Brain Cancer: Children

Jim Shannon: To ask the Secretary of State for Health what steps he is taking to prevent brain cancer amongst children. [180980]

Jane Ellison: The causes of brain tumours are largely unknown. The only unequivocally identified risk factors are inherited cancer syndromes and, in rare cases, ionising radiation. Therefore, we are not currently taking any steps to prevent brain cancer among children.

NHS England has responsibility for determining the overall national approach to improve clinical outcomes from health care services for children with cancer. One of the improvement areas for the national health service set out in the Government's mandate to NHS England is five year survival from all cancers in children.

Clinical Commissioning Groups: Bolton

Mr Crausby: To ask the Secretary of State for Health what funds per head of population are allocated to the Bolton Clinical Commissioning Group for 2013-14. [181313]

Dr Poulter: The allocation per head for NHS Bolton Clinical Commissioning Group (CCG) for the 2013-14 year was £1,127. This will rise to a per head allocation of £1,158 by 2015-16.

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General Practitioners: Suffolk

Dr Thérèse Coffey: To ask the Secretary of State for Health how much his Department spent per capita in each general practice area in Suffolk Coastal constituency in the last year for which data are available. [181039]

Dr Poulter: Information is not available in the format requested.

General practitioner (GP) practices hold contracts with NHS England to undertake work for the national health service. Funding for payments to GP practices is included in the general allocation made to NHS England by the Department.

Information supplied by NHS England on per capita expenditure for general practices in Suffolk for 2012-13 is shown in the following table.

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In Vitro Fertilisation

Mr Burrowes: To ask the Secretary of State for Health pursuant to the answer of 7 November 2013, Official Report, column 322W, on in vitro fertilisation, (1) what the survival rate was of human embryos following pronuclear transfer in available published studies; [181736]

(2) what the survival rate was of macaque embryos following pronuclear transfer; [181737]

(3) what assessment his Department has made of whether the use of proposed new techniques to prevent mitochondrial disorders will be more or less effective when used with human embryos than has been the case with macaque embryos. [181738]

Jane Ellison: The Department has taken advice on the safety and efficacy of mitochondrial donation over the last three years from an Expert Panel convened by the Human Fertilisation and Embryology Authority (HFEA).

The Expert Panel's April 2011 report “Scientific review of the safety and efficacy of methods to avoid mitochondrial disease through assisted conception” references a published study regarding pronuclear transfer in human embryos: Craven L, H. A. Tuppen, et al. (2010) “Pronuclear transfer in human embryos to prevent transmission of mitochondrial DNA disease.” Nature 465(7294):82-5. Section 4.2.4 of the Expert Panel's report outlines the study's findings regarding the survival rate of human embryos following pronuclear transfer (PNT), in terms of the rate of blastocyst (an embryo at around the six day stage) formation following PNT on abnormally-fertilised eggs.

Research is currently ongoing at the University of Newcastle Wellcome Trust Centre for Mitochondrial Research.

Section 2.2.8 of the Expert Panel's March 2013 update report “Scientific review of the safety and efficacy of methods to avoid mitochondrial disease through assisted

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conception” outlines considerations regarding the use of the macaque model for PNT. The Expert Panel concluded, in March 2013, that current research using PNT in macaques has yet to be shown to be successful. From unpublished data it appears that macaque zygotes (one-cell fertilised egg) do not survive the PNT process well, but published evidence suggests that there may be important differences between human and macaque eggs and early embryos and that the macaque may not be a sufficiently good model for the human.

The Department will be seeking further advice from the Expert Panel about the safety and efficacy of these techniques before putting regulations to allow them in treatment before Parliament.

Mental Health Services

Mr Charles Walker: To ask the Secretary of State for Health (1) what estimate he has made of bed occupancy rates in NHS mental health trusts in England; and if he will make a statement; [181755]

(2) what assessment his Department has made of the quality of patient care in NHS acute mental health services; and if he will make a statement; [181757]

(3) what steps are being taken to ensure mental health patients have appropriate access to crisis care and early intervention services; [181758]

(4) what indicators will be used by his Department to assess whether the NHS is delivering parity of esteem for mental health and physical health; and if he will make a statement; [181759]

(5) what progress NHS England has made in its review of calculating the proportion of the NHS budget spent on mental health conditions; [181761]

(6) what assessment his Department has made of the effectiveness and efficacy of the commissioning of specialised services for mental health conditions following the passage of the Health and Social Care Act 2012; [181762]

(7) when his Department plans to review the commissioning of specialised services for mental health conditions following the passage of the Health and Social Care Act 2012. [181763]

Norman Lamb: The information requested for mental health bed occupancy rates in national health service trusts in England is not held in the format requested. However, the NHS Health and Social Care Information Centre do collect information on the mental health bed occupancy and availability rates for all NHS trusts. Information collected from 2010-11 is shown in the following tables:

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Clinical commissioning groups are responsible for commissioning non-specialised acute mental health services and use the standard NHS contract and associated quality parameters.

