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They can be found in the file marked "Vol.79 June 1978-February 1996". The department is committed to releasing all relevant documents held from the period 1970 to 1985. Over 5,500 documents have been placed on the department's website since 2006.
The Parliamentary Under-Secretary of State, Department of Health (Baroness Thornton): We have not undertaken a formal assessment of the number of adults and children diagnosed with type 1 diabetes. Data from the quality and outcomes framework (QOF) show that that number of people with diabetes has increased annually. However, it is not possible from the QOF data to differentiate between people with type 1 or type 2 diabetes.
|QOF-Number of patients with a recorded diagnosis of diabetes|
The diabetes register only includes patients aged 17 years and over, as the care of children with diabetes is generally under the control of specialists. Data from Growing Up with Diabetes: Children and Young People with Diabetes in England reported that in February 2009 there were 22,947 children and young people with diabetes. Of this number, 20,488 were classified as having type 1 diabetes.
Diabetes is a complex lifelong condition that can affect every part of the body, and there are a number of associated complications with the condition; this makes it difficult to calculate the exact cost to the National Health Service.
To ask Her Majesty's Government how many people with type 1 diabetes who use insulin pump therapy are offered access to a dose adjustment for normal eating (DAFNE) course or an equivalent course. [HL2931]
Baroness Thornton: There are no data held centrally about how many people with type 1 diabetes who use an insulin pump have attended a dose adjustment for normal eating (DAFNE) course or such equivalent.
The DAFNE course is designed to educate patients (usually over the age of 17) with type 1 diabetes to help them manage their multi-injection therapy, the most common treatment for type 1 diabetes. The DAFNE course is not designed specifically for people with insulin pumps. However, centres that provide DAFNE would advise that all potential pump users attend a DAFNE course before commencing pump therapy.
Baroness Thornton: Diabetes is a complex lifelong condition that can affect every part of the body. There are a number of associated complications with the condition which makes it difficult to calculate the exact total cost to the National Health Service.
The department's programme budget figures indicate £1.26 billion of departmental gross expenditure in England in 2008-09 was spent on diabetes. This figure does not include spending on prevention or on general medical services or primary medical services.
|Diabetes expenditure||DH gross expenditure||Diabetes as a proportion of gross expenditure|
In England in 2008, according to the NHS Business Services Authority, about £595 million for diabetes-related items was spent on prescriptions dispensed in the community; ie by community pharmacists and appliance contractors, dispensing doctors, and prescriptions submitted by prescribing doctors for items personally administered. Also included are prescriptions written in Wales, Scotland, Northern Ireland and the Isle of Man but dispensed in England.
To ask Her Majesty's Government whether they have undertaken a cost-benefit analysis of the effects of the qualifying age range of 40 to 74 for the NHS
6 Apr 2010 : Column WA406
Baroness Thornton: The National Health Service Health Check programme (formerly vascular checks) is a universal and systematic programme for everyone between the ages of 40 and 74 that will assess an individual's risk of heart disease, stroke, kidney disease and diabetes and will support people to reduce or manage that risk through individually tailored advice. The programme was developed on the basis of advice from the National Screening Committee. It advised that, on current evidence, there was not a case for whole population screening for diabetes. However, there was a good case for targeted screening for diabetes in the wider context of cardiovascular risk assessment.
The department undertook modelling on a vascular risk assessment and management programme, which included diabetes, to establish whether such an approach would be cost and clinically effective as well as identifying the optimal starting age. Both the technical consultation on the modelling and the impact assessment are available in the House of Lords Library. Three different starting ages for the programme (40, 45 and 50) were modelled. The age range of 40 to 74 for everyone was found to be both clinically and cost effective.
In taking the decision about the age range with which to launch the programme, the department took further advice from the National Screening Committee and leading United Kingdom diabetologists. Their view was that, given the current state of knowledge, age 40 represented a good starting point for combined diabetes, cardio-vascular and kidney disease risk assessment. The content and age parameters of the programme will be kept under review.
We understand that some primary care trusts may be inviting people into the programme who are under 40 years of age, for example, in areas that have significant South Asian communities who are generally at higher risk of vascular disease including diabetes. However, this scenario was not tested through the modelling, and so we have no evidence of its clinical or cost effectiveness.
Baroness Thornton: The Government are not aware of insulin-dependent (or type 1) diabetes having been successfully treated in any species by nuclear transfer. This Government will continue to support all types of stem cell research to maximise the possibility of developing new treatments for unmet medical needs, such as type 1 diabetes.
Baroness Thornton: The Government have made no such assessment. The independent National Institute for Health and Clinical Excellence (NICE) has made a number of recommendations about the use of thiazolidinediones, which include rosiglitazone (Avandia), in its clinical guideline on newer agents for type 2 diabetes published in May 2009. Further information can be found on NICE's website at http://guidance. nice.org.uk/CG87
The Parliamentary Under-Secretary of State, Department of Health (Baroness Thornton): It is for strategic health authorities (SHAs) and National Health Service trusts to ensure that they resolve any gaps in their service delivery to ensure patient safety. It has been agreed that future monitoring will be managed at SHA and trust level.
Baroness Thornton: There is a review under way, which is looking at the impact of the European working time directive on junior doctors' training in the reduced hours environment. This is independently headed by Professor Sir John Temple, on behalf of Medical Education England.
The trusts were asked to report on the impact of the European working time directive, as well as any shortfall in specialty recruitment and shortages of medical locums. A risk rating for each trust was provided along with mitigating actions.
Baroness Thornton: The use of simulation-based training is already well established for junior doctors. We encourage the appropriate use of modern education techniques including simulation-based clinical training for all clinical staff to improve training and patient outcomes.
Baroness Thornton: Professor Sir John Temple is leading an independent review on the impact of the European working time directive on junior doctors' training in the reduced hour environment, on behalf of Medical Education England.
To ask Her Majesty's Government further to the Written Answer by Baroness Thornton on 17 March (WA 189), whether they will place in the Library of the House the exchange of letters between the United Kingdom and Ireland on the payment of €100 million healthcare costs for 2003-06, and on the settlement for 2007-09. [HL2993]
The Parliamentary Under-Secretary of State, Department of Health (Baroness Thornton): Correspondence between the department and the Irish Government on this matter has been provided on a confidential basis. Therefore, to publish it would be a breach of confidence and would be prejudicial to international relations with the Irish Government. For these reasons, the exchange of letters will not be placed in the Library.
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