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Mike Penning: To ask the Secretary of State for Health what recent research he has (a) commissioned and (b) evaluated on changes in acute care in Hemel Hempstead and the surrounding area following the removal of acute services from Hemel Hempstead hospital. 
Phil Hope: The Department does not hold information on how many social enterprises that provide one or more national health service healthcare services have been established in each of the last three years.
Joan Walley: To ask the Secretary of State for Health what financial penalties have been imposed on Stoke-on-Trent City Council as a result of delayed discharges from hospitals in each of the last three years. 
Mr. Evans: To ask the Secretary of State for Health what assessment he has made of the effectiveness of alcohol-based hand rubs in countering (a) Clostridium difficile and (b) other healthcare-associated infections. 
Ann Keen: The Purchasing and Supply Chain undertook an assessment of the effectiveness of alcohol-based hand rubs in 2004 prior to awarding their national contract. All products supplied under the NHS contract are effective for use at the point of care in most situations. However, guidance makes it clear that liquid soap and water should be used during Clostridium difficile outbreaks as hand rubs will not eradicate Clostridium difficile spores.
Mr. Evans: To ask the Secretary of State for Health what training the NHS has provided to (a) surgeons, (b) doctors, (c) nurses and (d) other healthcare professionals on best practice in the prevention, detection and treatment of (i) Clostridium difficile and (ii) other healthcare-related infections. 
Ann Keen: Under The Health and Social Care Act 2008 Code of Practice for the NHS on the prevention and control of healthcare associated infections and related guidance, there is an obligation for national health service, bodies to ensure that all staff are suitably educated in the prevention and control of healthcare associated Infections. A copy of this code of practice has been placed in the Library.
Training is a local decision, and we do not collect the information requested. However, BMJ Learning, in association with the Department, produced an e-learning module to learn practical ways to avoid an outbreak of Clostridium difficile. This is available at
Mr. Evans: To ask the Secretary of State for Health how much his Department has spent on research into (a) vaccines against, (b) treatments for and (c) other aspects of Clostridium difficile in each of the last five years. 
Ann Keen: The Department is not directly funding research to develop vaccines for Clostridium difficile infections. However, the Health Protection Agency is working with Acambis, a UK based company, through the Departments funded National Vaccine Evaluation Consortium to support clinical trials of a vaccine against Clostridium difficile.
The Medical Research Council (MRC) is one of the main agencies through which the Government support medical and clinical research. The MRC is an independent body that receives its grant-in-aid from the Department for Innovation, Universities and Skills.
|Expenditure (£ million)|
Understanding the relationship between bacteriophages and pathogenicity in the gut pathogen Clostridium difficile, led by Dr. M Clokie at the university of Leicester (awarded £350,000);
Structural and functional characterisation of cell wall proteins of Clostridium difficile, led by Professor R Titball at Imperial College of Science Technology and Medicine (awarded £1.4 million);
The I-STRAT trial: Do Isolation Strategies reduce endemic levels of Methicillin-resistant Staphylococcus aureus and Clostridium difficile associated diarrhoea, led by Dr. S Stone at University College London (awarded £420,000); and
Understanding the molecular basis of virulence in Clostridium difficile, led by Professor N Minton at the university of Nottingham (awarded £1.6 million).
The Departments policy research programme is currently supporting a research project on the environmental survival and antimicrobial resistance of pathogens (including Clostridium difficile) in hospitals. Expenditure on the project in 2007-08 was £15,000.
Mr. Evans: To ask the Secretary of State for Health how much his Department has spent on campaigns to raise public awareness of (a) Clostridium difficile and (b) other healthcare-associated infections in each of the last five years. 
Ann Keen: The National Patient Safety Agency has run the Cleanyourhands campaign focussed on hand hygiene in hospitals since 2004, broadening its focus in 2008 to primary care ambulance and mental health trusts. Currently over 90 per cent. of national health service trusts are signed up to the campaign. In addition, the Department has run a campaign on antibiotic awareness and participated in European antibiotic awareness days. The correct use of antibiotics and hand hygiene represent two important areas in tackling Clostridium difficile and other health care associated infections.
Mr. Evans: To ask the Secretary of State for Health what information is available to NHS patients and their families on the (a) prevention and (b) detection of (i) Clostridium difficile and (ii) other healthcare-associated infections. 
Ann Keen: The national health service, in order to meet its legal requirements under The Code of Practice of the Prevention and Control of Healthcare Associated Infections (HCAI) must provide suitable and sufficient information on HCAI to the patient, the public and other service providers when patients move to the care of another health care or social care provider.
