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Mr. Davey: To ask the Secretary of State for Health if she will make a statement on progress in reviewing the scans carried out by Alliance Medical. 
Mr. Ivan Lewis: Scan quality is independently audited every six months by the clinical guardian of the contract, Professor Adrian Dixon, national health service sponsors and Alliance Medical Ltds head of clinical governance. In addition, two audits have been produced by the Royal College of Radiologists in conjunction with the Department. The audits are available at the Royal College of Radiologists website at:
The second audit, which was published in April 2006, again found that there was little overall difference in the clinical opinion between independent service provider (Alliance Medical Ltd) and the NHS reports and, that there was little overall difference in the technical quality of the magnetic resonance examinations between the two services overall.
Quality is monitored consistently throughout the contract as an integral part of the clinical governance framework. Any discrepancies or concerns are audited on a case by case basis by the clinical guardian of the contract.
Mr. Carswell: To ask the Secretary of State for Health what estimate she has made of the likely effect on costs to (a) local authority social services and (b) the NHS of caring for patients with mild Alzheimers disease of the National Institute for Health and Clinical Excellences proposal to restrict treatment for such patients. 
Mr. Ivan Lewis: No such estimate has been made. The National Institute for Health and Clinical Excellence (NICE) appraisal of these drugs has not yet concluded. Until NICE issues revised guidance to the national health service, its original guidance issued in 2001 continues to apply.
Mr. Stephen O'Brien: To ask the Secretary of State for Health if she will take steps to ensure that voluntary, private and public providers of care receive the same levels of fee and remuneration for publicly-funded care places. 
Mr. Ivan Lewis: The principles for contracting for care services set out in Building Capacity and Partnerships in Care include fairness to all service providers and the encouragement of fair competition.
Rosie Cooper: To ask the Secretary of State for Health (1) how many people employed in the care of elderly and vulnerable people in West Lancashire have subsequently been found to have criminal records and to be unsuitable for such employment; and what steps she has taken to remedy this situation; 
(2) what steps her Department takes to ensure that private companies providing care in West Lancashire for (a) the elderly and (b) vulnerable adults ensure that all their employees are checked by the Criminal Records Bureau before commencing employment. 
Mr. Ivan Lewis: I understand from the Criminal Records Bureau that figures for people with criminal records found to be unsuitable for employment in the care of elderly and vulnerable people specifically in West Lancashire are not available.
All care homes, domiciliary care agencies, adult placements schemes and nurses agencies in England are regulated by the Commission for Social Care Inspection (CSCI), which is the independent regulator for social care. The CSCI is responsible for registering and inspecting the regulated social care sector in accordance with statutory regulations and national minimum standards to ensure consistency and improve the quality of life and level of protection for the most vulnerable people in society.
Regulated social care providers are required to conduct rigorous pre-employment checks on prospective staff including obtaining a Criminal Records Bureau Disclosure. Since 26 July 2004, there has also been a requirement for prospective employees in these areas to be checked against the protection of vulnerable adults list before starting work.
Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer to the hon. Member for Portsmouth, South (Mr. Hancock) of 20 March 2006, Official Report, column 175W, on section 64, when the central budget review will be completed. 
Mr. Ivan Lewis: The central budget review for 2006-07 was completed at the end of April 2006. Final central budget allocations were issued to directors at the start of June. The allocations have been subject to minor reductions to cover a small number of pressures that were considered inescapable.
Mr. Gray: To ask the Secretary of State for Health how many (a) letters and (b) other representations her Department has received on Chippenham community hospital. 
Mr. Ivan Lewis: Due to the way data is collected, the Department is unable to provide the number of letters received in relation to Chippenham community hospital.
Mr. Walter: To ask the Secretary of State for Health how many dental laboratories there were in (a) England and (b) North Dorset in December 2005; and what estimate she has made of the number of dental laboratories which have closed in each area since this date. 
Ms Rosie Winterton: Between December 2005 and July 2006, the number of dental laboratories registered under the medical devices directive in the United Kingdom increased from 3,090 to 3,104. We do not have any more detailed information on numbers of laboratories, as dental laboratories are private enterprises with which the national health service has no contractual relationship.
