Developing Countries: Health Services

Jim Dobbin: To ask the Secretary of State for International Development what steps her Department has taken to reorganise its funding model to ensure that it is encouraging service delivery for complex multiple needs, in line with an intregrated model of healthcare solutions. [198203]

Lynne Featherstone: DFID supports work to strengthen health systems and deliver health programmes, helping developing countries to assess and provide for the health needs of its people. This will enable countries to make sound decisions about the delivery of the promotion, prevention and treatment services that are needed.

Mr Jim Murphy: To ask the Secretary of State for International Development what steps she is taking to ensure that the problem of rising health costs, in part owing to ageing populations, is addressed in the Sustainable Development Goals. [198208]

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Justine Greening: Countries will need stronger health systems if they are to be able to meet the diverse needs of an ageing population and we are working with them to encourage investment in cost-effective solutions to these challenges. We have supported the inclusion of universal health coverage as a target in a post 2015 framework, the aim of which is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them. This includes the elderly.

Developing Countries: Unemployment

Mr Jim Murphy: To ask the Secretary of State for International Development what steps she is taking to ensure that the problems of youth unemployment and other forms of unemployment are addressed effectively in the Sustainable Development Goals. [198206]

Justine Greening: Economic development is the clearest way to end aid dependency through inclusive growth and job creation. The UK is a strong advocate for a post-2015 target and indicator on employment, including disaggregated targets for women and youth, and DFID is working through the United Nations Open Working Group process to achieve this.

Developing Countries: Urban Areas

Mr Jim Murphy: To ask the Secretary of State for International Development what steps she is taking to ensure that the Sustainable Development Goals effectively recognise the potential human and environmental costs arising from a growing proportion of the global population living in urban slums. [198205]

Justine Greening: The Government are keen that the Sustainable Development Goals include measures to improve conditions for poor urban residents and address the issues that lead to the formation of slums. We continue to support the approach to urban issues set out in the report of the High Level Panel on post-2015 goals, co-chaired by the Prime Minister. This promotes a detailed consideration of the urban implications of each goal and target.

Mr Jim Murphy: To ask the Secretary of State for International Development what steps she is taking to ensure that action is taken in the Sustainable Development Goals to address the pressures which rapid urbanisation is placing upon the infrastructure of cities around the world and their inhabitants. [198216]

Justine Greening: We continue to support the approach to urban issues set out in the report of the High Level Panel on post-2015 goals, co-chaired by the Prime Minister. This promotes a detailed consideration of the urban implications of each goal and target, including those for infrastructure.

Nigeria

Alison McGovern: To ask the Secretary of State for International Development what assessment she has made of the ability of Nigerian federal authorities to provide adequate security for young women in northern states. [197892]

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Lynne Featherstone: A team of UK experts who will advise and support the Nigerian authorities in its response to the abduction of over 200 school girls touched down in Abuja on the 9 May.

The team is drawn from across Government, including DFID, FCO and the MOD, and will work with the Nigerian authorities leading on the abductions and terrorism in Nigeria. The team will be considering not just the recent incidents but also longer-term counter-terrorism solutions to prevent such attacks in the future and defeat Boko Haram.

The team will be working closely with their US counterparts and others to coordinate efforts.

Alison McGovern: To ask the Secretary of State for International Development what assessment she has made of trends in the numbers of forced marriages in northern Nigeria over the last five years. [197893]

Lynne Featherstone: Data from the last, 2008, Demographic and Health Survey suggest that the median age at marriage for girls and women in the north is about 16 years. This compares with the national median age of about 20 years. The 2013, Demographic and Health Survey is expected to be released this summer and will enable us to assess if the situation is changing.

Alison McGovern: To ask the Secretary of State for International Development what assessment she has made of progress by Nigeria towards meeting Millennium Development Goal 3A on eliminating gender disparity in education. [197895]

Lynne Featherstone: The ratio of girls to boys in primary education in Nigeria has increased from 0.79 in 1990 to 0.91 in 2010. The regional average for Sub-Saharan Africa was 0.93 in 2011. Whilst some improvements have been made nationally, there remain significant challenges in the north to ensure that all children, girls and boys, have equitable access to a quality basic education.

Alison McGovern: To ask the Secretary of State for International Development what recent assessment she has made of the proportion of girls under the age of 16 years old in northern states of Nigeria who are in full-time education. [197896]

Lynne Featherstone: 52% of primary-aged girls and 36% of secondary-aged girls were attending school in northern states of Nigeria in 2011.

