Mr Benton: To ask the Secretary of State for Health with reference to his Department's publication, Abortion Statistics, England and Wales: 2013, published in June 2014, which method of stopping the fetal heart besides feticide is referred to in paragraph 2.25. [205991]

Jane Ellison: No other such method is referred to or required as the publication refers to cases where the procedure is undertaken under general anaesthesia i.e. patient and fetus are anaesthetised.

Mr Benton: To ask the Secretary of State for Health With reference to the findings of his Department’s Abortion Statistics 2013, published in June 2014, paragraph 2.4, that 81 per cent of abortions in that year were carried out for single women, if he will take steps to reduce the abortion rate by encouraging couples to stay together. [205993]

Jane Ellison: 51% of the women classified as “single” in Abortion Statistics 2013 were in a relationship but not married or in a civil partnership.

More broadly, the Government's Framework for Sexual Health Improvement in England (March 2013) highlights the importance of building knowledge and resilience amongst young people so they have the confidence and emotional resilience to understand the benefits of loving, healthy relationships and delaying sex.

Fiona Bruce: To ask the Secretary of State for Health what reports his Department has received of ground C abortions which were permitted for reasons of fetal gender in the last 10 years; and if he will make a statement. [206102]

Jane Ellison: The Department has received no reports of ground C abortions which were permitted for reasons of fetal gender between 2003 and 2013.

Alcoholic Drinks: Children

Jim Shannon: To ask the Secretary of State for Health what steps he is taking to encourage parents to prevent the consumption of alcohol by children; and what steps are being taken by schools to assist this prevention work. [205770]

22 July 2014 : Column 1077W

Jane Ellison: The Government’s Alcohol Strategy set out several measures to support our commitment to reducing underage drinking. These include educating young people on the risks associated with alcohol and by addressing factors that can influence young people’s attitude to alcohol, such as parental drinking. We are ensuring that guidance is available for parents through a range of public and community organisations including; NHS Choices, Directgov, Family Lives, and NetMum, Mumsnet, Dad Talk and Contact a Family.

Following the Government’s review of Personal, Social, Health, and Economic Education in March 2013, the Department for Education launched an evidence-based alcohol and drugs information service for those working with young people, which provides practical advice and tools based on the best international evidence.

Ambulance Services

Mr Watson: To ask the Secretary of State for Health what assessment he has made of the process used to appoint Dr Anthony Marsh to the post of Chief Executive for (a) West Midlands Ambulance Service NHS Trust and (b) East of England Ambulance Service NHS Trust; if he will place in the Library copies of all correspondence between his Department and both ambulance trusts on these appointments; what level of salary Dr Anthony Marsh receives for each role; and if he will make a statement. [206570]

Jane Ellison: Anthony Marsh was appointed chief executive of West Midlands Ambulance Service NHS Trust (WMAS) in July 2006. Dr Marsh was previously chief executive of Essex Ambulance Service.

Dr Marsh became chief executive of East of England Ambulance Service NHS Trust (EEAST) from 1 January 2014. He was seconded to EEAST at the request of the NHS Trust Development Authority (NHS TDA) because of persistent poor performance at EEAST and the trust’s failure to appoint a substantive chief executive when it attempted to recruit to the post on several occasions in recent years. He is contracted to work three days a week at EEAST in addition to continuing in his chief executive role at WMAS.

The NHS TDA advises that Dr Marsh’s salary is £232,226.42 per annum in total, which includes a £50,000 uplift to his former WMAS salary for his additional duties at EEAST. EEAST pays 60% of Dr Marsh’s salary. The £50,000 additional salary payment was agreed between the remuneration committees of WMAS and EEAST for the increased responsibility of running two trusts.

The NHS TDA believes that Dr Marsh has already made a significant impact at EEAST, with the recruitment of 400 additional paramedics expected this year, 147 new ambulances now ordered and a £1 million reduction in management costs, which is being re-invested into the front line.

A search of the Department’s ministerial correspondence database has not identified any correspondence between the Department and either ambulance trust on these appointments. This search represents correspondence received by the Department’s ministerial correspondence unit only.

22 July 2014 : Column 1078W

Mr Watson: To ask the Secretary of State for Health on how many occasions (a) Ministers and (b) officials in his Department have met Dr Anthony Marsh in the last three years; what the purpose was of such meetings; and if he will make a statement. [206572]

Jane Ellison: The Minister of State has met Dr Anthony Marsh on two occasions in the last three years to discuss the East of England Ambulance Service NHS Trust (EEAST)—11 June 2013 and 24 January 2014.

The Under-Secretary of State for Health, Earl Howe has met Dr Marsh on the following occasions in the last three years:

12 September 2012 at a meeting of the Ministerial Steering Group on Emergency Services Collaboration;

12 October 2012 at a meeting of the National Ambulance Service Network to discuss national issues;

6 November 2012 to discuss the West Midlands Ambulance Service NHS Trust;

10 April 2013 to discuss national ambulance policy and Dr Marsh's review of the governance of EEAST;

30 May 2013 during a visit to EEAST, to discuss Dr Marsh's review of the governance of EEAST;

11 June 2013 when Earl Howe hosted a meeting for local Members of Parliament to discuss EEAST. Dr Marsh was present at the meeting;

31 October 2013 to discuss national ambulance policy and issues relating to EEAST;

21 January 2014 to discuss winter pressures on ambulance performance nationally, and to provide an update on EEAST actions;

11 February 2014 to discuss EEAST performance with local Members of Parliament;

8 July 2014 to discuss EEAST performance; and

17 July 2014 (via phone call) to discuss national ambulance policy.

The Under-Secretary of State, my hon. Friend, the Member for Central Suffolk and North Ipswich (Dr Poulter) attended EEAST's Long Service and Excellence Awards on 9 May 2014 to present awards. Dr Marsh is likely to have been present at the event.

