Dementia
Oliver Colvile: To ask the Secretary of State for Health whether his Department has a dementia strategy. [151828]
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Norman Lamb: ‘Living well with dementia: A National Dementia Strategy’, was published by the Department of Health in 2009.
In March 2012, the Prime Minister's challenge on dementia was published with the ambition of building on the national dementia strategy to deliver improvements in health and care, create dementia-friendly communities and ensure better research into dementia. Copies of both documents have already been placed in the Library.
In November 2012, the groups published ‘Delivering major improvements in dementia care and research by 2015: a report of progress’. We expect to publish an annual report on progress in May 2013.
Dementia: Tower Hamlets
Rushanara Ali: To ask the Secretary of State for Health what steps he is taking to improve the diagnosis rate for dementia in the London borough of Tower Hamlets. [151604]
Norman Lamb: Improving diagnosis rates for dementia is a priority for the Government and we want to see both an increase in the overall rate and a reduction in the current regional variation.
Dementia has been prioritised by both the Department and through the NHS Mandate and by NHS England through their planning guidance.
We have asked local areas, through the NHS Mandate, to make measurable progress in improving dementia diagnosis over the next two years, which should reduce the variation and ensure access to timely diagnosis.
Diabetes
Alison Seabeck: To ask the Secretary of State for Health how many training places were (a) available and (b) filled for specialist diabetes nurses in each of the last five years. [150858]
Dr Poulter: The numbers of available and filled training places for specialist diabetes nurses is not held centrally.
The Department and its arm's length bodies do not collect population or attrition data for the number of nurses undertaking specialist, post registration training programmes.
In order to provide and maintain an efficient and responsive nursing work force that delivers the highest quality of care, local health care employers have responsibility for determining which specialist nurse training programmes are made available and in what number to meet the needs and demands of their local services.
Doctors: Recruitment
Jim Shannon: To ask the Secretary of State for Health what discussions he has had to increase the recruitment of specialist accident and emergency doctors across the UK. [150896]
Dr Poulter:
Departmental officials and members of the College of Emergency Medicine established the Emergency Medicine Taskforce in September 2011 to address work force issues in emergency medicine. The group considered these issues and made recommendations
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on the future clinician staffing of emergency departments (EDs) with the aim of ensuring patients within EDs receive high quality care that is consistent, responsive, safe and effective as well as being value for money.
The taskforce has developed an interim report, which contains a number of recommendations exploring many aspects of medical education and training, which may be contributing to the problems that the specialty is currently facing.
The interim report was presented to the last Medical Education England (MEE) Board on 19 September 2012. The recommendations in the report were strongly supported and MEE has passed the report to Health Education England for action.
Drugs: Prisons
Margot James: To ask the Secretary of State for Health (1) how many prisoners have been prescribed methadone because of a heroin addiction in each of the last five years; [151150]
(2) how much his Department spent on methadone prescriptions in prisons in each of the last five years. [151151]
Norman Lamb: Information is not available in respect of the number of prisoners who have been prescribed methadone to treat heroin addiction in each of the last five years. Data are available on the total number of methadone treatments in prison in each of the last five years and are shown in table 1.
| Table 1: Number of clinical interventions for opioid (heroin) dependence among prisoners in England between 2007-08 and 2011-12: maintenance-based prescription and abstinence-based detoxification programmes, male and female, all ages | |||
| Total number of in-year maintenance prescriptions | Total number of individual in-year detoxification treatments provided | Aggregate number of in-year clinical drug interventions | |
| Source: National Offender Management Service | |||
We are informed by Public Health England that data are not collected centrally on spending by prisons on methadone prescriptions. Data are available on total funding allocations for clinical drug treatment to primary care trusts in prisons over the last five years and are shown in table 2. However, the totals include spending on both detoxification and maintenance based interventions and it is not possible to extract methadone prescription costs from the data.
| Table 2: Total funding allocations made to primary care trusts for all clinical drug treatments in prisons in England between 2008-09 and 2012-13: male and female, all ages | |
| Total clinical drug funding allocation (£ million) | |
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| Source: Public Health England | |
From April 2011, the total allocation included funding for psychosocial interventions which had previously been funded by the National Offender Management Service. In 2012-13 the total included funding for the young persons’ secure estate and for immigration removal centres.
Drugs: Rehabilitation
Dr Huppert: To ask the Secretary of State for Health (1) what guidance his Department has issued to encourage prescribers to follow a recovery-based approach to treatment since the publication of the National Drug Strategy; [152249]
(2) what assessment he has made of current National Institute for Health and Clinical Excellence guidance on substance misuse to deliver recovery outcomes for patients. [152071]
Anna Soubry: The National Institute for Health and Clinical Excellence (NICE) issued a suite of drug treatment guidelines published between 2007 and 2008 which highlighted a range of evidence-based interventions which can help people recover from drug-dependence. NICE guidance represents best practice and we expect commissioners and clinicians to take it fully into account in their decision-making.
The 2010 Drug Strategy recognised that "Recovery can only be delivered through working with education, training, employment, housing, family support services, wider health services and, where relevant, prison, probation and youth justice services to address the needs of the whole person."
