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Maternity Services

Mr. George Howarth: To ask the Secretary of State for Health what his Department's policy is on the benefits of locating maternity services within general hospitals. [41403]

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Yvette Cooper: The national health service provides care for women during pregnancy and childbirth in various types, sizes and locations of maternity units, including units within general hospitals or stand alone units. The Department expects this choice to continue. It is for local health authorities, Trusts and communities to decide on the pattern of service provision, taking into account the needs of local people, evidence of effectiveness and available resources.

The Department has set up a maternity and neonatal workforce Group to make recommendations through the children's taskforce on workforce issues and various models for configuration of maternity services. This will feed into the children's national service framework to set national standards of care.

Diabetes

Mr. Wray: To ask the Secretary of State for Health what action the Government have taken to inform people of ways to avoid contracting diabetes. [41326]

Jacqui Smith: The risk factors for diabetes include poor diet, physical inactivity and obesity. We are taking forward a wide range of work across Government to reduce obesity, to increase physical activity and improve diet, especially among children. Prevention of diabetes is one of the key areas covered by the diabetes national

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service framework standards, published in December 2001. Local strategies on promoting healthy eating and physical activity, and reducing overweight and obesity, are also being developed as part of the implementation of the national service framework for coronary heart disease.

Mr. Wray: To ask the Secretary of State for Health how much money the Department has spent on research into diabetes since 1997; and if he will make a statement. [41322]

Jacqui Smith: The Department has consistently supported research into diabetes but has not in the past collected information on its total expenditure in this field. The greater part of the funding has gone to the clinical service support costs of research funded by other agencies such as the Medical Research Council and Diabetes UK. The landmark "UK Prospective Diabetes Study", a randomised multi-centre trial in more than 5,000 patients over 20 years, has been supported in this way and continues. The Department has also funded the direct costs of research through its national and regional research and development programmes.

A joint Department of Health/Medical Research Council research advisory committee on diabetes is currently reviewing this whole field of research, as part of the work to underpin the eventual implementation of the Diabetes National Service Framework.

Mr. Wray: To ask the Secretary of State for Health what assistance is provided to diabetics who are affected by (a) sudden and (b) gradual loss of vision. [41324]

Jacqui Smith: The National Institute for Clinical Excellence published a clinical guideline on the early management of and screening for diabetic retinopathy on 5 March, as part of its series on the management of Type II diabetes.

Mr. Wray: To ask the Secretary of State for Health how many medical practitioners in the NHS are specialised in diabetic detection and treatment. [41323]

Jacqui Smith: As at 30 September 2001, there were 23,142 general practitioner unrestricted principals and equivalents in England offering diabetes chronic disease management (CDM).

In addition as at 30 September 2001, there were 987 hospital medical staff working in endocrinology and diabetes mellitus in England, of which 428 were consultants.

Mr. Wray: To ask the Secretary of State for Health what provision is made for the (a) early screening and (b) management of diabetes. [41325]

Jacqui Smith: Services for the screening and management of diabetes are provided in a variety of health care settings and are of varying quality. There is evidence to show that the onset of Type II diabetes can be delayed, or even prevented, that effective management of diabetes increases life expectancy and reduces the risk of complications, and that self-management is the cornerstone of effective diabetes care. This evidence underpins our development of a national service framework for diabetes, for which we published the standards in December 2001. They set out 12 standards

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covering the prevention, identification and management of diabetes and its complications. The delivery strategy for the framework will follow later this year.

The diabetes national service framework provides the opportunity to clarify policy on screening for Type II diabetes, and we have requested advice from the UK National Screening Committee. The Committee has decided that further research, which may require some complex studies, is needed to inform its advice. It will report to the Department of Health in 2005.