Damian Green: To ask the Secretary of State for Health whether the licence fee structure of the Human Tissue Authority effects (a) full recovery and (b) more than full recovery of the costs of granting a licence. 
Mr. Bradshaw: The licence fee structure of the Human Tissue Authority covers the full cost of licensing only. This includes the evaluation of the licence application to assess the level of compliance and risk, the provision of advice and guidance, the management of conditions and variations in respect of each licence (of which there are 800), and site visit inspections.
Damian Green: To ask the Secretary of State for Health if he will publish the guidelines for including acellular material under the licence fee structure of the Human Tissue Authority; and if he will make a statement. 
Mr. Bradshaw: The Human Tissue Authority (HTA) has recently issued a position statement on regulating acellular material, which is available on its website at: www.hta.gov.uk
Dawn Primarolo: The seasonal influenza programme is a targeted vaccination campaign. The Department recommends that all people aged 65 and over and people aged under 65 years who are in clinical at-risk groups receive the annual influenza vaccine. The uptake information for England is shown in the following table:
|Uptake 2006-07||Uptake 2007-08||Uptake 2008-09|
Mr. Bradshaw: The Department do not currently hold figures for the number of people with learning disabilities employed in its workforce. This information will start to be collected later this year when learning disability will be introduced as a workforce monitoring category.
The New Opportunities White Paper published in January commits the civil service to producing action plans to employ more people with learning disabilities and from the other groups covered by public service agreement 16 about socially excluded adults (PSA 16). The Cabinet Office is working with Government Departments, including the Department, to help them develop their action based on recognised good practice.
Mr. Moss: To ask the Secretary of State for Health what measures he intends to adopt to ensure that local authorities in the Spearhead Group considered not to be on track to reach the 2010 target of reducing the gap in life expectancy compared with the population as a whole by 10 per cent. are able to meet their target. 
Mr. Bradshaw: Health inequalities are a key priority for the national health service as set out in the NHS Operating Framework 2009-10 and all primary care trusts (PCTs) are required to have plans that add up to a narrowing of the life expectancy gap. Incentives for the NHS and local authorities have been aligned with the same health inequalities indicators in both the NHS Operating Framework 2009-10 and the New Performance Framework for Local Authorities and Local Authority Partnerships: Single Set of National Indicators. PCT performance against health inequalities plan is managed through strategic health authorities.
The Department is working to provide local partners with the support and tools they need to tackle health inequalities effectively and meet the 2010 National Target. This includes establishing a range of national support teams (NSTs) with an inequalities focus, providing tailored, intensive, assistance to areas that face the biggest challenges in delivering public health-related Public Service Agreement targets. The NSTs which have a particular role in supporting the inequalities targets are:
Health Inequalities NST;
Infant Mortality NST;
Tobacco Control NST; and
Teenage Pregnancy NST.
In addition, the Department is funding the Improvement Foundation to deliver a Healthy Communities Collaborative programme to promote earlier presentations of cardiovascular disease and cancer symptoms in Spearhead areas. In addition, the Department has continued or expanded support for communities to tackle inequalities such as the Improvement and Development Agencys Healthy Communities and Communities for Health programmes.
Health Inequalities Intervention Tool;
Health Poverty Index;
Local authority Health Profiles; and
Health Equity Audit.
Mr. Moss: To ask the Secretary of State for Health what assessment he has made of the causes of excess deaths within the Spearhead Group of local authorities considered off track from reaching their 2010 target of reducing the gap in life expectancy compared with the population as a whole by 10 per cent. 
Phil Hope: National level analysis of the life expectancy gap by the Department shows circulatory disease, cancer and respiratory disease account for around two thirds of the gap in men and women. Other drivers of the gap are digestive diseases, external causes of injury and poisoning, infections and parasitic diseases and deaths under 28 days. Further information is contained in Tackling Health Inequalities: 2005-07 Policy and Data Update for the 2010 National Target, which has already been placed in the Library.
The relative contribution of specific causes varies from one Spearhead to another. The Health Inequalities Intervention Tool for Spearhead Areas, jointly developed by the Association of Public Health Observatories and the Department provides a breakdown of the causes of the life expectancy gap by disease type and age in each Spearhead local authority.
Mr. Stephen O'Brien: To ask the Secretary of State for Health how many deaths were caused by malnutrition among those in each age group over 65 years in each region in the last 10 years; and if he will make a statement. 
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