11 Jun 2012 : Column 125W

Cardiovascular System

Rosie Cooper: To ask the Secretary of State for Health what assessment he has made of the effectiveness of the Commissioning for Quality and Innovation payments scheme in improving care for patients with acute myocardial infarction. [109992]

Mr Simon Burns: No national assessment has been made of the effectiveness of the Commissioning for Quality and Innovation (CQUIN) payments scheme in improving care for patients with acute myocardial infarction.

The majority of CQUIN goals are locally agreed and commissioners can already choose to use the CQUIN framework to reward providers for ambitious improvements in improving care for patients with acute myocardial infarction.

National health service commissioners are encouraged to share their CQUIN schemes at the website of the NHS Institute for Innovation and Improvement. However, the information that is available is by no means a complete picture of CQUIN scheme activity across the NHS and would not provide sufficient information to provide a full and clear assessment of the effectiveness of CQUIN in improving care for patients with acute myocardial infarction. The website can be found at:

www.institute.nhs.uk/world_class_commissioning/pct_portal/cquin.html

Rosie Cooper: To ask the Secretary of State for Health what discussions officials in his Department have had with patient groups on the development of the Cardiovascular Disease Outcomes Strategy. [109993]

Mr Simon Burns: Representatives from patient organisations were invited to a national engagement event held on 10 May 2012. A set of regional engagement events is also under way which is including patients and patient organisations among attendees. A further event specifically dedicated to patients and carers is planned, and there will be other opportunities for organisations and individuals with an interest to feed in their views during the production of the strategy.

Chronic Fatigue Syndrome

Sir Bob Russell: To ask the Secretary of State for Health if he will publish the outcome of the National Institute for Clinical Excellence's initial consultation on the use of balloon angioplasty as a treatment for chronic cerebrospinal venous insufficiency for those with myalgic encephalomyelitis; if he will make it his policy for this treatment to be provided by the national health service; and if he will make a statement. [109328]

Paul Burstow: The National Institute for Health and Clinical (NICE) has not issued any guidance on the use of balloon angioplasty for chronic cerebrospinal venous insufficiency for patients with myalgic encephalomyelitis and there are no plans for it to develop guidance on this topic.

NICE has issued interventional procedures guidance on percutaneous venoplasty for chronic cerebrospinal venous insufficiency for multiple sclerosis which includes the use of balloon angioplasty, which is available at:

11 Jun 2012 : Column 126W

http://publications.nice.org.uk/percutaneous-venoplasty-for-chronic-cerebrbspinal-venous-insufficiency-for-multiple-sclerosis-ipg420

NICE considered that there was insufficient evidence to support the use of this procedure in the national health service and recommended that it should only be used in the context of research.

Clinical Trials

Adam Afriyie: To ask the Secretary of State for Health what plans he has to review the regulatory framework for adaptive trials in order to encourage sponsorship of adaptive trial designs. [110702]

Mr Simon Burns: The decision to adopt a particular clinical trial design is taken by the sponsor of the study and involves many considerations, one of which may be the acceptability of the study methodology for regulators. Medicines regulators are open to clinical trials with an adaptive design, and routinely endorse their use in drug development. Published guidance on clinical trials with adaptive designs in the context of submissions to regulatory authorities is available to sponsors of studies and is subject to periodic review.

Drugs: Prices

Andy Burnham: To ask the Secretary of State for Health (1) what assessment he has made of progress against his objective to introduce a new value-based system of pricing for medicines when the Pharmaceutical Price Regulation Scheme expires at the end of 2013; [110108]

(2) which patient groups or representative organisations he consulted as part of the process of developing a new value-based system of pricing for medicines. [110110]

Mr Simon Burns: The consultation, ‘A new value-based approach to the pricing of branded medicines’ ran from December 2010 to March 2011, and the Government response to the consultation was published on 18 July 2011, ‘A new value-based approach to the pricing of branded medicines: Government response to consultation’. This summarised the responses received to the consultation and set out the Government's views on the key issues raised. The response also included the names of patient groups and representative organisations that responded to the consultation. A copy has already been placed in the Library. It is also available from the Department's website at:

www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_128226

We continue to work towards the intended introduction of value-based pricing for medicines in 2014.

Electronic Cigarettes

Tracey Crouch: To ask the Secretary of State for Health (1) what assessment his Department has carried out of whether there are health risks associated with electronic cigarettes; [109647]

11 Jun 2012 : Column 127W

(2) whether his Department has issued guidance on the labelling and packaging of electronic cigarettes. [109648]

Mr Simon Burns: Electronic cigarettes are subject to the requirements of the General Product Safety Regulations 2005, which include labelling provisions.

Electronic cigarettes are not currently regulated as medicines which are required to meet appropriate standards of safety, quality and efficacy. Many such products claim to contain nicotine but the content of the products is not routinely assessed as it would be under medicines regulation.

In March 2011, the Medicines and Healthcare products Regulatory Agency (MHRA) published the outcome of a public consultation on whether to bring all nicotine containing products within the medicines licensing regime. The response to consultation suggested there was strong support for MHRA regulation. The response to consultation also highlighted the need for further information to inform a decision and the MHRA is co-ordinating further scientific and market research with a view to a final decision on the application of medicines regulation in spring 2013.

Fertility: Medical Treatments

Gareth Johnson: To ask the Secretary of State for Health what steps his Department is taking to ensure that GPs receive adequate training and support to commission infertility treatments. [109500]

Anne Milton: Infertility treatment services will be commissioned by Clinical Commissioning Groups (CCGs) with the NHS Commissioning Board providing oversight and support. This support will include the provision of supportive resources and tools on how CCGs can collaborate to commission infertility services.

Gareth Johnson: To ask the Secretary of State for Health what steps his Department is taking to monitor the cost of infertility treatment in private clinics. [109501]

Anne Milton: The cost of infertility treatment in private clinics is a matter between the clinic and the private patient. The Human Fertilisation and Embryology Act 1990 does not therefore regulate the level of charges for the provision of infertility treatments and services. Nor does the regulation of costs come within the remit for the national regulator, the Human Fertilisation and Embryology Authority (HFEA).