Departmental officials are likely to have been present at the ministerial meetings. Departmental officials have also met Dr Marsh separately on the following occasions:

19 April 2013 (via phone call) to discuss EEAST;

20 November 2013 to discuss EEAST; and

30 June 2014—Department of Health officials, together with Department for Communities and Local Government officials, facilitated a meeting between the Chief Fire Officers Association and the Association of Ambulance Chief Executives (AACE). Dr Marsh was present at this meeting as Chair of AACE. The meeting focused on progressing co-responding between the fire service and ambulance services across the country.

Notes:

1. Archived diaries for some former Ministers cannot be accessed. The list of ministerial meetings may not therefore be comprehensive.

2. There is no official record of meetings between departmental officials and Dr Marsh. The list may not therefore be comprehensive.

Anticoagulants

Luciana Berger: To ask the Secretary of State for Health (1) if he will estimate the amount that the NHS would have saved if the anti-coagulant drug Heparin were used instead of Bivalirudin during cardiac procedures in each year since 2010; [206057]

22 July 2014 : Column 1079W

(2) what assessment he has made of the cost-effectiveness of the anti-coagulant drug Bivalirudin. [206058]

Norman Lamb: We have made no such estimate.

The National Institute for Health and Care Excellence (NICE) has appraised bivalirudin in combination with aspirin and clopidogrel and recommends the drug as a possible treatment for adults with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention in guidance issued in July 2011.

Patients have the right to drugs and treatments that have been recommended by NICE technology appraisal guidance for use in the national health service, where their doctor believes they are clinically appropriate.

Arthritis

Yvonne Fovargue: To ask the Secretary of State for Health how many people have suffered complications following knee and hip operations related to osteoarthritis in the last five years. [206190]

Norman Lamb: This information is not available. Although some information on post-operative complications experienced by osteoporosis patients following surgery of the hip and knee is available via the Health and Social Care Information Centre’s Patient Reported Outcome Measures (PROMs) data collection, this only covers hip and knee replacement, and not the full range of surgical interventions. In addition to this, as PROMs is a voluntary reporting system the data published do not reflect the total number of osteoporosis patients having complications for all hip and knee replacements. More information on PROMS data can be found at the following link:

www.hscic.gov.uk/proms

Association of Ambulance Chief Executives

Mr Watson: To ask the Secretary of State for Health what funding and support his Department provides to the Association of Ambulance Chief Executives; and if he will make a statement. [206557]

Jane Ellison: The Association of Ambulance Chief Executives (AACE) is an independent organisation set up and run by the ambulance trusts themselves, like the parallel organisations for police and fire services.

The Department does not directly provide any money or support to the AACE.

Billing

Mr Watson: To ask the Secretary of State for Health what the value is of duplicate supplier payments identified by his Department since 2010; and what proportion of such payments have since been recovered in each of the last two financial years. [205973]

Dr Poulter: The Department checks for duplicate supplier payments as part of the business as usual processes within the finance team. As part of the internal process checks the Department has identified the value of duplicate supplier payments since 2010 as £1,287,260.31.

22 July 2014 : Column 1080W

The proportion of such payments the Department has recovered following these internal checks in each of the last two financial years is as follows:

(i) Payments for 1 April 2012 to 31 March 2013—£325,456.94—of which 100% has been recovered based on the internal processes.

(ii) Payments for 1 April 2013 to 31 March 2014—£282,198.56—of which 100% has been recovered based on the internal processes.

For completeness, in the financial year 2010-11 the value of such payments was £510,599.10 of which 99.7% was recovered, and in financial year 2011-12 the value of such payments was £169,005.71 of which 98.6% was recovered.

Further investigations are taking place into duplicate payments made as part of a Spend Recovery Audit that the Department has commissioned externally and we will seek to recover any further duplicates identified as part of this exercise.

Botulinum Toxin

Jim Shannon: To ask the Secretary of State for Health what discussions he has had with medical authorities on the use of botox as a painkiller; and whether it is used as such in the NHS. [205769]

Norman Lamb: We have had no such discussions. Botox is not licensed in the United Kingdom for use as a painkiller.

The National Institute for Health and Care Excellence (NICE) published technology appraisal guidance for the national health service in May 2012 which recommends botulinum toxin type A as a possible treatment for preventing headaches in some adults with chronic migraine, subject to certain clinical criteria.

Patients have the right to drugs and treatments that have been recommended by NICE for use in the NHS, where their doctor believes they are clinically appropriate.

Cerebral Palsy

Mr Hoban: To ask the Secretary of State for Health what estimate he has made of the cost to the public purse of supporting people with cerebral palsy. [206285]

Norman Lamb: No estimate has been made of the cost to the public purse of supporting people with cerebral palsy.

