monthly survey in March each year is given in the following table:

 Patients very satisfied and satisfied (percentage)

March 2002

99.2

March 2003

98.1

March 2004

98.2

March 2005

98.0

March 2006

96.6

Source: NHS Direct Patient Satisfaction Reports

NHS: Working Hours

Andrea Leadsom: To ask the Secretary of State for Health what steps he is taking to encourage the European Commission to introduce changes to the Working Time Directive; and what steps he is taking to minimise the effect of the Directive on the NHS. [138328]

Dr Poulter [holding answer 21 January 2013]: The previous Government implemented the Working Time Directive (WTD). However, the current Government recognise that the WTD has created problems for the national health service in terms of continuity of care for patients and the quality of training available to junior doctors.

This Government recognise the difficulties caused by the WTD and agreed to limit the application of it in the NHS.

The Department and the Department for Business, Innovation and Skills are working closely together on the application of the Directive to the United Kingdom health sector. We agree the priority is to obtain further flexibility in the areas of on-call time and compensatory rest as well as the preservation of the individual opt out.

22 Jan 2013 : Column 281W

In response to Professor Sir John Temple's review, “Time for Training”, which assessed the application of the Directive on medical education and training, Medical Education England has initiated a programme known as ‘Better Training, Better Care’ to improve both the quality of training and patient care.

Additionally, the Department is taking forward a programme of work known as ‘Better Contracting, Better Care’ to renegotiate the junior doctors’ contract so that it supports training within the Directive and provides flexibility for junior doctors to spend more time training with senior consultants.

Obesity

Mr Barron: To ask the Secretary of State for Health what assessment he has made of the recommendations to tackle obesity included in the recent Royal College of Physicians report, Action on obesity: Comprehensive care for all; and if he will make a statement. [137648]

Anna Soubry: I have noted this report from the Royal College of Physicians. “Healthy Lives, Healthy People:” A call to action on obesity in England sets out the Government's approach to tackling obesity in the new public health and national health service systems and the role of key partners, which includes the medical profession, business and other Government Departments.

A copy of “A call to action” has already been placed in the Library.

Mr Barron: To ask the Secretary of State for Health what recent assessment he has made of whether the indicators currently set out in the Quality and Outcomes Framework are effective in providing incentives to GPs to tackle obesity and overweight. [137649]

Dr Poulter: The Quality and Outcomes Framework (QOF) incentivises general practitioner (GP) practices to identify and keep a record each year of patients aged 16 and over with a body mass index greater than or equal to 30. This encourages GPs to identify patients who need lifestyle advice and provides information to public health professionals and commissioners on levels of need.

The National Institute for Health and Clinical Excellence (NICE) will continue to review obesity as part of its rolling programme of review and development of indicators for the whole of the QOF. Stakeholders can send comments directly to NICE on existing indicators.

Justin Tomlinson: To ask the Secretary of State for Health what steps he is taking to ensure that initiatives to tackle obesity are not only focused on prevention but also on the management of obesity and weight. [137843]

Dr Wollaston: To ask the Secretary of State for Health what steps he is taking to ensure that obese and overweight patients receive expert advice on weight loss and weight management as early as possible. [138232]

Anna Soubry: The Government have published “Healthy Lives, Healthy People: A call to action on obesity in England”, which sets out our approach to tackling obesity

22 Jan 2013 : Column 282W

in the new public health and NHS systems. The ‘call to action' sets out the importance of both preventing and helping people who are already overweight manage their weight. General practitioners, along with other clinicians, can play a key role in 'making every contact count' by raising the issue of obesity and providing advice or referral to appropriate services.

Primary care trusts are responsible for commissioning health care services to meet the needs of their population including services for those who are concerned about their weight. Health care professionals are encouraged to implement guidance from the National Institute for Health and Clinical Excellence (NICE) on the "Prevention, identification, assessment and management of overweight and obesity in adults and children" and, where appropriate, implement their local obesity care pathway to ensure that patients receive the support they need to manage their weight.