Although charges are a matter for the individual clinic to determine, the HFEA's Code of Practice sets out that before treatment or gametes and embryo storage services are offered, the clinic should give the person seeking these services and their partner a personalised, costed treatment plan, so the person seeking treatment services is clear on what this would cost at that clinic. The HFEA Code of Practice says:

“Before treatment, storage or both are offered, the centre should also give the person seeking treatment or storage, and their partner (if applicable) a personalised costed treatment plan.

11 Jun 2012 : Column 128W

The plan should detail the main elements of the treatment proposed (including investigations and tests), the cost of that treatment and any possible changes to the plan, including their cost implications. The centre should give patients the opportunity to discuss the plan before treatment begins”.

Fluoride: Drinking Water

Zac Goldsmith: To ask the Secretary of State for Health what his policy is on the use of industrial grade hexafluorosilicic acid in UK water fluoridation schemes. [109986]

Anne Milton: We understand that the hexafluorosilicic acid used in water fluoridation schemes in the United Kingdom is manufactured to exacting quality standards to meet European standards and approval by the Drinking Water Inspectorate.

Fraud

Mr Thomas: To ask the Secretary of State for Health what estimate he has made of the level of (a) procurement and (b) other fraud affecting his Department's spending in (i) 2010-11 and (ii) 2011-12; and if he will make a statement. [110174]

Mr Simon Burns: The Department does not make an estimate of the level of procurement and other fraud affecting departmental spend.

The Department takes the risk of procurement fraud seriously and operates an effective purchase to pay system with clear separation of duties and mandatory processes, from the raising of requisitions, receipting after satisfactory delivery and payment. All members of staff are required to comply with the Department's Standing Financial Instructions, procurement policies and the purchase to pay process, including the use of the request and receipt forms. The Department also operates a robust control and compliance process for payments made using the Government Procurement Card. This helps to deter and minimise any fraud in this area.

General Practitioners

Paul Goggins: To ask the Secretary of State for Health whether he plans to issue contracts of employment to the chairs of clinical commissioning groups; and if so when he plans to do so. [109753]

Mr Simon Burns: No. It will be for clinical commissioning groups (CCGs) to agree the contracts of employment for their staff. Each group may appoint such persons to be employees as it considers appropriate. It will pay remuneration and travelling and other allowances in accordance with determinations made by its governing body, and employ them on such other terms and conditions as it may determine. Where a chair is not an employee, it will be for the CCG to agree their remuneration and other terms and conditions, where these are not set out in regulations.

Chris Skidmore: To ask the Secretary of State for Health what the (a) average salary and (b) highest total remuneration was for GPs in (i) England and (ii) each strategic health authority region in the latest period for which figures are available. [110264]

11 Jun 2012 : Column 129W

Mr Simon Burns: The latest available average salary for general practitioners for England and by strategic health authority are published in the “GP Earnings and Expenses 2009-10 Final Report” published by the Health and Social Care Information Centre on 11 November 2011 as contained in the following table.

Average income before tax for general practitioner (GP) contractors for (1) England and (2) strategic health authorities (SHAs)
 Average income (£)

(1) England

109,400

  

(2) By strategic health authority

 

North East

105,700

North West

105,100

Yorkshire and the Humber

107,500

East Midlands

115,700

West Midlands

115,200

East of England

114,400

London

112,400

South East Coast

115,600

South Central

105,300

South West

94,800

It is not possible to determine top total remuneration for either GPs in England or individual SHAs as information is derived from a representative sample of tax data submitted by GPs. However, estimated data on GP contractors earnings at a United Kingdom level within each £10,000 earnings bracket is available in the GP Earnings and Expenses 2009-10 Final Report which has already been placed in the Library.

Chris Skidmore: To ask the Secretary of State for Health how much the NHS paid out to retired GPs as part of the NHS pension scheme in each financial year since 1997-98; and how many retired GPs received an NHS pension in each such year. [110265]

Mr Simon Burns: Data on the amount paid to retired general practitioners (GPs), and how many GPs received a national health service pension are not available.

Health Services: EU Nationals

Dr Poulter: To ask the Secretary of State for Health what estimate he has made of the likely revenue to the public purse if interest payments had been levied on other European Economic Area member states and Switzerland for outstanding health care claims under Regulation 987/2009 in each year from 1997-98 to 2009-10. [109640]

Anne Milton: The Regulations in force for the period 1997 to April 2010 did not contain a statutory deadline for payments to be made between member states or the ability to charge interest payments. Therefore, no estimate

11 Jun 2012 : Column 130W

has been made on the impact of interest charges on payments owed to the United Kingdom, or payments owed by the United Kingdom during that period.

Regulation 883/2004 and its implementing Regulation 987/2009 came into force on 1 May 2010. These Regulations introduced a statutory deadline of 18 months for payment of a valid claim to be made and the ability for member states to charge interest on any claims not met within 18 months. The United Kingdom does not currently have any cases of member states not reimbursing within that time period, nor has the United Kingdom failed to make payments within that period.

Health Services: Overseas Visitors

Chris Skidmore: To ask the Secretary of State for Health (1) hat assessment he has made of the reason for the increase in income to the NHS from overseas visitors under non-reciprocal arrangements in 2010-11; [110263]


(2) what the total (a) income received, (b) total losses, (c) bad debt and claims abandoned and (d) income which is still in the process of being recovered was in relation to bills incurred by overseas visitors in each NHS trust in the latest period for which figures are available; [110267]

(3) how many patients were treated by the NHS who are (a) non-UK EEA citizens and (b) non-EEA citizens in each of the last 10 years; [110269]


(4) what the average time taken was to collect debt in relation to bills incurred by overseas visitors to the NHS in each financial year since 1997-98. [110270]

Anne Milton: The total income recorded in relation to overseas patients, by each national health service trust, in 2010-11, is shown in the following table, together with the total losses, bad debts and claims abandoned recorded.

The Department has not made a central assessment of the reason for increases in income from overseas patients under non-reciprocal arrangements in 2010-11. Such increases may be due to a higher volume of chargeable overseas visitors receiving treatment, increased identification of such patients by NHS trusts, or local differences in accounting for income.

The Department does not hold information on income that NHS trusts are still in the process of recovering from overseas visitors, or on the average time to collect debts from overseas visitors.

