Cancer: Drugs

Michael Dugher: To ask the Secretary of State for Health what assessment he has made of the (a) quality and (b) safety of chemotherapy services in the NHS; and if he will make a statement. [168846]

Anna Soubry: NHS England has responsibility for chemotherapy services.

NHS England’s chemotherapy Clinical Reference Group (CRG) has set out service specifications defining what NHS England expects to be in place for providers to offer evidence-based safe and effective chemotherapy services. The chemotherapy CRG will keep the quality and safety of chemotherapy services under review. Chemotherapy delivery in provider organisations is also subject to peer review.

Care Homes

Michael Dugher: To ask the Secretary of State for Health how many (a) private and (b) local authority care homes for the elderly have (i) opened and (ii) closed in (A) England and (B) Yorkshire in each year since 1997. [168866]

Norman Lamb: We are informed by the Care Quality Commission (CQC), which, as regulator of health and adult social care services in England, registers care providers and collects data on their numbers, that information is not available for the years from 1997-2003.

The CQC records registrations and de-registrations. These include the numbers of homes which open and close, but also de-registration and re-registration in cases of new ownership, temporary closures for refurbishment, etc. Since 2010, the CQC has employed the terms “activation” and “de-activation” in place of “registration” and “de-registration”.

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The CQC has data from 1 April 2004, when its immediate predecessor as regulator of adult social care, the Commission for Social Care Inspection, was established under the Care Standards Act 2000.

Data for the years:

1 April 2004 to 30 September 2010—de-registrations and new registrations of private and local authority-owned care homes for older people under the Care Standards Act 2000, and;

1 October 2010 onwards—de-activations and new activations of care home locations for older people under the Health and Social Care Act 2008.

are shown in the following tables.

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Carers

Simon Kirby: To ask the Secretary of State for Health what support his Department gives to assist people who have given up their jobs to care for older relatives. [168971]

Norman Lamb: We recognise that many carers feel unable to balance their caring responsibilities with employment. The coalition Government's Carers' strategy ‘Recognised, valued and supported: Next steps for the Carers' Strategy, November 2010’ sets out the vision and priorities for action over four years to 2015, focusing on what will have the biggest impact on carers' lives, including enabling those with caring responsibilities to fulfil their educational and employment potential.

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We recently published ‘Supporting Working Carers: the benefits to families, business and the Economy’, which was the final report of the Carers in Employment Task and Finish Group. This group, which was co-chaired by the Department of Health and Employers for Carers, has developed the evidence base for supporting carers to remain in work, and made a number of recommendations. The group's final report and recommendations are available at:

www.gov.uk/government/publications/supporting-working-carers-the-benefits-to-families-business-and-the-economy

A copy has been placed in the Library.

We have provided an additional £400 million available to the national health service over four years from 2011 to provide carers with breaks from their caring responsibilities to sustain them in their caring role. From 2013-14, the allocation of resources to clinical commissioning groups (CCGs) has been a matter for NHS England. It is for CCGs, together with Health and Wellbeing Boards, to ensure appropriate investment for carers' support and breaks.

Carers are also central to the Government's proposals for care and support and there are significant improvements in the Care Bill (published on 10 May 2013) for carers. This includes plans to simplify the assessment processes for adult carers, so that more of them are able to access an assessment of their needs for support. For the first time, there will be a duty on local authorities to meet carers' eligible needs for support, putting them on an equal footing with the people they support.

Christmas Cards

Michael Dugher: To ask the Secretary of State for Health how much his private ministerial office spent on sending Christmas cards in 2012. [168682]

Dr Poulter: There was no expenditure on Christmas cards in ministerial private office in 2012.

CJD

Mr Gray: To ask the Secretary of State for Health (1) if he will make a statement on the commutation policy with regard to relations of deceased sufferers of variant CJD; [169435]

(2) how many claims against his Department made by relations of victims of variant CJD have been settled out of court in the most recent period for which records are available. [169436]

Dr Poulter: No claims have been settled out of court by the Department in relation to variant Creutzfeldt Jakob disease (vCJD).

The vCJD Trust, set up by Government in 2000, disburses no-fault compensation to vCJD patients and their families. The latest available figures, 12 September 2013, show that the trust has paid out £41,078,281 in compensation.

Since March 2012, it is the trust’s policy to increase the basic sum payable to each case, from an initial figure of £120,000, by 2% annually. As of March 2013, the sum payable is £124,848.

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Continuing Care

Mr Sheerman: To ask the Secretary of State for Health what progress he has made implementing the Government’s proposals to offer a new enhanced services to help patients with long-term conditions monitor their health. [169583]

Norman Lamb: Following changes to the general practitioner (GP) contract for 2013-14, the Secretary of State for Health, the right hon. Member for South West Surrey (Mr Hunt), directed NHS England to establish plans for a remote care monitoring enhanced service that will better enable patients to manage and monitor their condition in ways that improve their quality of life and do not require them to visit their GP practice as often.

NHS England identified that the GP practices and their respective clinical commissioning groups (CCGs) were best placed to identify the patient cohort that would be best served by this enhanced service.

NHS England delegated responsibility to CCGs to develop a remote care monitoring scheme with GP practices that meets the terms of the enhanced service. CCG’s were given until 31 August 2013 to work with their practices to develop remote care monitoring arrangements and report participation back to the area teams of NHS England.

Currently, details of participation are not held centrally but a system for monitoring uptake across all enhanced services is expected to be in place later this year.

Diabetes: China

Keith Vaz: To ask the Secretary of State for Health how many times he has (a) met and (b) had telephone conversations with the Chinese Minister of Health to discuss diabetes since September 2012. [169616]

Dr Poulter: The Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Mr Hunt), has not had any meetings or telephone conversations with the Chinese Minister of Health since September 2012, but hopes to meet with her later this year.

General Practitioners

Debbie Abrahams: To ask the Secretary of State for Health how he plans to monitor the number of same-day appointments being offered by GPs in the NHS in England. [169643]

Dr Poulter: There are currently no plans to monitor the number of same-day appointments.