The NICE guidance is available at:

www.nice.org.uk/CG43

A copy of the ‘call to action' has already been placed in the Library.

Justin Tomlinson: To ask the Secretary of State for Health what assessment he has made of the report Health at a Glance: Europe recently published by the European Commission and its findings on the level of obesity in the UK compared with that of other EU countries. [137964]

Anna Soubry: We have noted the report “Health at a Glance: Europe” which confirms that the rates of overweight and obesity in this country remain far too high. The Government have published “Healthy Lives, Healthy People: A Call to Action on Obesity in England”, which sets out how overweight and obesity among children and adults will be tackled in the new public health system and the national health service, and the role of key partners.

A copy of the “call to action” has already been placed in the Library.

Dr Wollaston: To ask the Secretary of State for Health what assessment he has made of the implications for his policies of the data on achievement, exceptions and prevalence for the Quality and Outcomes Framework published by the Health and Social Care Information Centre on the number of people registered as obese; and if he will make a statement. [138230]

Dr Poulter: Practices continue to maintain high levels of achievement against the Quality and Outcomes Framework (QOF) in England achieving 96.9% of the points available, compared to 94.7% in the previous year. The main reason for the small increase in average points achievement is technical, due to a change in the allocation of points between QOF areas.

Achievement on obesity is the same as the previous year at 100%. The indicator rewards general practitioners (GPs) for keeping a register of patients aged 16 years and over with a body mass index greater than or equal to 30 in the preceding 15 months. GPs cannot except patients from the obesity register. The percentage of patients included in the register is slightly higher than

22 Jan 2013 : Column 283W

the previous year (10.7% compared to 10.5%). However, the indicator only captures patients whose body mass index has been recorded as part of routine care during the past year and so does not record true prevalence in the population.

The QOF has brought improvements in patient care, but we need to go further and faster. This is why we have sent proposals to the British Medical Association for changes to the GP contract to drive up standards for all patients. We want the contract to reflect the most up-to-date expert guidance and excellent standards of care.

Under our proposals, the indicator on obesity will form part of the Public Health Domain in QOF from April 2013. Public Health England will set priorities for development of public health indicators for QOF. We are committed to identifying the best possible evidence of what works in tackling obesity and pulling together the evidence will be a key task for Public Health England.

Organs: Donors

Jonathan Evans: To ask the Secretary of State for Health what research he has commissioned or evaluated on the potential effect of the introduction of presumed consent on the level of organ donations; and if he will make a statement. [137821]

Anna Soubry: In 2008 the Organ Donation Taskforce considered presumed consent in considerable detail looking

22 Jan 2013 : Column 284W

at the clinical, communication, cultural, ethical, legal and practical aspects of opt-out legislation. As part of its evidence gathering for its second report, ‘The potential impact of an opt-out system for organ donation’, published in November 2008, the taskforce commissioned a systematic literature review from the University of York to assess the impact of opt-out legislation on organ donation rates in other countries. It also reviewed eight studies comparing different countries and found that direct comparison between countries was difficult because of the wide range of other factors that influence organ donation rates, for example, mortality from road traffic accidents, religion, education, and transplant infrastructure. The reviewers found that the evidence identified and appraised was not robust enough to provide clear guidance for policy.

The taskforce concluded that while such a system might have the potential to deliver benefits, it was not confident the introduction would increase organ donor numbers and that there was some evidence that donor numbers may go down. For example, although the majority of faith and belief groups interviewed were positive about donation most were opposed to the introduction of opt-out legislation.

Rehman Chishti: To ask the Secretary of State for Health how many people with diabetes have received organ donations (a) linked to diabetes and (b) not linked to diabetes in each of the last five years. [138261]

Anna Soubry: The information requested is shown in the following table:

Organ transplants in United Kingdom, 2008-2012 where diabetes (type I or II) listed as primary reason for transplant
Transplant type20082009201020112012

Kidney only

120

148

169

174

220

Pancreas only

51

35

34

32

32

Pancreas islets

2

8

11

23

36

Kidney/pancreas

152

144

146

154

159

Liver/pancreas.