The Department does not hold information centrally about the nationality of patients treated by the NHS. Entitlement to NHS treatment is not based on nationality, and NHS trusts do not routinely record the nationality of patients.

£000
NameOverseas patients (non-reciprocal) incomeOverseas patients losses, bad debts and claims abandoned

5 Boroughs Partnership NHS Trust

0

0

Airedale NHS Foundation Trust

0

0

Ashford and St Peter's Hospitals NHS Foundation Trust

45

63

Ashton, Leigh and Wigan Community Healthcare NHS Trust

0

0

Avon and Wiltshire Mental Health Partnership NHS Trust

0

0

11 Jun 2012 : Column 131W

11 Jun 2012 : Column 132W

Barking, Havering and Redbridge University Hospitals NHS Trust

892

0

Barnet and Chase Farm Hospitals NHS Trust

286

140

Barnet, Enfield and Haringey Mental Health NHS Trust

0

0

Barts and The London NHS Trust

1,284

938

Bedford Hospital NHS Trust

65

0

Bedfordshire and Luton Mental Health and Social Care NHS Trust

0

0

Birmingham Community Healthcare NHS Trust

0

0

Bradford District Care NHS Trust

0

0

Brighton and Sussex University Hospitals NHS Trust

243

0

Buckinghamshire Healthcare NHS Trust

275

72

Cambridgeshire Community Services NHS Trust

0

0

Central London Community Healthcare NHS Trust

0

0

Cornwall Partnership NHS Trust

0

0

Coventry and Warwickshire Partnership NHS Trust

0

0

Croydon Health Services NHS Trust

289

41

Dartford and Gravesham NHS Trust

98

31

Derbyshire Healthcare NHS Foundation Trust

0

0

Devon Partnership NHS Trust

0

0

Dudley and Walsall Mental Health Partnership NHS Trust

0

0

Ealing Hospital NHS Trust

50

168

East and North Hertfordshire NHS Trust

390

49

East Cheshire NHS Trust

67

1

East Lancashire Hospitals NHS Trust

51

12

East Midlands Ambulance Service NHS Trust

0

0

East of England Ambulance Service NHS Trust

0

0

East Sussex Hospitals NHS Trust

59

3

Eastern and Coastal Kent Community Health NHS Trust

0

0

Epsom and St Helier University Hospitals NHS Trust

187

107

George Eliot Hospital NHS Trust

0

1

Great Ormond Street Hospital NHS Trust

112

0

Great Western Ambulance Service NHS Trust

0

0

Hereford Hospitals NHS Trust

13

0

Hertfordshire Community NHS Trust

0

0

Hinchingbrooke Healthcare NHS Trust

15

0

Hull and East Yorkshire Hospitals NHS Trust

0

24

Humber Mental Health Teaching NHS Trust

0

0

Imperial College Healthcare NHS Trust

5,083

1,187

Ipswich Hospital NHS Trust

74

26

Kent and Medway NHS and Social Care Partnership NHS Trust

0

0

Kingston Hospital NHS Trust

109

16

Leeds Teaching Hospitals NHS Trust

1,238

3

Leicestershire Partnership NHS Trust

0

0

Liverpool Community Health NHS Trust

0

0

Liverpool Heart and Chest Hospital NHS Trust

0

0

London Ambulance Service NHS Trust

0

0

Maidstone and Tunbridge Wells NHS Trust

0

0

Manchester Mental Health and Social Care NHS Trust

0

0

Mersey Care NHS Trust

0

0

Mid Essex Hospital Services NHS Trust

1,212

3

Mid Yorkshire Hospitals NHS Trust

63

0

Newham University Hospital NHS Trust

345

337

NHS Direct NHS Trust

0

0

Norfolk Community Health and Care NHS Trust

0

0

North Bristol NHS Trust

367

226

North Cumbria University Hospitals NHS Trust

41

0

North East Ambulance Service NHS Trust

0

0

North Middlesex University Hospital NHS Trust

387

86

North Staffordshire Combined Healthcare NHS Trust

0

0

North West Ambulance Service NHS Trust

0

0

North West London Hospitals NHS Trust

985

611

Northampton General Hospital NHS Trust

155

54

Northamptonshire Healthcare NHS Trust

0

0

Northern Devon Healthcare NHS Trust

0

0

11 Jun 2012 : Column 133W

11 Jun 2012 : Column 134W

Northumberland Tyne and Wear NHS Trust

0

0

Nottingham University Hospitals NHS Trust

57

44

Nottinghamshire Healthcare NHS Trust

0

0

Nuffield Orthopaedic Centre NHS Trust

242

0

Oxford Learning Disability NHS Trust

0

0

Oxford Radcliffe Hospital NHS Trust

0

0

Pennine Acute Hospitals NHS Trust

418

291

Plymouth Hospitals NHS Trust

105

7

Portsmouth Hospitals NHS Trust

192

84

Princess Alexandra Hospital NHS Trust

86

31

Queen Elizabeth Hospital Kings Lynn NHS Foundation Trust

13

0

Robert Jones and Agnes Hunt Orthopaedic NHS Trust

0

0

Royal Brompton and Harefield NHS Trust

0

0

Royal Cornwall Hospitals NHS Trust

68

5

Royal Free Hampstead NHS Trust

526

457

Royal Liverpool Broadgreen Hospitals NHS Trust

0

58

Royal Surrey County Hospital NHS Trust

0

0

Royal United Hospital Bath NHS Trust

55

3

Royal Wolverhampton Hospital NHS Trust

27

83

Sandwell and West Birmingham Hospitals NHS Trust

90

33

Scarborough and North East Yorkshire NHS Trust

28

8

Shrewsbury and Telford Hospital NHS Trust

29

8

South Central Ambulance Service NHS Trust

0

0

South East Coast Ambulance Service NHS Foundation Trust

0

0

South London Healthcare NHS Trust

638

0

South Tees Hospitals NHS Trust

0

0

South Warwickshire General Hospitals NHS Trust

0

0

South West Ambulance Service NHS Foundation Trust

0

0

South West London and St George's Mental Health NHS Trust

0

0

South West Yorks Mental Health NHS Trust

0

0

Southampton University Hospitals NHS Trust

385

253

Southport and Ormskirk Hospital NHS Trust

1

0

St George's Healthcare NHS Trust

1,008

0

St Helens and Knowsley Hospitals NHS Trust

39

17

Suffolk Mental Health Partnership NHS Trust

0

0

Surrey and Sussex Healthcare NHS Trust

318

43

Sussex Community NHS Trust

0

0

The Hillingdon Hospital NHS Trust

1,089

396

The Lewisham Healthcare NHS Trust

435

283

The Royal National Orthopaedic Hospital NHS Trust

0

0

Trafford Healthcare NHS Trust

15

0

United Lincolnshire Hospitals NHS Trust

47

7

University Hospital of North Staffordshire Hospital NHS Trust

312

0

University Hospitals Coventry and Warwickshire NHS Trust

71

57

University Hospitals of Leicester NHS Trust

513

119

University Hospitals of Morecambe Bay NHS Foundation Trust

7

1

Walsall Hospitals NHS Trust

0

1

Walton Neurology Centre NHS Trust

0

0

West Hertfordshire Hospitals NHS Trust

137

41

West London Mental Health NHS Trust

328

0

West Middlesex University NHS Trust

268

0

West Midlands Ambulance Service NHS Trust

0