Mr. Greg Knight: To ask the Secretary of State for Health what assessment she has made of the relative (a) efficiency and (b) effectiveness of (i) naltraczone, (ii) Subutex and (iii) methadone in treating drug addiction; whether such drugs are to be made more widely available; and if she will make a statement. 
Caroline Flint: The Department recognises the key role that effective pharmacotherapies, including substitute opiate prescribing and medications such as naltrexone to assist relapse prevention, may play in the management of opiate dependence. The Department published its evidence-based Clinical Guidelines, Drug misuse and dependenceguidelines on clinical management, in 1999, on the advice of an independent expert group and in conjunction with relevant professional bodies. The 1999 Clinical Guidelines address the use of methadone, buprenorphine (more recently with a marketing authorisation for use as Subutex) and naltrexone. The guidelines discusses the relative effectiveness of buprenorphine and methadone, but as naltrexone is licensed only for use to support relapse prevention, no direct comparison is feasible with the opiate substitute methadone and buprenorphine. The guidelines do support the use of all these drugs as potentially effective opiate misuse treatments when used appropriately. The Departments clinical guidelines are due to be updated in 2006-07 and this will take into account-planned guidance on the use of all these drugs due to be published in 2007 by the National Institute for Health and Clinical Excellence (NICE).
The Department of Health has asked NICE, within a package of work that they will be undertaking on drug treatment, to carry out a technology appraisal on oral methadone and sublingual buprenorphine as opiate substitute treatments. This appraisal will evaluate the clinical effectiveness and cost-effectiveness of these drugs as substitute opiates for the management of opiate misusers. The Department also asked at the same time for a similar technology appraisal for naltrexone as a treatment for relapse prevention for opiate misuse. This will include appraisal of its clinical effectiveness and cost-effectiveness. Both these technology appraisals are scheduled for publication in March 2007.
All three of these drugs are currently prescribed for management of opiate dependence. Given that the NHS are obliged to implement guidance produced by NICE, the outcome of their work on drug treatment will be an important support in enhancing the effectiveness of drug treatment and in particular substitute prescribing.
Mr. Vara: To ask the Secretary of State for Health what progress has been made in combating the spread of MRSA in hospitals. 
Andy Burnham [holding answer 5 July 2006]: Combating meticillin-resistant Staphylococcus aureus (MRSA) and other health care associated infections (HCAIs), continues to be a priority for Government. A target, to reduce the number of MRSA bloodstream infections by half by April 2008 is in place and each trust has its own target. The total number of these infections in 2004-05 was 7,212, compared with 7,684 in 2003-04. Figures for 2005-06 will be published later this month.
acute trusts have signed up to a Saving Lives package
of best practice measures. The Department continues to engage those
trusts facing the most
significant challenges and it will seek to work with trusts most likely to benefit from support tailored to their organisational needs. Additionally, the Health Act, which received Royal Assent on 19 July, intends through the new code of practice, to give a statutory footing to what is already accepted as best practicethus driving-up standards of hygiene and infection control.
Mr. Oaten: To ask the Secretary of State for Health (1) what plans she has to introduce a preventative programme to reduce the prevalence of leg ulcers; and if she will make a statement; 
Mr. Ivan Lewis: The most common cause of leg ulcers is poor circulation triggered by high blood pressure, diabetes, and coronary heart disease. Obesity and smoking are also known to increase the risk of leg ulcers.
The Departments preventive programme is aimed at the effective management of these underlying medical conditions through the quality and outcomes framework component of the new general medical services contract for general practices introduced in April 2004, as well as public health campaigns to raise awareness of the health risks associated with smoking and clinical obesity.
Mr. Amess: To ask the Secretary of State for Health what steps she plans to take to ensure that primary care trusts continue to provide specialist myalgic encephalomyelitis and encephalopathy services after their reconfiguration in October 2006; and if she will make a statement. 
Mr. Ivan Lewis: We have no plans to address specifically the provision of services for those living with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) during the forthcoming reconfiguration of primary care trusts (PCTs).
The reconfigured PCTs will be expected to provide the same level of health and social care provision as existing trusts. PCTs have the freedom to decide how best to provide health and social care for those with CFS/ME, either in existing services or in a specialist centre.