The Department tasked a Recovery Orientated Drug Treatment Expert Group led by Professor John Strang (National Addiction Centre) to look at how to meet the ambition of the 2010 Drug Strategy to help more heroin users to recover and break free of dependence. Their 2012 report, “Medications in recovery: Re-orientating drug dependence treatment” makes clear that heroin users should not be maintained on substitute drugs, such as methadone, without regular review. It also sets out practical steps that local areas can take to increase the recovery orientation of their local treatment systems.
Eating Disorders
Mr Charles Walker: To ask the Secretary of State for Health how many people were treated in hospitals for eating disorders in 2011-12; and how many of those people had previously received treatment for an eating disorder through hospital admission. [151863]
Norman Lamb:
Statistics on hospital episodes gathered by the NHS Information Centre for Health and Social Care show that there were 2,287 finished hospital episodes with a primary diagnosis of eating disorders for 2011-12. The number of episodes does not represent the number of patients, as an individual may be admitted to hospital
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on more than one occasion in any given year. We do not collect information centrally on how many of those people had previously received treatment for an eating disorder through hospital admission.
Electronic Cigarettes
Mr Laurence Robertson: To ask the Secretary of State for Health what recent assessment he has made of any health risks associated with electronic cigarettes; and if he will make a statement. [151082]
Norman Lamb: There are a number of products on the market which claim to contain nicotine, such as electronic cigarettes, which are widely available but are not licensed medicines. Currently, any nicotine-containing product (NCP) which claims or implies that it can treat nicotine addiction is considered to be a medicinal product. This approach has allowed NCPs which do not make such claims to be used and sold without the safeguards built into the regulation of medicinal products.
In March 2011, the Medicines and Healthcare products Regulatory Agency (MHRA) published the outcome of a public consultation on whether to bring all NCPs within the medicines licensing regime. The response to consultation highlighted the need for further information to inform a decision. Since this time, the MHRA co-ordinated a programme of research to advise on:
an investigation of the levels of nicotine which have a significant physiological effect through its pharmacological action;
the nature, quality and safety of unlicensed NCPs;
the actual use of unlicensed NCPs (excluding tobacco products) in the marketplace;
the efficacy of unlicensed NCPs in smoking cessation; and
modelling of the potential impact of bringing these products into medicines regulation on public health outcomes.
The MHRA is currently bringing to a conclusion this period of scientific and market research with a view to a final decision on the application of medicines regulation later this year.
Mr Frank Field: To ask the Secretary of State for Health when he expects the Medicines and Healthcare Products Regulatory Agency to make its final decision on the application of medicines regulation to electronic cigarettes containing nicotine. [151721]
Norman Lamb: 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 the consultation highlighted the need for further information to inform a decision. The MHRA is co-ordinating a programme of scientific and market research and aims to inform a final decision on the application of medicines regulation later this year.
Fertility
Mr Barron: To ask the Secretary of State for Health which directorate of the NHS Commissioning Board is responsible for infertility. [151187]
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Anna Soubry: NHS England has informed us that oversight of the commissioning of national health service fertility services will be the responsibility of its medical directorate.
General Practitioners
Mr Nicholas Brown: To ask the Secretary of State for Health what the average age is of general practitioners in the NHS. [151232]
Dr Poulter: At 30 September 2012, the average age of general practitioners (GPs) providing NHS primary medical services was 46.69. This compares to 46.66 in 2011 and 46.63 in 2010.
This information, which was provided by the Health and Social Care Information Centre, includes all GPs (excluding GP retainers and GP registrars) and is based on GPs with a known age.
Haemolytic Uremic Syndrome
Mr Virendra Sharma: To ask the Secretary of State for Health if he will take steps to ensure that the health of people with atypical haemolytic uremic syndrome (aHUS) are not disadvantaged by his Department's decision to refer to the National Institute for Health and Clinical Excellence the evaluation of cost, benefit and affordability of eculizumab for the treatment of aHUS in England. [151930]
Norman Lamb: Until the National Institute for Health and Clinical Excellence (NICE) has completed its evaluation of eculizumab under its highly specialised technologies programme, arrangements have been put in place to ensure existing patients previously funded by primary care trusts will continue to receive eculizumab following the transferral of responsibility for specialised commissioning to NHS England from 1 April 2013.
NHS England is also developing a single process for considering new funding requests for this drug in the period prior to the completion of NICE's evaluation.
Haemophilia
Mr Jim Cunningham: To ask the Secretary of State for Health what steps his Department has taken to support the haemophilia community. [152623]
Anna Soubry: The Department has supported the haemophilia community in a number of ways and I refer the hon. Member to the written answers I gave him on 1 November 2012, Official Report, columns 360-61W.
For the first time standards and pathways of care are being standardised across England, with specifications developed through clinical leadership and oversight supported by NHS England which has responsibility for the commissioning of specialised services.
Clinical commissioning groups, working with Health and Wellbeing Boards, are responsible for ensuring local pathways. Services are commissioned based on local needs and these services will be supported by the appropriate, nationally commissioned, specialist services.
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Health Professions: Regulation
Mr Gregory Campbell: To ask the Secretary of State for Health what his policy is on the recommendation of the Health and Care Professions Council that health care practitioners be subject to statutory regulation. [152515]
Dr Poulter: The Command Paper ‘Enabling Excellence’, published in February 2011, sets out the Government's vision for the future of work force regulation which is that while statutory regulation is sometimes necessary where significant risks to users of services cannot be mitigated in other ways, it is not always the most proportionate or effective means of assuring the safe and effective care of service users.