0

West Suffolk Hospital NHS Trust

25

11

Western Sussex Hospitals NHS Trust

59

0

Weston Area Health NHS Trust

2

0

Whipps Cross University Hospital NHS Trust

608

160

Whittington Hospital NHS Trust

245

72

Winchester and Eastleigh Healthcare NHS Trust

218

0

Worcestershire Acute Hospitals NHS Trust

0

0

Worcestershire Mental Health Partnership NHS Trust

0

0

11 Jun 2012 : Column 135W

11 Jun 2012 : Column 136W

Yorkshire Ambulance Service NHS Trust

0

0

Total

23,184

6,771

Note: Where an NHS trust obtains foundation trust status part way through any year, the data provided are only for the part of the year the organisation operated as an NHS Trust. Source: 2010-11 NHS Trusts Audited Summarisation Schedules

Health Services: Reciprocal Arrangements

Chris Skidmore: To ask the Secretary of State for Health how many patients were treated by the NHS under the provisions of a European Health Insurance Card in each of the last 10 years; and what proportion of the total number of NHS patients treated this represented in each such year. [110272]

Anne Milton: The national health service records the number of treatments rather than the number of patients treated. The number of treatments carried out in the NHS under the provisions of the European Health Insurance Card (EHIC), and what proportion of overall NHS treatments this represents are shown in the following table. EHIC data figures were not recorded centrally prior to October 2009.

 Number of EHIC treatmentsProportion of total number of NHS treatments (percentage)

2009-10

1,292

0.002

2010-11

2,636

0.004

2011-12

3,027

0.005

Note: Treatment activity could include one individual using the NHS on multiple occasions.

Health Services: Scotland

John Robertson: To ask the Secretary of State for Health what provisions he has put in place to prevent Foundation Trusts charging for treating NHS patients resident in Scotland on the grounds that it is not regarded as income received for activity undertaken in pursuit of their principal purpose. [109521]

Mr Simon Burns: There are no provisions in the Health and Social Care Act 2012 that allow a foundation trust to charge a national health service patient resident in Scotland. The Government regards income foundation trusts earn from treating NHS patients that are resident in Scotland as income received for activity undertaken in pursuit of their principal purpose of providing goods and services for the purposes of the NHS England.

Health Services: Sign Language

Dr Wollaston: To ask the Secretary of State for Health if he will issue guidance to commissioners of sign language interpreters in the NHS to ensure that only fully qualified interpreters are used during health appointments; and if he will make a statement. [109509]

Debbie Abrahams: To ask the Secretary of State for Health who he proposes will be responsible for commissioning sign language interpreters for healthcare appointments in the new NHS structure. [109616]

Paul Burstow: From 1 April 2013, it will be for the NHS Commissioning Board and clinical commissioning groups to make arrangements, for the delivery of services they are responsible for, including the appropriate provision of interpreters for users of sign language services during health care appointments.

The Department has no plans to issue guidance on this matter. From 1 April 2013 it will be for the NHS Commissioning Board to decide what guidance it wishes to issue to clinical commissioning groups.

When making decisions about what services are delivered locally, all national health service organisations must assure themselves that they have complied with the Equality Act 2010. This includes advancing equality of opportunity between people who share a protected characteristic, including a disability such as hearing loss, and those who do not. Advancing equality involves, for example, taking steps to meet the needs of people from protected groups where these are different from the needs of other people.

Home Care Services: Nottinghamshire

Gloria De Piero: To ask the Secretary of State for Health how many people in (a) Ashfield and (b) Nottinghamshire had home care services fully paid by their local authority in the last two years for which figures are available. [109911]

Paul Burstow: Information on the numbers of people receiving home care in Ashfield constituency is not collected centrally.

We are informed by the NHS Information Centre for Health and Social Care that information on people receiving home care which is partly or fully funded by Nottinghamshire county council, which includes Ashfield, is collected. However, it is not possible to break the data down to show numbers whose care is fully funded separately from those whose care is partially funded.

Table 1 shows the number of people receiving home care which was partly or fully funded by Nottinghamshire county council during the period 1 April to 31 March for the years 2009-10 and 2010-11 (that is, at some point during the year in question). Table 2 shows the same information but for the number of people receiving home care on 31 March, the final day of each period.

11 Jun 2012 : Column 137W

Table 1. Number of people receiving home care which was partly or fully funded by Nottinghamshire county council during financial years 2009-10 and 2010-11
 2009-10(1)2010-11

Number of people receiving home care

6,655

6,465

Table 2. Number of people receiving home care which was partly or fully funded by Nottinghamshire county council as at 31 March 2010 and 2011
 2010(1)2011

Number of people receiving home care

4,420

3,745

(1) In 2009-10 councils were asked to record people receiving a personal budget under the heading “Existing Direct Payment and/or Personal Budget” on P2s and P2f and not record the different services the service user received as part of their care package. As a result, the figures in the tables for 2009-10 and 2010 do not include people getting home care-as part of a personal budget. This was changed for 2010-11, so people getting home care as part of a personal budget are included for 2010-11 and 2011. Source: Referrals, Assessments and Packages of Care (RAP) return. NHS Information Centre for Health and Social Care.