National health service expenditure on cerebral palsy is included in the programme budgeting category ‘neurological problems’, but cannot be separately identified. Aggregate annual NHS expenditure in this category in 2012-13, the latest period for which data are available, was £4.44 billion.

The programme budgeting data return are an analysis of commissioning expenditure by health care condition and care centre based on figures provided to NHS England by primary care trusts (PCTs) and PCT successor organisations. Programme budgeting data, as well as further information on how these figures were calculated, can be found on the NHS England website at the following link:

www.england.nhs.uk/resources/resources-for-ccgs/prog-budgeting/

22 July 2014 : Column 1081W

Mr Hoban: To ask the Secretary of State for Health what estimate he has made of the average age at which children are diagnosed with cerebral palsy. [206286]

Dr Poulter: Information is not collected centrally on the age at which children are diagnosed with cerebral palsy and therefore no estimate of the average age of diagnosis has been made.

The age at which a diagnosis of cerebral palsy is made will depend on its severity and type. In some cases it will be diagnosed at birth other cases will be picked up through screening and monitoring.

Under the Healthy Child Programme schedule, babies undergo screening and health checks or immunisations at birth, at 72 hours, at five to eight days, at six to eight weeks, 12 weeks, 16 weeks, six to eight months and 12 months, 2½ years and at school entry.

Diabetes

Mr Virendra Sharma: To ask the Secretary of State for Health what data his Department gathers on the number of patients with diabetes who are admitted to hospital each month as a result of a hypoglycaemic episode; and what estimate has been made of the overall cost of hypoglycaemia to the NHS. [205903]

Jane Ellison: Providers of NHS services in England are required to supply information on activity to the Secondary Uses Services (SUS) database via commissioning datasets. Each month an extract from the SUS database is taken and populated into the Hospital Episode Statistics database which is then made available for analysis.

Diseases are classified using the World Health Organization International Classification of Diseases. Codes to identify diabetes and hypoglycaemia exist, so it is possible to report activity on admissions to hospital for patients with a primary diagnosis of hypoglycaemia and a secondary diagnosis of diabetes.

NHS England has not made an estimate of the overall cost of hypoglycaemia to the national health service.

Disability Aids

Andrew Gwynne: To ask the Secretary of State for Health what plans he has to report to hon. Members on the steps he is taking to ensure the continued quality and availability of assistive technology. [205835]

Norman Lamb: Through the Mandate we have asked NHS England to improve the lives of 3 million people with long-term conditions through the use of the assistive technologies of telehealth and telecare by 2017; supporting them to manage and monitor their condition at home, and reducing the need for avoidable visits to their general practitioner practice and hospital.

NHS England’s Technology Enabled Care Services Programme is the national initiative which aims to improve the lives of people with long term conditions through the use of technologies such as telehealth, telecare, telemonitoring, telecoaching and self-care applications.

NHS England's annual report and assessment of progress against the Mandate will be laid before Parliament this summer.

22 July 2014 : Column 1082W

East of England Ambulance Service NHS Trust

Mr Watson: To ask the Secretary of State for Health if he will place in the Library copies of the resignation letters from the former chairs of the East of England Ambulance Service NHS Trust (a) Dr Geoffrey Harris and (b) Maria Bell; and if he will make a statement. [206556]

Jane Ellison: The Department does not hold copies of resignation letters from the former chairs of the East of England Ambulance Service NHS Trust.

The hon. Member may wish to approach the NHS Trust Development Authority (TDA), which will hold the relevant information. However, the NHS TDA has advised that, as a personal letter, permission would be required before placing this in the public domain in order to meet obligations under the Data Protection Act 1998.

Foetal Alcohol Syndrome

Luciana Berger: To ask the Secretary of State for Health what assessment he has made of the adequacy of training for midwives on foetal alcohol syndrome. [206054]

Dr Poulter: The Government has mandated Health Education England (HEE) to provide national leadership on education, training and workforce development in the national health service. This mandate includes a commitment that HEE will ensure that midwifery training produces midwives with the required competencies to practice in the NHS.

In the Mandate from the Government to HEE for the period from April 2013 to March 2015 the Government has stated that HEE should work with NHS England and others to ensure that sufficient midwives and other maternity staff are trained and available to provide every woman with personalised one-to-one care throughout pregnancy, childbirth and during the postnatal period.

HEE is leading on the Personalised Maternity Care Project, which will make recommendations on how women who have mental health or substance misuse support requirements will receive appropriate support from specialised trained midwives.

General Practitioners

Mr Jamie Reed: To ask the Secretary of State for Health how many GP surgeries (a) he and (b) Ministers in his Department have visited in an official capacity in the last 12 months. [206586]

Dr Poulter: My right hon. Friend the Secretary of State for Health and Ministers in his Department have undertaken the following visits to general practitioner (GP) surgeries in the last 12 months:

22 July 2014 : Column 1083W

Health

Luciana Berger: To ask the Secretary of State for Health with reference to the answer on 21 November 2013, what estimate he has made of the number of local authorities currently employing acting or interim directors of public health; and what steps he is taking to fill such posts on a more permanent basis. [206055]

Jane Ellison: As at 16 July 2014, 107 of the 131 (82%) Director of Public Health posts are filled by substantive roles. The 131 posts cover 152 local authorities, as some have agreed joint/shared arrangements. There are currently 24 positions vacant (18%). All vacancies are covered by interim/acting arrangements with the exception of one recently vacant post where Public Health England (PHE) is working actively with the council to secure interim arrangements.