We are not ruling out compulsory statutory regulation. However, any decision to extend compulsory statutory regulation to a professional or occupational group, including those groups previously recommended for statutory regulation by the Health and Care Professions Council, must be based on a solid body of evidence demonstrating a level of risk to the public, and which cannot be effectively addressed through other means of assurance, including assured voluntary registration.
Health Services
Alison Seabeck: To ask the Secretary of State for Health what steps he is taking to ensure that patient groups are involved in the design of the procurement tenders by NHS trusts. [150696]
Dr Poulter: The NHS Standards of Procurement which were published in May 2012, and are due to be refreshed in May 2013, were issued as guidance for trusts on how to improve their procurement performance. One of the Standards includes the development of ‘user groups’ for clinical goods and services, which should in some cases include patient representation. It is the individual trusts that will decide when and under what circumstances this is appropriate and how to involve patient groups.
Alison Seabeck: To ask the Secretary of State for Health what steps he is taking to ensure that patient groups are included in strategic decision-making by (a) his Department and (b) the NHS Commissioning Board. [150697]
Dr Poulter: The Department has developed a National Stakeholder Forum as part of the Department's programme of work to engage with patient groups and other external stakeholders to strengthen the quality of their input into the development and implementation of health and social care policies.
The new system-wide Health and Care Voluntary Sector Strategic Partner programme for 2013-14 will enable a number of voluntary and community sector organisations to influence strategic decision-making by the Department, NHS England (the NHS Commissioning Board) and Public Health England.
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There is a duty on clinical commissioning groups (CCGs) to promote the involvement of patients and carers in decisions which relate to their care or treatment, including diagnosis, care planning, treatment and care management.
A second duty relates to the requirement for CCGs to ensure public involvement and consultation in commissioning processes and decisions. CCGs must include a description of these arrangements their constitution.
Health Services: Foreign Nationals
Philip Davies: To ask the Secretary of State for Health how many individual items of correspondence his Department received in each of the last 10 years expressing concern about NHS trusts' total losses, bad debts and claims abandoned in relation to overseas visitors not entitled to free NHS treatment. [150891]
Anna Soubry: The Department cannot provide the information requested without incurring disproportionate cost.
Heart Diseases: Children
Mr Nicholas Brown: To ask the Secretary of State for Health (1) what assessment he has made of the adequacy of the number of hospitals identified to provide specialist children's congenital heart surgical services by the safe and sustainable review to meet future demand for the service; [151233]
(2) when he plans to name the seven hospitals that will continue to provide specialist children's congenital heart surgery following the outcome of the safe and sustainable review. [151234]
Anna Soubry: The provision of children's heart surgery is a matter for NHS England.
The national health service review of children's heart surgery conducted by the Joint Committee of Primary Care Trusts (JCPCT) was independent of Government. It concluded that children's heart surgery should be concentrated in seven units to maintain and improve the quality of the service to ensure that children received the very best care now and in future.
Following initial advice from the Independent Reconfiguration Panel (IRP) on referrals from three overview and scrutiny committees, the Secretary of State asked the IRP to undertake a full review of the JCPCT’s decision on which units should continue to provide children's congenital heart surgery. The IRP has been asked to report back by 30 April 2013.
Hilary Benn: To ask the Secretary of State for Health (1) which organisation will now be responsible for responding to the High Court judgment in respect of the proposal by the Safe and Sustainable Review to close the Leeds Children's Heart Surgery Unit; [152064]
(2) whether he intends to issue guidance to (a) the Independent Reconfiguration Panel and (b) the Safe and Sustainable Review about the matters it should now consider in respect of the High Court decision on the proposal to close the Leeds Children's Heart Surgery Unit; [152065]
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(3) whether he is satisfied by the assessment of the quality of children's heart surgery carried out by the Safe and Sustainable Review to date; and whether it will now review the new data published by the National Institute for Cardiovascular Outcomes Research; [152066]
(4) whether he has been advised that it is the intention of the Safe and Sustainable Review to appeal against the decision of the High Court in respect of its proposal to close the Leeds Children's Heart Surgery Unit. [152067]
Anna Soubry: The Safe and Sustainable Review of children's congenital heart services was a national health service review, independent of Government. From 1 April 2013, responsibility for the review passed to NHS England. It is for NHS England to respond to the High Court judgment. We understand that NHS England has now lodged an appeal against the Court's decision of 27 March 2013 to quash the decision made by the Joint Committee of Primary Care Trusts on the future location of children's congenital heart services.
In these circumstances, and given the Safe and Sustainable review is the subject of an Independent Reconfiguration Panel review, it would not be appropriate for me to comment further at this stage.
Horsemeat
Mary Creagh: To ask the Secretary of State for Health what reports the Food Standards Agency has received on the number of (a) meatballs stored by IKEA in freezers after withdrawing the product because of test results showing the presence of equine DNA and (b) phenylbutazone tests IKEA has conducted on meatballs which have been stored in freezers after originally being withdrawn because of test results showing the presence of equine DNA. [152230]
Anna Soubry: IKEA has reported to the Food Standards Agency (FSA) details of the quantities of meatballs on hold in the United Kingdom following the quantification tests for horse DNA at 1% and above. As this information is commercially sensitive, and the public interest in favour of disclosure does not outweigh the public interest in withholding the detail of these reports, it is not possible to release this information.