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Quality at a national level is assessed through a number of measures including through National Clinical Audits and Confidential Inquiries which are commissioned by NHS England. The National Clinical Audit is designed to assess and improve patient outcomes across a wide range of medical, surgical and mental health conditions.

NHS England is making a number of changes in respect of ensuring greater parity of esteem between mental health and acute services, as a result of the review of incentives, rewards and sanctions. These are in the NHS Standard Contract and the Commissioning for Quality and Innovation (CQUIN) scheme.

Within the NHS Standard Contract for 2014-15, we will:

establish a specific mandated financial sanction in respect of provider performance against the existing standard for patients on the Care Programme Approach to be followed up within one week of discharge; and

introduce new standards, again with specific mandated financial sanctions, for completion of Mental Health Minimum Data Set returns, in respect of completion of the fields relating to ethnicity and Improving Access to Psychological Therapies Minimum Data Set returns relating to patient outcomes.

Of the four national CQUIN indicators proposed for 2014-15, two will relate specifically to mental health services—the Dementia and Delirium indicator and a new indicator, applicable to mental health providers only, on improving physical health care to reduce premature mortality in people with severe mental illness. The third national indicator is the Friends and Family Test, a measurement of patient experience which will be rolled out to mental health service providers during 2014-15. (The fourth indicator is the NHS Safety Thermometer.)

The Care Quality Commission (CQC) is responsible for developing and consulting on its methodology for assessing whether providers are meeting the registration requirements. On 29 November 2013, the CQC published the report ‘A fresh start for the regulation and inspection of mental health services’. The report sets out changes the CQC is proposing to make in the way it inspects specialist mental health care services. The key changes are:

including mental health specialists on all inspections of mental health services and bringing together our work under the Mental Health Act and how we regulate mental health services;

setting up inspection teams of specialist inspectors, Experts by Experience and professional experts;

rating mental health services with one of the following: Outstanding, Good, Requires improvement or Inadequate;

engaging with people who use services, their carers and families, during inspections and at other times in new ways;

making sure we have better information about mental health services and developing our intelligent monitoring system for these services;

looking at how people are cared for as they move between services; and

recognising that mental health treatment and support is part of services in all sectors.

The Department is currently working with a range of agencies and representative organisations to develop a single national Crisis Care Concordat. It is important that people receive the right type of high quality care at the right time. Handling mental health problems early in the community means that acute care is then available to people who need it quickly. Secondary mental health services have been reorganised to improve care in the community and in hospitals.

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Improving early intervention services remains a key national priority. The cross-Government mental health strategy, ‘No Health Without Mental Health’, highlights the case for prevention and early intervention and the costs of doing nothing.

Public Health England's priorities for 2013-14 include a commitment to

“develop a national programme on mental health in public health that supports ‘No Health Without Mental Health’, prioritising the promotion of mental wellbeing, prevention of mental health problems and the prevention of suicide, along with improving the wellbeing of those living with and recovering from mental illness.”

We will hold the NHS to account for the quality of services and outcomes for mental health patients through the NHS Outcomes Framework. There are four measures which relate specifically to mental health. Improvements for people with mental health problems will also be a crucial element of success across the framework as a whole.

The Department has also recently published the Mental Health Dashboard which brings together mental health outcomes data to show progress made against the Mental Health Strategy ‘No Health without mental health’. This is available at:

www.gov.uk/government/publications/mental-health-dashboard

NHS England plans to publish annual estimates of NHS commissioned expenditure by health care condition, which will include an analysis of mental health expenditure. NHS England is currently working with stakeholders to establish the format, processes and timetable for the data collection.

NHS England works with the 10 Area Teams responsible for commissioning specialist mental health services locally, meeting monthly to ensure consistency in approach and equity for patients. All aspects of the standard NHS contract apply equally to specialised mental health services and the same national mandated requirements apply.

Clinical Reference Groups (CRGs) cover the full range of specialised services and are responsible for providing NHS England with clinical advice regarding these directly commissioned services. The CRGs are made up of clinicians, commissioners, public health experts and patients and carers, and are responsible for the delivery of key ‘products' such as service specifications and commissioning policies, which enable NHS England to commission services from specialist providers through the contracting arrangements overseen by its Area Teams. CRGs approach the development of service specifications and quality standards from a clinically effective, patient centred perspective.