Of the 24 current vacancies, 15 are under active recruitment in which adverts have been released and/or interview dates set, and nine are the subject to discussion between PHE and the local authority on the development and approval of a job description.

Health Services

Mr Amess: To ask the Secretary of State for Health (1) how NHS England evaluates service specific A3 change proposals for its five-year strategy development for specialised services; when authors of those proposals will learn the outcomes of their proposals; and if he will make a statement; [205760]

(2) how NHS England’s specialised commissioning taskforce intends to incorporate work submitted by (a) clinical reference groups and (b) other stakeholders in response to its requests for A3 change proposals to inform the development of its five year strategy for specialised services; and if he will make a statement; [205757]

22 July 2014 : Column 1084W

(3) what progress NHS England has made on development of the (a) mission and vision and (b) service-level planning elements of its five year strategy for specialised services; when publication of that strategy is expected; and if he will make a statement; [205758]

(4) when NHS England plans to publish its five year strategy for specialised services; and if he will make a statement. [205759]

Jane Ellison: NHS England established the specialised commissioning taskforce to make some immediate improvements to the way in which NHS England commissions specialised services, and to put commissioning arrangements on a stronger footing for the longer-term. The taskforce is not conducting a complete review of specialised commissioning, although there are some aspects of this work which will require some specific services or arrangements to be reviewed. The life of the taskforce was originally three months running from May to July 2014: this has now been extended to the end of October 2014.

The publication and application of the specialised services strategy have been paused while the taskforce undertakes its work. At this stage, NHS England is yet to confirm when the strategy will be published. However, many aspects of the work of the taskforce will contribute to taking the strategy work forward later in the year.

Information on the work on development of the mission and vision and service-level planning elements of the specialised services strategy, prior to the pause, is available on the following webpages:

www.england.nhs.uk/ourwork/commissioning/spec-services/five-year-strat/mission-vision/

www.england.nhs.uk/ourwork/commissioning/spec-services/five-year-strat/service-level-plan/

NHS England has advised that the A3 change proposals were a pilot process to establish how NHS England might be able to achieve multiple stakeholder involvement on future service change. Proposals that demonstrate good opportunities to increase value and contain cost have moved into the quality, innovation, productivity and prevention (QIPP) programme for specialised services. Other proposals which support strategic service planning continue to be considered. Authors with proposals that do not meet the objectives of QIPP or strategic services planning will be informed within the next few weeks.

Luciana Berger: To ask the Secretary of State for Health what steps he is taking to reduce inequalities covering his public health functions for the whole population. [206558]

Jane Ellison: Reducing health inequalities is a Government priority, shown by our introduction of the first-ever set of health inequalities duties in the 2012 Health and Social Care Act.

Public health has a key role to play in reducing health inequalities across the whole population through ill health prevention and helping reduce premature, avoidable mortality. We transferred responsibility for improving public health from the national health service to local government to bring greater effectiveness and innovation in responding to local health needs. We provided local government with a ring-fenced grant of £5.36 billion.

22 July 2014 : Column 1085W

At local level, Directors of Public Health will champion these health needs and work with local government, NHS colleagues and other sectors to address them.

We established Public Health England (PHE) to provide leadership, and to protect and improve the public's health and well-being and reduce health inequalities. It supports action on health inequalities at local and national level by promoting good practice and building on the evidence of ‘what works'.

We have recently published ‘Living Well for Longer’ (April 2014) which provides national support for local action on reducing premature mortality. It sets out what PHE and NHS England will do alongside the Department and the rest of Government to address avoidable and premature mortality across the population, including vulnerable groups such as those on low incomes and those with mental illness.

Health: Business

Mr Jamie Reed: To ask the Secretary of State for Health which organisations have withdrawn from the Responsibility Deal; and for what reason they so withdrew. [206585]

Luciana Berger: To ask the Secretary of State for Health which organisations have withdrawn from the Responsibility Deal; and for what reason they withdrew. [206583]

Jane Ellison: Since its launch in March 2011, 61 organisations have withdrawn from the Responsibility Deal (RD). At 18 July 2014, there were 690 RD partners.

A list of the organisations who have withdrawn from the RD since its launch is provided in the following table.

22 July 2014 : Column 1086W

Hormone Replacement Therapy

Tracey Crouch: To ask the Secretary of State for Health with reference to the cessation of manufacturing of the MSD Oestradiol implant in

22 July 2014 : Column 1087W

August 2011, what discussions his Department has had with the National Institute for Health and Care Excellence on the licensing of a new HRT implant. [206499]

Norman Lamb: We have had no such discussions. The National Institute for Health and Care Excellence is not responsible for the licensing of medicines, which is the responsibility of the Medicines and Healthcare products Regulatory Agency and the European Medicines Agency.

Hospitals: North East

Mr Iain Wright: To ask the Secretary of State for Health (1) how long the North Tees and Hartlepool NHS Foundation Trust's submission on a new hospital at Wynyard has been considered by his Department; [205709]

(2) what the reasons are for the time taken to make a decision on the North Tees and Hartlepool NHS Foundation Trust's submission on a new hospital at Wynyard; [205710]

(3) when he expects to make a decision on the North Tees and Hartlepool NHS Foundation Trust's submission on a new hospital at Wynyard. [205723]

Dr Poulter: The Department is currently considering the business case submitted by North Tees and Hartlepool NHS Foundation Trust in August 2013. It is not possible to give an indication of when a final decision on the case will be made. The proposals represent a very significant financial commitment and it is vital we ensure they are value for money and affordable to the Trust.

