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24 Oct 2002 : Column 500W—continued

Mental Health Services

Bob Spink: To ask the Secretary of State for Health what action he is taking to ensure that psychiatric patients in the community take their medicines. [75480]

Jacqui Smith: Development of robust community-based mental health provision is the key to ensuring that patients adhere to their care plans.

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The NHS Plan pledged to establish a total of 220 assertive outreach teams by December 2003. There are 180 teams in operation at present. These teams provide services to people with a mental illness in the community who have difficulty engaging with mainstream mental health services.

Another NHS Plan initiative is to create crisis resolution teams which provide intensive support for people in a mental health crisis in their own homes. These teams are designed to offer prompt and effective home treatment, including medication, in order to prevent hospital admissions. A total of 335 crisis resolution teams will be established by 2004 when all people in contact with specialist mental health services will be able to access crisis resolution teams at any time.

Although, community-based teams can support and encourage patients to adhere to their care plans, they currently cannot compel them to do so. The draft Mental Health Bill contains proposals so that patients who meet the criteria for treatment under compulsion might remain at home, supported by an outreach service, rather than having to be detained in hospital. Patients will not be forcibly treated in their own homes. These patients will be subject to conditions authorised by the independent mental health tribunal to ensure that they comply with their individual care plan, including where necessary taking medication.

NHS Hospital Trusts

Bob Spink: To ask the Secretary of State for Health if he will list the English hospital trusts that fall under two or more PCTs. [75478]

Mr. Hutton: Primary care trusts (PCTs) have the freedom to commission services from wherever they can to obtain the best services for their patients. It is likely that the majority of National Health Service trust hospitals have more than one PCT that commissions care from them, although the precise figures are not collected centrally.


Mr. Watts: To ask the Secretary of State for Health whether the new pay and conditions package will encourage surgeons to increase the number of operations that they carry out for the NHS. [74955]

Mr. Hutton: The proposed new consultant contract is designed to provide a much more effective system of planning and time-tabling consultants' duties and responsibilities for the National Health Service in ways that best meet local service needs and priorities. Under the proposed arrangements, full-time consultants will typically devote at least seven out of a total of ten weekly programmed activities to direct clinical care. The new contract will also facilitate arranging extra consultant activity on a more planned and efficient basis.


Chris Grayling: To ask the Secretary of State for Health whether his Department categorises ME as a neurological illness. [76269]

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Jacqui Smith: The Department does not have its own system for categorising conditions such as myalgic encephalomyelitis in this way. However, it employs the World Health Organisation's International Classification of Diseases (ICD). Benign myalgic encephalomyelitis appears in the current version, ICD–10, as a neurological illness.

Chris Grayling: To ask the Secretary of State for Health what guidance he gives to general practitioners about ME. [75976]

Jacqui Smith: Action on ME, a voluntary group active in this area, has recently produced guidance on the management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). We have brought this guidance to the attention of National Health Service chief executives through the CE Bulletin; and will be making reference to in the next issue of the GP Bulletin.

The CFS/ME independent working group's report, which was published on 11 January 2002, has been placed on the Chief Medical Officer's web-site, so that it can be accessed by all interested parties including general practitioners.

Chris Grayling: To ask the Secretary of State for Health (1) how many specialist centres for ME there are in the UK; [75975]

Jacqui Smith: Information on local service configuration for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is not held centrally.

Most cases of CFS/ME are managed in the community although general practitioners can refer patients for specialist opinion and advice where appropriate.

ME is mainly managed in primary care. It is the responsibility of local primary care trusts to commission services for their local populations including those suffering from CFS/ME.

Compulsory Treatment

Miss McIntosh: To ask the Secretary of State for Health what recent assessment his Department has made of the social and psychological effects on patients of compulsory treatment for (a) 72 hours, (b) 28 days and (c) a longer period. [76688]

Jacqui Smith: The Department has not recently made an assessment. The social services inspectorate's report Detained focused on the quality of service experienced by detained patients generally and in particular, the approved social worker's role. It was published in February 2001.

NHS University

Mr. Boswell: To ask the Secretary of State for Health if he will make a statement on the proposed NHS University. [76411]

Mr. Hutton: Professor Bob Fryer CBE was appointed as Chief Executive of NHSU and Vice Chancellor designate of the proposed NHS University in February

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2002. NHSU is the body that has been set-up to prepare the establishment of a university for the National Health Service.

NHSU is currently finalising a development plan for the NHSU setting out the vision for the university, as the basis for an extensive consultation exercise with the NHS and its partners, between November 2002 and January 2003. The plan will be widely distributed and a number of consultation events will be organised jointly with NHS workforce development confederations around the country.

The NHSU will begin to work later next year.

Wythenshawe Hospital

Helen Jones: To ask the Secretary of State for Health for what reason Wythenshawe Hospital scheduled an operation on Mr. S. Ford of Warrington at a time when the relevant consultant was known to be away; how many times this has happened to other patients in the last year; and what procedures will be put in place to prevent such occurences in the future. [76648]

Jacqui Smith: There was a breakdown in communication within the cardiac waiting list department. This was the first and only time such an incident has occurred. Staff have been reminded of the importance of informing the cardiac waiting list department in the event that a consultant is not available to cover the trans-oesophageal echo list.