11 Jun 2012 : Column 138W

Hospital Beds

Chris Skidmore: To ask the Secretary of State for Health if he will estimate the bed-to-qualified-staff ratio in (a) England, (b) each foundation trust and (c) each acute trust in each of the last five years. [110262]

Mr Simon Burns: The information at foundation trust and acute trust level could be obtained only at disproportionate cost. However, aggregate figures for England are in the following table.

It is unclear to which type of beds my hon. Friend is referring. Therefore, four scenarios are provided using full-time equivalent (FTE) staff, so that an increase in the ratio indicates an increase in the number of staff per bed.

Data presented are for beds in national health service organisations in England and staffing data for FTE include doctors, qualified nurses, qualified scientific, therapeutic and technical staff (ST&Ts) and qualified ambulance staff working in NHS Hospital and Community Health Services (HCHS) in England:

 2007-082008-092009-102010-112011-12

Ratio of professionally qualified FTEs to available beds open overnight

3.2

3.3

3.5

3.9

4.0

Ratio of professionally qualified FTEs to occupied beds open overnight

3.8

3.9

4.1

4.6

4.7

Ratio of professionally qualified FTEs to available beds open overnight plus day only beds

3.0

3.1

3.2

3.6

3.7

Ratio of professionally qualified FTEs to occupied beds open overnight plus day only beds

3.6

3.6

3.8

4.2

4.3

Notes: 1. Work force FTE data exclude general practitioners and practice nurses as they work in primary care settings. 2. Work force FTE data are as at 30 September in each year. 3. FTE figures include some types of staff who might not work in roles directly connected with bed activity, for example health visitors. 4. Beds open overnight data include general and acute, learning disability, maternity and mental illness beds. 5. From Quarter 1 2010-11 the KH03 became a quarterly collection. Prior to this the KH03 collection had been an annual collection from all NHS organisations that have beds, (ordinary or day case), both NHS trusts and primary care trusts that collected the total number of available bed days and the total number of occupied bed days by ward classification. Figures for 2010-11 and 2011-12 are based on average bed numbers from each quarter. 6. The classification for bed occupancy was changed from ward type to the consultant specialty of the responsible consultant in Q1 2010-11. Care should therefore be taken when comparing 2009-10 to 2010-11 as data might not be directly comparable. 7. It is likely that beds open overnight and day only beds require different levels of staffing. Therefore, care should be taken when comparing changes in staff to bed ratios that include both types of bed. Sources: 1. Work force data: Health and Social Care Information Centre: Medical and Dental Workforce Census; Non-medical Workforce Census 2. Beds data: Department of Health KH03

Hospitals: Standards

Rosie Cooper: To ask the Secretary of State for Health what steps have been taken by his Department to ensure that (a) patients receive adequate nutrition while in hospital, (b) patients receive adequate hydration while in hospital, (c) patients' toileting needs are adequately met, (d) patients receive adequate pain relief to meet their needs and (e) patients are able to receive help when they ask for it. [110117]

Anne Milton: There are a great deal of best practice guidance and resources in place that support the delivery of high quality, safe and effective care. This includes ensuring patients receive adequate food and drink, pain relief and help when requested.

The Energising for Excellence Framework being taken forward by the strategic health authority chief nurses, is a total quality approach to improving care. “The Operating Framework for the NHS in England 2012/13” includes requirements to improve the care of older people and dignity and respect, and a national Commissioning for Quality and Innovation (CQUIN) goal relating to the use of the safety thermometer will help focus commissioners and providers on reducing the harm from pressure ulcers, falls, catheter-related infections and blood clots.

At the heart of the health care reforms is a focus on improving the quality and outcomes of health care for patients. One of the NHS Commissioning Board's roles will be to provide national leadership, in driving up the quality of care. The board, along with clinical commissioning groups, will have a legal duty to secure continuous Improvement in the quality of services and outcomes. The Chief Nursing Officer will have a specific remit to improve the safety and people's experience of nursing care.

On 6 January 2012 the Prime Minister announced a series of measures to improve the quality of nursing care and free up nurses to provide the care patients and their relatives expect. These included setting up the independent Nursing and Care Quality Forum, tasked with ensuring that best nursing practice is spread throughout the national health service and social care.

Departmental Staff

Mr Thomas: To ask the Secretary of State for Health what target he has set to reduce headcount across his Department, its non-departmental public bodies and executive agencies in (a) 2010-11, (b) 2011-12 and (c) 2012-13; and if he will make a statement. [110228]

11 Jun 2012 : Column 139W

Mr Simon Burns: The Department does not have specific headcount reduction targets for the years in question. In line with the parameters of the 2010 spending review, the Department is committed to reducing total administration costs by one-third in real terms over the period 2010-11 to 2014-15. The Department has already reduced its staffing expenditure significantly by running a voluntary exit scheme for permanent staff in 2010-11 and by reducing significantly its non-permanent workforce.

We expect the number of permanent staff in the Department to reduce further over the spending review period through turnover, voluntary redundancy and, if necessary, compulsory redundancy.

The reduction in funding over the spending review period applies to the Department's non-departmental public bodies and agency, the Medicines and Healthcare products Regulatory Agency. While there are no specific headcount reduction targets, the impact will result in fewer staff in those organisations.

11 Jun 2012 : Column 140W

Medicine: Education

Chris Skidmore: To ask the Secretary of State for Health how many places for (a) student midwives, (b) student doctors and (c) student nurses there were in each region in each academic year since 1997-98. [110249]

Anne Milton: The total population of student midwives and nurses has not been collected for every year since 1997-98. Data regarding the number of non-medical trainees is collected based on the number of new commissions, and is collected by financial year rather than academic year. The following table shows the number of midwifery training commissions by each strategic health authority (SHA) between 2006-07 and 2011-12.

Midwifery commissions, 2006-07 to 2011-12
 Region
 North EastNorth WestYorkshire and the HumberEast MidlandsWest MidlandsEast of EnglandLondonSouth East CoastSouth CentralSouth WestEngland total

2006-07

84

234

197

44

228

49

282

136

82

114

1,450

2007-08

85

247

162

45

233

204

283

139

142

119

1,659

2008-09

86

257

211

157

295

276

454

203

173

160

2,272

2009-10

92

263

269

179

330

289

511

178

203

168

2,482

2010-11

90

233

255

170

295

284

575

219

198

169

2,488

2011-12

89

255

271

169

287

270

573

216

200

154

2,484

Source: SHA multi professional education and training (MPET) financial information returns.

