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Lord Skelmersdale asked Her Majesty's Government:

Baroness Andrews: Notifications of tuberculosis are made to the Health Protection Agency. The number of notifications reported in the North-West and South-West regions for the last seven years are as follows:

YearNorth-WestSouth-West
1996581201
1997615212
1998674213
1999693209
2000651226
2001661198
2002(10)650248

(10) Provisional figure.


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Health and Social Care: New Audit and Inspectorate Bodies

Baroness Noakes asked Her Majesty's Government:

    How they can reconcile the statement at paragraph 453 of the Explanatory Notes to the Health and Social Care (Community Health and Standards) Bill that £22 million of set-up costs for the Commission for Health Audit and Inspection and the Commission for Social Care Inspection have already been allocated to the department with the Written Answer by Lord Warner on 8 September (WA 68) that parliamentary approval had not yet been obtained for £22 million for the set-up of new services by those bodies.[HL4438]

Baroness Andrews: The Explanatory Notes paragraph 453 is incorrect in regard to the allocation funds. The Department of Health had earmarked resources within its existing departmental expenditure limit but the ability to incur such expenditure is dependent on parliamentary approval. The Written Answer I gave on 8 September at column WA 68, reported that approval for the resources for the set up of the new services would be sought in a supplementary estimate and pending that approval, expenditure would be met by repayable cash advances from the contingencies fund which allows for cash advances to departments for expenditure on urgent services in anticipation of parliamentary approval.

Baroness Noakes asked Her Majesty's Government:

    What is the total amount of set-up costs expected to be incurred in respect of the Commission for Health Audit and Inspection and the Commission for Social Care Inspection in 2003–04.[HL4439]

Baroness Andrews: We estimate that the total set-up costs for the Commission for Social Care Inspection and the Commission for Healthcare Audit and Inspection to be circa £22 million.

Foundation Trusts

Baroness Noakes asked Her Majesty's Government:

    Whether they will publish the formula for determining National Health Service foundation trust borrowing referred to in the Health Journal on 11 September.[HL4478]

Baroness Andrews: Subject to parliamentary approval, the Health and Social Care (Community Health and Standards) Bill provides for the Independent Regulator for NHS Foundation Trusts to make a code for determining the limit of borrowing by each NHS foundation trust, having regard to generally accepted principles used by financial institutions. The regulator is required to lay the code before Parliament.

In the course of developing policy on the financial regime for NHS foundation trusts, the Department of Health has consulted leading financial institutions on

6 Oct 2003 : Column WA48

the financial metrics and ratios that it might be appropriate to include in such a code. These have been made available to NHS foundation trust applicants for planning purposes as they prepare their full applications. The metrics and ratios are currently under review and will be published shortly.

Baroness Noakes asked Her Majesty's Government:

    What consultation requirements will be applied to the first wave of National Health Service foundation trusts.[HL4479]

Baroness Andrews: Guidance on the consultation requirements has been provided to all first wave applicants for NHS foundation trust status. Copies of the guidance will be placed in the Library.

Baroness Noakes asked Her Majesty's Government:

    Whether any amounts have been paid to any National Health Service trusts to assist them in preparing applications for National Health Service foundation trust status; and, if so, whether they will state the amounts paid to each such National Health Service trust.[HL4480]

Baroness Andrews: £100,000 was provided to the 29 shortlisted trusts announced in May 2003. A further payment of £75,000 is now being made to the 25 currently developing applications.

Baroness Noakes asked Her Majesty's Government:

    Whether they intend to use advisers outside the Department of Health in connection with evaluating and approving applications for National Health Service foundation trust status; and, if so, whether they will give the names of the advisers and their expected fees.[HL4481]

Baroness Andrews: External advisers will be used in the process of evaluating and approving application for the NHS foundation trust status. There will be two main ways in which they will be involved. First, applicants will undergo an independent financial review. This review, following a competitive tendering exercise, will be carried out by Price Waterhouse Coopers, KPMG and Delloitte & Touche. Our estimated cost of this exercise is £1.1 million.

In addition, the Department of Health is taking advice from a group of external experts on the proposed governance arrangements. The members of this external reference group will not be paid. However, the department will meet their reasonable expenses. It is also intended to establish reference groups on human resources and service development strategy to help inform development of the assessment criteria in that area.

Healthcare Workers: Smallpox Immunisation

Lord Jopling asked Her Majesty's Government:

    Further to the Written Answer by the Lord Warner on 9 July (WA 43–44), whether they will place in the Library of the House a copy of Lord

6 Oct 2003 : Column WA49

    Warner's letter of 5 September in which he sets out the numbers of doctors and nurses, as originally requested, rather than the percentages which were provided in the Written Answer. [HL4500]

Baroness Andrews: A copy of the Lord Warner's letter of 5 September to the noble Lord Jopling will be placed in the Library.

Paediatric Continence Services

Earl Howe asked Her Majesty's Government:

    Whether any guidance on best practice has been issued to primary care trusts, concerning the benefits of dedicated paediatric continence services. [HL4586]

Baroness Andrews: Good Practice in Continence Services was issued by the Department of Health in April 2000, and provides guidance to primary care trusts (PCTs) on continence services. Copies are available in the Library. This includes that PCTs should have specialist continence services in place which provide patients with an individual assessment of their needs. This assessment should include the provision of continence products to any patient who needs them.

Earl Howe asked Her Majesty's Government:

    What assessment they have made of how the Children's National Service Framework will benefit children with nocturnal enuresis; and [HL4587]

    Whether the Children's National Service Framework will set out suggested interventions and services for children with continence conditions, which primary care trusts would be expected to establish; and [HL4588]

    Which aspects of the Children's National Service Framework will promote the need for primary Care Trusts to address the adequacy of paediatric continence services in their respective areas; and [HL4589]

    Whether the Children's National Service Framework will include standards on treating and managing continence conditions in children through integrated paediatric continence services. [HL4590]

Baroness Andrews: The Children's National Service Framework will set out standards covering a broad range of services, including the management of common childhood conditions. Whilst few specific conditions will be covered, the standards are likely to cover what support should be available to children and their parents in managing a wide range of conditions and problems, including enuresis. The NSF will emphasise the promotion of evidence-based clinical guidelines and a number of examples of good practice in a range of different areas.

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BSE: Muscle Tissue Testing

Baroness Byford asked Her Majesty's Government:

    Whether there have been any searches for prions in the muscles of BSE or scrapie-infected animals since March 2002; and, if so, what the results have been.[HL4393]

The Parliamentary Under-Secretary of State, Department for Environment, Food and Rural Affairs (Lord Whitty): Research to investigate the possible presence of BSE agent in muscle from infected cattle is being funded by the Food Standards Agency. Muscle tissue from cattle experimentally challenged with BSE has been injected into groups of non-infected cattle. This bio-assay technique is currently the most sensitive means of determining the presence of BSE infectivity. Muscle for testing has been taken from BSE challenged animals at several time points after infection. The study was initiatied in 1996 and is projected to continue until 2013. The recipient animals are at various stages in the study, but none have been found positive for BSE infection. At present the longest interval after exposure of recipients is 82 months with no evidence of infection.


    Note: These studies are designed to detect transferrable infectivity rather than the detection of prions in muscle. At present the quantitive relatiolnship between prions and infectivity is not determined.


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