Helen Jones: To ask the Secretary of State for Health if he will ask the Commission for Health Improvement to investigate (a) the procedures in place for monitoring the number of times patients have operations cancelled at Wythenshawe Hospital, (b) the procedures which are involved when the hospital cancels a patient's surgery more than once and (c) the system used for ensuring patients are notified of a new date for surgery within 28 days. [76646]

Jacqui Smith: The Commission for Health Improvement (CHI) has power to undertake special investigations into particular areas of concern in the delivery of health care. The Commission considers all such requests against six guiding principles which are set out in its, Policy on assessing requests for investigations and fast track clinical governance reviews, copies of which are available in the Library and on its website at These principles include situations where there has been an incident of great severity, where there is evidence of repeated service failure and where action by CHI could result in lessons for the whole of the National Health Service.

Waiting Lists

Mr. Laws: To ask the Secretary of State for Health how many patients have been waiting more than (a) three (b) six (c) nine (d) 12 (e) 18 and (f) 24 months between (i) referral by a GP for a diagnostic test and (ii) referral by a consultant for a diagnostic test; and if he will make a statement. [75989]

Mr. Hutton: Information is not collected centrally on the number of patients waiting for diagnostic tests. The length of time that a patient may have to wait for any diagnostic test is dependent on their clinical condition.

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Emergency cases need to be seen immediately. Other cases will be carried out as quickly as possible, however this is dependent on the clinical priority of all remaining patients waiting to have diagnostic tests.

The NHS Cancer Plan set new targets to shorten the time patients have to wait for diagnosis and treatment. The first step in reducing cancer waiting times was the introduction of the two week waiting time standard form urgent general practitioner referral to outpatient appointment for cases of suspected breast cancer from April 1999. The two week standard was extended to all other urgent cases of suspected cancer during 2000. By 2005 there will be a maximum two month wait from urgent general practitioner referral to treatment for all cancers.

We are making unprecedented investment in the provision of new and replacement diagnostic equipment, improving the recruitment and retention of staff and streamlining the way care is delivered through the cancer services collaborative.

Mr. Laws: To ask the Secretary of State for Health if he will publish guidance from his Department to NHS trusts and health authorities on the speed of processing of patients onto (a) inpatient and (b) outpatient waiting lists following (i) GP and (ii) consultant referral; and if he will make a statement. [76288]

Mr. Hutton: All guidance to the National Health Service is published in the NHS data dictionary/manual. This covers the relevant information on when a patient should appear on a waiting list and how a waiting time should be recorded.

Patients are added to the inpatient elective admission list at the time there is a decision to admit the patient and the waiting time is calculated from that date. For first outpatient appointments the waiting time is calculated from the date the NHS trust receives the referral, except where a patient as been referred under the urgent cancer referral route, then the waiting time is calculated from the date the general practitioner decided to refer.

Mr. Laws: To ask the Secretary of State for Health whether endoscopy tests are included in the waiting list figures for (a) inpatients and (b) outpatients; what guidance has been issued to hospital trusts and health authorities about exclusion of endoscopies from waiting list statistics over the last five years; and if he will make a statement. [75985]

Mr. Hutton: Data on waiting times for consultant led inpatient elective admissions and consultant led first outpatient appointments, following a general practitioner referral, are collected on the consultant's main specialty not by procedure. Endoscopies can be recorded as either inpatients or outpatients depending on the setting in which the endoscope takes place. Guidance to this effect is available on the Department's web-site, at

Mr. Laws: To ask the Secretary of State for Health if he will list, for each English health authority and trust, the number of patients who have been waiting for more than six months to see a consultant, after having been referred by a consultant; and if he will make a statement. [75846]

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Mr. Hutton [holding answer 23 October 2002]: Data on consultant to consultant referrals are not centrally collected. Data on first general practitioner referrals to consultants are collected and published on the Department's website at

Mr. Laws: To ask the Secretary of State for Health if he will make a statement on the length of the waiting lists for neurophysiology treatment in English hospitals. [75734]

Mr. Hutton [holding answer 23 October 2002]: The outpatient target, to have no over 26 week waiters following first outpatient appointment from a general practitioner referral by March 2002, was achieved for the specialty clinical neuro-physiology.

In 2002–3 the National Health Service is working to reduce maximum waiting times for first outpatient appointments from a GP referral from 26 weeks to 21 weeks.

Mr. Laws: To ask the Secretary of State for Health how many people were waiting more than (a) six months and (b) 12 months as (i) in-patients and (ii) out-patients in England as at (A) 31 March 1997 and (B) the latest date for which information is available; and if he will make a statement. [75847]

Mr. Hutton [holding answer 23 October 2002]: The tables below show the number of patients still waiting for elective admission and a consultant outpatient appointment by length of time waiting at 31 March 1997 and the latest available date. Data are not collected on patients waiting over 12 months for a consultant outpatient appointment.

Patients Waiting for Elective Admission: England
(Responsible population based)

Patients waiting
Month endover 6 monthsover 12 months


Department of Health form QF01

Patients Waiting for First Consultant Outpatient Appointment Following GP Referral: NHS Trusts in England

Month endPatients waiting over 26 weeks


Department of Health form QM08

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