Due to restructuring of the SHAs, regional data is not available for prior years and therefore the England totals have been provided in the following table for the year 1997-98 to 2005-06.

Midwifery commissions, 1997-98 to 2005-06
 England total

1997-98

1,704

1998-99

1,751

1999-2000

1,772

2000-01

1,887

2001-02

1,878

2002-03

2,110

2003-04

2,226

2004-05

2,374

2005-06

1,949

Source: SHA MPET financial information returns.

Nursing commissions are collected on the same basis as midwifery commissions as shown in the following tables.

Nursing commissions, 2006-07 to 2011-12
 Region
 North EastNorth WestYorkshire and the HumberEast MidlandsWest MidlandsEast of EnglandLondonSouth East CoastSouth CentralSouth WestEngland total

2006-07

1,132

3,633

2,555

1,538

2,684

1,791

3,705

1,341

1,248

1,572

21,199

2007-08

1,073

3,428

2,007

1,452

2,402

1,590

3,523

1,293

1,106

1,478

19,352

2008-09

1,132

3,617

2,053

1,641

2,607

1,881

3,849

1,195

1,146

1,543

20,664

2009-10

1,132

3,602

2,148

1,744

2,612

1,949

3,783

1,176

1,154

1,529

20,829

2010-11

1,047

3,430

2,150

1,585

2,521

1,730

3,688

1,303

1,142

1,496

20,092

2011-12

1,007

3,033

1,822

1,435

2,073

1,516

3,259

1,123

1,112

1,361

17,741

Source: SHA MPET financial information returns.
Nursing commissions, 1997-98 to 2005-06
 England total

1997-98

15,743

1998-99

16,837

1999-2000

17,692

2000-01

18,923

2001-02

20,624

2002-03

21,523

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2003-04

22,815

2004-05

23,369

2005-06

20,308

Source: SHA MPET financial information returns.

11 Jun 2012 : Column 142W

Information on student doctors is collected as the total number of undergraduate medical training places in each financial year. A regional breakdown is available only from 2007-08, as shown in the following table.

Undergraduate medical training places, 2007-08 to 2011-12
 Region
 North EastNorth WestYorkshire and the HumberEast MidlandsWest MidlandsEast of EnglandLondonSouth East CoastSouth CentralSouth WestEngland total

2007-08

1,050

2,559

1,929

1,756

1,719

866

5,386

399

1,301

1,307

18,272

2008-09

1,079

2,277

2,011

1,791

2,088

931

5,363

419

1,249

1,304

18,512

2009-10

1,087

2,462

2,005

1,792

2,144

974

5,606

392

1,261

1,374

19,097

2010-11

1,066

2,466

1,937

1,837

2,110

954

5,690

392

1,280

1,374

19,106

2011-12

1,043

2,469

1,977

1,913

2,144

990

5,668

416

1,286

1,396

19,302

Source: SHA MPET financial information returns.

Prior to 2003-04 the funding methodology for undergraduate medical training was not based on activity and therefore the number of training places are not available for these years. Information between 2003-04 and 2006-07 has been provided as a national level due to restructuring of the SHAs as shown in the following table.

Undergraduate medical training places, 2003-04 to 2006-07
 England total

2003-04

12,924

2004-05

14,416

2005-06

16,114

2006-07

17,560

Source: SHA MPET financial information returns.

Chris Skidmore: To ask the Secretary of State for Health how many (a) student midwives, (b) student doctors and (c) student nurses were in receipt of a bursary in each academic year since 1997-98; what the average bursary paid to each was in that year; and what the total cost was to his Department of bursaries paid to those students. [110250]

Anne Milton: The number of student midwives, student doctors and student nurses who held a bursary in each year since 1997-98; the average bursary paid to those students; and the total cost are shown in the following tables.

Student midwives on pre-registration degree and diploma courses
 Number of bursary holders(l)Average amount paid per bursary holder(2 )(£)Total amount paid £)

1997-98

102

2,999

305,914

1998-99

362

2,853

1,032,758

1999-2000

1,216

3,868

4,703,867

2000-01

1,980

4,250

8,415,316

2001-02

2,751

4,726

13,002,223

2002-03

3,166

4,863

15,397,679

2003-04

3,541

4,995

17,688,013

2004-05

3,738

5,521

20,637,109

2005-06

3,901

5,657

22,067,168

2006-07

3,812

5,716

21,787,618

2007-08

3,996

5,813

23,228,490

2008-09

4,265

5,715

24,373,689

2009-10

4,777

5,765

27,539,804

2010-11

5,218

5,722

29,854,947

Student nurses on pre-registration degree and diploma courses
 Number of bursary holders(1)Average amount paid per bursary holder(2) (£)Total amount paid (£)

1997-98

1998-99

1,272

1,991

2,531,982

1999-2000

18,207

3,805

69,274,583

2000-01

33,507

4,463

149,556,571

2001-02

48,700

5,121

249,376,136

2002-03

56,500

5,118

289,171,150

2003-04

58,088

5,207

302,438,759

2004-05

59,369

5,531

328,364,818

2005-06

60,108

5,744

345,257,860

2006-07

60,464

5,825

352,179,688

2007-08

57,441

6,001

344,721,676

2008-09

56,415

6,243

352,183,188

2009-10

57,786

6,404

370,037,635

2010-11

57,725

6,422

370,723,915

Student doctors on degree courses
 Number of bursary holders(1)Average amount paid per bursary holder(2) (£)Total amount paid excluding tuition fees (£)Tuition fees(3 )(£)

1997-98

1998-99

1999-2000

2000-01

14

2,120

29,687

n/a

2001-02

932

586

546,045

n/a

2002-03

4,153

1,386

5,755,069

n/a

2003-04

5,965

1,559

9,298,854

n/a

2004-05

6,694

1,709

11,439,462

n/a

2005-06

8,406

1,759

14,789,517

8,055,885

2006-07

9,249

1,865

17,251,889

9,075,960

2007-08

10,022

1,851

18,551,600

10,909,494

2008-09

10,640

1,754

18,658,860

12,798,778

2009-10

10,932

1,809

19,779,938

14,572,596

11 Jun 2012 : Column 143W

2010-11

11,402

1,717

19,580,043

23,214,244

(1) Includes nil award holders (European Union fees only students and students whose living allowance element of the bursary has been reduced to nil after income assessment). Apart from a small number of students on graduate training programmes, the majority of medical students only became eligible for national health service funding from academic year 2002-03. (2) Includes the basic award and all supplementary allowances and one-off payments e.g. reimbursement of practice placement costs and disabled students allowance. (3) A student's liability for a tuition fee contribution is paid directly to the higher education institution upon receipt of an invoice. Tuition fee data for student doctors can only be extracted from NHS Student Bursary Scheme database from 2005-06 onwards. Prior to these data these payments were made by a manual process. Bursary amounts and averages have been rounded to the nearest pound. Source: NHS Business Services Authority.