The FSA notes that recent media coverage of IKEA's plans to re-label and resell the meatballs containing horsemeat, subject to regulatory approval, are limited to Sweden.
IKEA has also reported to the FSA the results of phenylbutazone (bute) testing on batches of meatballs, where quantification tests identified horse DNA present at 1% and above. IKEA has advised the FSA that all tests were negative for bute. As this information is commercially sensitive, and the public interest in favour of disclosure does not outweigh the public interest in withholding the detail of these reports, it is not possible to release this information.
Hospital Beds
Jeremy Lefroy: To ask the Secretary of State for Health how many acute beds there were by hospital in England in (a) 2009-10, (b) 2010-11, (c) 2011-12 and (d) 2012-13. [151542]
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Anna Soubry: The available information has been placed in the Library.
Hospitals: Admissions
Jeremy Lefroy: To ask the Secretary of State for Health how many emergency and acute admissions to hospital there were by primary care trust in (i) 2009-10, (ii) 2010-11, (iii) 2011-12 and (iv) 2012-13. [151416]
Anna Soubry: The available data have been placed in the Library. Hospital Episodes Statistics for admitted patient care data for 2012-13 will be published by the Health and Social Care Information Centre in November 2013 (provisional date).
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Nick de Bois: To ask the Secretary of State for Health what the 10 most common causes of (a) child and (b) adult emergency (i) admissions to and (ii) attendances at hospital were in each of the last five years for which figures are available. [152202]
Anna Soubry: Information on the most common primary diagnoses of children and adults who attended or were admitted to hospital as an emergency patient is shown in the following tables. Final information for 2012-13 will be published by the Health and Social Care Information Centre in November 2013 for admissions and January 2014 for accident and emergency (A&E) attendances (provisional dates).
| Emergency admissions (excluding via NHS A&E departments) | ||||||
| Age group | Primary diagnoses(1) | 2007-08 | 2008-09 | 2009-10 | 2010-11 | 2011-12 |
|
Acute upper respiratory infections of multiple and unspecified sites | ||||||
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| NHS A&E attendances | ||||||
| Age group | Primary diagnoses(1) | 2007-08 | 2008-09 | 2009-10 | 2010-11 | 2011-12 |
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| (1) Top 10 primary diagnoses for 2011-12. Where this is different in a previous year, additional primary diagnoses have been shown to provide coverage of the top 10 for that year. Source: Hospital Episode Statistics (HES), The NHS Information Centre for health and social care. | ||||||
Hospitals: Construction
Chris Ruane: To ask the Secretary of State for Health pursuant to Question 148422, what the reasons were for the decrease in capital investment in hospital building between 2010-11 and 2011-12. [151316]
Dr Poulter: The capital expenditure figures provided in the answer to Question 148422 were the sum of capital investment by all national health service organisations than provided data through the Estates Return Information Collection.
Each NHS organisation makes decisions locally on the amount of capital investment they undertake each year. The level of capital investment they make will depend on the changes to their infrastructure they wish to undertake balanced with the capital funding they have available. Information on the reasons for such local decisions are not collected centrally.
Hospitals: Waiting Lists
Mr Hanson: To ask the Secretary of State for Health what recent assessment he has made of (a) the length of waiting times for spinal surgery, (b) the number of specialist spinal surgeons and (c) the number of patients waiting for emergency and routine treatment in England. [151601]
Anna Soubry: The latest provisional Hospital Episode Statistics for the period April 2012 to December 2012 show a median waiting time of 55 days from decision to admit to admission to hospital for spinal surgery.
Information on the number of specialist spinal surgeons in England is not collected centrally. Latest data on the number of medical staff in trauma and orthopaedic surgery is shown in the following table.
| Hospital and community health services: medical and dental staff within the specialty by consultant grade | ||||||||||||
| England at 30 September 2010 | England at 30 September 2011 | England at 30 September 2012 | ||||||||||
| All staff | Consultant (including Director of Public Health) | All staff | Consultant (including Director of Public Health) | All staff | Consultant (including Director of Public Health) | |||||||
| No. | FTE(1) | No. | FTE | No. | FTE | No. | FTE | No. | FTE | No. | FTE | |
| (1) Full time equivalent. Source: The Health and Social Care Information Centre. Medical and Dental Workforce Census 2011, 2012 and 2013 | ||||||||||||
Latest referral to treatment waiting times data show that at the end of January 2013 there were 350,240 patients waiting for non-emergency consultant-led trauma and orthopaedics treatment in England and that 90.9 % of these patients had been waiting less than 18 weeks from referral. Information on the waiting times of patients waiting for emergency trauma and orthopaedics treatment is not available centrally.
Human Embryo Experiments
Mr Gregory Campbell: To ask the Secretary of State for Health if he will make an assessment of (a) moral and (b) scientific issues relating to a technique for implanting donor DNA from a third party into in vitro embryos approved by the Human Fertilisation and Embryology Authority. [152263]
Anna Soubry: We will carefully consider the advice about mitochondria replacement that we received on 28 March from the Human Fertilisation and Embryology Authority, following its public consultation, and will respond in due course.
