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Ministerial Travel

Bob Russell: To ask the Secretary of State for Trade and Industry when she last travelled on the London underground in the course of her official duties. [3686]

Ms Hewitt: In the course of my official duties, I travel using the most efficient and cost-effective mode of transport and travel on the underground as and when appropriate.

Energy Resources Review

Llew Smith: To ask the Secretary of State for Trade and Industry if the Performance and Innovation Unit's Energy Resources Review will examine the options set out in the report on interim storage of spent nuclear fuel, prepared by Harvard university and the university of Tokyo published in June. [3960]

Mr. Wilson: The review of energy policy will be considering what role, if any, the nuclear industry should play in meeting longer term environmental and security of supply objectives and will take into account any relevant

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information. I will refer the report referred to by my hon. Friend to the attention of the PIU team which is undertaking the review.

HEALTH

Older People

Mr. Burstow: To ask the Secretary of State for Health by what date the NHS and local councils will have concluded the work set out in paragraph 7.19 of the National Service Framework for Older People; and what he expects to be included in specialist residential care services. [4087]

Jacqui Smith: We are working with local councils, National Health Service agencies and care providers on an agreement to give greater direction to the commissioning of care for older people. This includes encouraging the development of specialist residential and nursing care services for people with dementia.

Mr. Burstow: To ask the Secretary of State for Health what assessment the Task Force for Older People has made of delivery of the National Service Framework for older people to date. [4082]

Jacqui Smith: The National Taskforce for Older People has an advisory role on the implementation of policy. It gives advice on the basis of its members' expertise in the delivery of frontline services. However, it does not have an executive role to monitor performance of the National Health Service or social services against National Service Framework targets. This task is undertaken by the officials responsible for NSF implementation and the information is fed through to taskforce members to inform their discussions.

Mr. Burstow: To ask the Secretary of State for Health what the remit, membership and reporting lines of the national implementation group for the National Service Framework for Older People are; and how the group relates to the Task Force for Older People. [4078]

Jacqui Smith: A national implementation group for the National Service Framework (NSF) for Older People met during development of the NSF in March 2001. A group of officials from the National Health Service and social care regional offices together with departmental policy officials continues to meet regularly to plan and monitor implementation of a range of policies, including the NSF. The discussions of this group are also fed through to the members of the Older People's Taskforce.

The Taskforce for Older People has an advisory role on the implementation of policy. It gives advice on the basis of its members' experience in their delivery of frontline services, which is fed into the policy making process. It does not have an executive role to monitor performance.

Mr. Burstow: To ask the Secretary of State for Health what assessment he has made of the extra numbers of staff required to establish the falls services described in paragraphs 6.37 and 6.38 of the National Service Framework for Older People; and what assessment he has made of the numbers of such staff (a) already trained and (b) in training. [4084]

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Jacqui Smith: The detailed assessment of the number and appropriate skill mix of staff teams to establish the falls service described in Standard Six of the National Service Framework for Older People will be undertaken by the National Workforce Development Board, informed by the Care Group Workforce Team for older people which will be established shortly.

Mr. Burstow: To ask the Secretary of State for Health if he will set out how many (a) consultants in old age medicine and (b) consultants in rehabilitation there were in each of the last three years for which figures exist; how his Department calculated its estimate of old age medicine consultants on page 139 of the National Service Framework for Older People; and what his estimate is of the number of extra rehabilitation consultants required. [4086]

Jacqui Smith: The number of consultants employed in old age medicine and rehabilitation are set out in the table.

There are already a number of specialist registrars, based on the Specialty Workforce Advisory Group's assessment of demand, training in old age psychiatry and geriatric medicine. The figures quoted in the National Service Framework reflect the increases that would be achieved if those trainees are employed as consultants as they complete their training. The increases are offset by estimates of the annual number of retirements

The number of extra rehabilitation consultants required will be determined by the National Workforce Development Board informed by the Care Group Workforce Team for older people.

Hospital medical consultants within the geriatric and rehabilitation medicine specialities

Numbers
England as at 30 September199819992000
Geriatric medicine710720770
Rehabilitation medicine707080

Notes:

Figures are rounded to the nearest ten.