Mental Health Services

Mr Charles Walker: To ask the Secretary of State for Health how many times the Care Quality Commission called on clinical associates to assist in making regulatory judgments which have a specialist mental health element in each of the last three years for which figures are available. [110079]

Mr Simon Burns: The Care Quality Commission (CQC) is the independent regulator of health and adult social care providers in England.

The CQC is responsible for assessing whether providers are meeting the registration requirements which set out essential levels of safety and quality.

The CQC has provided the following information:

The CQC compliance inspectors have always had access to clinical expertise to support their regulatory work where they require it. However, the CQC does not currently collect the information in the format requested.

The CQC has replaced the term “clinical associates” with “specialist advisors”.

The CQC is on track to begin introducing a bank of specialist advisors by June 2012, as set out in its action plan in response to the Department's Performance and Capability review of the CQC. The CQC expect the bank to be fully operational by July 2012 and from then it will be able to report on which compliance reports are completed with assistance from specialist advisors.

Mental Health Services: Prisons

Ben Gummer: To ask the Secretary of State for Health what steps his Department is taking to improve pathways through secure mental health services to reduce the long waiting times for prison transfers when people are acutely unwell. [110064]

Paul Burstow: The Department published a good practice procedure guide in March 2011 to facilitate the transfer of prisoners to secure psychiatric hospitals. Between January and April 2012 the Department consulted on commissioning guidance for low secure mental health services and psychiatric intensive care services. The outcome of that consultation will be published later this year. Defining standards for low secure services is expected to ease pressure on medium secure services, and bring further improvement in transfer times between prison and hospital.

11 Jun 2012 : Column 144W

Mental Health Services: Veterans

Kelvin Hopkins: To ask the Secretary of State for Health if he will take steps to enable local groups working with veterans to access public funds to help them deal with individuals who have mental health problems. [109952]

Mr Simon Burns: With regards specifically to funding, the Department of Health runs an annual grants scheme for Innovation, Excellence and Strategic Development, which all voluntary sector organisations are able to apply to. The scheme receives applications from organisations supporting military veterans, and military veterans with mental health problems. Voluntary organisations Combat Stress and the Royal British Legion are also part of the Department's Strategic Partner Programme, and therefore will have knowledge of funding opportunities for the sector should they arise.

Veterans' mental health is an area which has received significant attention from this Government in the past two years. Following the publication of Dr Andrew Murrison's report 'Fighting Fit', the Government pledged £1.8 million per annum for the remainder of the spending review period to implement its recommendations. Much work has already been completed, such as the launch of a 24-hour veterans telephone helpline, a pilot of the online wellbeing service 'Big White Wall' and an e-learning package for general practitioners to familiarise themselves with veteran-specific health problems.

In addition, each of the 10 Armed Forces Networks (based geographically in the old strategic health authority areas) have received £150,000 with which to build up enhanced community veterans’ mental health services in their areas. These services are now up and running in almost every region with the remainder planned to come on line by the end of this calendar year. These services were developed in conjunction with local groups, for the local population.

Mental Health

Ms Abbott: To ask the Secretary of State for Health (1) how many people in each (a) socio-economic, (b) ethnic and (c) age group were diagnosed with a mental health condition in each of the last 10 years; [109601]

(2) how many people in each (a) socio-economic, (b) ethnic and (c) age group were diagnosed with obsessive compulsive disorder in each of the last 10 years. [109602]

Paul Burstow: We do not hold annual data on the number of people diagnosed with a mental health condition or with obsessive compulsive disorder by socio-economic, ethnic and age group for the last 10 years.

Data from the Adult Psychiatric Morbidity Survey (APMS) providing information on the prevalence of various mental health conditions in 2007 by ethnic group, age group and equivalised household income group has been placed in the Library. It should be noted that these data concern the presence of symptoms, not whether someone has received a diagnosis. These also relate to common mental disorders, including obsessive compulsive disorder, and do not include other groups of disorders, e.g. disorders such as psychosis and personality

11 Jun 2012 : Column 145W

disorder, dependence disorders (substance and gambling) and conditions such as ADHD and eating disorders, which also come under the term ‘mental disorder’.

Data from the Mental Health Bulletin 2011, and Table 1.2-1.4 of the associated national reference tables/providing information on the number of people accessing NHS funded secondary mental health services by age and ethnic group in the years between 2006-07 and 2011-12 has also been placed in the Library. The Data Quality and Methodology document published alongside the main report notes that the data for each year are not completely comparable because of improvement in collection of key data over time.

Methadone

Mr Brady: To ask the Secretary of State for Health what assessment his Department has made of the efficacy and value for money that might be obtained by using non-racemic levo and dextro-methadones instead of racemic methadone in the treatment of drug addiction and neuropathic pain. [109969]

Anne Milton: Marketing authorisation by the Medicines and Healthcare products Regulatory Agency, has only been sought for racemic methadone. Levo-methadone has not been authorised in the United Kingdom and data in support of its efficacy have not been submitted for evaluation.

Mutual Societies

Mr Thomas: To ask the Secretary of State for Health what estimate he has made of the number of full-time equivalent staff who will transfer from his Department, its non-departmental public bodies and executive agency's workforce to a mutual in (a) 2011-12 and (b) 2012-13; and if he will make a statement. [110195]

Mr Simon Burns: No staff in the Department, its agency the Medicines and Healthcare products Regulatory Agency, or its non-departmental public bodies transferred to a mutual in 2011-12. No staff have transferred during 2012-13 to date, and there are currently no plans for transfers to a mutual in the future.