NHS England now has one contract per independent sector provider with different Area Teams taking the lead for individual providers. This ensures greater consistency with regard to services expectations and quality. Each Area Team is responsible for the quality and safety of the services in their catchment area, and will work with the Area Team that holds the contract to ensure key messages and areas of concern are pursued contractually if required. NHS England also case manages secure patients within each specialised Area Team catchment area to ensure they are in the right place, at the right time receiving the right treatment. Child and Adolescent Mental Health Services case management has also been introduced and is being rolled out.

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NHS England has directions on the commissioning of high secure services and reports annually to the Department.

NHS 111

Tom Blenkinsop: To ask the Secretary of State for Health how many calls were received by NHS 111 on (a) 24, (b) 25 and (c) 26 December 2013; and how many clinicians were on duty at NHS 111 on those dates. [181408]

Jane Ellison: The total number of calls received by NHS 111 for the dates requested are:

22,505 on 24 December 2013;

32,093 on 25 December 2013; and

51,730 on 26 December 2013.

Information on the number of clinicians on duty at NHS 111 sites is not collected.

Radiotherapy

Tessa Munt: To ask the Secretary of State for Health (1) pursuant to NHS England's document Improving Outcomes: A Strategy for Cancer Third Annual Report, paragraph 5.17 on stereotactic ablative radiotherapy (SABR), how NHS England plans to examine the potential utility of SABR to treat oligometastatic disease; [181036]

(2) pursuant to NHS England's document Standards for the Provision of Stereotactic Ablative Radiotherapy (SABR), for what specific cancers other than early stage lung cancer SABR has clear benefits; [181037]

(3) pursuant to NHS England's document Standards for the Provision of Stereotactic Ablative Radiotherapy (SABR), section 2.2 Service description/care pathway, what programmes NHS England has in place to measure the cost and clinical effectiveness of SABR treatment for renal cancer, hepatic primary tumours, hepatic metastases, spinal tumours and oligometastases against (a) conventional radiotherapy and (b) surgical procedures. [181038]

Jane Ellison: The radiotherapy clinical reference group is undertaking a review of the role and evidence to support the use of stereotactic ablative radiotherapy (SABR) in oligometastatic disease. This review will consider the options for collecting additional evidence of its clinical and cost-effectiveness which will be used to inform NHS England's commissioning position.

Current evidence only supports the routine use of SABR for a small subset of patients with early non-small cell lung cancer, as set out in NHS England's commissioning policy statement on SABR. NHS England's SABR commissioning policy statement will be reviewed in April 2014, at which time the radiotherapy clinical reference group will examine whether further evidence has come to light regarding the clinical and cost-effectiveness of SABR in treating other cancers.

Rail Travel

Luciana Berger: To ask the Secretary of State for Health what the total cost of rail travel in both directions between London and Leeds by officials in his Department was in each of the last 10 years. [181881]

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Dr Poulter: The Department is unable to provide information requested for the whole 10 year period. Costs for rail travel for each financial year are available since April 2005 and are shown in the following table:

Data are taken from Management Information from centrally-provided contracts used by officials to book travel and hotel accommodation. Information drawn from the Department's Business Management System for costs claimed through i-expenses, where staff have incurred legitimate business costs themselves and subsequently claimed reimbursement, is not included as it is not possible to establish where journeys originated and ended.

Training

Luciana Berger: To ask the Secretary of State for Health what broadcast media training he or ministers in his Department have undergone in the last 12 months; and what the total cost of such training was. [181883]

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Dr Poulter: Neither the Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Mr Hunt), nor his Ministers have received broadcast media training in the last 12 months.

Culture, Media and Sport

Credit: Interest Rates

Mike Crockart: To ask the Secretary of State for Culture, Media and Sport what plans she has to ban adverts for payday loan companies from television programmes aimed at children. [181707]

Sajid Javid: I have been asked to reply on behalf of the Treasury.

Payday loan adverts are subject to the Advertising Standards Authority's strict content rules. The ASA will not hesitate to ban irresponsible adverts, and has a strong track record of doing so.

The Broadcast Committee of Advertising Practice (BCAP), the body that writes the Broadcast Advertising Code, is considering the extent to which payday loan advertising features on children's TV and whether there are any implications for the ASA's regulation of this sector.

Separately, the Financial Conduct Authority is consulting on new rules for consumer credit adverts, including proposals to introduce mandatory risk warnings and signposting to debt advice. It has powers to ban misleading adverts which breach its rules.