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Laming Inquiry Report: Implementation of Recommendations

Baroness Barker asked Her Majesty's Government:

Baroness Ashton of Upholland: When the Victoria Climbie inquiry report was published on 28 January, my right honourable friend the then Secretary of State for Health said that we will study its 108 recommendations with care. We will make our substantive response to the report as part of the Green Paper on children, which will be published in September.

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So far, 83 of the recommendations have been partially or fully implemented. We have already made some major progress.

Baroness Barker asked Her Majesty's Government:

    What estimate they have made of the total cost of implementation of the recommendations in the Laming report (a) for each local authority and (b) in England as a whole.[HL4135]

Baroness Ashton of Upholland: Fifty-six of the recommendations have been accepted as basic good practice, already set out in government guidance. This good practice should already be in place in local authorities, health bodies and the police, and is covered within the budgets already allocated. The response to the inquiry, covering all the other

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recommendations, will be made as part of the Green Paper on children.

School Admissions Project

Lord Lucas asked Her Majesty's Government:

    With reference to the proposed pan-handle system for co-ordinated admission to secondary schools, whether they are confident that by the proposed start date boroughs will be effective and efficient in implementing the system and that the software will be perfected; and whether, if there are any doubts on either score, they will pilot the scheme with a small group of boroughs in its first year.[HL4182]

Baroness Ashton of Upholland: The PAN London School Admissions Project, funded by the Office of the Deputy Prime Minister as a national project, and headed by the London Borough of Wandsworth, is now well under way. Although my department is represented on the project board, this is a local authority-led project which will enable parents to make school applications on-line, and will facilitate the secure and speedy exchange of information on admission applications between local education authorities.

The first stage of the project, in which 10 London boroughs will implement and pilot the system, is due for completion by September this year. The remaining boroughs will "go-live" by September 2004 in time to deal with applications for entry to schools in September 2005.

Lord Lucas asked Her Majesty's Government:

    With reference to the co-ordinated admissions scheme for primary schools, what problems in the current system require solution; what benefits the new system will bring; what proportion of children will be significantly better off; what implementation of the new system will cost and whether it will represent value for money.[HL4183]

Baroness Ashton of Upholland: Co-ordination will make the admissions process smoother. Parents will be able to apply for all the schools they wish their child to attend in the LEA's area on one application form instead of having to make several applications to different admission authorities. They will receive only one offer from their LEA and all will receive the offer on the same day. Currently offers may be notified at different times and some parents may have a number of offers while others have none. This creates anxiety for parents and children and additional work for LEAs who must then find places for children with no offer.

The regulatory requirements for co-ordinated admissions schemes were drawn up in consultation with a focus group of interested parties, including representatives of LEAs, the Churches and foundation and voluntary-aided schools. The requirements for

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primary schemes are minimal and allow LEAs to draw up timetables which will suit the needs of their area.

My department does not keep figures for the numbers of children involved, but our research has shown that parents find the process easier when admissions are co-ordinated. We expect co-ordinated admissions to be cost neutral in the longer term.

Prescriptions: Electronic Transmission

Lord Clement-Jones asked Her Majesty's Government:

    (a) whether they have assessed the number of patients who have come to rely on electronic transmission of prescriptions in the electronic transmission of prescriptions pilots now being terminated;

    (b) what timeframes are being agreed for ceasing electronic prescriptions;

    (c) what the costs would be for extending the pilots until a "sustainable, national prescription service" can be developed by the National Programme for National Health Service Information; and

    (d) what their estimated timescale is for the development of electronic transmission of prescriptions nationwide.[HL3937]

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): Over the past 12 months the Prescription Pricing Authority (PPA) has processed 55,947 electronic prescriptions from the electronic transmission of prescriptions (ETP) pilots, these relate to around 13,500 different patients. This figure is a very small percentage of the 600 million-plus prescriptions processed by the PPA during the period.

The ETP pilots closed at the end of June 2003 and the remaining pilot consortia are in the process of winding-down their pilots. In order to give the pilot consortia reasonable time in which to manage the closure process, the PPA will continue to receive electronic prescriptions for payment processing until 30 September 2003. This should enable pilots to ensure that patients who have signed up for the pilot do not experience difficulties in obtaining their prescriptions, and that they are clear about the arrangements for receiving their medicines once ETP transmission has ceased. The timescale should also minimise inconvenience for healthcare professionals.

The ETP pilots have been closed as they have served their purpose to test the feasability of the electronic transmission of prescriptions. An independent evaluation on the pilots has been completed and received by the Department of Health. Because of this, limited work has been done to model potential costs for their continuation. Based on the current patient and prescription numbers, the costs to the National Health Service and the department are relatively small (with most costs being met by the pilot consortia). However, there are some resource implications. The main costs to the department relate to the processing

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of the electronic prescriptions from the pilots by the PPA. Assuming prescription volume did not exceed 10,000 items per month and there was no increase in functionality or scope the PPA estimate their costs at around £230,000 per annum. This figure does not include the cost of connecting the participating pharmacies to the NHSNet.

Delivering 21st Century IT states that the National Prescriptions Service will be 50 per cent. implemented by 2005 and fully implemented by 2006–07.

Maternity Services

Baroness Cumberlege asked Her Majesty's Government:

    What is their policy towards 24-hour birthing centres.[HL3992]

Lord Warner: The National Health Service has a responsibility to provide a 24-hours maternity service. However, we advocate local decision making in designing appropriate, effective services and available resources that fits in with the ethos of woman-centred care. It is inevitable that the requirements of women will vary in different parts of the country and this is why it is so important that decisions about service provisions are made at a local level.

NHS Delayed Discharges: Catheter-associated Urinary Tract Infection

Baroness Cumberlege asked Her Majesty's Government:

    What impact catheter-associated urinary tract infection has on bed blocking in the National Health Service.[HL4096]

Lord Warner: Data on catheter-associated urinary tract infections are not collected centrally. Data on delayed discharges do not provide information on medical reasons for delays.

Hospital Infections

Baroness Cumberlege asked Her Majesty's Government:

    What progress they have made towards the 15-30 per cent reduction in hospital acquired infection, highlighted as achievable by the Public Accounts Committee.[HL4097]

Lord Warner: As national data on hospital infections are limited we are unable to assess percentage changes but we are developing a new national mandatory surveillance system for healthcare associated infection.

Hospital performance against the infection control standards has improved over the past three years and for the first time this year contributed to star ratings. The Chief Medical Officer is leading a new initiative to

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produce a longer-term strategy to reduce healthcare associated infections.

Devizes: Community Healthcare

Lord Carter asked Her Majesty's Government:

    Whether capital receipts from the sale of existing medical facilities in Devizes, Wiltshire, will be used to finance the building of a new community hospital in Devizes.[HL4107]

Lord Warner: Any decision on the use of capital receipts would be subject to the normal value-for-money assessment process to ensure that best use is made of public funds. This will be subject to the option appraisal on the redevelopment of the Devizes Community Hospital (and associated facilities) and the progression of the outline business case. The outline business case will include all of the options to be approved by the strategic health authority from both the service and financial aspects before any scheme can proceed.

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