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Palestinians

Ian Austin: To ask the Secretary of State for International Development what recent discussions she has had with the Palestinian Authority on that body's use of UK funding. [197752]

Mr Duncan: The UK regularly meets Palestinian Authority Ministers, most recently on 6 March 2014 as part of our regular strategic dialogue to discuss progress against commitments in our Memorandum of Understanding. The discussion covered the range of areas of cooperation (including security and justice, finance and the economy) as well as progress on developing the new Palestinian National Development Plan.

Health

Abortion

Jeremy Lefroy: To ask the Secretary of State for Health whether all abortions commissioned by NHS England from private providers are recorded in the abortion statistics. [198165]

Jane Ellison: It is a legal requirement for a medical practitioner terminating a pregnancy to notify the chief medical officer on form HSA4 within 14 days of the procedure whether it is undertaken in a national health service hospital or in the independent sector. All procedures are recorded in “Abortion Statistics, England and Wales” published annually.

Mr Laurence Robertson: To ask the Secretary of State for Health when he last amended his Department's guidelines on the authorising of abortions; and if he will make a statement. [198255]

Jane Ellison: The chief medical officer for England has written twice (on 23 February 2012 and 22 November 2013) to all medical practitioners reminding them of their responsibilities under the Abortion Act.

The Department will be providing further guidance to all those involved in providing abortion care on compliance with the Act; this will be published shortly.

Ambulance Services

Steve Rotheram: To ask the Secretary of State for Health what the average ambulance response time was in (a) Liverpool, (b) Merseyside and (c) England in each month since May 2007. [197760]

Jane Ellison: The information is not available in the format requested. Such information as is available is shown in the following tables.

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Before April 2011, data were collected annually in the KA34 Ambulance Statistics. This shows the annual trend in national ambulance activity has been increasing since 2007-08: from 4.3 million emergency journeys in 2007-08 to 5 million in 2012-13 (latest available).

The performance of ambulance services is performance measured on a monthly basis against three response time standards. On the basis of these standards performance in the North West Ambulance Trust is broadly stable.

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Arthritis

Nic Dakin: To ask the Secretary of State for Health what plans he has to improve awareness of and early intervention for rheumatoid arthritis. [198171]

Norman Lamb: In 2009, the National Institute for Health and Care Excellence (NICE) published clinical guidance on the management of rheumatoid arthritis (RA) in adults, which set outs best practice on the diagnosis, care, treatment and support of patients. The guidance makes clear the importance of early diagnosis and is explicit that suspected cases should be referred as an urgent priority for specialist assessment and that early initiation of treatment can prevent irreversible damage to joints.

In addition to this, information on the diagnosis and treatment of RA can also be accessed via the NICE Clinical Knowledge summaries website at:

http://cks.nice.org.uk/rheumatoid-arthritis

and more general information for the public can be found on the NHS Choices website at:

www.nhs.uk/conditions/rheumatoid-arthritis

Through the mandate we have asked NHS England to make measurable progress towards making our health service among the best in Europe at supporting people with ongoing health problems, such as RA, to live healthily and independently, with much better control over the care they receive.

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Cancer: Northern Ireland

Ms Ritchie: To ask the Secretary of State for Health what recent discussions he has had with the Minister for Health in Northern Ireland on the establishment of a cancer drugs fund; and if he will make a statement. [197834]

Norman Lamb: We have had no such discussions.

Community Nurses

Bill Wiggin: To ask the Secretary of State for Health whether the pay of community staff nurses rises in line with inflation. [198081]

Dr Poulter: In 2012 the Chancellor announced that public sector pay awards would be capped at an average of 1% in 2013-14 and at an average of up to 1% in 2014-15.

The national health service’s greatest asset is its staff who deserve to be properly rewarded for the hard work they do in looking after patients. In the NHS, incremental pay costs almost £1 billion. In our evidence to the Pay Review Bodies we were clear that the NHS is facing the most significant financial challenge in its history and that trusts could not afford to pay all staff 1% which would cost £450 million (about £350 million for non-medical staff) and increments which for most staff is over 3.5% on average. The NHS cannot afford to employ more staff, pay them more and pay for increments.

This year, all NHS staff should receive an additional payment of 1% either through their incremental pay or via a pay award if they are no longer eligible to receive incremental pay.

In the wake of the Francis Inquiry, our first priority must be to protect and properly staff the front line so staff are confident that they will have the right number of colleagues working alongside them in hospitals or in patient’s homes. We have to make difficult decisions in order to protect frontline patient care. Giving all NHS staff a 1% pay award is equivalent to employing around 14,000 new nurses and could result in unsafe care.