Human Papillomavirus
Harriett Baldwin: To ask the Secretary of State for Health how many yellow card reports for the drug Cerverix were received by the Medicines and Healthcare products Regulatory Agency in (a) 2009, (b) 2010, (c) 2011 and (d) 2012. [151271]
Norman Lamb:
Reports of 'suspected' adverse drug reactions (ADRs) are collected by the Medicines and Healthcare products Regulatory Agency (MHRA) and Commission for Human Medicines (CHM) through the spontaneous reporting scheme, the Yellow Card scheme.
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The scheme collects suspected ADR reports from the whole of the United Kingdom in relation to all medicines and vaccines. Reporting to the Yellow Card scheme is voluntary for healthcare professionals and members of the public. There is however also a legal obligation for pharmaceutical companies to report all serious ADRs for their products that they are aware of.
Between 1 January 2009 and 31 December 2012 the MHRA has received a total of 5,125 United Kingdom spontaneous suspected ADR reports in association with Cervarix and the Human Papillomavirus (HPV) Vaccine where the brand was not specified. The following table provides a breakdown of these reports by year.
| Receipt year | Number of reports |
It is important to note that Yellow Card reports are not proof of a side effect occurring but only a suspicion by the reporter that the vaccine may have caused the side effect. Yellow Card reports may therefore relate to true side effects of the vaccine, or they may be due to coincidental illnesses that would have occurred in the absence of vaccination.
As with all vaccines and medicines, the MHRA continues to closely monitor the safety of HPV vaccines using all available sources of data with advice from the CHM. The benefits of HPV vaccination in protecting against cervical cancer far outweigh any known side effects.
Mr Bain: To ask the Secretary of State for Health what recent assessment his Department has made of the increased risk to human health through cancer following infection with the human papilloma virus (HPV); and what his policy is on the extension of an immunisation programme against HPV, particularly amongst men. [151413]
Anna Soubry: Information was updated in 2012 on the role of the Human Papillomavirus (HPV) vaccine in cancer and on the epidemiology of HPV-related disease presented in the Human Papillomavirus chapter of “Immunisation against infectious disease”, which is the guidance document produced by United Kingdom health departments. This publication is available on the Department's website, by searching for ‘Green Book’. Chapter 18a refers to HPV.
The Joint Committee on Vaccination and Immunisation (JCVI)—the independent experts that advise Government on immunisation—keeps the eligibility criteria of all vaccination programmes under review and most recently considered the HPV immunisation programme in June 2012. In relation to the eligibility criteria for HPV immunisation, the committee's meeting minutes record:
“The committee was presented with data on HPV infections and noted that:
there is early evidence to suggest the HPV immunisation programme in England is lowering the number of HPV 16 and 18 infections in females in birth cohorts that have been eligible for vaccination;
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data are very limited on the prevalence of HPV infections in MSM. However, research is underway at University College London that will provide more data and an age profile of HPV prevalence;
HPVs, particularly types 16 and 18, are associated with the majority of anal cancers as well as cervical cancers. HPVs are associated to lesser degree with penile, vaginal, vulval and head and neck cancers but HPV types 16 and 18 predominate in cancers at those sites that are HPV-reiated. Data on the impact of HPV vaccination on infection at some of these non-cervical sites is limited.
The committee noted that the potential impact of HPV vaccination on non-cervical cancers would make the current HPV immunisation programme even more cost effective. However, it would remain the case that, given the expected effects of immunisation on HPV transmission and the indirect protection of boys that accrues from high levels of coverage of HPV vaccination in girls, vaccination of boys in addition to girls was unlikely to be cost effective. Evidence for indirect protection would continue to be evaluated by the ongoing HPV surveillance programme at the HPA. However, there may be little indirect protection of MSM from the current immunisation programme. Therefore, the impact and cost effectiveness of vaccination strategies for MSM with the offer of vaccination through general practice and/or at genitourinary medicine clinics needs to be assessed. Data on the prevalence of HPV infections in MSM by age, and in the settings where vaccination could be offered to MSM, are needed to determine the potential effectiveness and cost effectiveness of HPV vaccination of MSM. The vaccines are less effective against those with vaccine type HPV infection(s) at the time of vaccination. Additionally it would be important to understand better the rates of HPV-related disease in MSM and the influence of HPV on HIV infection. JCVI asked the HPA to undertake modelling work to assess the impact and cost effectiveness of HPV immunisation of MSM acknowledging that it may take some time to acquire the data needed and that additional modelling resources may be required.”
The full minute of the meeting has been placed in the Library.
The Committee will consider the modelling study requested from the Health Protection Agency (now Public Health England (PHE)) once it has been completed and provide advice. The Department, together with PHE and NHS England, will consider the JCVI's advice once it has been received.
Kidneys: Injuries
Graeme Morrice: To ask the Secretary of State for Health what training is provided to NHS staff on identifying and treating acute kidney injury. [151563]
Dr Poulter: The content and standard of healthcare training is the responsibility of the independent regulatory bodies.
Through their role as the custodians of quality standards in education and practice, these organisations are committed to ensuring high quality patient care delivered by high quality health professionals and that healthcare professionals are equipped with the knowledge, skills and behaviours required to deal with the problems and conditions they will encounter in practice, including the treatment of acute kidney injury.