Hysterectomy

Jim Shannon: To ask the Secretary of State for Health how many women in each age group had hysterectomies in the UK in each of the last five years. [205822]

Jane Ellison: This information is not available in the format requested.

The table shows information concerning the number of finished consultant episodes for the years 2008-09 to 2012-13.

22 July 2014 : Column 1088W

22 July 2014 : Column 1089W

Liver Diseases: Children

Luciana Berger: To ask the Secretary of State for Health pursuant to the answer of 1 July 2014, Official Report, column 516W, on liver diseases, what assessment he has made of the reasons for the increase in hospital admissions for primary and secondary liver disease in children since 2010. [206575]

Dr Poulter: NHS England has made no formal assessment of the reasons for the increase in hospital admissions for primary and secondary liver disease in children since 2010.

London Underground

Mark Pritchard: To ask the Secretary of State for Health if he will discuss with Transport for London the installation of hand sanitisers on London Underground trains and platforms. [205750]

Jane Ellison: Hand sanitisers can make an additional useful contribution to reduction of carriage of bacteria and viruses on the hands. However, the mainstay for reduction in transmission of bacteria and viruses remains regular washing of hands with soap and water. There has not been a trial of the use of hand sanitisers in public places such as train stations so there is no evidence for how effective an intervention like this might be. The Director of the London office of Public Health England and health adviser to the Mayor of London will raise the issue with Transport for London.

22 July 2014 : Column 1090W

Members: Correspondence

Mr Simon Burns: To ask the Secretary of State for Health for what reason the Chief Executive of NHS England has not replied to the letter of 30 May 2014 from the right hon. Member for Chelmsford on behalf of his constituent Mr John McPhee; and when he expects a substantive response to the letter. [206452]

Jane Ellison: NHS England has advised that a response has now been sent to my right hon. Friend. The earlier failure to acknowledge my right hon. Friend's correspondence was due to an administrative error within NHS England's processes, which has now been rectified.

Monitor

Tessa Munt: To ask the Secretary of State for Health to what extent NHS England is obliged to follow guidance issued by Monitor. [205780]

Jane Ellison: It is the National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013 that place requirements on NHS England, including requirements as to good practice in relation to procurement.

Enforcement of the procurement requirements by Monitor may only follow its investigation of a complaint that there has been a failure by a commissioner to comply with the requirements. Monitor has published guidance for NHS England and other commissioners of healthcare services which provides advice on how to comply with the regulations. Monitor expects to follow the interpretation of the regulations that it has set out in its guidance when exercising its enforcement powers under the regulations.

In addition, to the extent that NHS England acts as a commissioner of services, it has a legal duty to have regard to guidance which Monitor publishes for commissioners of services which are designated as ‘commissioner requested services'. Before publishing the guidance or any revisions to it, Monitor must have first consulted NHS England.

NHS: Finance

Mr Virendra Sharma: To ask the Secretary of State for Health what estimate he has made of the proportion of the NHS budget allocated to (a) diabetes, (b) cancer, (c) dementia and (d) cardiovascular disease. [205929]

Jane Ellison: NHS England allocates funding to clinical commissioning groups, which are responsible for distributing that funding in line with local clinical need. Funding is not generally allocated by disease area.

However, the following table shows the most recent figures collated by NHS England on primary care trust (PCT) expenditure in 2012-13 on diabetes, cancer, organic mental health disorders (including dementia) and problems of circulation (including cardiovascular disease). These figures exclude strategic health authority and arm's length body expenditure.

22 July 2014 : Column 1091W

NHS England has also identified around £90 million annually that is available nationally to the national health service to support timely diagnosis of dementia and to ensure that by 2015, two-thirds of people with dementia have a diagnosis and receive appropriate support following diagnosis.

Notes on interpretation:

Expenditure data included here are taken from the 2012-13 programme budgeting returns. Programme budgeting returns are based on a subset of PCT accounts data and represent a subset of overall NHS expenditure data.

Calculating programme budgeting data is complex and not all health care activity or services can be classified directly to a programme budgeting category or care setting. When it is not possible to reasonably estimate a programme budgeting category, expenditure is classified as “Other”. Expenditure on general medical services and personal medical services cannot be reasonably estimated at disease specific level, and is separately identified as a subcategory of “Other” expenditure.

The allocation of expenditure to programme budgeting subcategories is not always straightforward, and subcategory level data should therefore be used with caution.

Estimates of expenditure are calculated using price paid for specific activities and services purchased from health care providers. PCTs follow standard guidance, procedures and mappings when calculating programme budgeting data.

Patients' Rights

Maria Miller: To ask the Secretary of State for Health what assessment he has made of the effect of the recent Supreme Court ruling concerning which individuals in care homes and hospitals should be subject to a deprivation of liberty assessment; and if he will make a statement. [206097]

Norman Lamb: On 19 March 2014, the Supreme Court handed down a judgment that clarified the test for what constitutes a deprivation of liberty. The clarified test is:

“An individual who lacks the mental capacity to consent to the arrangements for his or her care and is under continuous control and supervision and is not free to leave”.