0

0

0

1

0

Total

325

335

360

384

447

Source: NHS Blood and Transplant

NHS Blood and Transplant have advised that they do not routinely record a recipient's diabetes status. This information is only recorded where it is the primary reason for needing the transplant. Therefore they can not clarify the number of transplants unrelated to diabetes, as in some recipients diabetes may have been a contributing factor to another primary reason.

Rehman Chishti: To ask the Secretary of State for Health how many people were (a) on the organ donor register and (b) were added to the organ donor register in (i) Gillingham and Rainham, (ii) Medway, (iii) Kent and (iv) England in each of the last five years. [138262]

Anna Soubry: The information requested is in the following table:

Number on the organ donor register as at the end of 2007 and added each year, 2008-12
AreaAs at end 2007Added 2008Added 2009Added 2010Added 2011Added 2012As at end 2012

Gillingham/Rainham

22,138

1,643

1,558

1,557

1,390

1,273

29,559

Medway

51,090

3,927

3,778

3,573

3,226

2,983

68,577

Kent

411,527

31,448

30,844

31,694

29,157

26,764

561,434

England

11,846,526

938,624

879,688

914,665

844,803

774,634

16,198,940

Note: Numbers added each year are net increase after any removals from the register—for example death, change of address to out of boundary. Source: NHS Blood and Transplant

Rehman Chishti: To ask the Secretary of State for Health how many organ (a) donors and (b) recipients were over 18 years old in each of the last five years. [138263]

22 Jan 2013 : Column 285W

Anna Soubry: The information requested is shown in the following tables.

Table 1: Deceased organ donors and recipients 18 years and older, United Kingdom, 2008-12
 20082009201020112012

Donors

827

886

976

1,012

1,126

Recipients

2,334

2409

2,500

2,617

2,840

Source: NHS Blood and Transplant
Table 2: Living organ donors and recipients 18 years and older, UK, 2008-12
 20082009201020112012

Donors

979

1,018

1,057

1,062

1,063

Recipients

895

943

974

975

967

Source: NHS Blood and Transplant

Rehman Chishti: To ask the Secretary of State for Health what proportion of organ (a) recipients and (b) donors were (i) male and (ii) female in the latest period for which figures are available; and what proportion were from each ethnic group in the latest period for which figures are available. [138264]

Anna Soubry: The information requested is shown in the following tables.

Deceased organ donors and recipients, in United Kingdom, 2012, by sex
SexDonors (number)PercentageRecipients (number)Percentage

Male

621

53.4

1,869

61.9

Female

543

46.6

1,149

38.1

Not recorded

0

2

Total

1,164

3,020

Living organ donors and recipients in UK, 2012, by sex
SexDonors (number)PercentageRecipients (number)Percentage

Male

523

49.20

647

60.90

Female

540

40.80

415

39.10

Not recorded

0

1

Total

1,063

1,063

Deceased organ donors and recipients in UK, .2012, by ethnic origin
Ethnic originDonors (number)PercentageRecipients (number)Percentage

White

1,071

94.9

2,456

81.4

Asian/Asian-British

22

2.0

330

10.9

Black/Black-British

18

1.6

162

5.4

Chinese/Oriental

4

0.4

33

1.1

Mixed

7

0.6

9

0.3

Other

6

0.5

26

0.9

Not Recorded

36

4

Total

1,164

3,020

Living organ donors and recipients in UK, 2012, by ethnic origin
Ethnic originDonors (number)PercentageRecipients (number)Percentage

White

894

85.00

871

82.60

Asian/Asian-British

83

7.90

111

10.50

22 Jan 2013 : Column 286W

Black/Black-British

42

4.00

46

4.40

Chinese/Oriental

7

0.70

3

0.30

Mixed

4

0.30

3

0.30

Other

22

2.10

20

1.90

Not Recorded

5

18

Total

1,057

1,072

Source: NHS Blood and Transplant

Rehman Chishti: To ask the Secretary of State for Health how many people received a second organ donation within (a) one year and (b) five years of a previous transplant in the last five years for which figures are available. [138266]

Anna Soubry: The information requested is shown in the following table.