From 1 April 2013 Health Education England is responsible for promoting high quality education and training that is responsive to the changing needs of patients and local communities and will work with stakeholders to influence training curricula as appropriate to ensure that they met both patient and service needs.
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Leukaemia
Mark Garnier: To ask the Secretary of State for Health (1) what steps he has taken to ensure that those diagnosed with chronic myeloid leukaemia have access to a wide range of treatment options, including Dasatinib’ [151773]
(2) what recent discussions he has had to ensure that those diagnosed with chronic myeloid leukaemia have access to a wide range of treatment options, including Dasatinib. [151774]
Norman Lamb: The Mandate to NHS England clearly states the need to improve access to treatment for people when they need it.
The National Institute for Health and Clinical Excellence (NICE) has issued technology appraisal guidance that recommends the drugs imatinib and nilotinib for use in the treatment of chronic myeloid leukaemia. NICE guidance does not recommend dasatinib as a clinically and cost-effective use of national health service resources.
Commissioners are under a statutory obligation to provide funding for such treatments and drugs recommended by NICE within three months of the guidance being published.
Patients have a right under the NHS Constitution to clinically appropriate drugs and treatments recommended by NICE technology appraisal guidance.
Since October 2010, the £650 million Cancer Drugs Fund has helped over 28,000 patients in England to access the drugs their clinicians believe will help them. NHS England has now taken on oversight of the fund, bringing even greater consistency to decision making.
The Secretary of State for Health has had no recent discussions about this matter.
Local HealthWatch
Chi Onwurah: To ask the Secretary of State for Health whether his Department's definition of a social enterprise with regard to Healthwatch organisations reflects a cross-Governmental definition of social enterprise. [152487]
Norman Lamb: The term “Social Enterprise” describes the purpose of a business, not its legal form. It is defined by Government as
“a business with primarily social objectives whose surpluses are principally reinvested for that purpose in the business or in the community, rather than being driven by the need to maximise profit for shareholders and owners”.
In the context of Local Healthwatch, section 222(8) of the Local Government and Public Involvement in Health Act 2007 sets out that a body is a social enterprise if it could reasonably be considered to act for the benefit of the community in England and satisfies any criteria prescribed by regulations.
Regulations 35 to 38 of the NHS Bodies and Local Authorities (Partnership Arrangements, Care Trusts, Public Health and Local Healthwatch) Regulations 2012 make related provision.
Regulation 35 prescribes the criteria to be satisfied for a body to be a social enterprise, including criteria relating to the distribution of profits. Regulation 36 sets out certain activities of a political nature which are not
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to be treated as carried on for the benefit of the community. Regulation 37 makes provision about what constitutes a section of the community. Regulation 38 prescribes the criterion to be satisfied by a social enterprise and this concerns involvement of lay persons and volunteers in governance.
In our view, these provisions together ensure that Local Healthwatch is a social enterprise spirit as well as in name. They reflect the approach to social enterprises in existing legislation and are in keeping with the Government's description of social enterprises as businesses with social objectives whose surpluses are principally reinvested in the business or in the community.
Macfarlane Trust
Mr Jim Cunningham: To ask the Secretary of State for Health what his plans are for future funding of the Macfarlane Trust; and if he will make a statement. [152626]
Anna Soubry: Allocations to the Macfarlane Trust are decided on an annual basis. This year we have made available an allocation of up to £2.2 million. In addition, the Trust is holding funds of about £3.5 million in reserve, which it is able to disburse to its beneficiaries.
Maternity Services: West Midlands
Karen Lumley: To ask the Secretary of State for Health what the spare capacity level for birth is at (a) Heartlands Hospital, (b) Worcestershire Royal Hospital and (c) Birmingham Women's Hospital. [151265]
Dr Poulter: The information requested is not held centrally.
The hon. Member should approach the national health service trusts concerned respectively, which may hold the relevant information.
Medicine: Research
Mr Laurence Robertson: To ask the Secretary of State for Health what his policy is on accreditation for the clinical research industry. [151089]
Dr Poulter: The Department does not accredit the clinical research industry.
Mr Laurence Robertson: To ask the Secretary of State for Health what steps he is taking to encourage pharmaceutical companies to carry out clinical research in the UK. [151090]
Dr Poulter: The Department is working with other Government Departments and engaging with the life sciences industry, including the pharmaceutical industry, to ensure that the country has the best possible environment to carry out clinical research.
The Department has made good progress in implementing its research-related measures in the “Plan for Growth” (2011). Furthermore, the joint “Department for Business, Innovation and Skills/Department of Health Strategy for UK Life Sciences” (2011) includes a range of initiatives which together aim to support building a life sciences ecosystem, attracting, developing and rewarding the best talent, and overcoming barriers and creating
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incentives for the promotion of health care innovation. The Strategy highlighted the importance of the National Institute for Health Research (NIHR), funded by the Department, for supporting life sciences industry research.
Through the NIHR, the Department is funding a range of infrastructure facilities including biomedical research centres and units to undertake collaborative translational research with industry, two translational research partnerships which support industry to work with the national health service and academia on a shared risk/shared reward basis, the NIHR Office for Clinical Research Infrastructure which facilitates collaborations between the NIHR-funded infrastructure and funders of research including industry, and the Clinical Research Network which supports the delivery of commercial and non-commercial studies and provides dedicated support for the life sciences industry.