Mr. Harper: To ask the Secretary of State for Health which health service facilities in the geographical area covered by the new strategic health authority for the South West (a) she and (b) her Ministers plan to visit; and when. 
Mr. Ivan Lewis: My right hon. Friend the Secretary of State for Health plans to visit the geographical area covered by the new strategic health authority for the South West on 25 July 2006. She will visit a number of health facilities (yet to be confirmed) in Shepton Mallet, Cirencester and Bath. The Parliamentary Under-Secretary of State for Care Services will also visit the area in September although specific details are yet to be arranged.
Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 16 June 2006, Official Report, column 1558W, on the National Programme for Information Technology, what the total level of savings are which have been achieved by NHS organisations where national programme systems and services have been delivered ahead of time; and in which NHS organisations these savings were achieved. 
Caroline Flint: Comprehensive information of the kind requested is not collected centrally. However, the most obvious example of savings of the kind described is when new systems, paid for under the programme, have replaced systems that local national health service bodies have previously been paying for. Across the whole of the NHS, and over the 10-year life of the national programme, these savings will be very substantial. In the case of the local service provider contracts, local savings are expected to offset nearly half the local costs over the lives of the contracts; a saving of some £2.5 billion.
In the case of picture archiving and communications (PACS) systems, local savings are expected fully to offset the local costs of £684 million. Smaller savings are also expected in other areas, for example, where local NHS bodies use N3 or NHSmail to replace services for which they are currently paying. The business case for NHSmail estimated such savings at £185 million.
Mr. Clifton-Brown: To ask the Secretary of State for Health what the outcome was of capital spending against budget for (a) Avon, Wiltshire and Gloucestershire strategic health authority and (b) the Cotswold and Vale primary care trust for each of the last five years. 
Mr. Ivan Lewis: The information requested is shown in the table for the years that the organisations have been in existence, 2004-05 is the latest year for which information is available.
1. Audited summarisation forms of the Avon, Wiltshire and
Gloucestershire SHA. 2. Audited summarisation schedules of
Cotswold and Vale
Mr. Stephen O'Brien: To ask the Secretary of State for Health what assessment she has made of the efficiency of the roll-out of the NHS IT programme to genito-urinary medicine clinics; what representations she has received on this matter; and what response she has given. 
Caroline Flint: National and local systems and services continue to be rolled out across the country in ever-increasing numbers, and every national health service location has already benefited under the national programme from delivery of software, hardware or the broadband connections that enables these to be accessed. We are on track to complete the national programme, as planned, by 2010.
In parallel with the deployment of national systems, thousands of local systems have now been delivered and serve more than 240,000 users. This includes many acute sector departmental systems supporting clinical specialties, though no systems designed specifically to support genito-urinary medicine (GUM) clinics, or other sexual health services, have yet gone live. We are not aware of any representations specifically on this matter. However, the programme's national Do Once and Share project, under the directorship of Professor Muir Gray, has engaged GUM and other sexual health clinicians, and consulted them on their future IM and T needs. The results are being shared nationally with the support of the IM and T group of the British Association of Sexual Health and HIV.
We recognise that
it is of enormous importance that systems and services delivered
through the national programme should guarantee the very particular
information security and confidentiality requirements of patients
accessing GUM and sexual health services. Stringent security controls
and safeguards have been incorporated to prevent unrestricted or
uncontrolled access to personal information. Access is controlled via
a unique user identity, involving a pass-code and smart card, which can only be obtained on verification of identity and through a formal user registration process.
John Austin: To ask the Secretary of State for Health (1) what proportion of (a) hospital trusts, (b) primary care trusts, (c) general practitioner services and (d) intermediate care services have undertaken medicine utilisation reviews or other medicine review initiatives to ensure patients suffering from osteoporosis are prescribed the most appropriate medicine type and dosage; 
Mr. Ivan Lewis: The Department has not assessed the merits of nurse-led fracture services to support people living with osteoporosis.
The content of the Life Check assessments at each life stage is yet to be determined and agreed, but will include the major lifestyle risk factors relevant to each life stage, such as smoking, physical activity and diet.
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