Source:

Department of Health medical and dental workforce census


Mr. Burstow: To ask the Secretary of State for Health when he expects the assessment working group to provide the further evidence referred to in paragraph 2.44 of the National Service Framework for Older People. [4085]

Jacqui Smith: Guidance on the introduction of a single assessment process across health and social care promised in the National Service Framework for Older People will be published shortly.

Respite Health Care

Mr. Burstow: To ask the Secretary of State for Health if he will define (a) respite health care and (b) specialist health care support, set out in paragraph 16 of HSC 2001/015: LAC (2001)18. [4090]

Jacqui Smith: Respite health care is typically understood to describe packages of care to provide respite for the main carer of a person where the care being provided is primarily health care, for example continence care.

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Specialist health care support is typically understood to describe the expertise of health care professionals available to patients with more specialised health care needs, such as tissue viability or continence, or the maintenance of domiciliary equipment.

Patient Consultation

Vernon Coaker: To ask the Secretary of State for Health what plans he has for reforming patient consultation in the national health service; and if he will make a statement. [1841]

Ms Blears: Sections 7 to 11 of the Health and Social Care Act 2001 make provision for strengthening patient and public consultation and involvement in the operation of the national health service. Local authority overview and scrutiny committees will scrutinise the NHS including decisions on local NHS reorganisations and service change. NHS bodies will have a statutory duty to make arrangements with a view to securing that the public are involved in and consulted on the planning of NHS services and decisions affecting the operation of those services. We intend to build on these foundations to make sure patients and the public are at the heart of shaping and developing NHS services in the future.

National Cardiothoracic Transplant Service

Mr. Brady: To ask the Secretary of State for Health what provision will be made to meet the additional travelling expenses of transplant patients receiving extended post-operative care following the reorganisation of the National Cardiothoracic Transplant Service. [2832]

Mr. Hutton [holding answer 9 July 2001]: Under the hospital travel costs scheme, transplant patients are treated in the same way as any other patients receiving treatment at specialist centres.

Patients who are in receipt of benefits including weekly Income Support, Working Families Tax Credit, Disabled Persons Tax Credit, or Income Based Jobseeker's Allowance are entitled to receive help with their hospital travel costs. Other patients may be eligible for full or partial reimbursement on the basis of a low income and patients who would not normally fall into the low income category might become entitled to receive help if they have to travel long distances frequently.

Antidepressants

Dr. Naysmith: To ask the Secretary of State for Health what assessment he has made of the World Health Organisation figures relating to SSRI antidepressants and benzodiazepines; and if he will issue further guidance to GPs on the prescribing of these drugs. [2955]

Ms Blears: The Medicines Control Agency (MCA) has on-line access to the World Health Organisation (WHO) data on adverse drug reactions (ADRs) and routinely evaluates these data. MCA contributes all United Kingdom suspected ADR reports to the WHO database. Prescribing information on selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines in the UK is consistent with the known safety profiles of these medicines.

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Guidance on how to prescribe SSRIs and benzodiazepines, including information on dose and duration of treatment and possible adverse effects, is available in the authorised summary of product characteristics for these medicines. Guidance is also provided to general practitioners in the British National Formulary.

Paul Flynn: To ask the Secretary of State for Health what his assessment is of the therapeutic value of antidepressants compared with placebos. [2377]

Ms Blears [holding answer 9 July 2001]: There is a large scientific literature that indicates that antidepressant medication is superior in efficacy to placebo. This is particularly the case where depression is more severe. Placebos have been noted to be of some benefit and there is a range of so-called non-specific factors (care, interest and attention from the clinician) which are relevant.

An example is the National Institute of Mental Health Treatment of Depression Research Program in the United States reported in the mid 1990s. They compared two forms of psychotherapy, antidepressant medication (imipramine) and placebo. The latter two treatments also involved "clinical management" which included a weekly meeting with the clinician to discuss symptoms, side effects and progress. For mild depression no significant differences were found between the treatment groups. However for the more severely affected patients the antidepressant treatment was the most effective.

Early studies with tricyclic antidepressant drugs showed that 60 per cent. to 70 per cent. of patients with depression will respond to antidepressant drug treatment as compared with 15 per cent. to 30 per cent. of those treated with placebo. The response to antidepressant medication will take at least two weeks but in some cases up to four weeks or more. The newer antidepressant drugs have been shown to have similar, but not greater, efficacy to the older style medications. The advantage of the newer drugs lies in lower toxicity and different side effects.


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