We know that NHS staff are disappointed that they did not receive the pay award they were expecting. Our door remains open to discussions with trade unions on how consolidated pay awards for all NHS staff can be made affordable in each of the next two years.

Diseases

Mr Virendra Sharma: To ask the Secretary of State for Health how his Department will take into account NHS England's responsibility for commitments in the UK Strategy for Rare Diseases in its delivery of the strategy as a whole. [197755]

Jane Ellison: NHS England recently published its statement of intent showing how it will play its part in delivering the UK Strategy for Rare Diseases in England. A more detailed plan will be built into NHS England’s five year strategy for specialised services.

The UK Rare Disease Forum, supported by the Department, will monitor activity against the 51 commitments outlined in the UK Strategy for Rare Diseases. It will report progress to the health ministers of the four UK countries.

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Doctors: Disciplinary Proceedings

Stephen Barclay: To ask the Secretary of State for Health how many doctors have opted to retire and remove themselves from the medical register before facing an impending disciplinary hearing in each of the last three years. [198222]

Dr Poulter: The information requested is held by the General Medical Council (GMC), an independent body responsible for dealing firmly and fairly with doctors whose fitness to practise is in doubt. Departmental officials have spoken with the GMC who have advised that, as it will take some time for them to extract the data, they will provide a response to my hon. Friend directly.

Epidermolysis Bullose

Jim Shannon: To ask the Secretary of State for Health how many people have been diagnosed with Epidermolysis Bullose in each of the last five years. [197960]

Jane Ellison: Information concerning the number of people diagnosed with Epidermolysis Bullose (EB) on an annual basis is not collected.

NHS England commissions services for patients with EB as part of its remit to deliver specialised services. The service specification it has published for EB sets out that the condition is estimated to affect one in 17,000 live births and that there are around 5,000 people living with EB in the United Kingdom.

Euthanasia: Children

Mr Amess: To ask the Secretary of State for Health (1) when his Department’s investigation into child euthanasia will be concluded; and if he will make a statement; [197923]

(2) how many cases of suspected child euthanasia his Department is currently investigating; and if he will make a statement; [197924]

(3) when he plans to publish full details of the circumstances which led to his Department’s investigation into child euthanasia; and if he will make a statement. [197925]

Norman Lamb: Following public allegations of child euthanasia, the Department launched inquiries into them. These allegations, while serious, did not include details of specific cases, and we continue to urge those with any relevant information to contact the police in the first instance.

General Practitioners

Mr Hoban: To ask the Secretary of State for Health pursuant to the answer of 6 May 2014, Official Report, column 127W, if he will list the outlier practices and the amount each is forecast to lose as a result of removing performance indicators from the Quality and Outcomes Framework. [198248]

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Jane Ellison: The Department does not hold this information centrally, but details of practices identified by NHS England have been sent to area teams.

As part of the changes to the General Medical Services (GMS) contract from April 2014, we have reduced the Quality and Outcomes Framework by more than a third. These changes are intended to free up space for general practitioners to provide more proactive and personalised care for their patients which includes their new responsibility of being accountable for all of their patients aged 75 and over.

These changes were part of changes to GMS contract negotiated with the General Practitioners Committee of the British Medical Association.

General Practitioners: Fareham

Mr Hoban: To ask the Secretary of State for Health (1) what estimate his Department has made of the average annual change in income for GP practices in Fareham and Gosport arising from the withdrawal of the minimum practice income guarantee; [198213]

(2) what estimate he has made of how many GP practices in Fareham and Gosport will lose income as a consequence of the withdrawal of the minimum practice income guarantee; and what actions his Department has put in place to mitigate the impact of any such losses on services. [198214]

Dr Poulter: Both the Government and NHS England consider Minimum Practice Income Guarantee (MPIG) payments to be inequitable because practices serving very similar populations get paid very different amounts per patient.

As part of the general practitioner contract settlement in 2013, the Department decided to phase out MPIG payments over a seven year period, starting in the financial year 2014-15. The money released by doing this will be reinvested in the basic payments made to all General Medical Services (GMS) practices.

NHS England advises that there are 16 practices in Fareham and Gosport currently receiving a MPIG payment under GMS contracts. Practices that face particular difficulty are encouraged to contact their local NHS England Area Team to discuss any issues so that they can together plan to mitigate these.