Number of recipients of organs for a second similar transplant(1), United Kingdom, 2008 to 2012 (year of second transplant)
Second transplantWithin 1 yearWithin 5 years(2)

2008

38

90

2009

39

89

2010

39

97

2011

30

90

2012

38

98

(1 )There will be others who had a third or subsequent transplant and recipients who have received a different transplanted organ. (2 )Includes those with one year. Source: NHS Blood and Transplant.

Rehman Chishti: To ask the Secretary of State for Health how many domino transplants (a) in total and (b) for each type of organ were performed in each of the last five years. [138267]

Anna Soubry: The information requested is shown in the following table.

Domino Transplants, United Kingdom, 2008-12
 Year
Organ20082009201020112012

Kidney

0

1

0

2

4

Liver

8

3

4

4

3

Heart

0

0

1

3

0

Total

8

4

5

9

7

Source: NHS Blood and Transplant

Rehman Chishti: To ask the Secretary of State for Health in which hospitals the greatest increase in transplant surgeries have taken place in the last year. [138268]

Anna Soubry: The information requested is shown in the following table:

Transplant units with biggest increase in transplant operations 2011 to 2012, United Kingdom
Unit20112012Increase (no.)% increase

Queen Elizabeth Hospital, Birmingham

340

382

42

12.4

St Helier Hospital, Carshalton

18

36

18

100.0

Source: NHS Blood and Transplant

22 Jan 2013 : Column 287W

Paracetamol

Nick de Bois: To ask the Secretary of State for Health pursuant to the answer of 16 January 2013, Official Report, column 860W, on paracetamol, what the cost was to the public purse of those prescriptions issued for the use of paracetamol in England in each of the last five years; and if he will make a statement. [138711]

Norman Lamb: The net ingredient cost of paracetamol prescription items, dispensed in the community, in each of the most recently available five years, is as follows:

Net ingredient cost (NIC) of paracetamol prescription items written in the United Kingdom and dispensed in the community, in England(1,2)
 NIC (£000)

2007

56,130.4

2008

42,531.3

2009

54,146.9

2010

64,241.9

2011

61,270.1

(1) Does not include items dispensed in hospitals, including mental health trusts, or private prescriptions. (2) Does not include preparations that contain both paracetamol and other chemicals, in combination. Source: Prescription Cost Analysis (PCA) system. The Health and Social Care Information Centre, Prescribing and Primary Care Services.

Pay

Ms Abbott: To ask the Secretary of State for Health how many staff in his Department are paid an annual salary of more than £100,000. [137869]

Dr Poulter: As at 31 December 2012, 38 civil servants had a full-time equivalent salary of more than £100,000.

This information is based on basic salaries paid to civil servants and does not include allowances, bonuses or overtime payments. The data include part-time civil servants whose full-time equivalent salary is in excess of £100,000.

Peterborough and Stamford Hospitals NHS Foundation Trust

Mr Stewart Jackson: To ask the Secretary of State for Health what steps his Department is taking to facilitate the accurate prediction of hospital admissions at Peterborough and Stamford Hospital's NHS Foundation Trust, by reference to the (a) Acute Trust and (b) emerging clinical commissioning group; and if he will make a statement. [137743]

Anna Soubry: As part of commissioning planning for 2013-14, the NHS Cambridgeshire and Peterborough primary care trust cluster will work with Cambridgeshire and Peterborough Clinical Commissioning Group to discuss hospital capacity in the local area, including historic admission rates at providers such as Peterborough and Stamford Hospitals NHS Foundation Trust, and ensure these are taken into consideration in determining service provision.

