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Haemophilia Society Report

Lord Morris of Manchester asked Her Majesty's Government:

Lord Hunt of Kings Heath: We are considering the Haemophilia Society's detailed report and will respond as soon as this has been completed.

Hip Replacements

Lord Jacobs asked Her Majesty's Government:

Lord Hunt of Kings Heath: The number of patients waiting for elective admission to hospital for hip replacement is not collected centrally. Our aim is to balance data requirements with the burden that they place on the National Health Service, and there are no plans to start collecting this information.

Data on patients waiting for elective admission is collected on the consultant's main specialty function. Usually patients waiting for hip replacement are listed under the trauma and orthopaedic specialty. At 31 March 2002, 260,000 patients were waiting for elective admission to hospital in the trauma and orthopaedic specialty.

During the financial year 2000–01, 70,000 hip replacements were performed.

29 Jul 2002 : Column WA150

Diabetes National Service Framework

Lord Lofthouse of Pontefract asked Her Majesty's Government:

    What progress they are making towards forming the Diabetes National Service Framework; and whether specific funding will be allocated to implement it; and[HL5364]

    Whether they will make resources available to ensure that the Diabetes National Service Framework is effective; and[HL5365]

    Whether they will make it clear to local health bodies that diabetes is a funding priority and should be included in future local health improvement programmes; and[H5366]

    Whether they have any plans to encourage local health providers (for example, general practitioner practices) to meet agreed diabetes standards by receiving additional central funds for so doing; and[HL5367]

    Whether they believe that spending money on preventing and managing diabetes now will save money, as well as lives, over the long term, as the complications of diabetes can be delayed or avoided; and[HL5368]

    Whether they think investment in the Diabetes National Service Framework will also help deliver existing government targets, for example, those on older people and heart disease.[HL5395]

Lord Hunt of Kings Heath: We published the standards for the Diabetes National Service Framework in December 2001. The forthcoming delivery strategy for the framework will set requirements for implementation at local level. Planning at a local level will respond to these requirements, taking account of local priorities and progress, and showing how milestones will be reached. Local strategies to deliver the framework will also be integrated in the wider planning process.

Funding for diabetes is being considered as part of the current government Spending Review, together with other priorities. The Budget provides the highest sustained growth in NHS history, with annual average increases of 7.4 per cent in real terms over the five years 2003–04 to 2007–08. Decisions about the allocation of the increased funding will be announced later this year. The pace of change for delivery of the Diabetes National Service Framework will take account of the resources that will be available.

Diabetes shares a number of common risk factors with coronary heart disease and stroke. Investment in the promotion of healthier lifestyles and in the control of blood pressure, in particular, will help to combat all three conditions. The standards for the Diabetes National Service Framework highlight the importance of common strategies for prevention and treatment. In doing so, they build on the National Service Frameworks for Coronary Heart Disease and Older People.

29 Jul 2002 : Column WA151

Under the new general medical services contract for general practitioners, a quality framework will reward practices for delivering quality care and provide extra incentives to encourage even higher standards of care. The NHS Confederation and the General Practice Committee of the British Medical Associations are negotiating the content of the quality framework and this includes detailed clinical standards and their levels. The framework agreement makes clear that the standards will be fair, reasonable and evidence-based.

Mental Health Bill, Clause 6(4)

Lord Lucas asked Her Majesty's Government:

    With reference to the draft Mental Health Bill, for the most recent period for which data are available on which reasonable estimates can be based, (a) what number of patients would fall under Clause 6(4) of that Bill; (b) what illnesses would they be diagnosed with and in what numbers; (c) what classes of treatment are available for those illnesses; and (d) what plans there are to refer those treatments to the National Institute of Clinical Excellence for their consideration.[HL5449]

Lord Hunt of Kings Heath: Nobody will be subject to compulsory treament under the Bill's proposals who does not meet all the conditions for compulsion. It is not a question of different people being treated under different conditions. (a) The best estimate of the number of patients who could be so dealt with can be derived from the latest statistics of the number of inpatients detained in hospitals under the Mental Health Act 1983. This bulletin is prepared by the Government Statistical Service and was last published in October 2001.