Health

Jeremy Lefroy: To ask the Secretary of State for Health what the cost was of (a) developing and (b) marketing the Smart Restart mobile application for the Change for Life back to school campaign; and how many downloads of the application there have been to date. [169350]

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Dr Poulter: The integrated cost of developing the Smart Restart application (including the web version), was £68,055. The proportion of the marketing cost specifically promoting the mobile application (app) was £100,000.

Between the 28 August (the launch) and 12 September 2013 there were 86,084 downloads of the mobile app.

Debbie Abrahams: To ask the Secretary of State for Health pursuant to the answer of 10 September 2013,

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Official Report

, column 678W, on health, which organisations have withdrawn from the Responsibility Deal; on what dates they withdrew; and for what reason they withdrew. [169635]

Dr Poulter: A list of the organisations who have withdrawn from the Responsibility Deal since its launch in March 2011 is provided as follows.

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Health Services

Dame Tessa Jowell: To ask the Secretary of State for Health when he plans to announce his decision on which areas have been chosen to become a pioneer site to support the delivery of integrated care. [169551]

Norman Lamb: The integrated care and support pioneers will be selected by a panel composed of representatives of national partners in integrated care and support, as well as domestic and international experts, and will be announced in October.

We received over 100 applications to the pioneers programme, and have introduced a number of selection stages to ensure we select the most innovative areas; those short-listed are now undergoing face to face interviews that will inform the decision of the final selection panel. Once selected, the pioneers will be given dedicated central support in overcoming the barriers to integrated care and support, and the learning from this process will be shared nationally to support all localities in delivering integrated care and support.

Health Services: Foreign Nationals

Mr Ward: To ask the Secretary of State for Health what steps his Department has taken to explain to overseas visitors to the UK the costs of NHS treatment and the need for health insurance. [168444]

Dr Poulter: The NHS (Charges to Overseas Visitors) Regulations 2011 place a legal obligation on national health service hospitals to identify overseas visitors that are not exempt from charge and to make and recover charges from them.

The Department has produced comprehensive guidance on the NHS Choices website to explain to overseas visitors about the regulations and how it may affect them. The Department also has a dedicated helpline and e-mail service to provide advice on interpretation of the rules to both NHS staff and overseas visitors. Additionally, NHS bodies are asked to ensure as a priority that all its staff and patients are aware of the charging regime and potential costs of treatment.

Under the regulations, there is no mandatory requirement for overseas visitors to have health insurance although visitors are strongly advised to take out health insurance before they travel.

Health Services: Homelessness

Simon Kirby: To ask the Secretary of State for Health what steps his Department is taking to improve the health of homeless people in Brighton. [169191]

Dr Poulter: We are taking steps to address the poor health outcomes experienced by the homeless and the difficulties that they, and other vulnerable groups, face in accessing some health services.

For the first time, we have introduced legal duties on national health service commissioners to reduce inequalities in access to and outcomes from health services. In addition, we have developed an Inclusion Health programme, through which we are working with other Government Departments, the NHS and the third sector to tackle the poor health of people in vulnerable groups and to ensure everyone gets the care they need, regardless of their needs or circumstances. As part of this broad programme, we are looking at how to improve hospital discharge arrangements for the homeless and on 3 September 2013, we announced the 52 projects which will receive funding from the new £10 million homeless hospital discharge fund. Funding has been awarded to a hostels hospital discharge project in Brighton. This includes an award of £89,742 to Brighton Housing Trust to deliver the Hostels Hospital Discharge Project. This will involve a general nurse and specialist support worker working across all high support hostels in Brighton to provide support and care to patients who are discharged from hospital back to hostels.

Health Services: Older People

Simon Kirby: To ask the Secretary of State for Health what steps his Department is taking to improve care for vulnerable older people. [169190]

Norman Lamb: The Government recognise that vulnerable older people often do not receive the care that they need and deserve. The Government's ambition to improve care for the most vulnerable, frail elderly is for primary care to provide stronger public health and prevention, improve access and support for self-management, and provide proactive case management. This ambition will require a shift in the way that services are provided.

Improving care for vulnerable older people will not be for general practice alone, and will need to be considered alongside other out of hospital and hospital services. In particular, changes to general practice will need to build on the work of the National Health Service Medical Director's review of urgent and emergency care services, to ensure that services are best equipped to meet modern demand and provide consistently high quality care to patients. Improving out-of-hospital care will also need close working between NHS and social care, for example, between primary care and care homes, and with the voluntary sector.

To support this vision the Government will be working with NHS England to set out a plan for improving out-of-hospital care for vulnerable older people.

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The Government also recently announced measures to reduce pressure on accident and emergency departments in the longer term which will be set out in the vulnerable older people's plan. This covered three aspects of the emergent plan (currently being consulted on) for improving care for vulnerable older people and set out how each element will make a difference to care for this cohort of people:

1. Every vulnerable older person should expect greater joint working to provide their care between the health and social care systems so that they do not fall between the cracks. We prioritised an additional £2 billion of funding in the spending review to help do this.

2. Every vulnerable older person should expect to receive personalised, proactive primary care, overseen by a named general practitioner (GP) who is accountable for this care.

3. Every vulnerable older person should expect that their GP records can be shared with the different organisations delivering care to them, including out of hours GP services and the ambulance services. The technology fund will be used to help support this.

Through engagement with patients, carers, health and social care staff, and the public over the summer, the Government have been testing proposals and the best ways to implement them. The final plan will be published in the autumn and will be reflected in the refreshed Mandate to NHS England for 2014-15.