As part of its regulatory process, Monitor, the independent regulator of national health service foundation trusts, announced on 10 December 2012 that it would appoint a contingency planning team to Peterborough and Stamford Hospitals NHS Foundation Trust. The team will work with the trust, local commissioners and other stakeholders to deliver a sustainable financial solution for the trust that safeguards the future delivery of quality services for patients in the local area.

22 Jan 2013 : Column 288W

Physical Inactivity

Ms Abbott: To ask the Secretary of State for Health what estimate his Department has made of the cost to the economy since 2010 of physical inactivity. [137868]

Anna Soubry: Our most recent estimate of the cost to the economy of physical inactivity was published in July 2011 in the UK Chief Medical Officers' report ‘Start Active Stay Active’.

This describes an annual cost of £1.06 billion to the national health service across the UK, based upon data published in 2007. In 2002, the annual costs to the wider economy in England were estimated at £5.5 billion arising from sickness absence and £1 billion from the premature death of people of working age.

Plagiocephaly

James Wharton: To ask the Secretary of State for Health (1) what recent representations he has received on whether treatment for plagiocephaly should be provided by the NHS; [137970]

(2) how many cases of plagiocephaly have been diagnosed in the NHS in each of the last five years. [138254]

Dr Poulter: Plagiocephaly is a relatively common condition and is self correcting in the great majority of cases. It is for clinicians to determine in each case whether any treatment is required and it is for the local health commissioners' to decide whether to fund appropriate treatment.

Information is not collected in the format requested. The table shows the number of finished consultant episodes for children with a period of care in hospital with a diagnosis of plagiocephaly.

A count of finished consultant episodes (FCEs)(1) with a primary or secondary diagnosis(2) of plagiocephaly(3) 2007-08 to 2011-12(4)
Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector
 Episodes

2007-08

863

2008-09

907

2009-10

875

2010-11

1,212

2011-12

1,213

(1 )A finished consultant episode (FCE) is a continuous period of admitted patient care under one consultant within one health care provider. FCEs are counted against the year in which they end. Figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year. (2 )The number of episodes where this diagnosis was recorded in any of the 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) primary and secondary diagnosis fields in a Hospital Episode Statistics (HES) record. Each episode is only counted once, even if the diagnosis is recorded in more than one diagnosis field of the record. (3 )ICD 10 code—Q67.3 plagiocephaly (4 )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, changes in activity may be due to changes in the provision of care. Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre.

Radiotherapy

Grahame M. Morris: To ask the Secretary of State for Health (1) with reference to his Department's document on the value for money addendum to the strategic outline case for the national proton beam

22 Jan 2013 : Column 289W

therapy (PBT) service development programme if the Exchequer has made an assessment of the economic viability of the PBT proposal; and what advice the Exchequer has given to mitigate the financial risks in the £250 million investment; [137655]

(2) pursuant to the answer of 19 December 2012, Official Report, column 855W, on Varian Medical Systems UK and Hospital Corporation of America, and with reference to his Department's document on the value for money addendum to the strategic outline case for the national proton beam therapy (PBT) service development programme, section 4.11, for what reasons he will not publish all correspondence entered into with trusts and other detailed working papers produced as part of the development of that document; [137656]

(3) pursuant to the answer of 19 December 2012, Official Report, column 855W, on Varian Medical Systems UK and Hospital Corporation of America, and with reference to his Department's document on the value for money addendum to the strategic outline case for the national proton beam therapy (PBT) service development programme, section 4.10, which suppliers were involved in the costing discussions with University College Hospital, London and The Christie Hospital, Manchester; [137657]

(4) whether the capital for purchasing the proton radiotherapy machines to be installed at Christie Hospital, Manchester and University College Hospital, London will be supplied as a loan; at what interest rate any such loan will be made; and over how many years each hospital will repay that loan. [137658]

Anna Soubry: The Strategic Outline Case (SOC) for the development of a Proton Beam Therapy (PBT) Service was submitted to HM Treasury in December 2011 as part of the standard process for the approval of major capital projects. Approval was received in February 2012.

