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Mr. Dunne: To ask the Secretary of State for Health what the (a) Downs syndrome birth rate and (b) birth defect rate was for each electoral ward in Shropshire, in each year from 2000 to 2005. 
John Healey: I have been asked to reply.
As National Statistician I have been asked to reply to your recent Parliamentary Question asking what the (a) Downs Syndrome birth rate and (b) birth defect rate was for each electoral ward in Shropshire in each year from 2000 to 2005. (82401)
The Office for National Statistics (ONS) is responsible for maintaining the National Congenital Anomaly System (NCAS) notifications in England and Wales. These notifications are collected only for live and stillbirths (e.g. terminations are excluded) and are provided by NHS Trusts on a voluntary basis either directly to ONS on form SD56 or via local congenital anomaly registers that exchange data with ONS. Information on congenital anomalies is routinely published for strategic health authorities. Figures cannot be provided by electoral ward because of the risk of disclosing individuals information due to very small number of events.
Notifications of congenital anomalies, numbers and rates, in Shropshire County from 2000 to 2004 (the most recent year for which figures are available) are given in the table below.
|Congenital anomaly notifications - Down Syndrome, All babies: number and rates for Shropshire county, 2000-04|
Numbers smaller than 5 and rates based on these numbers have been
suppressed to protect confidentiality of
Mr. Lansley: To ask the Secretary of State for Health how much was spent on information technology by (a) NHS trusts and (b) primary care trusts in (i) 2002-03, (ii) 2003-04, (iii) 2004-05 and (iv) 2005-06. 
Caroline Flint: The information requested is shown in the table.
These figures, rounded to the nearest whole million pounds, comprise revenue expenditure reported through a national survey of information technology investment by national health service organisations; and capital expenditure, including information technology additions and software licences, identified in NHS accounts. They do not include expenditure by strategic health authorities, special health authorities, or central expenditure funded by the Department.
Mr. Burstow: To ask the Secretary of State for Health how many and what percentage of people (a) admitted to and (b) discharged from hospital were malnourished in the last year in which figures are available, broken down by age; and if she will make a statement. 
Caroline Flint: Information on the numbers admitted and discharged is shown in the following table.
|Count of finished in-year admission episodes and in-year discharges where the patients main diagnosis was malnutrition, national health service hospitals in England, 2004-05|
|Age||Malnutrition admissions||All admissions||Malnutrition admissions per 100,000||Malnutrition discharges||All discharges||Malnutrition discharges per 100,000|
Chris Ruane: To ask the Secretary of State for Health if she will seek to amend the rules governing confidentiality of personal information for those with severe mental health problems to ensure that specified family members may be given full disclosure of medication and treatment. 
Caroline Flint: The rules governing confidentiality of personal information distinguish between individuals who lack the capacity to meaningfully consent to, or dissent from, information being shared, and those who have this capacity. Where capacity is judged to be absent, a health professional is expected to share information with those who need to know, including family members where appropriate, where this is in the patient's best interest or where the public interest in sharing outweighs the obligation of confidentiality.
Where an individual has the capacity to consent but refuses to do so, a health professional may still disclose information where the public interest served by doing so outweighs the obligation of confidentiality. This may include, where the risk is sufficient to warrant it, the protection of the individual's health or to safeguard others.
Mr. Lansley: To ask the Secretary of State for Health for what reasons she has delayed the introduction of the NHS Care Records Service (CRS); where she expects the pilot sites to test the NHS CRS will be established; and what information will be uploaded onto the national system (a) under the NHS CRS pilots and (b) when the NHS CRS is fully enabled. 
Caroline Flint: The NHS Care Records Service (NHS CRS) is the key component of the new systems and services being delivered through the national programme for information technology. It has a number of applications, including:
personal demographics service (PDS), which holds nationally demographic information for every patient covered by the national health service in England, accessible through local systems, and is currently processing message transactions at a rate of over 9 million per month;
spine directory services, which holds reference data such as users and locations. Over 260,000 users are now registered, around 50,000 currently access the system on any given day;
access control framework, which registers and authenticates users, including patients, and provides a single log-in and a record of each professional accessing a NHS care record; and
transaction messaging system, which processes and routes data messages, for example from a GP to a hospital or from one general practitioner to another.
Introduction of the NHS CRS has not been delayed. These four elements went live on time and to budget in July 2004 to support choose and book. Among other planned applications, the first stage of the secondary uses service went live in June 2005 to support payment by results. Other core modules are scheduled for release over the course of 2006 and 2007. However, ambitious initial targets were set to drive the programme, and some individual components have been delayed.
implementation is being achieved in carefully managed stages, via
incremental rollout both geographically, and by increasing
functionality over time to build the care record. The programme is
about patient and clinician benefit and improved safety. We believe it
is best to get things right in the long term rather than to push on
regardless against a rigid
timetable and risk getting things wrong in the short term. In the context of a 10-year programme the impact of this is limited.
When fully deployed, the NHS CRS will be made up of records of individual clinicians recording episodes of care, key aspects of which will be placed in the detailed care record for sharing with others as their roles allow within local health communities, and a summary care record. The national programmes national clinical leads, working with NHS Connecting for Health, have undertaken work with a wide range of groups including the British Medical Association and the royal colleges to consider the best way of populating and launching the summary care record.
As a result, a limited amount of clinical information will be automatically uploaded, such as prescriptions and allergies. More detailed information would then be added on a case by case basis. This approach is supported by the BMA on the basis that as it takes full account of the views of patients.
Mr. Hoyle: To ask the Secretary of State for Health if she will ask the chief executive of NHS Direct to explain to the hon. Member for Chorley the reasons for the delay in replying to his letter dated 16 May. 
Ms Rosie Winterton: I have asked the chief executive of NHS Direct to write to the hon. Member for Chorley to explain the reasons for the delay in replying to his letter dated 16 May 2006 and understand a reply has been sent. I know that the chief executive of NHS Direct has also offered to meet the hon. Member and he may wish to consider whether he accepts that offer.
Steve Webb: To ask the Secretary of State for Health how many calls to NHS Direct were (a) received, (b) handled and (c) abandoned in each year since 1999-2000; and how many and what percentage of calls that were handled were redirected to other services. 
Ms Rosie Winterton [holding answer 30 March 2006]: The available information requested is shown in the table.
|NHS Direct data: calls offered, calls answered, calls abandoned and the percentage of calls redirected by NHS Direct to other parts of the national health service, including 999, accident and emergency, general practitioners, walk-in centres, dental and other professionals.|
|Calls offered||Calls answered||Calls abandoned after 30 seconds||Percentage of calls abandoned after 30 seconds||Proportion of calls redirected as a percentage of calls answered|
| Notes: 1.
Clinical sorting data was not collected at a national level prior to
January 2003. 2. Data are shown for the periods January 2003
to March 2003 and for financial years April 2003 to March
2006. 3. Data includes combined calls = 0845, out-of-hours and
other. 4. Definitions of data: Calls
offerednumber of calls offered/made, including wrong numbers
and people hanging up within 30 seconds. Calls
answerednumber of calls answered/handled after the introductory
message. Calls abandonednumber of calls abandoned
after the introductory message. Source: NHS
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