Health: Screening

Nadine Dorries: To ask the Secretary of State for Health (1) whether the formal audit of practice suggested by the UK National Screening Committee to establish how effectively guidance from the Royal College of Obstetricians and Gynaecologists and the National Institute for Health and Care Excellence is being implemented at a national level will include practice as well as a review of policy documents; [169479]

(2) what evidence his Department holds on the effectiveness of negative results for group B streptococcus from a urine test in early pregnancy as a predictor of maternal group B streptococcus colonisation in labour; [169561]

(3) pursuant to the answer of 4 September 2013, Official Report, columns 432-3W, on streptococcus, whether the study to be commissioned by the National Institute for Health Research Health Technology Assessment programme will include a comparison of the effectiveness of the high risk factors at predicting GBS colonisation in labour with women without these high risk factors. [169562]

Dr Poulter: The audit was developed as an implementation tool for use locally to audit current practice and to improve implementation of the revised Royal College of Obstetricians and Gynaecologists on the prevention of early-onset neonatal group B streptococcal disease.

The Department does not hold the requested evidence on the effectiveness of negative results for group B streptococcus from a urine test in early pregnancy.

The research question for which the Health Technology Assessment (HTA) programme is seeking to commission a study is not designed to make a specific comparison of the effectiveness of the high risk factors at predicting strep B streptococcal colonisation in labour with women without these high risk factors.

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The study will focus on pregnant women at high risk for antenatal group B streptococcal colonisation; with reference to the risk factors identified in the guidance from the Royal College of Obstetricians and Gynaecologists and in the National Institute for Health and Care Excellence clinical guideline on antibiotics for early-onset neonatal infection, and whether testing using new methods could help identify women who carry group B streptococcal from those who do not, and so reduce unnecessary antibiotic use.

The research brief is available on the HTA website at:

www.hta.ac.uk/funding/standardcalls/briefs/13_82cb.pdf

Heath Services: Weather

Helen Jones: To ask the Secretary of State for Health pursuant to his statement of 10 September 2013, Official Report, columns 833-34, on accident and emergency departments, for what reasons the extra funds to relieve the pressures on accident and emergency departments have not been allocated to hospitals in north Cheshire; and if he will make a statement; [169271]

Mr Iain Wright: To ask the Secretary of State for Health pursuant to the statement of 10 September 2013, Official Report, column 46WS, on NHS winter planning, whether (a) North Tees and Hartlepool NHS Foundation Trust and (b) South Tees Hospitals NHS Foundation Trust applied for additional funding. [169412]

Dr Poulter: Decisions on which high risk trusts to concentrate the resources for the upcoming winter were made jointly by NHS England, Monitor and the NHS Trust Development Authority (NTDA), based on accident and emergency (A and E) performance and the specific plans for initiatives to alleviate pressures on local A and E departments presented by each of the 143 urgent care boards. There was no process for trusts to apply for money.

Decisions were made on the basis of a number of factors including risk to delivery of the A and E standard, challenging local circumstances and the needs of local populations. This gave a picture of those facing the greatest compound risk and identified the trusts thought most likely to benefit most from additional funding.

The money will be targeted at the local systems that will benefit most from the extra funding. If a trust has not been identified to receive a share of these winter monies it is a sign that they are performing well in delivering their A and E services. Nonetheless we are not complacent. NHS England, Monitor and the NTDA will be working with hospitals across the whole country to ensure that emergency services are ready for winter.

Hospitals: Appeals

Tessa Munt: To ask the Secretary of State for Health for what reasons NHS England does not have appeal processes for hospitals which wish to challenge that body’s decisions on funding specific procedures or treatments. [168500]

Anna Soubry: NHS England has informed us that in line with the NHS England Standard Operating Procedure for Individual Funding Requests (IFRs), individual patient requests for specific procedures/treatments are considered by an IFR panel.

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In the event that the IFR panel does not agree funding of the procedure or treatment, either the patient or patient’s carer or their referring clinician may request a review of an IFR panel decision.

Reviews are considered by the IFR review panel, which considers whether the process followed by the IFR panel:

was consistent with the standard operating procedure for IFRs;

took into account and weighed all relevant information;

did not take into account irrelevant factors;

indicated that the members of the IFR panel acted in good faith; and

reached a decision that a reasonable IFR panel would be entitled to reach.

Hospitals: Disclosure of Information

Mr Godsiff: To ask the Secretary of State for Health what his policy is on hospitals supplying personal contact data of new mothers on hospital wards to private companies. [169049]

Dr Poulter: Decisions about sharing personal confidential information with private companies are made by local national health service trusts who must ensure there is a lawful basis for doing so. It is our expectation that these decisions will be taken in accordance with the principles in the NHS Confidentiality Code of Practice. This means that in the absence of a statutory requirement to disclose information should only be shared by NHS trusts when they have obtained the explicit consent of their patients.

Hospitals: Food

Gloria De Piero: To ask the Secretary of State for Health what steps he is taking to raise the nutritional standards of meals in NHS hospitals. [169043]

Dr Poulter: Nutritious and appetising hospital food and drink is an essential part of the personal package of care and hospitals should take all reasonable steps to ensure that patients have a healthy food experience.

The existing registration system, established under the Health and Social Care Act 2008, requires all providers of health and adult social care regulated activities to meet essential levels of safety and quality, and nutrition is a part of this. The requirement for food is that

“people are encouraged and supported to have sufficient food and drink that is nutritional and balanced, and a choice of food and drink to meet their different needs.”

The Department encourages hospitals to adopt Government Buying Standards for Food and Catering Services (Food GBS) which include food standards relating to nutrition, sustainability and animal welfare.

Data collected as part of the 2013 Patient Led Assessment of the Care Environment process will be used to assess the current levels of uptake of Food GBS in hospitals, as well as to assess the standard of food served. In addition, financial incentives are now available to providers who adopt food standards. These incentives are part of the exemplar Commissioning for Quality and Innovation process and are negotiated locally.