The Treasury's approval required the SOC to include updates on demand, technological advances and the market, as well as more detail on the relative value for money of the scheme.

It was subsequently decided that the two Trusts should develop separate SOCs for Treasury approval. To address the Treasury's request for more detail to be included on value for money, the Value for Money (VFM) addendum was submitted to the Treasury for approval in August 2012 and was published by the Department with its PBT SOC in October 2012.

When developing the SOC and VFM addendum, all steps were taken to ensure that appropriate governance requirements were met and best practice was employed. We do not intend to publish correspondence and working papers associated with the development of the SOC or VFM as, by their nature, working documents do not always contain complete or validated information, and their publication could mislead when the full picture has now been published in the final document. To put our detailed assumptions about the costs of equipment in the public domain could also jeopardise the Trust's ability to secure value for money from the equipment procurement process.

No suppliers were involved in the costing discussions held with the two Trusts in the development of the SOC and VFM Addendum.

22 Jan 2013 : Column 290W

The capital that will be used by the Trusts to purchase PBT equipment will be provided as part of the wider financial arrangements that are currently under discussion. Details of the financial arrangements will be included in the Trust's SOCs, which will be placed in the public domain once they are approved by the Department and the Treasury, in line with standard departmental practice.

Tessa Munt: To ask the Secretary of State for Health (1) which body will be responsible for commissioning the workforce for radiotherapy services after April 2013; [138118]

(2) with reference to Radiotherapy Services in England 2012, what funding he will make available to meet the required increases in the radiotherapy workforce by 2016; [138218]

(3) with reference to Radiotherapy Services in England 2012, what funding he will make available for additional linear accelerators needed by the NHS by 2016. [138219]

Anna Soubry: “Improving Outcomes: A Strategy for Cancer”, published on 12 January 2011 set out a commitment to expand radiotherapy capacity by investing over £150 million in additional funding up to 2014-15. The Government have yet to set spending plans beyond 2014-15 and these will be subject to a future spending review.

This money is provided to commissioners through baseline allocations and commissioners can use this funding to purchase additional radiotherapy services from providers through locally negotiated tariffs or other payment mechanisms. Providers may use this income to purchase additional radiotherapy equipment to meet the increased demand.

To encourage the national health service to update the existing medical technology infrastructure, the Department also established a £300 million fund in March 2012 to bulk purchase medical equipment, such as radiotherapy equipment, and achieve better prices for the NHS. The fund is operated by NHS Supply Chain.

At present, strategic health authorities plan the workforce required to deliver healthcare services, including radiotherapy services. From April 2013, Health Education England (HEE) assumes national leadership for a new system of planning and developing the entire health and care workforce, including responsibility for the multi professional education and training budget. HEE, supported by Local Education and Training Boards (LETBs), will ensure that the shape and skills of the future health and care workforce evolves to sustain high quality health outcomes for patients. All LETBs will commission the workforce for such services.

“Radiotherapy Services in England 2012”, published on 6 November 2012 provides an up to date position on the provision of radiotherapy services in England and sets out levels of expected need in future and the workforce and equipment required to meet that need in 2016. A copy has been placed in the Library. Radiotherapy providers and professional bodies will need to ensure HEE and LETBs have the right information and data to enable the right numbers of radiotherapy workforce with the right skills are in place.