Following the judgment, the Department issued an advice note to health and care professionals and local authorities to highlight this legal interpretation and its implications.

The Department is currently monitoring the effects of the judgment on the health and care system and on local authorities. The Health and Social Care Information Centre will carry out an additional voluntary data collection. This will gather information from local

22 July 2014 : Column 1092W

authorities on how many applications have been received for authorisations in care homes and hospitals under the Deprivation of Liberty Safeguards since the judgment. We expect the data to be available in October 2014; this will facilitate an assessment of the judgment’s impact.

At the Department’s request, the Association of Directors of Adult Social Services is leading a task group to consider the implications of the judgment. This group has representation from local authorities, NHS England, the Care Quality Commission and the Department. The group intends to issue advice in the autumn.

Radiotherapy

Tessa Munt: To ask the Secretary of State for Health for what reason none of the £42 million his Department has made available for increasing the use of radiotherapy is to be spent on treating cancer patients with Stereotactic Ablative Radiotherapy this year. [205834]

Jane Ellison: In July 2011, the National Radiotherapy Implementation Group concluded that current evidence supports treatment with stereotactic ablative radiotherapy (SABR) for only a small number of patients. The evidence supports its use in the treatment of early stage lung cancers for patients who are unsuitable for surgery (approximately 1,000 per annum).

NHS England recognises the positive clinical impact that its national policy on SABR for the treatment of early non-small cell lung cancer has had. It is currently examining the potential use of SABR in patients with oligometastatic disease—where a cancer is in the early stages of spreading.

NHS England is also currently undertaking a review of stereotactic radiosurgery (SRS) and SABR for intracranial conditions to establish what the national demand is in line with its national clinical commissioning policies on SRS and SABR, and what the national capacity requirements are for this specialised treatment. Following the review, it is planned that a final decision will be taken by the Specialised Commissioning Oversight Group in October 2014.

Later this year, the Radiotherapy Clinical Reference Group will review its current policy position on SABR to assess whether there is new evidence to recommend its use on other conditions. It is important to ensure that treatments commissioned are supported by robust evidence of their benefit to patients.

Respiratory System: Diseases

Henry Smith: To ask the Secretary of State for Health what steps (a) his Department and (b) NHS England plan to take to reduce premature mortality from respiratory disease. [205718]

Jane Ellison: The NHS Outcomes Framework 2014-15 sets out the Department’s priority areas for the national health service and includes reducing deaths from respiratory disease as a key indicator. In addition to this, the Mandate sets out the requirements for NHS England to improve outcomes in a range of areas, including preventing premature deaths from the biggest killers (including respiratory) and supporting people with long term physical and mental health conditions.

22 July 2014 : Column 1093W

‘Living Well for Longer: National Support for Local Action to Reduce Premature Mortality’, launched in April, sets out what the health and care system will do to achieve the Government’s ambition to be among the best in Europe at reducing levels of premature mortality. It brings together in one place the national actions taken by the Department of Health and wider Government, NHS England and Public Health England, in prevention, early diagnosis and treatment, focusing on the five big killers, including lung disease, and shows how they will support local leadership and interventions.

The Department has supported a number of initiatives to help improve outcomes for people with respiratory disease. In July 2011, it published an outcomes strategy for people with chronic obstructive pulmonary disease (COPD) and asthma in England, which sets out six high-level objectives to improve outcomes in these areas through high quality prevention, detection, treatment and care services. The Department has also supported the publication of a good practice guides on services for adults with asthma, which was published in 2012.

The National Institute for Health and Care Excellence has published Quality Standards for COPD and for asthma setting out the markers of high-quality, cost-effective care and the implementation of these will also raise the standard of care people with these conditions receive.

The Department has collaborated with the National Review of Asthma Deaths which is examined the circumstances surrounding deaths from asthma from 1 February 2012 to 30 January 2013 and reported on its findings in May of this year. Lessons learnt about the factors that contribute to asthma deaths will inform the NHS about what constitutes good care, and encourage the development of appropriate services for people with asthma.

Public Health England recently ran a local pilot campaign in Oldham and Rochdale to raise awareness among the public about the importance of visiting their general practitioner with symptoms of breathlessness.

Royal Sussex County Hospital

Caroline Lucas: To ask the Secretary of State for Health (1) if he will take steps to ensure that (a) estates maintenance for the Royal Sussex County Hospital remains in-house following the 3Ts redevelopment and (b) (i) catering, (ii) portering, (iii) cleaning and (iv) other soft ancillary services currently outsourced to Sodexo are brought in-house at the end of its contract in 2017 and remain in-house under the redeveloped hospital; and if he will make a statement; [206061]

(2) how many and what proportion of the beds and what proportion of the facilities planned under the 3Ts redevelopment of the Royal Sussex County Hospital are planned to be used by private patients; and if he will make a statement. [206060]

Dr Poulter: The decision to outsource or bring services in-house is the responsibility of the Brighton and Sussex University Hospitals NHS Trust Board, which will make these decisions in due course.

We are advised by the NHS Trust Development Authority that the trust has not earmarked beds for the use of private patients. The trust has made a small allowance of 633 square metres of floor area for private patient facilities within the new development (representing

22 July 2014 : Column 1094W

0.68% of the total planned floor area), but not bed capacity. The cost of equipping this area would fall either directly to the trust or a private patient facility operator, and the Trust Board will decide in due course whether to proceed with a private patient facility or an alternative use. We understand that any money generated from private patients would be reinvested to directly benefit national health service patients at the hospital.

