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DWP's advertising spend is split by activity of the Central Office of Information (COI) and direct advertising through a wide range of media channels. All major campaign advertising is delivered via the COI. Advertising costs cover both campaign advertising and recruitment advertising.

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£ million2004-052005-062006-072007-082008-09








n/a *





Health: Botox


Asked by Lord Jopling

Baroness Thornton: The Medicines and Healthcare products Regulatory Agency monitors the import of botulinum toxin where it is notified for import to the Medicines and Healthcare products Regulatory Agency as an unlicensed medicine for medical use, but not where it is imported as a cosmetic product for non-medical use.

Health: Commissioning


Asked by Lord Warner

Baroness Thornton: This is a matter for strategic health authorities (SHAs). SHAs are responsible for the performance management of primary care trusts (PCTs), providing regional oversight to ensure services best meet patient needs.

The department is undertaking an assurance programme for SHAs, which will include their system management functions. This programme is expected to be rolled out in autumn 2009.

Furthermore, the annual world-class-commissioning assurance system assesses the PCTs' overall achievement on health outcomes, organisational competencies and governance. The assessment includes an evaluation of PCTs' market management competence.

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Health: Contaminated Blood Products


Asked by Lord Morris of Manchester

To ask Her Majesty's Government further to the Written Answer by Lord Darzi of Denham on 16 July (WA 252-3), what were the different denominations contained in the representations by the Macfarlane Trust that demonstrated the average level of disbursement to the infected beneficiary community was £8,600 at 31 March 2009. [HL5257]

Baroness Thornton: I refer the noble Lord to the reply given by Lord Darzi of Denham on 16 July 2009-Official Report, cols. WA252-53-where it was explained the derivation of the department's calculations. It is not for the department to explain the trust's calculations.

Health: Generic Substitution of Medicines


Asked by Baroness Cumberlege

Baroness Thornton: Generic substitution is a complex issue with many interested stakeholders. We want to make sure we engage with all stakeholders in the best way possible and we therefore intend to formally consult in the autumn on our proposals for the implementation of generic substitution. We expect the consultation period will last 12 weeks and the timetable for implementation will be influenced by the outcome of this consultation.

Health: Race Equality


Asked by Lord Ouseley

Baroness Thornton: Since the publication of the South East Coast Black and Ethnic Minority Network's findings on race equality within the National Health Service (NHS) in 2008, NHS South East Coast has taken active steps to effect improvements. Using a regional audit tool, South East Coast trusts have

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self-assessed their performance and, where appropriate, drafted action plans so that the necessary progress to compliance could be made. Following a further strategic health authority-led assurance process, NHS South East Coast now confirms that all trusts meet their baseline duties under the Race Relations (Amendment) Act and where appropriate trusts have set out action plans setting out how they will maintain their compliance.

The NHS constitution affirms the NHS as a service for all. The newly formed NHS Equality and Diversity Council will strengthen the national focus on improving quality in the NHS. The department is running a number of programmes and initiatives to help NHS organisations to achieve compliance with equality legislation and to make step-change improvements for patients and staff from communities likely to experience discrimination and disadvantage.

Health: SHA Chairmen


Asked by Lord Mawhinney

Baroness Thornton: The department does not routinely collect this information.

Health: Stress-related Illness


Asked by Lord Jones of Cheltenham

The Minister for International Defence and Security (Baroness Taylor of Bolton): Diagnosis and treatment of stress-related illnesses and other mental health disorders in members of the Armed Forces are performed by fully trained and accredited mental health personnel, and measures are in place to increase awareness at all levels and to mitigate the development of operational stresses. In Afghanistan, we deploy uniformed mental health nurses to provide in-theatre care and treatment for our personnel. If personnel need to leave the operational environment, then their care continues either on an out-patient or in-patient basis in the UK.

