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In view of the finding of the Lancet report in 1998 on the presence of inflammatory bowel disease amongst autistic children, whether they will offer such children specialist treatment by paediatric gastroenterologists. [HL362]
Lord Warner: We understand the report to be entitled Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children, (Lancet. 1998 Feb 28;351(9103):637-41) to which a retraction was published in the Lancet in March 2004.
Children with learning or motor disability have an increased incidence of gastroenterological problems. These include feeding difficulties, gastro-oesophageal reflux, and constipation. A child with gastroenterological symptoms suggesting inflammatory bowel disease should be referred to a paediatric gastroenterologist for specialist investigation. These considerations apply irrespective of any other medical conditions in the child, including learning disability, neurological disorders, or autistic spectrum disorders.
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Lord Warner: The Department of Health paid £5,875 to Whiteloop for technical support and maintenance of www.mmrthefacts.nhs.uk in 200304. Whiteloop were paid £13,054 for joint technical support and maintenance of www.mmrthefacts.nhs.uk and www.immunisation.nhs.uk in 200405.
In light of the recent report by the Commission for Social Care Inspection, what action they are taking to ensure that the London Borough of Ealing addresses the needs of vulnerable children and adults in that area. [HL386]
Lord Warner: We understand from the Chair of the Commission for Social Care Inspection (CSCI) that Ealing Council must submit to it by 10 January 2005 a performance improvement plan. CSCI will evaluate whether it will deliver the improvements needed. The commission will monitor Ealing's performance against this plan monthly.
Following the commission's evaluation of Ealing's performance improvement plan, the commission will write in January 2005 to the Secretary of State for Health recommending any special measures, which it considers we should take.
Lord Warner: The Diabetes National Service Framework (NSF) Delivery Strategy makes it clear that primary care trusts (PCTs) should offer structured education programmes and a joint care planning process to people with diabetes to support self-management. The National Institute for Clinical Excellence technology appraisal on the use of patient-education models for diabetes supports this approach.
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Two national structured education programmes for people with diabetes are currently being rolled-out. These are DAFNE (Dose Adjustment for Normal Eating) for Type 1 and DESMOND (Diabetes Education and Self-Management for Ongoing and Newly Diagnosed) for Type 2.
Patient education programmes should include an element of goal setting and action planning. This supports the care planning process where people with diabetes agree a self-management regime with their healthcare professional. Empowering People With Diabetes: An Exploration of the Role of Personal Diabetes Records and Care Plans
a report drawing together examples of care plans for people with diabetes and identifying best practicewas published in April 2003 and is available on the National Diabetes Support Team website. This is supported through Standard 3 of the Diabtes NSF and is about patient empowerment. All people with diabetes will receive a service that encourages partnership in decision-making and supports them in managing their diabetes.
Diabetic retinopathy screening is a priority for PCTs with a target in the Priorities and Planning Framework 200306 and Diabetes NSF Delivery Strategy. Strategic health authorities performance-manage PCTs on progress. Capital funding of £27 million is available to support the purchase of digital cameras and related equipment for diabetic retinopathy screening for implementation of the target. A UK National Screening Committee programme, carried out with professional organisations and Diabetes UK is setting standards and supporting local implementation.
Further to the European Commission decision to disqualify £599 million of Britain's claim arising from the foot and mouth outbreak, whether they will give an assurance that existing financial allocations will not be cut. [HL145]
Lord Whitty: I am not aware of any figures for 1975. However, two surveys were carried out after that. One between 1985 and 1988 1 and the other between 1994 and 1997. 2 The first study gave an estimate of the badger population in Britain as around 250,000. The second study estimated an overall increase of 77 per cent but noted that there was regional variation in the amount of change. Regional breakdowns are available in the 1980s and 1990s surveys, references for which are given below.
Whether they are satisfied that the proposed reduction of £250,000 to the funding of the National Bee Unit in England will have no adverse effect on the control of diseases and pests such as Varroa, foul brood and the small hive beetle. [HL302]
Lord Whitty: The Government acknowledge that beekeepers are concerned about a number of risks that may arise from its proposals to reduce inspections for certain diseases over the coming three years. However, we believe our proposals are reasonable in the light of current disease status and available means of control. We will continue to work closely with the National Bee Unit and beekeeping associations to manage the changes envisaged and the risks which have been identified.
Work is continuing in parallel both to ensure that there is a robust testing system in place so that the OTM rule can be amended and to ensure that export restrictions are eased and the Date Based Export Scheme can be closed.
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