The Department established the Health Research Authority (HRA) in December 2011 to protect and promote the interests of patients and the public in health research. The HRA is working with others to streamline health research approvals and to promote consistent, proportionate standards for compliance and inspection helping to make the United Kingdom a more attractive place to undertake research.
The Government have also introduced incentives at a local level for the initiation and delivery of research. Since autumn 2011, all new NIHR contracts include a benchmark of 70 days or less to recruit the first patient to a study and a requirement to report on delivery of research to time and target. By encouraging an improvement in performance in initiating and delivering research by the NHS, the Government intend to enhance the nation's attractiveness as a host for research.
The Government also welcome the European Commission's proposal for a Clinical Trials Regulation to replace the Clinical Trials Directive (Directive 2001/20/EC). The Government consider that the proposal has the potential to create a more favourable environment for the conduct of clinical trials in the UK and across the European Union, making it easier to conduct trials in multiple member states. The Government are participating in negotiations across member states on the text of the Regulation.
Other steps the Department has taken include the creation of the Clinical Practice Research Datalink providing access to anonymised patient records to support clinical trials, tools to support faster contracting such as model agreements and standard costing templates, and support to the NHS to help it improve performance for example through the Research Support Services framework.
Medirest
Nick de Bois: To ask the Secretary of State for Health what representations he has received from (a) trade unions and (b) other staff representatives on the non-payment of contract staff at Chase Farm Hospital employed by Medirest under Agenda for Change; and if he will make a statement. [151407]
Dr Poulter:
A search of the Department's ministerial correspondence database has not identified any correspondence received from trade unions or other
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staff representatives about the non-payment of contract staff at Chase Farm Hospital employed by Medirest under Agenda for Change.
Meningococcal Disease
David Morris: To ask the Secretary of State for Health what steps he is taking to raise awareness of meningococcal group B disease. [151176]
Anna Soubry: Public Health England (PHE), an Executive agency of the Department of Health, works closely with meningitis charities, including Meningitis UK and the Meningitis Research Foundation, to support the production of literature and public awareness campaigns. PHE staff also contribute to scientific meetings to raise awareness of meningitis in health professionals. PHE collaborated with the Royal College of Paediatrics and Child Health on two courses entitled 'How to Manage Bacterial meningitis'.
In addition, the local Health Protection teams in PHE's centres follow up all individual cases of meningococcal infection. This involves public health management which includes raising awareness in the community and with local health professionals to ensure that both groups—patients and healthcare professionals—are aware of the signs and symptoms of infection and therefore present early for medical care.
Methadone
Ian Austin: To ask the Secretary of State for Health what assessment he has made of the effectiveness of dispensing methadone from community pharmacies in terms of reducing dependence on drugs. [151477]
Anna Soubry: Community pharmacies play an integral role in local drug treatment systems by dispensing opioid substitute medicines such as methadone and sterile needles and syringes. Together these interventions are a proven way to keep blood borne viruses rates relatively low among injecting drug users. Independent research has shown that introducing supervised methadone dosing (where a pharmacist oversees the consumption of opioid substitute medicines) was followed by substantial declines in related overdose deaths.
Drug treatment encompasses a range of treatments and services which help people overcome their dependency and reduce the physical and psychological harms caused by drugs to themselves, their families and communities. So although community pharmacies dispensing methadone are an important part of any drug treatment system, it is difficult to isolate its particular effectiveness in reducing drug dependence.
However we know that overall the drug treatment system is helping more and more people to overcome their addiction. The latest drug treatment figures show that 29,855 successfully completed their treatment in 2011-12, compared with 11,208 in 2005-06.
Ian Austin: To ask the Secretary of State for Health how much has been paid to community pharmacies to dispense methadone prescriptions in each of the last three years. [151478]
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Norman Lamb: The net ingredient cost of methadone dispensed in the community in England is shown in the following table:
| Number of prescription items (thousand) | Net ingredient cost (£000) | |
| Source: Prescription Cost Analysis provided by NHS Prescription Services | ||
NHS Prescription Services is unable to provide data on how much has been paid to community pharmacies to dispense methadone prescription items as extracting information on the applicable fees for methadone prescriptions would incur a disproportionate cost.
Musculoskeletal Disorders
Mr Clappison: To ask the Secretary of State for Health when the National Institute for Health and Care Excellence quality standard for muscular degeneration will be developed. [151945]
Norman Lamb: The topic macular degeneration is in the core library of quality standards referred to the National Institute for Health and Care Excellence (NICE). We understand from NICE that this topic has not yet been scheduled into its work programme as development of the quality standard is dependent on the publication of the corresponding clinical guideline from which it will be derived. The clinical guideline is currently scheduled for publication in July 2015.
National Cancer Research Institute
Andrew Stephenson: To ask the Secretary of State for Health (1) what amount of funding his Department will spend on research into (a) all types of cancer, (b) site-specific cancers and (c) brain cancer in each year from 2013 to 2015; [150942]
(2) what assessment he has made of the effectiveness of the National Cancer Research Institute in reducing duplication in cancer research over the last 10 years; [150943]
(3) on which areas of research his Department expects the National Cancer Research Institute to increase its focus over the next five years. [150944]
Dr Poulter: The Department's National Institute for Health Research (NIHR) spent £104 million on cancer research in 2011-12; a figure for 2012-13 is not yet available. Expenditure in future years, including spend on research relating to brain cancer and other specific cancer sites, depends on the volume and quality of scientific activity. The usual practice of the NIHR is not to ring-fence funds for expenditure on particular topics: research proposals in all areas compete for the funding available. The NIHR welcomes funding applications for research into any aspect of human health, including cancer. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the scientific quality of the proposals made.