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Hospitals: Older People

Simon Kirby: To ask the Secretary of State for Health how many people aged 75 years and over were readmitted to hospital within one month of discharge in Brighton, Kemptown in the latest period for which figures are available. [168969]

Anna Soubry: Information is not available in the format requested. Information is available on emergency readmissions of over 75-year-olds within 28 days of discharge for the Brighton and Hove Unitary Authority area (UA) and is as follows:

Simon Kirby: To ask the Secretary of State for Health what steps his Department is taking to improve the treatment of elderly people whilst in hospital. [168970]

Norman Lamb: The initial Government response to the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, Patients First and Foremost, emphasised the importance of making the quality of care as important as the quality of treatment. It addressed the way people are cared for across the health and care settings and set out a range of actions that will be crucial to improving services for older people in hospitals but also in other settings, including residential and care homes, primary care and in the community. These actions include:

the development of a set of fundamental standards that make explicit the basic standards beneath which care should never fall;

the appointment of three new Chief Inspectors—one for hospitals, one for social care and one for general practice—who will have a key role in identifying concerns and triggering action; and

a single aggregated rating system for NHS trusts, comparable to OFSTED reports, that will provide a single version of the truth about how hospitals are performing on what really matters. A rating will also be produced for care homes.

The Government will be publishing a further response to the Public Inquiry Report in the autumn.

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The Government are currently consulting on a plan to improve care for vulnerable older people across the system. The plan will be published later this year and will include:

Every vulnerable older person should expect greater joint working to provide their care between the health and social care systems so that they don't fall between the cracks. We prioritised an additional £2 billion of funding in the spending review to help do this;

Every vulnerable older person should expect to receive personalised, proactive primary care, overseen by a named general practitioner (GP) who is accountable for this care; and

Every vulnerable older person should expect that their GP records can be shared with the different organisations delivering care to them, including out of hours GP services and the ambulance services. The Technology Fund will help to provide funding for this.

In Vitro Fertilisation

Ian Austin: To ask the Secretary of State for Health (1) what steps he is taking to minimise variation in the cost of a cycle of IVF treatment to the NHS; [168413]

(2) what guidance his Department gives to clinical commissioning groups on best practice in providing IVF treatment. [169236]

Dr Poulter: Clinical commissioning groups (CCGs) are responsible for commissioning many health care services, including infertility services, to meet the requirements of their population. In doing so, CCGs need to ensure that the services they provide are fit for purpose, reflect the needs of the local people and are value for money.

To support CCGs in their commissioning of infertility services, NHS England issued a factsheet to CCGs which sets out how CCGs should approach commissioning fertility services and take account of the revised National Institute for Health and Care Excellence fertility guideline.

Meningitis

Sir Tony Cunningham: To ask the Secretary of State for Health what assessment he has made of the conclusions in the Annual Report of the Chief Medical Officer, 2011 that (a) an effective vaccine against meningitis B would have a substantial impact on morbidity and mortality from meningitis and (b) a greater emphasis needs to be placed on preventative health measures. [169017]

Anna Soubry: We agree with the conclusions in the Chief Medical Officer's 2011 Annual Report and earlier this year we asked the Joint Committee on Vaccination and Immunisation (JCVI) to provide the Department with a recommendation in relation to the possible introduction of routine meningococcal B immunisation into the national immunisation programme provided by the national health service. The Committee issued recently an interim position statement on its assessment and has asked stakeholders for comments before finalising and providing its advice to us.

Meningitis: Vaccination

Sir Tony Cunningham: To ask the Secretary of State for Health what assessment he has made of the effect of the recent decision by the Joint Committee on Vaccination and Immunisation on the meningococcal B vaccine on the life sciences industry. [168966]

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Anna Soubry: The Joint Committee on Vaccination and Immunisation (JCVI) recently issued an interim position statement on its assessment on the use of meningococcal B vaccine in the United Kingdom. The Committee has asked stakeholders for comments on the interim statement before finalising it and providing advice to the Department. Thus, since the advice of the Committee has not yet been finalised and provided to Government, no decisions about the use of meningococcal B vaccine in the UK have been made and no assessment on the effect on the life sciences industry have been carried out by the Government.

Mental Health Services: Children

Ms Abbott: To ask the Secretary of State for Health how many inpatient beds for child and adolescent mental health services there were in each year from 2009. [168926]

Norman Lamb: The information requested is not collected centrally.

Mid Staffordshire NHS Foundation Trust

Peter Luff: To ask the Secretary of State for Health with reference to the oral statement of 26 March 2013, Official Report, column 1473, on Mid-Staffordshire NHS Foundation Trust, what progress he has made on the development of a barring scheme to prevent managers found guilty of gross misconduct from finding a job in another part of the NHS. [169091]

Dr Poulter: The Government are committed to establishing a barring mechanism to ensure that managers found guilty of gross misconduct are prevented from being re-employed in a similar role in the national health service.

A scheme such as this needs to be developed very carefully to ensure that it reassures the public while at the same time enhancing the professional esteem of the majority of senior managers who provide good leadership that results in patients receiving care that is dignified, compassionate and respectful.

To this effect we have been working closely with key organisations to develop an effective, proportionate approach and will publish an update on progress later in 2013.

Ministers' Private Offices

Michael Dugher: To ask the Secretary of State for Health how many full-time equivalent staff of each civil service grade are currently employed in the private office of each Minister in his Department; and what the pay band of each such member of staff is. [168720]

Dr Poulter: As of 12 September 2013, the number, grade and pay bands of staff employed in ministerial private offices are shown in the following tables:

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Musculoskeletal Disorders

Simon Wright: To ask the Secretary of State for Health what estimate NHS England has made of the number of cases of musculoskeletal conditions currently managed in primary care; and what assessment NHS England has made of the role that care planning can play in empowering patients with musculoskeletal conditions in relation to their health and wellbeing. [169368]

Norman Lamb: Information regarding the number of cases of musculoskeletal conditions (MSK) currently managed in primary care is not held centrally.

NHS England recognises the importance of care planning and the role that it can play in empowering patients with long term conditions.

NHS Improving Quality, as part of NHS England, is running a number of work programmes for 2013-14, including looking at evidence based tools for the management of long term conditions. Interventions will involve care plans; care coordination, use of technology, risk stratification, self-care and the role of carers.

This work will be evaluated and best practice identified.