Health Professions: Insurance

Bill Wiggin: To ask the Secretary of State for Health what information his Department holds on (a) the number of companies that provide indemnity insurance for nurses and midwives and (b) the policies that are available for this. [198141]

Dr Poulter: The Department does not hold information on the number of companies that provide indemnity insurance for nurses and midwives or details on the policies that are available for this. In national health service organisations, it is not necessary for individual employees to take out their own indemnity insurance, unless they also undertake private work, because their employing organisation is, in law, vicariously liable for any negligence arising out of and in the course of their employment. All NHS trusts in England are members

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of the Clinical Negligence Scheme for Trusts operated on behalf of the Secretary of State by the NHS Litigation Authority.

Health Services

Mr Virendra Sharma: To ask the Secretary of State for Health when NHS England plans to publish its report on specialised service derogations; and what additional steps it is taking to ensure compliance. [197751]

Jane Ellison: NHS England advises that the publication date has yet to be determined. However, the report will not be published until after the pre-election period for the forthcoming local authority and European Parliamentary elections is completed on 22 May 2014.

NHS England continues to work with their area teams on ensuring that all providers have robust plans for delivering services that meet the service specification.

Hepatitis

Mr Virendra Sharma: To ask the Secretary of State for Health how many people have been admitted to hospital with a (a) primary and (b) secondary diagnosis of viral hepatitis in each year since 1997-98. [197863]

Jane Ellison: The Health and Social Care Information Centre collects data on the number of hospital admission episodes for hepatitis C. This does not reflect the actual number of people admitted to hospital, because the same person may have had more than one admission episode within the same time period. The data held by the Health and Social Care Information Centre are as follows:

Mr Virendra Sharma: To ask the Secretary of State for Health what estimate he has made of the number of people (a) infected and (b) diagnosed with viral hepatitis in each of the last 10 years. [197865]

Jane Ellison: Hepatitis A, B, C and E are viruses that affect the liver. Where tests can differentiate acute from chronic infections data are presented as newly acquired infections and where not data are presented as newly diagnosed cases.

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Cases of confirmed newly acquired hepatitis A virus infection are reported by laboratories to Public Health England.

Data on acute hepatitis B infections are reported both from laboratories and from Health Protection Teams to Public Health England. Reporting in this way commenced in 2008.

Laboratory reports of newly diagnosed cases of hepatitis C are reported to Public Health England.

Laboratory reports of confirmed cases of hepatitis E are reported to Public Health England. Surveillance began in 2003.

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Incontinence

Jim Dobbin: To ask the Secretary of State for Health what assessment he has made of the findings of the recent Global Forum on Incontinence into improving health and social care in incontinence. [198200]

Norman Lamb: No assessment has been made of the findings of the recent Global Forum on Incontinence (GFI) into improving health and social care in incontinence. However, we applaud the work of the GFI and the work it is doing to improve the health and social care provisions for incontinence, giving patients and care givers a better quality of life.

Responsibility for continence services sit with NHS England and clinical commissioning groups (CCG). CCGs are responsible for commissioning high quality continence services based on an assessment of local need and performance managing their providers in the delivery of high quality services.

The Mandate to NHS England requires it to deliver continued improvements in relation to enhancing the quality of life for people with long-term conditions, including those suffering incontinence, across the five domains of the NHS Outcomes Framework. NHS England will be taking forward a major programme of work through the Primary Care Strategy; it has established a working group on continence care and will provide an update for the All Party Parliamentary Group for Continence Care on 24 June.

To improve standards in continence care, the Department commissioned the National Institute for Health and Care Excellence (NICE) to develop clinical guidelines on the management of urinary incontinence in women (issued in 2006) and faecal incontinence in adults (issued in 2007), which are supported by commissioning tools to support CCGs. In February, NICE published a clinical Quality Standard on Faecal Incontinence, QS54, which describes high-priority areas for quality improvement in this area. NHS England continues to champion the use of Quality Standards with both commissioners and providers.

We believe all patients have the right to be treated with dignity, respect and compassion.

We recognise that continence can impact on every aspect of peoples’ lives and that it often requires a joined approach from both health and social care services. That is why in April the Department published the policy paper, “Transforming Primary Care: safe proactive, personalised care for those who need it”, which focuses on improving and individualising the management of out of hospital care, directly supporting those with continence problems by creating more integrated health and social care services. This paper has been placed in the Library.

