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Mr. Amess: To ask the Secretary of State for Health what steps (a) he has taken in each year since 1997 and (b) plans to take in each of the next three years to reduce the incidence of liver disease; what discussions (i) he, (ii) Ministers in his Department and (iii) officials have had since January 2007 with representatives of (A) the medical profession and (B) the brewing industry on the matter; and if he will make a statement. 
Dawn Primarolo: We are concerned about the increasing incidence ofand mortality fromliver disease. Since 1997, we have taken important action on a number of fronts to combat the primary causes of liver disease, namely alcohol misuse, viral hepatitis and obesity.
In 2004, the Government published the first ever cross-Government alcohol strategy. The Governments renewed alcohol strategy, Safe. Sensible. Socialthe next steps in the National Alcohol Strategy, published in June 2007, builds on this and focuses on 18-24 year-old binge drinkers, young people under 18 who drink alcohol and harmful drinkers.
In 2007, the Department negotiated a ground breaking agreement with the drinks industry and by the end of this year we expect the majority of alcoholic drink labels to include alcohol unit information.
As part of the recent spending review, the Chancellor of the Exchequer announced that a new national priority for the national health service would be to reduce the rate of hospital admissions for alcohol related conditions. This is expected to encourage earlier identification of, and intervention for, people who drink too much, linked to advice and support from general practitioners or hospitalsshown to be the best way of reducing the kind of everyday drinking which, over time, can lead to liver disease and other problems.
The Government will shortly be embarking on a £10 million advertising campaign on alcohol and healththe biggest ever. This will focus on daily drinking guidelines, so that people are better able to estimate how much they are drinking.
We have in place a range of measures to prevent and control Hepatitis B and C, which can cause serious liver disease. For example, the Hepatitis C Action Plan for England, launched in 2004, sets out a framework of action to improve the prevention, diagnosis and treatment of hepatitis C, and is supported by a centrally funded awareness campaign.
Evidence shows a direct link between obesity and fatty liver disease. Reducing obesity across the population is a key Government priority. Action to tackle obesity in both adults and children will be taken forward through the new cross-Government obesity strategy.
In addition, we are considering the possibility of developing a strategy for liver disease, which would cover health promotion as well as the full range of health services. Decisions will be informed by preliminary work undertaken in 2007, which has included a series of informal meetings with members of the medical profession and other stakeholders.
I recently met with Professor Ian Gilmore, president of the Royal College of Physicians, to discuss tackling alcohol related harm. Since January 2007, Ministers and officials have also met with the Food and Drink Federation, Alcohol Concern, the Wine and Spirits Trade Association, British retail Consortium and other representatives of the alcohol industry.
Mr. Dismore: To ask the Secretary of State for Health what progress has been made by the National Institute for Health and Clinical Excellence on decisions relating to treatment for macular degeneration. 
Ann Keen: The National Institute for Health and Clinical Excellence (NICE) has published a second Appraisal Consultation Document (ACD) on Lucentis (ranibizumab) and Macugen (pegaptanib) for the treatment of wet age-related macular degeneration. Stakeholders had until 14 January 2008 to provide comments on the ACD and these comments will be considered by NICEs Appraisal Committee before the guidance is finalised. NICE expects to publish its final guidance later in 2008.
Mr. Burrowes: To ask the Secretary of State for Health (1) what steps have been taken to increase provision of mental health in-reach teams in prison for those with mental illnesses which are not severe or enduring; 
In addition, this year an additional allocation of £2.5 million was made to further develop mental health services within male and female local prisons in line with guidance set out in the Offender Mental Health Care Pathway, published in 2005 by the Department.
Dawn Primarolo: The National Institute for Health and Clinical Excellence (NICE) is currently appraising sunitinib (Sutent) along with three other drugs, bevacizumab, sorafenib and temsirolimus, for renal cell carcinoma. We understand that subject to appeals, NICE expects to publish final guidance to the NHS in early 2009. Further information on this appraisal can be found on NICEs website at:
Dr. Richard Taylor: To ask the Secretary of State for Health how many complaints about care in the national health service are under investigation by the Healthcare Commission; and what the average length of time between the start of an investigation and the publication of a report on it has been in the last 12 months. 
Mr. Bradshaw: As at 17 January 2008, the Healthcare Commission had 1,795 open independent reviews about national health service care. This compares with approximately 4,000 at the same time in 2007. At the end of December 2007, the average length of time for independent reviews was less than four months; this compares with 7.2 months at the end of December 2006.
Mr. Lansley: To ask the Secretary of State for Health if he will place in the Library a copy of the guidance he has issued to the NHS on procedures for induction and training on infection prevention and control for staff. 
Ann Keen: There is a statutory obligation for all national health service organisations under the code of practice for the prevention and control of healthcare associated infections, to ensure that all staff are suitably educated in the prevention and control of healthcare associated infections. In addition, the Knowledge and Skills Framework includes health, safety and security as a core aspect of all jobs under Agenda for Change. The Knowledge and Skills Framework makes clear that it is vital that each member of staff takes responsibility for promoting the health, safety and security of patients, clients, the public, colleagues and themselves. This would include reducing the risks of healthcare associated infections.
