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Dr. Kumar: To ask the Secretary of State for Health what guidance his Department gives general practitioners and accident and emergency departments on recognising the different symptoms of heart attacks demonstrated by men and women. 
Ann Keen: As women continue to live longer than men, more of them are presenting with heart disease. It is important that health services recognise this, and ensure that men and women alike receive treatment in line with best practice.
The National Service Framework (NSF) for Coronary Heart Disease (CHD), published in 2000, sets out national standards for treatment of CHD. The NSF includes information about the way in which rates of CHD vary according to social circumstances, gender and ethnicity. One of the objectives in publishing the NSF was to bring these variations to the attention of the health service in order to reduce undesirable variations and inconsistencies in service delivery and access, and to improve the overall quality of care for CHD.
To ask the Secretary of State for Health what representations have been received by (a) the National Commissioning Group and (b) other
competent bodies on assessing the potential use of beating heart transplant technology in transplant units; what the outcomes have been of assessments undertaken by those bodies; what the reasons are for decisions that may have been reached; and if he will make a statement. 
Ann Keen: The National Commissioning Group has received no representation on assessing the potential use of beating heart technology but is aware that both Papworth and Harefield hospitals participated in a European study of the organ care system; the results of which have not yet been published in a peer-reviewed journal.
Mike Penning: To ask the Secretary of State for Health what response he has made to the report by the Healthcare Commission on Intervention at Papworth Hospital NHS Foundation Trust and its recommendations on reducing ischaemic time; whether he has assessed the merits of using beating heart transplant technology in the UK's transplant units; and if he will make a statement. 
Ann Keen: Heart transplantation operations are inherently high risk and services need to be actively monitored and practice reviewed to assure the quality and the safety of patients. Papworth hospital has resumed heart transplantation after the Healthcare Commission said that quality of care at the hospital was good and the Trust agreed to implement a number of recommendations to improve some aspects of practice in line with the best standards. We are aware that Papworth hospital has participated in a European study looking at the merits of using beating heart technology but that results have not yet been published in a peer-reviewed journal.
Mike Penning: To ask the Secretary of State for Health (1) what assessment he has made of research on the correlation between ischaemia time and 30 day mortality rates after heart transplantation; and if he will make a statement; 
(2) whether he has reviewed all commercially-available medical technologies and assessed their ability to reduce ischaemic injury to donor organs for use in organ transplantation; and if he will make a statement; 
(3) what estimate he has made of the 30 day survival rate for heart transplant patients who received a beating heart transplant using the organ care system at Papworth and Harefield hospitals; and if he will make a statement; 
(4) if he will make an assessment of the likely effect on survival rates in heart transplantation of the use of the organ care system/beating heart transplant technology in all the UK's transplant units; and if he will make a statement; 
(5) if he will make an assessment of the likely effect on the number of donor organs in heart transplantation of the use of the organ care system/beating heart transplant technology in all the UK's transplant units; and if he will make a statement. 
Ann Keen: A European study of the use of the organ care system has been carried out in 20 patients including seven at Papworth hospital and one at Harefield hospital. We understand that the study was not a randomised controlled trial and had no comparison group. The results were presented at 2007 meeting of the International Society for Heart and Lung Transplantation but have yet to be published in a peer-reviewed journal. This presentation stated that there were no deaths within 30 days of transplantation in the 20 patients in the study. We have not made an assessment of the merits of using the organ care system in United Kingdom transplant units but understand that the Food and Drug Administration has given approval of a research study at five named centres in the United States of America to evaluate the safety and performance of the organ care system in heart transplantation. This study will start in 2008 and may provide relevant evidence for the future. The International Society for Heart and Lung Transplantation publishes figures for survival at one year following heart transplant according to different ischaemic times.
Mike Penning: To ask the Secretary of State for Health whether (a) he and (b) other Ministers in his Department have discussed the clinical merits of beating heart transplant technology with the Clinical Director of Transplant Services at Papworth Hospital; and if he will make a statement. 