We should add to this the estimate of people who are dangerous by virtue of severe personality disorder and who could be treated under the Bill but could fall outside the scope of the 1983 Act. This estimate is derived from the Office for National Statistics Psychiatric Morbidity Survey of Prisoners (1997). The estimate is that 124 such people might be dealt with per annum under the Bill. (b) It is estimated that in total 26,774 people per annum coud be made subject to compulsory treatment under the Bill. This is based on experience of the operation of the 1983 Act; 26,650 formal admissions to hospital were recorded in 2000–01; and the estimate of the number of people who are dangerous by virtue of severe personality disorder and who could be treated under the Bill but who could fall outside the scope of the 1983 Act.

We do not expect any significant change in the diagnosis of mental disorder under which people meet the conditions. It is likely, however, that the number of people with a primary diagnosis of personality disorder treated under the powers of the Bill will be higher than those of the 1983 Act.

29 Jul 2002 : Column WA152

At 31 March 2001, 13,829 people were detained. The break-down by mental disorder was:


    Mental illness: 11,164


    Psychopathic disorders: 698


    Mental impairment: 842


    Severe mental impairment: 166


    Not specified: 959 (c) The same classes of treatment will be available for patients who fall within the scope of the draft Bill as to those that are available for all other patients with mental disorders. (d) The same procedure for referring treatments to the National Institute for Clinical Excellence will apply to all treatments that may be provided to patients with mental disorders.

Adoption: European Court of Human Rights Judgment

Earl Howe asked Her Majesty's Government:

    What directions or guidance they propose to issue to social services departments of local authorities in the light of the judgment delivered by the European Court of Human Rights in the case of P.C. and S.v the United Kingdom.[HL5408]

Lord Hunt of Kings Heath: The Government received the judgment delivered by the European Court of Human Rights in the case of P.C. and S. v the United Kingdom on Tuesday 16 July 2002. The Court did not find any Department of Health legislation or guidance to be in breach of the convention. However, the judgment has raised a number of issues that the Department of Health is giving careful consideration to. The department will ensure that these issues are kept carefully in mind as it develops the guidance necessary to implement the adoption legislation currently before Parliament.

Dental Treatment

Lord Colwyn asked Her Majesty's Government:

    How many patients were registered with (a) the general dental services; and (b) the community dental services in each year since 1990, showing the figure both as a total and as a percentage of the population.[HL5450]

Lord Hunt of Kings Heath: Arrangements are now in place to ensure that patients can gain access to National Health Service services by calling NHS Direct. this means that even if a patient is not registered with a dentist it will still be possible for that patient to access all forms of dentistry that are provided by the NHS.

29 Jul 2002 : Column WA153

The number of patients registered in the general dental service and the percentage of patients registered per population for September each year from 1992 to 2001 is shown in the table.

Comparable data for 1990 and 1991 are not available as registrations were introduced only in October 1990 and registration numbers had not yet had time to reach consistent levels.

Registration numbers were reduced by the shortening of the registration period for new registrations from September 1996. The adult registration period changed from 24 months to 15 months. The child registration period changed to 15 months; previously child registrations expired at the end of the following calendar year. Hence, registration numbers after 1997 are not comparable to the numbers for earlier years.

The data are also affected by improvements in the methods used for the removal of duplicate registration records which were first employed in 1993 by the Dental Practice Board.

Patients with the community dental service (CDS) are not registered for dental treatment therefore registration data for the CDS is not available.

General dental service: Number of patients registered (3) and percentage of the population registered, 1992 to 2001
England

At 30 SeptemberNumber of patients registered (4) (millions)Percentage of population (3) registered
199228.759
199328.960
199428.458
199527.356
199626.855
199726.854
199823.547
199923.547
200023.747
200123.647

(3) Based on the number of registrations at 30 September each year.

(4) The number registered is affected by the shortening of the registration period to 15 months from September 1996.

(5) Office for National Statistics mid-year adult population estimates used to calculate percentage of patients registered.



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