In the UK, our mental health services for military personnel are configured to provide community-based mental health care, primarily through our 15 military Departments of Community Mental Health (DCMH) across the UK (plus satellite centres overseas), which provide out-patient mental healthcare. The DCMH mental health teams comprise psychiatrists, mental health nurses, clinical psychologists and mental health social workers. A wide range of psychiatric and psychological treatments are available (including psychological therapies, environmental adjustment and

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medication) where appropriate. The Ministry of Defence mental health services have particular expertise in treatments for psychological injury.

For the relatively small number of military patients who need it, in-patient care is currently provided by a group of seven NHS trusts located throughout England and Scotland, led by South Staffordshire and Shropshire Healthcare NHS Foundation Trust (SSSFT) through a central MoD contract.

The MoD is also committed to protecting the health, safety and well-being of its civilian employees and has a number of procedures in place to reduce stress at work based on the Health and Safety Executive's management standards. The MoD intranet web portal contains information on health promotion and includes specific advice to employees on how to reduce stress.

Responsibility for identification of the factors leading to stress rests with business areas, and line managers are required to adapt the culture of their business to reduce stress levels. This includes maintaining a zero-tolerance approach to bullying and harassment.

We provide guidance and training for managers and supervisory staff in good management practices, as well as specific training on managing stress and recognising stress in others, some of which is delivered by our own business training organisation.

In cases of sick absence for a stress-related illness, MoD policy is to make an early referral to our occupational health providers.

Confidential support is also available through the MoD occupational welfare service, for employees affected by stress caused by either work or external factors. This includes "signposting" to external agencies where appropriate.

MoD civilians and other public servants seconded to MoD who deploy in support of operations overseas receive care in-theatre on the same basis as their military counterparts. Special arrangements are in place to provide psychological support to any civilian employee or secondee affected by post-traumatic stress following deployment on operations. This includes assessment and referral to a military DCMH if appropriate.

Health: Vaccines


Asked by Baroness Cumberlege

Baroness Thornton: The life sciences industry, which includes the pharmaceutical sector, was involved in the development of the Life Sciences Blueprint published on 14 July 2009. As a major stakeholder, the industry will continue to be involved in the implementation of the proposals in the blueprint.

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NHS: Chief Executives


Asked by Lord Warner

Baroness Thornton: An estimate from the Electronic Staff Record Data Warehouse suggests that around 15 per cent of chief executives left their role in the 12 months ending 30 April 2009. The completeness of the data does not support a breakdown by strategic health authority; nor does an analysis for the two preceding years.

NHS: Debts


Asked by Lord Warner

Baroness Thornton: Of the 44 National Health Service trusts showing a cumulative deficit in their 2008-09 financial accounts, at present seven are no longer expected to be in cumulative deficit by 31 March 2009-10 and a further 10 by 31 March 2010-11.

Any NHS trust that is not planning to be out of a cumulative deficit position by the end of the 2011-12 financial year is expected to have a locally agreed recovery plan in place which details the steps being taken to recover its cumulative deficit position. The delivery against these recovery plans is managed at a local level by strategic health authorities, which are able to take action as necessary in order to ensure these plans are met.

NHS: Expenditure


Asked by Lord Warner

Baroness Thornton: The following table shows the percentage of primary care trust (PCT) expenditure on secondary healthcare covered by the payment by

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results national tariff between 2006-07 and 2008-09. There are no plans to increase this percentage in 2010-11.

Percentage of PCT expenditure on secondary healthcare covered by the national tariff









2006-07 and 2007-08 Payment by Results market forces factor (MFF) adjustment actual outturn exercise (Stage 4)

2008-09 Payment by Results MFF adjustment draft accounts exercise (Stage 3)

2006-07 and 2007-08 audited PCT summarisation schedules

2008-09 unaudited PCT summarisation schedules

NHS: Finances


Asked by Lord Mawhinney

Baroness Thornton: The number of National Health Service (NHS) trusts and primary care trusts (PCTs) that ended each of the previous three financial years in deficit are shown in the following table.

Financial YearNumber of NHS trusts reporting an operating deficitNumber of PCTs reporting an operating deficit










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