Ann Keen: Information is not available in the format requested. However, the information is collected at trust level. The following table shows information on how many cases of methicillin resistant Staphylococcus aureus (MRSA) bloodstream infections and Clostridium difficile infection from the mandatory surveillance scheme run by the Health Protection Agency (HPA). Data are only available from 2001.
|April to March each year||Number of (MRSA) bloodstream infection reports at the Hillingdon hospital NHS trust|
|Number of C. difficile reports for patients aged 65 years and over at the Hillingdon hospital NHS Trust|
Health Protection Agencyprovisional data
Mike Penning: To ask the Secretary of State for Health which the 10 most common types of hospital infection were in the last year for which figures are available; and what the incidence was in each in 1997. 
The following table gives data collected from the voluntary reporting system for 1997 and 2006 for the nine most common causes of bacteraemia(1) (bacterial bloodstream infections) and for Clostridium difficile, which is associated with diarrhoea and not the blood stream.
(1 )These organisms are associated with infections that are transmitted mainly or partly within hospitals.
Data source HPA laboratory reports (voluntary reporting system).
The increase in bacteraemias is partly due to better reporting, surveillance and testing and may also reflect a changing hospital population, with more patients who are vulnerable to infection through conditions which compromise their immune systems being treated.
Mike Penning: To ask the Secretary of State for Health (1) how many hospitals have special arrangements with local police forces to allow (a) permanent and (b) semi-permanent stationing of police officers on their grounds to deter criminal activity; 
The NHS SMS has signed a memorandum of understanding with the Association of Chief Police Officers. This encourages NHS trusts to agree a protocol with their local police to address how they can work together to deter criminal activity. Special arrangements between NHS trusts and the police are a matter for local agreement and information is not collated centrally on these agreements.
Since 2004-05, the NHS SMS has collected statistics on the number of physical assaults against NHS staff and the number of criminal sanctions against individuals who have assaulted NHS staff. Information on assaults and sanctions in relation to ambulance and hospital staff in the year 2006-07 is provided in the following table.
|NHS sector||Number of reported assaults||Number of criminal sanctions( 1)|
|(1) Figures include all criminal sanctions:|
Cautions and conditional cautions
Community rehabilitation or punishment orders
Imprisonment (including suspended sentences)
Mr. Stephen O'Brien: To ask the Secretary of State for Health for what reasons the Commercial Directorates latest consultation on reimbursement for stoma and incontinence products and services under Part IX of the Drug Tariff omits reference to four of the seven objectives originally set for the review covering fair prices for the NHS and reasonable returns for suppliers, facilitating the introduction of innovative solutions, maintaining local choice in the provision of services and keeping administration to the necessary minimum; and how performance against all the reviews objectives will be measured. 
In the current consultation document, the list of objectives is streamlined for simplicity. The Department has subsequently reiterated all of the objectives of the
review contained in Clarification Document published on 4 October, which is available on the Departments website at:
Andrew George: To ask the Secretary of State for Health what targets the Government sets for waiting times for cancer patients requiring diagnostic endoscopies; and what the average waiting time was for cancer patients awaiting diagnostic endoscopies by the Royal Cornwall Trust in the most recent period for which figures are available. 
Ann Keen: There are no specific waiting time targets for urgent endoscopies for cancer patients and endoscopy waiting times are not collected centrally. However, where a patient needs an urgent endoscopy following urgent referral by their general practitioner for suspected cancer, the whole patient pathway from referral to commencing first cancer treatment should not exceed 62 days.
Mr. Ivan Lewis: In 2001, the document Changing the Outlook: A Strategy for Developing and Modernising Mental Health Services in Prisons (2001) asked prisons to work with their local national health service partners to review the mental health needs assessments they made during 2001-01 and to develop action plans to fill any gaps in provision that may have been identified.
This process informed the development of prison mental health services, and the introduction of prison mental health in-reach teams, during the process of transferring responsibility for prison health services from HM Prison Service to the NHS.
Since 2006, all prison health services, including prison mental health services, have been fully commissioned by NHS primary care trusts (PCTs). Local health needs assessments for prison populations are now therefore a matter for PCTs.
Mr. Ivan Lewis: In England the total amount allocated specifically to primary care trusts for national health service mental health services in prisons was £1,719,000 in 2001-02; £3,685,000 in 2002-03; £9,400,000 in 2003-04; and £20,000,000 for each year since 2005-06.
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