NHS 111

Miss McIntosh: To ask the Secretary of State for Health what plans he has to review the operation of the 111 telephone service; and if he will make a statement. [169027]

Dr Poulter: NHS 111 is now available across more than 90% of England. Latest published performance data (8 September 2013) shows that over 580,000 patients used NHS 111 in July 2013. In addition, over 96% of calls were answered within 60 seconds, above the 95% target.

NHS England is undertaking a full review of the NHS 111 service to ensure it is fit for the future and is collecting data to monitor impact on emergency service demand. In addition, the Urgent and Emergency Care Review, being led by Sir Bruce Keogh, will look in depth at the system of emergency care and how we ensure that it provides the care patients need, from the right people, in the right place. This will include piloting opportunities for NHS 111 clinicians to have access to patient records, to enable a more integrated service for patients.

As part of the £250 million of support for emergency care this winter announced by the Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Mr Hunt), on 10 September 2013, Official Report, columns 45-48WS, we have set aside £15 million towards securing a reliable NHS 111 service throughout the winter period. This will pay for up to an additional 200 call handlers and 60 clinicians, who would be able to handle an extra 20,000 calls to the service each week.

There is widespread consensus that NHS 111 is in principle a good idea. For many patients, accessing the national health service by telephone is often the quickest and easiest way to get advice and speak to a doctor or nurse when needed, and we remain committed to ensuring the best possible service for patients.

NHS: Privatisation

Nic Dakin: To ask the Secretary of State for Health if he will make an assessment of the findings of the NHS Support Federation's quarterly review for April to June 2013 on privatisation in the NHS in 2013. [169472]

Dr Poulter: The Department has not received this publication, however we would be happy to consider it.

The Government have committed that the national health service will continue to be available for everyone

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who needs it, free at the point of use with access to services based on clinical need, not ability to pay.

NHS: Productivity

Priti Patel: To ask the Secretary of State for Health what estimate his Department has made of the productivity of the national health service in each of the last 10 years. [169145]

Dr Poulter: United Kingdom national health service productivity, as measured by the Office for National Statistics (ONS), is given in the following table:

Obesity

Gloria De Piero: To ask the Secretary of State for Health what estimate he has made of the number of people classified as obese in (a) Ashfield constituency, (b) Nottinghamshire, (c) the East Midlands and (d) England. [169042]

Dr Poulter: Estimates of the number of people classified as obese have not been made in the format requested.

Information on the prevalence of adults who are obese is available in Table 4 of the Adult trend tables from “Health Survey for England—2011 trend tables”'. This information is available at:

www.ic.nhs.uk/pubs/hse11trendtables

This information has already been placed in the Library.

Information, on the prevalence of adults who are obese by former strategic health authority (SHA) is available in Table 10.4 of the “Health Survey for England—2011: Health, social care and lifestyles”. This information is available at:

www.ic.nhs.uk/pubs/hse11report

This information has already been placed in the Library.

Information showing the prevalence of children who are obese in England is available in Table 4 of the Child trend tables from “Health Survey for England—2011 trend tables”.

Information on the prevalence of children who are obese by former SHA is available in Table 11.3 of the “Health Survey for England—2011: Health, social care and lifestyles”.

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Information on the prevalence of children who are obese by region and local authority is available in the “National Child Measurement Programme: England, 2011/12 school year” tables 3A and 3B. This information is only available for children in reception year (four to five years) and year six (10 to 11 years). This information is available on the:

www.ic.nhs.uk

website, by searching “National Child Measurement programme”, and clicking on the third link.

This information has already been placed in the Library.

Pain

Dan Jarvis: To ask the Secretary of State for Health what steps his Department is taking to support those who have complex regional pain syndrome; and if his Department will create a strategy to address that syndrome. [169607]

Norman Lamb: Through the Mandate we have asked the NHS England to make measurable progress in supporting people with ongoing health problems, such as complex regional pain syndrome (CRPS) to live healthily and independently, with much better control over the care they receive.

Many patients with long term chronic pain, such as those with CRPS, can be successfully supported and managed through routine primary and secondary care pain management services. However, it is important that those with the most serious pain management issues receive specialist treatment.

NHS England is responsible for commissioning highly specialised pain management services for patients with CRPS and has recognised more can be done to identify those most seriously affected. NHS England's Specialised Pain Clinical Reference Group is working with the Royal Colleges and the British Pain Society's guidelines to ensure the needs of these patients are appropriately met.

Press: Subscriptions

Michael Dugher: To ask the Secretary of State for Health which newspapers, periodicals and trade profession publications his private ministerial office subscribes to on a (a) daily, (b) weekly, (c) monthly and (d) quarterly basis. [168701]

Dr Poulter: Departmental records show the following paid subscriptions for each ministerial private office.

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There is no record of any subscriptions held by the office of the Parliamentary Under-Secretary of State (Dr Daniel Poulter) in his capacity as a Health Minister.

Procurement

Chris Ruane: To ask the Secretary of State for Health what assessment his Department makes of the (a)

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payment of minimum wage,

(b)

payment of living wage and

(c)

use of zero hours contracts when tendering for public procurement contracts. [169321]

Dr Poulter: The Department, within its own terms and conditions, includes clauses relating to statutory legal requirements, and when there is a legislative requirement to advertise for goods and services, the Department provides potential suppliers with a link to the Department for Work and Pensions website. The Department evaluates tenders based on a value for money solution which in the main incorporates the most economical solution to provide services and is set out within invitation to tender award criteria.

When engaging temporary staff and specialist contractors, the Department uses suppliers sourced from compliant framework agreements negotiated and put in place by the Government Procurement Service.

Public Relations

Michael Dugher: To ask the Secretary of State for Health how much his Department and its associated public bodies spent on (a) external public relations consultants and (b) public affairs consultants, in each of the past three years; and for what purposes such consultants were engaged. [168664]

Dr Poulter: The information requested is shown in the following table.

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PR companies are employed to support a very wide range of marketing and policy initiatives including our major public health behaviour change programmes (such as tobacco control, sexual health, obesity prevention and drug and alcohol harm reduction programmes). In addition to providing specialist knowledge of a wide range of media through which the Department needs to communicate with specific target audiences, they also provide extensive creative input to communications programmes.