Vaccination

Luciana Berger: To ask the Secretary of State for Health what assessment he has made of the effect of moving the immunisation co-ordinator role from primary care trust into commissioning positions on the availability of immunisation advice to nurse-based practitioners. [206559]

Jane Ellison: Public Health England (PHE) Screening and Immunisation Teams, including immunisation co-ordinators, have been embedded within NHS England area teams since 1 April 2013.

Immunisation advice remains available to health professionals, including nurse-based practitioners, through local PHE Health Protection Teams and Screening and Immunisation Teams within NHS England, who are supported by a national expert advice line. Comprehensive web-based advice including such resources as frequently asked questions, also remain available.

We have not made any specific assessment of the possible effect on the availability of immunisation advice to nurse-based practitioners by PHE in this context.

Treasury

Air Passenger Duty: Northern Ireland

Mr Ivan Lewis: To ask the Chancellor of the Exchequer what estimate he has made of the direct financial benefit of the abolition of air passenger duty bands C and D to airports in Northern Ireland. [205812]

Priti Patel: The abolition of Air Passenger Duty bands C and D cuts up to £52 per passenger off the cost of a journey originating in Northern Ireland, including connecting flights.

Air Travel

John Woodcock: To ask the Chancellor of the Exchequer on what occasions each Minister within his Department has taken domestic flights on official business since May 2010. [204303]

Sheila Gilmore: To ask the Chancellor of the Exchequer pursuant to the answer of 19 June 2014, Official Report, column 675W, on official visits, what domestic visits each of the Ministers of his Department has made since January 2013; and what the purpose of each such visit was. [204368]

Andrea Leadsom: This information could be provided only at disproportionate cost.

Details of all ministerial overseas travel are published on a quarterly basis and can be found at:

www.gov.uk/government/publications

22 July 2014 : Column 1095W

Business: Taxation

Shabana Mahmood: To ask the Chancellor of the Exchequer how many unresolved tax enquiries there were in the Large Business Service (LBS) in (a) 2013-14 and (b) 2014-15 to date; and how many unresolved tax enquiries in the LBS are (i) one year old and (ii) more than three years old. [206355]

Mr Gauke: HM Revenue and Customs (HMRC’s) Large Business Service dealt with the tax affairs of the 800 or so largest businesses in the UK up to 31 March 2014. HMRC’s approach has enabled it to recover around £31 billion in additional compliance revenues from large businesses, including those dealt with by Large Business Service, between April 2010 and March 2014.

The number of tax risks under enquiry in the Large Business Service at the relevant dates were:

HMRC deals with large business risks quickly, despite their complexity. In most cases it reaches a decision within 18 months.

From 1 April 2014, HMRC’s new Large Business directorate deals with the tax affairs of the 2,100 largest business in the UK.

Shabana Mahmood: To ask the Chancellor of the Exchequer how many people were employed by HM Revenue and Customs in the Large Business Service (LBS) in (a) 2013-14 and (b) 2014-15 to date; and how many companies the LBS worked with in each of those years. [206356]

Mr Gauke: In 2013-14 HMRC’s Large Business Service (LBS) dealt with the tax affairs of the 800 largest businesses in the UK. At 31 March 2014, HMRC employed 1,303 staff in LBS, equivalent to 1,198 full-time posts.

From 1 April 2014 HMRC’s new Large Business (LB) directorate deals with the tax affairs of the 2,100 largest businesses in the UK.

Consumers: Credit

Mr Virendra Sharma: To ask the Chancellor of the Exchequer whether consumer credit firms and peer-to-peer platforms located outside the UK but within the European Economic Area will (a) need to be authorised or supervised by the Financial Conduct Authority and (b) continue to be able to lend money online to UK consumers under the terms of the EU Electronic Commerce Directive. [204077]

Andrea Leadsom: In general, firms which are established outside the UK and which carry on a regulated activity in the UK require permission from the Financial Conduct Authority (FCA) and come under FCA supervision.

22 July 2014 : Column 1096W

Consumer credit firms and peer-to-peer platforms which are established outside the UK but within the European economic area (EEA) may only provide services in the UK without permission from the FCA if they do so as an ‘information society services’ (ISS) under the electronic commerce directive. This means that the firm must be operating exclusively online and have no physical presence in the UK.

The Government have announced that we intend to give the FCA new powers to take action against credit firms trying to abuse their rights under the e-commerce directive to avoid FCA regulation.

Credit: Interest Rates

Mr Dodds: To ask the Chancellor of the Exchequer if he will bring forward legislative proposals to ensure that payday loan companies are restricted from deliberately intimidating their customers. [205836]

Andrea Leadsom: The Government have fundamentally reformed the regulation of the payday lending market. Regulatory responsibility for consumer credit transferred from the Office of Fair Trading (OFT) to the Financial Conduct Authority (FCA) on 1 April. The FCA has transposed key parts of the OFT’s Debt Collection Guidance into binding rules, which sets out the types of business practices considered unfair and incompatible with fitness to operate.