Epilepsy

Mr. Wray: To ask the Secretary of State for Health what assistance is provided to carers of severe epileptic sufferers. [41319]

Jacqui Smith: The National Carers strategy is providing better support, information, and care for carers. Carers of people with epilepsy will benefit from the strategy, which includes: extending the Carers Grant to ensure that 75,000 carers will receive a break by 2004; improving social security provision to benefit 300,000 carers financially; providing information and guidance through the Carers UK help-line, Government and voluntary sector booklets and leaflets, carers centres and on-line services, and telephone conferencing to bring carers together to discuss their experiences and provide mutual support; and, allowing carers to access relevant services and support from general practitioners.

Mr. Wray: To ask the Secretary of State for Health how many people he estimates suffer from epilepsy in the UK. [41320]

Jacqui Smith: Epilepsy is the commonest serious neurological disorder affecting around one in 130 of the UK population, or 380,000 people.

Around seventy per cent. of people newly diagnosed with epilepsy are prescribed oral anti-epileptic drugs (anti-convulsants). It has been estimated that seventy per cent. of people taking anti-convulsants have their seizures prevented completely or greatly reduced.

Mr. Wray: To ask the Secretary of State for Health what the Government have done since 1997 (a) to raise awareness of epilepsy and (b) to reduce triggers of epilepsy in the environment. [41321]

Jacqui Smith: The Government has undertaken a range of co-ordinated initiatives to raise awareness of epilepsy. These include: supporting the Epilepsy Advisory Board to produce "Epilepsy Care—Making it Happen", a highly useful publication for improving epilepsy services; holding a NHS Epilepsy Day in October 1999; commending the Clinical Standards Advisory Group (CSAG) report, Services for people who have epilepsy, to the NHS; providing Section 64 funding to the Joint Epilepsy Council (JEC) to undertake a project to draw upon the good practice advice in the CSAG report and other recent epilepsy initiatives; supporting the National Sentinel Audit into Epilepsy Related Deaths which is expected to be published in May 2002; and, publishing the Chief Medical Officer's (CMO) Annual Report 2001, On the State of the Public Health, which included information on epilepsy.

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The National Institute for Clinical Excellence (NICE) is producing a clinical guideline for epilepsy to help address widespread variations in clinical practice and contribute to the delivery of improvements in prevention, diagnosis, treatment and management of epilepsy. This will be supported by an appraisal of the clinical and cost effectiveness of new "add-on" drugs in children and adults, to help promote appropriate uptake and equitable access.

People with epilepsy will also benefit from the emerging Expert Patients Programme, which aims to provide training in self-management skills for people with long term chronic conditions. The first pilot phase will begin shortly in selected primary care group and trust sites, one of which will focus activity on people with epilepsy.

The CMO's Annual Report makes a commitment to putting in place an action plan which will cut the level of preventable deaths from sudden unexpected death in epilepsy three months after the National Sentinel Audit into Epilepsy Related Deaths is published in May 2002.

These initiatives will contribute to raising awareness of epilepsy and specific trigger factors.

Mr. Wray: To ask the Secretary of State for Health how many medical practitioners in the NHS are specialised in epilepsy detection and treatment. [41318]

Jacqui Smith: The Department does not collect information about the number of general medical practitioners in the NHS who are specialised in epilepsy detection and treatment.

Mr. Wray: To ask the Secretary of State for Health how much money the Department has spent on research into epilepsy since 1997; and if he will make a statement. [41317]

Jacqui Smith: The Department funds research to support policy and the delivery of effective practice in health and social care. The Department's expenditure on completed and ongoing directly commissioned projects since May 1997 is about £1.5 million.

In addition to specific projects, the Department also provides support for research commissioned by charities and the research councils that takes place in the national health service . Management of much of the research supported by NHS research and development funding is devolved and expenditure at project level is not held centrally by the Department. The total investment is therefore considerably greater than just the spend on directly commissioned projects.

The main Government agency for research into the causes of and treatments for disease is the Medical Research Council (MRC) which receives its funding via the Department of Trade and Industry. In 2000–01 the MRC spent £3 million on epilepsy research.


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