22 Jan 2013 : Column 291W

Rehabilitation

Ms Abbott: To ask the Secretary of State for Health how much his Department spent on the treatment of (a) drug, (b) alcohol, (c) smoking and (d) gambling addictions in (i) 2012 and (ii) each of the last five years. [137994]

Anna Soubry: The commissioning of treatment for dependence on drugs or alcohol is undertaken at a local level. The Department does not directly purchase treatment but allocates funds to support local areas to do so. The Department does not monitor spend, but the national adult pooled treatment budget allocations are set out in the following table:

 National (£)

2008-09

373,300,000

2009-10

381,300,000

2010-11

381,300,000

2011-12

381,300,000

2012-13

381,300,000

The Department does not record the cost to the national health service of treating people with tobacco-related diseases, but people can access a range of smoking cessation services.

The Department does not record the cost to the NHS of treating people with problem gambling but those with problem gambling can access services in primary care and secondary care including specialised mental health and addiction services.

Ulcers

Jim Shannon: To ask the Secretary of State for Health what steps are being taken to promote campaigns to address the problem of ulcers; and how many people aged (a) 0 to 20, (b) 21 to 30, (c) 31 to 40, (d) 41 to 50, (e) 51 to 60 and (f) 60 plus have been diagnosed with ulcers. [138240]

Anna Soubry: All general practitioners will be familiar with the signs and symptoms suggestive of gastric ulcers and with the methods available to confirm the diagnosis and treat the condition. Information for patients about gastric ulcers is available from “NHS Choices”, from the website “Patientco.uk”, and from the patient support organisation CODE. In addition, NHS Direct offer a “symptom checker” which helps patients with conditions such as abdominal pain to seek appropriate help.

Information on the number of people diagnosed with ulcers is not available centrally. The available information on the number of hospital in-patient episodes is given in the following table. Some patients may have had more than one spell of hospital treatment in the year in question, and diagnoses made in primary care or in hospital outpatient clinics will be excluded from the figures unless they resulted in a subsequent inpatient admission.

22 Jan 2013 : Column 292W

Finished consultant episodes(1 )(FCEs) with a primary or secondary diagnosis(2 )of gastric ulcer(3) by age group for 2011-12. Activity in English national health service hospitals and English NHS commissioned activity in the independent sector
Age groupFCEs

0-20

537

21-30

1,348

31-40

2,697

41-50

5,290

51-60

7,439

61 and over

35,125

Unknown age

132

Total

52,568

(1) Finished Consultant Episode (FCE) A finished consultant episode (FCE) is a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which they end. Figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year. (2) Number of episodes with a (named) main or secondary procedure This denotes the number of episodes where the procedure (or intervention) was recorded in any of the 24 (12 from 2002-03 to 2006-07 and four prior to 2002-03) procedure fields in a HES record. A record is only included once in each count, even if the procedure is recorded in more than one procedure field of the record. Note that more procedures are carried out than episodes with a main or secondary procedure. For example, patients under going a 'cataract operation' would tend to have at least two procedures—removal of the faulty lens and the fitting of a new one—counted in a single episode. (3) ICD-10 code: K25—Gastric ulcer Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre

Vaccination

Mr Jamie Reed: To ask the Secretary of State for Health how nationwide seasonal vaccination programmes are co-ordinated through local healthcare providers; and what support such providers are given by his Department. [138565]

Anna Soubry [holding answer 21 January 2013]: The influenza (flu) immunisation programme is currently the only seasonal immunisation programme. This programme is currently co-ordinated at local level by primary care trust (PCT) immunisation co-ordinators supported by strategic health authority (SHA) immunisation leads.

The Department is taking a range of measures in the 2012-13 season to support commissioners and providers, including:

publishing a seasonal flu plan to assist local national health service organisations in developing robust and flexible operational plans;

running an assurance process with SHA and PCT clusters to ensure adequate plans are in place for the flu season;

running a targeted national communications campaign to promote improved uptake of flu vaccine in clinical risk groups;

liaising with flu vaccine manufacturers to help ensure security of supply;

holding a central strategic reserve of flu vaccine to address any serious supply issues;

providing updated information to NHS commissioners and providers via the Department's monthly Vaccine Update bulletin; and

monitoring levels of flu and vaccine coverage throughout the season.