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Written Answers

Wednesday, 28 April 2004.

Munchausen's Syndrome by Proxy

The Countess of Mar asked Her Majesty's Government:

    Whether, following the distribution of local authority circular LAC(2004)5—Review of Children's Cases, they will ensure that medical and social workers working with children are aware of issues arising over the medical evidence for Munchausen's Syndrome by Proxy, also known as fabricated or induced illness in children, by issuing supplementary guidance.[HL1992]

The Parliamentary Under-Secretary of State, Department for Education and Skills (Baroness Ashton of Upholland): The Government's guidance, Safeguarding Children in Whom Illness is Fabricated or Induced (2002), sets out the processes to be followed when there are concerns a child may be or is having illness fabricated or induced. In addition, the Royal College of Paediatrics and Child Health issued a report on Fabricated or Induced Illness by Carers (2001). It describes the role of paediatricians and child health services and how they should work with other agencies on this issue. We have no plans to introduce additional guidance.

Children Bill: Play and Recreation

Lord Pendry asked Her Majesty's Government:

    Whether the terms "play and recreation" as set out in the Green Paper Every Child Matters, will be included on the face of the Children Bill and not left to interpretation.[HL2398]

Baroness Ashton of Upholland: As stated in Every Child Matters: Next Steps, the Government are committed to embedding the five outcomes identified by children into their programme for change to improve the well-being of children and young people. This includes the recognition that, in each local area, young people need "opportunities for personal development, learning and recreation outside school hours, including access to sport, art and cultural activities". The five identified outcomes for children are: being healthy; staying safe; enjoying and achieving; making a positive contribution, and economic well-being.

The Children Bill seeks to reflect these outcomes legislatively—providing a context to ensure work by all parties is clearly based on what children and young people have told us is important. The translation of the

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outcomes into legislation has had to reflect wording which is appropriate for legislation. However, the intent remains unchanged. We are confident that the combination of the outcomes that refer to "education and training" and "social and economic well-being" do encompass the important matters of play, recreation and leisure activities. This ensures that these areas will be covered by the legislative framework and included in the work that local agencies do in assessing the needs of local children and young people and making arrangements to meet them.

Economic and Monetary Union

Lord Lester of Herne Hill asked Her Majesty's Government:

    Whether they intend to introduce legislation for a referendum on whether the United Kingdom should enter the eurozone.[HL2452]

The Parliamentary Under-Secretary of State, Department for Culture, Media and Sport (Lord McIntosh of Haringey): The Government's policy on membership of the single currency was set out by the Chancellor in his statement to Parliament in October 1997 and updated in the government statement on EMU membership on 9 June 2003. The draft Single European Currency (Referendum) Bill was published on 10 December 2003.


Lord Berkeley asked Her Majesty's Government:

    Under what circumstances the British and French Governments can refuse Eurotunnel's creditor banks permission to take over the company in the event of default in interest or other payments due to them.[HL2461]

Lord Triesman: The provisions relating to lenders are spelled out in Clause 32 of the Channel Tunnel Concession Agreement of 14 March 1986 (Cmnd 9769).

Clause 32.1(1), supported by Annex IV, sets out the circumstances in which the lenders may seek to install substitute concessionaires, and the assurance that must be provided to the two governments.

Hip Replacements

Lord Jacobs asked Her Majesty's Government:

    How many people are awaiting a hip replacement in the National Health Service; what is the maximum time that any are waiting; how many hip replacements were carried out in 2003; and what is the current monthly rate of demand for hip replacements.[HL2462]

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The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): Data are not collected centrally on waiting times for hip replacements, nor are they collected centrally for rate of demand for hip replacements.

The total number of hip replacements in 2002–03 was 77,902*.


    Finished Consultant Episode (FCE)

    An FCE is defined as a period of admitted patient care under one consultant within one healthcare provider. Please note that the figures do not represent the number of patients, as a person may

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    have more than one episode of care within the year. OPCS4 codes W37–W39 and W46–W48 have been used to define Hip Replacements.

    All Operations count of Episodes

    These figures represent a count of all FCE's where the procedure was mentioned in any of the 12 (four prior to 2002–03) operation fields in a HES record. A record is only included once in each count, even if an operation is mentioned in more than one operation field of the record.

    Ungrossed Data

    Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).

    Source: Hospital Episode Statistics (HES), Department of Health.

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