The FCA is undertaking a thematic review into payday lenders’ debt collection practices to ensure that firms treat customers who are struggling with repayments fairly. The FCA expects to publish the final report early in 2015 which will set out what practices it has found across the market and how it expects all firms in the market to make sure they are observing the right standards of behaviour.

First Time Buyers

Mr Dodds: To ask the Chancellor of the Exchequer what recent assessment he has made of the success of steps taken to encourage and facilitate first time buyers and young people to get onto the property ladder. [205895]

Andrea Leadsom: The Help to Buy scheme is helping hardworking people realise their home-owning aspirations across the UK. Over 27,000 households have bought a new home through Help to Buy so far, and 85% of these have been first-time buyers. Between 2011-12 and 2013-14 11,000 first time buyers were helped through the FirstBuy scheme.

Local Government: Wales

Jonathan Edwards: To ask the Chancellor of the Exchequer what progress has been made in applying aspects of the City Deal in Wales, in accordance with the undertaking given in paragraph 1.236 of the autumn statement 2013. [204821]

Danny Alexander: Autumn statement 2013 committed the Government to delivering an ambitious City Deal for Glasgow by working with the Scottish Government and local delivery partners. Following the announcement of the Glasgow and Clyde Valley City Deal (Heads of Terms Agreement) on 4 July, the UK Government are now working with the Scottish Government and local councils in Glasgow to finalise the deal.

22 July 2014 : Column 1097W

This is a new approach to working with a city in a part of the UK where the UK Government, the relevant devolved Administration and local bodies have responsibilities which overlap and complement each other. As the next step, we hope to conclude the Glasgow City Deal, and take the opportunity to assess its immediate impact and longer-term out-workings.

Given the complexity of this process, we believe it is prudent to ensure this assessment can be undertaken before exploring the potential application of the City Deal process more widely across the UK. At that point, the lessons learned from Glasgow on funding, governance, responsibility and accountability covering a range of bodies should be clearer.

Separately, the UK Government are providing the Welsh Government with new tax and borrowing powers through the Wales Bill, the latter of which will further enable the Welsh Government to decide when and how to invest in infrastructure in Wales. And in advance of the powers in the Wales Bill being implemented, we have agreed that the Welsh Government can use their existing, more limited, borrowing powers to proceed with improvements to the M4, should they choose to do so.

Mortgages

Andrew Bingham: To ask the Chancellor of the Exchequer what steps he is taking to reduce the bureaucracy required to apply for a new mortgage. [205997]

Andrea Leadsom: The Financial Conduct Authority (FCA) has recently put in place new regulations for mortgages in the UK, known as the ‘Mortgage Market Review’ (MMR). The MMR is a matter for the FCA, whose day-to-day operations are independent from Government control and influence.

Procurement

Sadiq Khan: To ask the Chancellor of the Exchequer how much and what proportion of his Department’s budget was spent on activities which were contracted out in (a) 2009-10, (b) 2010-11, (c) 2011-12, (d) 2012-13 and (e) 2013-14; and how much and what proportion of his Department’s budget he expects to be contracted out in 2014-15. [205215]

Andrea Leadsom: The Department’s accounting system does not separately identify spend on activities which are contracted out; this information could not be extracted within the disproportionate cost threshold.

Public Expenditure: North West

Tim Farron: To ask the Chancellor of the Exchequer if he will estimate the amount of money from the public purse invested in public projects in (a) Westmorland and Lonsdale constituency, (b) South Lakeland, (c) Cumbria and (d) the North West (i) since 2010 and (ii) between 2005 and 2010. [204791]

Danny Alexander: Data on money from the public purse invested in public projects in Westmorland and Lonsdale constituency, South Lakeland and Cumbria are not centrally available. The Department for

22 July 2014 : Column 1098W

Communities and Local Government collects information on local authority current and capital expenditure, however, this forms just part of total public expenditure.

In addition, there is no central source on money from the public purse invested in public projects in the English regions. However, the following table shows total identifiable capital expenditure on services in the north-west.

Social Security Benefits: Children

Chris Heaton-Harris: To ask the Chancellor of the Exchequer how many adults claim child tax credit for children not residing in the UK; and for how many children such UK child benefit is claimed. [205924]

Priti Patel: The main purpose of child benefit and the child tax credit is to support families in the UK. Consequently, the rules for these benefits generally do not provide for them to be paid in respect of children who live abroad.

Nevertheless, both child benefit and the child tax credit are family benefits under EC Regulation 883/2004. This regulation protects the social security rights of nationals of all member states of the European economic area, including the UK and Switzerland, when they exercise their rights of free movement under EU law.

I refer my hon. Friend to the reply given on 14 May 2014, Official Report, columns 676-77W, for details about the number of claims for family benefits paid under the EC Regulations for children resident in another member state and which member states such children reside.

Taxation: Rebates

Fiona Mactaggart: To ask the Chancellor of the Exchequer (1) how many taxpayers qualified for a refund on their 2013-14 tax payments; how many of them received the refund; and what the average value is of these refunds; [205874]

(2) what average length of time was taken to provide individual taxpayers with refunds of overpaid tax in (a) the most recent year for which figures are available and (b) the preceding four years. [205873]

Mr Gauke: HM Revenue and Customs (HMRC) refunds tax to individual customers for different types

22 July 2014 : Column 1099W

of taxes throughout the year. HMRC endeavours to refund tax as soon as practicable after it identifies tax is to be refunded.