PR companies are a highly flexible and cost-effective resource, as they can be commissioned for the duration of each individual, project, thus reducing the need for increasing internal headcount.

Publications

Michael Dugher: To ask the Secretary of State for Health if he will list (a) the title and subject, (b) the total cost to his Department and (c) the commissioned author or organisation of each external report commissioned by his Department in each year since 2010. [168787]

Dr Poulter: The Department does not keep a central record of reports that may have been commissioned and the information could be collected only at disproportionate cost.

Radiotherapy

Tessa Munt: To ask the Secretary of State for Health (1) under which section of the mandate from the Government to the NHS Commissioning Board is NHS England given the authority to restrict the number of providers of radiosurgery services in England; [169369]

(2) when NHS England launched its review into the provision of stereotactic radiosurgery services; what the scope and duration of that review is; which clinicians, hospitals and other interested parties have been consulted to date; and when the outcome of the review will be published. [169370]

Dr Poulter: Sections 9.2 and 9.3 of the Mandate from the Department to NHS England state that the Department will hold NHS England to account for its direct commissioning responsibilities. These responsibilities include the commissioning of radiosurgery services, which are included in the list of 143 specialised services that NHS England commissions directly.

Section 9.3 of the Mandate states that NHS England must measure and publish information about the quality and value of the services that it commissions. NHS England has developed a specification for radiosurgery services, following wide stakeholder consultation. The specification defines what NHS England expects from providers in terms of evidence-based, safe and effective

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services. NHS England has also published clinical commissioning policies outlining the services that are available to patients in England.

As part of its commissioning responsibilities, NHS England decides on the most appropriate approach to commissioning the service concerned, and in some cases this can mean a restricted number of providers in order to ensure that a high level of clinical expertise, specialised resources, skills and staffing are maintained. This is particularly important when considering a service such as stereotactic radiosurgery (SRS) that requires very expert technical ability in order to deliver good outcomes.

NHS England has recently commenced its demand and capacity review project for SRS and stereotactic radiotherapy (SRT) for intracranial conditions. The output of this project will be to inform a national strategy to support the 10 Area Teams commissioning specialised services. NHS England expects the strategy to be completed by the end of the year, and published in early 2014.

The review aims to ensure access to equitable and nationally consistent access to high quality SRS/SRT services. This project will include reviewing the national patient demand for routinely funded SRS/SRT that NHS England commissions and will consider the appropriate technology and capacity requirements needed to provide services to meet patient needs.

The Clinical Reference Groups for Radiotherapy and SRS will be providing the clinical advice to the review. NHS England will be working with industry and providers as appropriate to provide the demand and capacity information required.

Satellite Broadcasting

Michael Dugher: To ask the Secretary of State for Health what subscriptions his Department has for premium satellite television channels; and what the cost of each such subscription was in the most recent year for which figures are available. [168646]

Dr Poulter: During the financial year 2012-13, the Department's Media Centre paid £2,531.72 (which includes value added tax) to maintain its monthly corporate subscription to Sky TV. For comparison, the amount paid in previous years is shown in the following table:

School Milk

Andrew Bridgen: To ask the Secretary of State for Health what assessment he has made of the (a) cost and (b) timescales of a procurement exercise for a contract for direct supply of milk as part of the Nursery Milk Scheme. [168967]

Dr Poulter: A decision on the future operation of the Nursery Milk Scheme will be taken after full consideration is given to the consultation responses, the accompanying impact assessment and other relevant information. The

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Department has not made a specific assessment of the precise cost of the procurement exercise for the direct supply of nursery milk. If the Government proceed with the direct supply option for the future operation of the scheme, the Department in line with Cabinet Office policy will apply lean procurement principles to the procurement exercise and use the Open

Official Journal

of the European Union (OJEU) procedure. Application of the lean methodology will allow us to engage with the market to explore cost impact in more detail. The timescales followed will be in line with Open OJEU guidelines.

Mr Sanders: To ask the Secretary of State for Health what calculation was used for the target price range for a pint of milk included in the direct supply option within his Department's next steps for nursery milk consultation. [169335]

Dr Poulter: The direct supply price of milk in the impact assessment which accompanied the consultation document was an estimate based on farm-gate prices. The estimate may change as we factor in evidence gathered from the consultation. A decision on the future operation of the Nursery Milk Scheme will be taken after full consideration is given to the consultation responses, further evidence received and other relevant information.

Jonathan Evans: To ask the Secretary of State for Health how many local authorities currently have a local contract for the supply of milk under the Nursery Milk Scheme; and what the average duration of these contracts is. [169356]

Dr Poulter: The number of local authorities who use an agent for the supply of nursery milk is 171. The Department is unable to comment on contractual issues between child care settings and the organisations which provide them with milk.

Security

Michael Dugher: To ask the Secretary of State for Health how many departmental identity cards or passes have been reported lost or stolen by staff in his Department since May 2010. [168611]

Dr Poulter: The Department only retains a record of lost or stolen passes for one calendar year.

From 12 September 2012 to 11 September 2013, staff reported a total of 68 building passes as lost or stolen.

Social Workers: Training

Lisa Nandy: To ask the Secretary of State for Health (1) what assessment he has made of the number of placements available for social work students in (a) the current year and (b) the previous year; [169537]

(2) what estimate he has made of the potential shortfall in the placements available for social work students in the next 12 months. [169572]

Norman Lamb: It is the responsibility of higher education institutions (HEIs), in partnership with employers, to determine the size of the student intake for social work qualifying courses. As part of that decision-making

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process, HEIs will need to consider the number and availability of placement days required. Government provide a contribution to the cost of employers hosting a placement through the education support grant. We are currently consulting on the resource allocation formula for the education support grant.