Skills for Health has developed competence frameworks and national occupational standards for healthcare staff in all sectors of the workforce. These include competencies and national occupational standards in infection prevention and control. More information on this can be found on the Skills for Health website at:
The Department is currently working together with partners in the Social Partnership forum, such as trade unions and employers, to develop and implement workforce policies in relation to tackling healthcare associated infections. This will include producing a guide this year for local employers on how Human Resources processes such as training, induction and
disciplinary action can be best used to encourage good practice in infection control.
In addition, the Department is working with undergraduate and postgraduate deans, the General Medical Council, the Medical Royal Colleges and the Nursing and Midwifery Council to ensure that training in infection prevention and control is embedded at all stages of medical and nurse training.
the NHS Infection Control programme, a free online resource funded designed to increase understanding of infection control practice in clinical and non-clinical staff this is available at: www.infectioncontrol.nhs.uk;
the National Resource for Infection Control, a one-stop shop for infection control guidance which is available at: www.nric.org.uk; and
online training for doctors on methicillin resistant Staphylococcus aureus and Clostridium difficile which is available at: www.doctors.net.uk.
Anne Milton: To ask the Secretary of State for Health what representations he has received from manufacturers of medical consumables on the classification of their products by his Department; what steps he plans to take in response; and if he will make a statement. 
Mr. Bradshaw: Following publication of Arrangements under the Part IX of the Drug Tariff for the provision of stoma and incontinence appliances and related services to Primary Care revised proposals on 6 September 2007, the Department received a number of representations that indicated that some errors highlighted in the item classification table in the November 2006 consultation had not been corrected in the latest published consultation document.
Mr. Hoban: To ask the Secretary of State for Health (1) what public funds in addition to those announced in the 2007 Spending Review have been allocated to the (a) programme of preventative care, (b) checks in GP surgeries and (c) screening programme announced by the Prime Minister on 7 January 2008; 
Mr. Bradshaw: Information is collected on the cash receipts from the sale of NHS capital assets in annual audited summarisation schedules. Information is not available on the sale of assets which have not been capitalised. The following table includes sales by health authorities, strategic health authorities, primary care trusts and national health service trusts in London from 1 April 2000 to 31 March 2007 by financial year. Receipts include sales to other NHS organisations as well as to the private sector. Information is not held prior to 2000 by individual NHS bodies therefore 2000-01 is the earliest year which can be provided.
|Receipts from the sale of NHS capital assets in London|
|Receipts from all capital assets (£000)|
Mr. Lansley: To ask the Secretary of State for Health pursuant to paragraph 21, page 67 of his Departments resource accounts for 2006-07, on what basis his Department calculated the periods over which clinical negligence provisions are expected to be payable. 
Ann Keen: All clinical negligence claims are managed and accounted for by the NHS Litigation Authority. In arriving at its valuation of provisions when constructing its own annual accounts the authority effectively reviews the value of individual reported claims against the national health service.
This review is part of the continuous legal process adopted by the authority and includes an assessment of the likely timing of settlement of each claim, ie the point at which any damages payable are likely to be agreed along with associated third party costs. For claims not yet reported but where the negligent incident is considered to have already occurred the authority makes a global incurred but not reported (IBNR) provision in its accounts. This IBNR provision is an actuarially assessed value based upon extensive data, held by the authority, relating to the level of reporting of negligent incidents within the English NHS.
Essentially the authority then combines the individual claims data for all known claims with the global IBNR calculation in order to arrive at a forecast regarding the future timing and value of the settlement
of claims against the NHS and it is these results which are reported within paragraph 21 on page 67.
Mr. Lansley: To ask the Secretary of State for Health pursuant to paragraph 21, page 67 of his Departments resource accounts for 2006-07, for what reason provision for clinical negligence was increased during 2006-07. 
Ann Keen: The reporting of clinical negligence provisions referred to in paragraph 21 are essentially data reported from the activities of the NHS Litigation Authority. There are several reasons for the increases in value of clinical negligence provisions in any given financial period and during 2006-07 the main ones were:
the value of new claims reported to the authority where the negligent treatment had been delivered in the same financial period, ie where a patient has brought a claim for negligence in the same financial year that they allege negligent treatment. (Claims reported in 2006-07 where the negligent treatment was in an earlier financial year would already have been provided for in the accounts of the authority as incurred but not reported (IBNR));
where the value of existing claims has required alteration due to improved or further knowledge regarding the individual claim, eg where the courts have established new values for specific heads of damage or where original valuations excluded damage which is subsequently agreed to be relevant through the litigation process; and
actuarial review of IBNR suggests that forecast values of claims to be reported in the future require amendment, for example because claim reporting patterns appear to suggest more claims than originally forecast are being reported for a particular financial period or periods.
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