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Learning Disability

Mr Tom Clarke: To ask the Secretary of State for Health (1) what proportion of the £2.7 million announced for learning disability in the recently published NHS England business plan for 2014-15 will be spent on the proposed premature mortality review function; [197897]

(2) whether responsibility for implementing the premature mortality review function for people with a learning disability, announced in the NHS England business plan 2014-15 will sit at a national or local level; whether all local areas in England will be mandated to implement the review; and how local areas will be held accountable for implementing the review; [197898]

(3) when he expects the premature mortality review function for people with a learning disability, announced in the NHS England business plan 2014-15, to become fully operational; whether the data from that review will be analysed at a national level; and when he expects initial findings from that review to become available. [197899]

Norman Lamb: NHS England has made £1.5 million available in 2014-15 to undertake the work required to establish a national learning disability mortality review function by the end of March 2015. NHS England is currently undertaking work to define the detail of how the review function will operate. However, NHS England is clear that the starting point will be the proposals put forward by the Confidential Inquiry into Premature Deaths of People with Learning Disabilities team and will aim to develop proposals with input from a range of partners.

Liver Diseases

Mr Virendra Sharma: To ask the Secretary of State for Health when he discussed liver disease with his Department's Chief Medical Officer in the last 12 months; what the content of those discussions was; and if he will make a statement. [197861]

Jane Ellison: A wide variety of issues, including liver disease, are discussed at regular meetings between the chief medical officer and the Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Mr Hunt). As these meetings are not routinely minuted it is not possible to specify at which meetings liver disease was discussed, or the specific contents of individual meetings. There have been no meetings specifically focused on liver disease between the Chief Medical Officer and the Secretary of State within the last 12 months.

Mr Virendra Sharma: To ask the Secretary of State for Health (1) what meetings (a) he and (b) Ministers in his Department have had with representatives of people with liver disease since September 2012; [197862]

(2) when his Department has held meetings with external organisations to discuss a strategy for combating liver disease since 11 May 2010; if he will place minutes of those meetings in the Library; and if he will make a statement. [197866]

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Jane Ellison: NHS England is responsible for the overall national approach to improving clinical outcomes for people with liver disease. It is adopting a broad strategy to reduce premature mortality, including mortality from liver disease.

The Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Mr Hunt), has not met any external organisations to discuss a strategy for combating liver disease since 11 May 2010. The Secretary of State and current Ministers at the Department have not met with representatives of people living with liver disease since September 2012.

NHS England and Public Health England are supporting clinical commissioning groups and local authorities to reduce premature mortality by providing commissioners with a suite of tools to help them maximise the best possible outcomes for their local communities such as Local Authority Profiles. These can help local authorities and clinical commissioning groups identify the significance of liver disease in their local area compared with the rest of the country and the actions they could prioritise to tackle it.

Mr Virendra Sharma: To ask the Secretary of State for Health how many people have been diagnosed with (a) liver disease and (b) viral hepatitis in each of the last 10 years. [197864]

Jane Ellison: Data are not collected on new cases of liver disease. Liver disease covers many individual diseases caused by different factors, such as alcoholic liver disease, fatty liver disease as well as hepatitis related diseases. The identification of new cases will take place in different settings, from general practice to hospital outpatients.

The nearest proxy measure that we have is hospital admissions. However, hospital admissions only reflect the most serious cases when people are admitted to hospital. The number of hospital admissions for liver disease rose from 35,581 in 2001-02 to 57,682 in 2011-12, an increase of 62%.

Hepatitis A, B, C and E are viruses that affect the liver. Where tests can differentiate acute from chronic infections, data is presented as newly acquired infections and where not, data is presented as newly diagnosed cases. Hepatitis surveillance data for 2013 will be available in August 2014.

Cases of confirmed newly acquired hepatitis A virus infection are reported by laboratories to Public Health England.

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Data on acute hepatitis B infections are reported both from laboratories and from Health Protection Teams to Public Health England. Reporting in this way commenced in 2008.

Laboratory reports of newly diagnosed cases of hepatitis C are reported to Public Health England.

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Mr Virendra Sharma: To ask the Secretary of State for Health how many finished consultant episodes relating to liver disease there have been for patients aged (a) under and (b) over 18 years old in (i) England and (ii) each parliamentary constituency in England in each year since 1997-98. [197867]

Jane Ellison: The information is not collected centrally in the format requested. A count of finished consultant episodes with a primary diagnosis of liver disease for patients aged 0-17 and over 18 years old, by primary care trust of residence and England in total for the years 1997-98 to 2012-13 has been placed in the Library.

Mr Virendra Sharma: To ask the Secretary of State for Health what the rate of liver disease among adults was in the most recent period for which figures are available in each clinical commissioning group area. [197868]

Jane Ellison: The following table shows finished admission episodes for liver disease in 2012-13 by clinical commissioning group of residence, where the patient was 18 years or older. The rate is supplied per 100,000 of the population.

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