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Mental Health

Mrs. Helen Clark: To ask the Secretary of State for Health (1) what plans he has to extend to patients who are not formally detained under the Mental Health Act 1983 the right to review their admission; [32752]

Jacqui Smith: I apologise to the hon. Member for the delay in responding to this question. I refer her to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

There are two groups of patients who may be treated for a mental disorder without being formally detained under the Mental Health Act 1983: those who have consented and are being treated voluntarily and those who are unable to consent and do not resist treatment.

The Government are committed to reforming the Mental Health Act 1983 and a Bill will be introduced as soon as parliamentary time allows.

The Government do not plan to introduce any new rights for patients who are capable of giving consent to treatment and who do so, as they can stop consenting at any time. Neither detention in hospital nor treatment can lawfully continue if a capable patient withdraws consent, except where formal powers under the legislation are used. Once formal powers are invoked, patients have the benefit of the statutory safeguards which accompany the use of those powers.

There has been concern about the position of patients who are not formally detained but who have not consented to their treatment. These are patients with long-term incapacity who are therefore unable to consent and young people under 18 who may be treated against their wishes if their parents consent.

New legislation will bring in measures to protect adult patients who have a long-term incapacity to consent, who are in a hospital or nursing home receiving treatment for a serious mental disorder and who do not resist treatment. These safeguards will include, among other things, the right to challenge admission and treatment before a mental health tribunal. As, in practice, it is unlikely that such patients will be able to take advantage of safeguards for themselves, the legislation will also provide for a nominated person to act on the patient's behalf. Where such patients demonstrate resistance to detention or treatment, they will only be lawfully detained or treated under formal powers. New rights will also be introduced for young people with serious mental disorders who are, nevertheless, able to give a view about their own treatment.

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Surgical Instruments

Dr. Murrison: To ask the Secretary of State for Health what were the excess (a) mortality and (b) morbidity figures associated with single-use instruments for tonsillectomy in 2001. [32780]

Yvette Cooper: I apologise to the hon. Member for the delay in responding to this question. I refer him to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

The Hospital Episode Statistics (HES) does not collect details of instruments used during tonsil and adenoid surgery or the cause of death. The HES database does show that there were 41,483 finished consultant episodes in tonsil and adenoid surgery in 2000. From January to September 2001 figures show over 20,700 finished consultant episodes reported, but these figures are not complete.

HES does not record deaths in hospital, but can give no information on cause of death or morbidity measures. As the number of deaths following tonsillectomy is so small (fewer than six), the Department is unable to publish these mortality figures for patient confidentiality reasons.

Publicity Expenditure

Mr. Bercow: To ask the Secretary of State for Health what assessment he has made of the total real terms expenditure of his Department, its agencies and non- departmental public bodies on publicity in each of the years (a) 1997–98, (b) 1998–99, (c) 1999–2000, (d) 2000–01 and (e) 2001–02 (i) to date and (ii) as estimated for the whole of the present year; and if he will break these figures down to indicate expenditure on (A) advertising and (B) press and public relations. [36170]

Ms Blears: I apologise to the hon. Member for the delay in responding to this question. I refer him to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

This information could be provided only at disproportionate cost.

Efficiency Taskforce

Mr. Heald: To ask the Secretary of State for Health, pursuant to the answer of 21 January 2002 to the hon. Member for Woodspring (Dr. Fox), Official Report, column 673W, for what reason it is not possible to ascribe specific financial savings to the work of the NHS efficiency taskforce. [37431]

Mr. Hutton: I apologise to the hon. Member for the delay in responding to this question. I refer him to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

The taskforce and its members provided general advice on a range of issues relating to performance improvements. It would not be possible without

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disproportionate cost to quantify the contribution of specific initiatives that the taskforce made to overall efficiency savings.

Rehabilitation

Mr. Boswell: To ask the Secretary of State for Health what steps he is taking to improve awareness of rehabilitation issues among trainee doctors. [11311]

Mr. Hutton [holding answer 31 October 2002]: I apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

The content and standard of postgraduate medical training is the responsibility of the UK competent authorities, the Specialist Training Authority (STA) for specialist medicine and, for general practice, the Joint Committee on Postgraduate Training for General Practice (JCPTGP). They are responsible for setting quality standards in postgraduate medical education and practice. They are independent of the Department of Health.

In addition, the General Medical Council's Education Committee has the general function of promoting high standards of medical education. The committee also co-ordinates all stages of medical education, to ensure that students and newly qualified doctors are equipped with the knowledge, skills and attitudes essential for professional practice.

NHS Budget

Mr. Laws: To ask the Secretary of State for Health what his estimate is of the annual increase in the NHS budget needed to meet the higher costs associated with (a) an aging population and (b) improved healthcare technology; and if he will make a statement. [10818]

Mr. Hutton [holding answer 31 October 2001]: I apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

Since there is no single agreed methodology for estimating the impact of aging and improving healthcare technology on the cost of health care, the Department takes an alternative approach to estimating the underlying pressures on health care expenditure. The Department uses the trend increase in activity and expenditure for individual services as an indicator of likely future increases in costs. For example, the Department uses trend growth in the following categories of services:


These trend increases include the impact of aging population and health care technology. They also capture the effect of other factors, such as changes in public expectations and changes in the underlying health status of the population.

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Treatment Abroad

Mr. Laws: To ask the Secretary of State for Health how many NHS patients have been sent abroad for operations over the last three months; in which countries they have been treated; what has been the cost saving to the NHS; and if he will make a statement. [11474]

Mr. Hutton [holding answer 1 November 2001]: I apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

Under the pilot scheme to send national health service patients abroad, currently under way in south-east England, 18 patients travelled for treatment in January and 41 in February. 11 patients travelled for treatment on Friday 1 March and a further 20 are due to travel in the week commencing 4 March. The patients are being treated in France and Germany. We expect up to 200 patients to travel overseas for treatment as part of the pilot.

The prices for these procedures are commercially confidential. However, they are comparable to the prices charged for individual operations in the United Kingdom private sector.

The Department has authorised a total of 252 E112 applications since the beginning of December 2001, permitting patients to receive treatment, maternity care or continuing care in other countries of the European Economic Area, funded by the NHS. 72 in December, 94 in January and 86 in February. (These figures are GB figures, as the Department administers this scheme on behalf of Scotland and Wales.) However, the fact that a given number of forms were authorised in a given period does not necessarily mean that the same number of patients actually travelled overseas in that period. The countries involved were Austria, Belgium, France, Germany, Greece, Italy, Norway, Portugal and Spain.

No information on costs can be provided as invoices are submitted retrospectively.


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