NHS: Charitable Donations

Chris Skidmore: To ask the Secretary of State for Health how many charitable donations were received by each NHS organisation in each financial year since 1997-98; and what the total amount of these donations was. [110260]

Mr Simon Burns: The information is not collected in the format requested.

The Department does not collect data on the number of charitable donations received by each national health service organisation. However, the Department does collect information on the value of charitable and other contributions to expenditure and donated assets. This information has been placed in the Library.

In common with many other public and private sector organisations, the Department only holds accounting data at organisation level for seven years, and therefore

11 Jun 2012 : Column 146W

data cannot be provided prior to 2004-05. A separate table has been provided for each year, owing to changes in organisations over the period.

NHS: Drugs

Gareth Johnson: To ask the Secretary of State for Health what the average time was for the National Institute for Health and Clinical Excellence to make a decision on the licensing of new drugs for use in the NHS in the latest period for which figures are available. [109529]

Paul Burstow: The National Institute for Health and Clinical Excellence (NICE) is not responsible for the medicines licensing process. The Medicines and Healthcare products Regulatory Agency and the European Medicines Agency have responsibility for licensing new drugs.

NICE issues technology appraisal guidance to the national health service on the clinical and cost-effectiveness of new and existing drugs and treatments.

NHS: Interest Rates

Chris Skidmore: To ask the Secretary of State for Health if he will estimate the cost and likely implications for the NHS if the UK were subject to commercial interest rates of 6.5 per cent. [110271]

Mr Simon Burns: Most borrowing in the national health service is by NHS providers for capital investment. The majority of this borrowing is from the Department. Repayments to the Department for this borrowing are recycled into allocations to the NHS or into further borrowing. Thus, as a sealed system, there are no resources lost to the NHS as a whole regardless of the actual level of the interest rate.

NHS providers have a choice as to whom they borrow money from. If rates were increased to become similar to commercial rates, they would still be somewhat lower than commercial rates as commercial rates would always include an additional margin for risk. Thus most borrowing, in reality, would still be sourced from the Department and thus would not represent a net increased cost to the NHS as a whole.

NHS: Pensions

Chris Skidmore: To ask the Secretary of State for Health what estimate he has made of the number of retired members of the NHS pension scheme who are in receipt of (a) £142,500 or more and (b) £150,000 or more per year as part of their NHS pension. [110266]

Mr Simon Burns: The information requested could be obtained only at a disproportionate cost.

NHS: Recruitment

Chris Skidmore: To ask the Secretary of State for Health what the total cost to the NHS was of employing (a) managers and senior managers, (b) consultants, (c) GPs, (d) nurses and (e) all other staff in each financial year since 1997-98. [110247]

Mr Simon Burns: The information requested is provided in the following table:

11 Jun 2012 : Column 147W

£000
 Senior managers and managersNursing, midwifery and health visiting staffAll other staff

1997-98

911,539

6,631,381

8,532,500

1998-99

952,327

6,982,090

9,124,743

1999-2000

1,054,677

7,691,928

9,929,109

2000-01

1,186,573

8,337,843

10,973,000

2001-02

1,331,350

9,379,697

12,428,737

2002-03

1,563,565

10,270,654

13,952,285

2003-04

1,772,177

10,896,121

15,744,577

2004-05

2,084,540

11,453,680

17,077,514

2005-06

2,199,533

11,522,049

17,140,363

2006-07

2,072,432

11,114,727

16,655,460

2007-08

1,852,879

10,252,329

15,688,601

2008-09

1,844,837

9,501,689

15,478,930

2009-10

1,966,503

9,152,504

15,494,890

2010-11

1,951,458

8,904,702

15,385,718

Notes: 1. Information on the cost of employing consultants cannot be disaggregated from other staff cost information held centrally. 2. Most General Medical Practitioners are independent contractors and are not directly employed by the national health service, rather they receive contractual payments for delivering primary medical care services.

NHS: Redundancy

Chris Skidmore: To ask the Secretary of State for Health how many NHS staff were made redundant who were subsequently re-employed by the NHS in each financial year between 1997 and 2010; and what the total cost of these redundancies was in each year. [110248]

Mr Simon Burns: The number and cost of national health service staff made redundant and subsequently re-employed by the NHS is not held centrally.

NHS: Repairs and Maintenance

Andy Burnham: To ask the Secretary of State for Health what the cost of backlog maintenance for the NHS estate in England was, by level of assessed risk, in (a) 2009-10, (b) 2010-11 and (c) 2011-12. [110377]

Mr Simon Burns: The information requested is shown in the following table:

£ million
 2009-102010-11

High risk

301

322

Significant risk

1,107

1,022

Moderate risk

1,514

1,524

Low risk

1,174

1,299

Total backlog maintenance

4,096

4,166

Data for 2011-12 are currently being collected and will be published in October 2012.

Backlog maintenance is the amount of investment heeded to bring the estate up to a satisfactory standard. It is reduced through either capital investment or the disposal of the estate.

The Department collects data on backlog maintenance annually from the national health service trusts through its Estates Returns Information Collection (ERIC). The data collected have not been amended centrally and its

11 Jun 2012 : Column 148W

accuracy always remains the responsibility of the contributing NHS organisations.

NHS organisations are locally responsible for the provision and maintenance of their facilities. This includes planning and investment to reduce backlog maintenance.

The data definitions used in ERIC to collect data are:

Risk levelDefinition

High risk

Where repairs/replacement must be addressed with urgent priority in order to prevent catastrophic failure, major disruption to clinical services or deficiencies in safety liable to cause serious injury and/or prosecution.

Significant risk

Where repairs/replacement require priority management and expenditure in the short term so as not to cause undue concern to statutory enforcement bodies or risk to healthcare delivery or safety.

Moderate risk

Where repairs/replacement require effective management and expenditure in the medium term through close monitoring so as not to cause undue concern to statutory enforcement bodies or risk to healthcare delivery or safety.

Low risk

Where repairs/replacement are required to be addressed through agreed maintenance programmes or included in the later years of an estate strategy.