South Essex Partnership NHS Trust

Mr Amess: To ask the Secretary of State for Health what action he has taken in regard to the increasing number of complaints about South Essex Partnership trust. [169490]

Dr Poulter: As part of the Government's response to Robert Francis's report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, the Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Mr Hunt), commissioned a review of the handling of complaints in national health service hospitals in England, chaired by Ann Clwyd MP and Professor Tricia Hart, Chief Executive of South Tees Hospitals NHS Foundation Trust. The review is considering how concerns and complaints from patients, their carers and families are listened to, heard and acted upon, and identifying key components of good practice. We envisage the report will be published soon, and the Government will consider its recommendations and respond in its further response to the Francis Inquiry, to be published in the autumn.

The number of complaints received by South Essex Partnership University NHS Foundation Trust is an operational matter for the foundation trust. We have therefore written to Lorraine Cabel, Chair of South Essex Partnership University NHS Foundation Trust, informing her of the hon. Member's enquiry. She will reply shortly and a copy of the letter will be placed in the Library.

Mr Amess: To ask the Secretary of State for Health what steps he has taken to improve the oversight of Monitor's responsibility in regards to South Essex Partnership trust. [169491]

Dr Poulter: Monitor is an independent economic regulator established at arm's length with independence over its day-to-day operational decision-making. The Department ensures that Monitor is discharging its statutory duties, managing risk and spending public money appropriately, for example through regular accountability meetings.

Standards

Michael Dugher: To ask the Secretary of State for Health what the reasons are for the time taken to publish his Department’s quarterly data summary for the second quarter of 2012-13 and the third quarter of 2012-13. [168822]

Dr Poulter: The quarter 2 and quarter 3 quarterly data summary (QDS) returns of all 17 Departments participating in the QDS process were delayed owing to the development of the Cabinet Office’s Government Interrogating Spending Tool (GIST). The GIST was developed in response to recommendations made in Dr Martin Read’s independent report entitled “Practical

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Steps to Improve Management Information in Government”. The GIST is an online tool that allows the public to access a breakdown of Government expenditure through the gov.uk website. It makes the process of accessing and analysing complex QDS and OSCAR (online system for central accounting and reporting) data easier and quicker, and for these reasons was seen to justify a short delay in publishing QDS data.

Streptococcus

Grahame M. Morris: To ask the Secretary of State for Health (1) with reference to the remarks made by the Director of the UK National Screening Committee during a radio interview on 19 August 2013, from what dataset the reference to 40 babies a year badly affected by group B streptoccus was drawn; and what the basis was for the classification given to such babies; [168547]

(2) how many babies aged between zero and six days were diagnosed with group B streptococcal infections in England in (a) 2003 and (b) 2011; and how many such infections were classified as mild; [168548]

(3) what estimate he has made of the proportion of women in England (a) with and (b) without standard risk factors for group B streptococcal infection developing in a newborn will be carrying the infection at the point of delivery in the next 12 months; [168549]

(4) how his Department plans to involve women in policy decision making in respect of measures to prevent group B streptococcal infection; [168550]

(5) what assessment he has made of the effectiveness of the guidance on risk-based group B streptococcal infection issued by the Royal College of Obstetricians and Gynaecologists in (a) 2003 and (b) 2012 in reducing the incidence of early-onset group B streptococcal infection in babies; [168551]

(6) what the policy is of his Department on recommending that all women are informed about Group B streptococcus as a routine part of antenatal care. [168896]

Dr Poulter: The UK National Screening Committee director of programmes' comment was based on data derived from the British Paediatric Surveillance Unit study published in The Lancet in 2004 which highlighted the screening programmes internationally report little impact on group B streptococcus in premature babies.

The UK National Screening Committee estimates that about 25% (about 140,000) of low-risk pregnant women will be group B streptococcus carriers at term while a much lower number, about 200, will have an affected baby. As such, a consequence of screening programme would be that many thousands of women testing positive would need to receive antibiotics in order to ensure that those whose babies would be affected received antibiotics during labour.

In addition, studies of the test suggest that between 13% and 40% of screen positive women will no longer be carriers at the point of delivery. Because of this, a proportion of women will receive antibiotics when they do not carry group B streptococcus. The National Institute for Health and Care Excellence (NICE) recently concluded

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that group B streptococcus carriage in pregnancy was not a useful predictor of early onset group B streptococcus disease.

The following table information on number of incidents of group B streptococcal bacteraemia in babies aged between 0 and 6 days, without classification as mild.

The Department is working together with the national health service, the Royal College of Obstetricians and Gynaecologists (RCOG), the Royal College of Midwives, the National Institute for Health Research Heath Technology Assessment and the pharmaceutical industry to raise awareness and make improvements in the reduction of early-onset group B streptococcus infection in newborn babies.

The RCOG published its updated guidelines on prevention of group B streptococcus on incidence of group B streptococcus infection in neonates in July 2012. The updated guideline took into account new evidence on the prevention of early-onset neonatal group B streptococcus disease.

It is important that services undertake local clinical audits to ensure the effective use of intrapartum antibiotic prophylaxis recommended by the guideline.

Following the publication of the revised guideline, the UK National Screening Committee suggested a formal audit of practice, to establish how well the new guidance is being implemented at a national level.

The RCOG, in partnership with the London School of Hygiene and Tropical Medicine, has now appointed a clinical research fellow to carry out an audit across the United Kingdom. The aim is to provide feedback and advice to ail participating trusts about how they can further improve their adherence to the RCOG guidelines on the prevention of neonatal group B streptococcus disease.

In addition, NICE published two clinical audit tools which include clinical audit standards, a data collection form and an action plan template for use by services that care for women in labour or for babies at risk of, or being treated for, early-onset neonatal infection. We expect NHS organisations to take them fully into account in their decision making, including on antibiotics for the prevention and treatment of early onset neonatal infection.

A midwife offers every woman testing for asymptomatic bacteria early in pregnancy and this includes looking for group B streptococcus.

NHS Choices and RCOG provide consistent and complimentary advice on group B streptococcus (early and late onset) for women and their families who are expecting a baby or are planning to get pregnant.

Information from NHS Choices is available at:

www.nhs.uk/chq/pages/2037.aspx?categoryid=54& subcategoryid=137

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Information from the Royal College of Obstetricians and Gynaecologists is available at:

www.rcog.org.uk/womens-health/clinical-guidance/group-b-streptococcus-gbs-infection-newborn-babies-information-you

Televisions

Michael Dugher: To ask the Secretary of State for Health how many flat screen televisions have been purchased by his Department in the last 24 months; and what the cost to the public purse was of such purchases. [168754]

Dr Poulter: The Department has purchased and installed nine flat screen (plasma and liquid crystal display) televisions in the last two years, (2011-12 and 2012-13 to date), costing a total of £5,008.86.

Thromboembolism

Michael Dugher: To ask the Secretary of State for Health what arrangements there are to ensure that clinical commissioning groups are held accountable for the prevention of venous thromboembolism. [168847]

Anna Soubry: On 1 April 2013, the National Venous Thromboembolism (VTE) Prevention Programme moved to NHS England under the continued leadership of Dr Mike Durkin in his role as director of patient safety.

The clinical commissioning group (CCG) outcomes indicator set (CCGOIS) provides clear, comparative information to support CCGs and health and wellbeing boards to identify local priorities and demonstrate progress on improving outcomes, as well as supporting public transparency about local health services.

All of the CCGOIS indicators have been chosen on the basis that they contribute to the overarching aims of the five domains in the NHS outcomes framework. In relation to VTE, the relevant objective of the NHS outcomes framework is

“reduced harm from failure to prevent VTE in a healthcare setting”.

Tobacco: Packaging

Cathy Jamieson: To ask the Secretary of State for Health whether he plans to discuss plain packaging of cigarettes with his Scottish counterparts. [169657]

Dr Poulter: Ministers and officials discuss issues relating to public health with their Scottish Government counterparts as necessary, this would include standardised packaging of tobacco products when appropriate.

Trillium Group

Mr Sheerman: To ask the Secretary of State for Health how much his Department has spent on contracts with Trillium Group in each year since 2008. [169257]

Dr Poulter: The Department's business management system (BMS) shows spend with Telereal Trillium in the following table. BMS shows no spend with Telereal Trillium for the financial years 2008-09 to 2011-12. Figures for 2013-14 are up to 31 August 2013.

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Tuberculosis

Mr Virendra Sharma: To ask the Secretary of State for Health how much the NHS spends procuring drugs for an average course of (a) latent TB infection treatment, (b) standard drug-sensitive TB treatment, (c) Isoniazid-resistant TB treatment, (d) Rifampicin-resistant TB treatment, (e) multi-drug resistant treatment. [168424]

Norman Lamb: This information is not available in the format requested.

National health service expenditure¹ on anti-tuberculosis drugs² dispensed in primary and secondary care in England in 2012 are shown in the following tables.

¹ Some supplies through homecare providers may not be captured, therefore cost estimates may be under-stated.

² Antituberculosis drugs are defined as those listed in British National Formulary chapter 5.1.9.

Mr Virendra Sharma: To ask the Secretary of State for Health what assessment he has made of the current rate of TB infection in the UK; and if he will make a statement. [168425]

Anna Soubry: The incidence of Tuberculosis (TB) in the United Kingdom is assessed through systematic analysis of notification data obtained from the Enhanced Tuberculosis Surveillance System (ETS) run by Public Health England (PHE). In 2012, a total of 8,751 cases of TB were reported, a rate of 13.9 cases per 100,000 population.

TB rates in the UK showed a sustained increase from 2000 until 2005, and have remained among the highest in Western Europe. Certain sub-groups, such as new migrants, ethnic minority groups, and those with social risk factors (homelessness, imprisonment or problem drug/alcohol use) have particularly high rates.

The Department is working with PHE, the national health service, local government and the wider health and social care system to strengthen TB services. Every year, PHE produces an analysis on TB epidemiology in the UK. The latest analysis can be found in the PHE TB annual report, which has been placed in the Library.

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Mr Virendra Sharma: To ask the Secretary of State for Health what assessment he has made of the (a) efficacy and (b) possible side effects of the current range of anti-tuberculosis drugs available on the NHS. [168459]

Norman Lamb: New drugs for treatment of tuberculosis are assessed for efficacy and safety based on results of clinical trials carried out in accordance with current European Union regulations. A risk-benefit approach is taken to ensure that all licensed medicines provide maximum benefit to the target patient population with minimal risk to patient safety. Some of the anti-tuberculosis drugs commonly used in the national health service have been on the United Kingdom market for many years and assessment of efficacy would have been carried out against the criteria in force at the time of approval.

As with all medicines used in the UK, the Medicines and Healthcare products Regulatory Agency (MHRA) continually monitors the safety of anti-tuberculosis drugs after they are licensed using all available sources of information. This includes the Yellow Card Scheme for spontaneous reporting of adverse reactions by health care professionals and patients, reports from pharmaceutical companies—which are a legal requirement under UK law and worldwide health authorities, data from clinical and epidemiological studies and the published medical literature. These data are assessed to establish whether the benefits of licensed products continue to outweigh the risks. If necessary, regulatory action is taken to ensure that the medicine is used in a way which minimises risk, and maximises benefits to the patient. The balance of benefits and risks of currently licensed anti tuberculosis drugs continues to be positive.

International Development

Absenteeism

Michael Dugher: To ask the Secretary of State for International Development what the rates of staff (a) absence and (b) sickness absence in her Department in each of the past five years were; and what the departmental targets were in each case. [168738]

Mr Duncan: The information is as follows.

(a) DFID as with any Department has a number of different types of absence for which employees can apply i.e. paternity leave, adoption leave, special or discretionary leave along with statutory leave i.e. annual leave and maternity leave.

The majority of non-sickness related absence types are not currently recorded centrally and can be obtained only at disproportionate cost.

(b) Sickness absence rates for the last five financial years are given in the following table. There are no departmental targets on sickness absence but the DFID Executive Management Committee note DFID sickness rates against overall civil service rates.

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