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The National Cancer Research Institute (NCRI) is a United Kingdom-wide partnership between the Government, charity and industry which promotes co-operation in cancer research among the 22 member organisations. The Department has made no specific assessment of the effectiveness of the NCRI in reducing duplication in cancer research over the last 10 years. The NCRI is a partner in the International Cancer Research Partnership (ICRP). The ICRP database includes research awards from all member organisations; it allows users to identify potential collaborators and avoid duplication of effort.
Research themes for the period 2012-17 are discussed in the current NCRI strategic plan. This is available at the following link:
www.ncri.org.uk/includes/Publications/reports/ncri_strategic_plan_2012_-_web.pdf
NHS Foundation Trusts
John Stevenson: To ask the Secretary of State for Health how many hospitals (a) have and (b) have not acquired foundation trust status. [151172]
Anna Soubry: There are currently 145 national health service foundation trusts and 102 NHS trusts in England. Some of these trusts manage more than one hospital while others, such as ambulance trusts, are not hospital based.
NHS: Crimes of Violence
Mr Brady: To ask the Secretary of State for Health which local authority areas in England did not have a violent patient scheme in the most recent period for which information is available. [151095]
Dr Poulter: The provision of NHS primary medical services under the violent patients' scheme was, up to 1 April 2013, the responsibility of primary care trusts (PCTs). The data requested are not routinely collected but it is possible to provide information from data, provided by PCTs, on recorded expenditure on such schemes.
As at December 2012, 117 out of 151 PCTs operated a violent patients' scheme. A list of those PCTs with arrangements for providing primary medical services to violent patients is in the following list. From 1 April 2013, the provision of primary medical services in England became the responsibility of NHS England.
PCTs with a violent patients' scheme prior to 1 April 2013
Ashton, Leigh and Wigan PCT
Barking and Dagenham PCT
Barnet PCT
Barnsley PCT
Bassetlaw PCT
Bath and North East Somerset
Berkshire East PCT
Berkshire West PCT
Bexley NHS Care Trust PCT
Birmingham East and North PCT
Blackburn with Darwen Teaching Care Trust Plus PCT
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Blackpool PCT
Bournemouth and Poole Teaching PCT
Bradford and Airedale Teaching PCT
Brent Teaching PCT
Brighton and Hove City Teaching PCT
Bristol PCT
Bromley PCT
Buckinghamshire PCT
Bury PCT
Central and Eastern Cheshire PCT
Central Lancashire PCT
City and Hackney Teaching PCT
Cornwall and Isles of Scilly PCT
County Durham PCT
Cumbria Teaching PCT
Derby City PCT
Derbyshire County PCT
Devon PCT
Doncaster PCT
Dudley PCT
East Lancashire Teaching PCT
East Sussex Downs and Weald PCT
Eastern and Coastal Kent PCT
Gateshead PCT
Great Yarmouth and Waveney PCT
Greenwich Teaching PCT
Hammersmith and Fulham PCT
Hampshire PCT
Haringey Teaching PCT
Harrow PCT
Hartlepool PCT
Hastings and Rother PCT
Herefordshire PCT
Hertfordshire PCT
Heywood, Middleton and Rochdale PCT
Isle of Wight NHS PCT
Islington PCT
Kensington and Chelsea PCT
Kingston PCT
Kirklees PCT
Knowsley PCT
Lambeth PCT
Leeds PCT
Leicester City PCT
Leicestershire County and Rutland PCT
Lincolnshire Teaching PCT
Liverpool PCT
Manchester PCT
Medway PCT
Mid Essex PCT
Milton Keynes PCT
Newham PCT
Norfolk PCT
North East Essex PCT
North East Lincolnshire Care Trust Plus PCT
North Lancashire Teaching PCT
North Lincolnshire PCT
North Somerset PCT
North Staffordshire PCT
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North Yorkshire and York PCT
Northamptonshire Teaching PCT
Northumberland Care PCT
Nottingham City PCT
Nottinghamshire County Teaching PCT
Oldham PCT
Oxfordshire PCT
Peterborough PCT
Plymouth Teaching PCT
Portsmouth City Teaching PCT
Redcar and Cleveland PCT
Richmond and Twickenham PCT
Salford PCT
Sandwell PCT
Sefton PCT
Sheffield PCT
Shropshire County PCT
Solihull PCT
Somerset PCT
South Birmingham PCT
South Staffordshire PCT
South Tyneside PCT
Southampton City PCT
Southwark PCT
Stoke on Trent PCT
Suffolk PCT
Sunderland Teaching PCT
Surrey PCT
Sutton and Merton PCT
Swindon PCT
Tameside and Glossop PCT
Telford and Wrekin PCT
Torbay PCT
Tower Hamlets PCT
Trafford PCT
Walsall Teaching PCT
Waltham Forest PCT
Warrington PCT
Warwickshire PCT
West Essex PCT
West Kent PCT
West Sussex PCT
Westminster PCT
Wiltshire PCT
Wirral PCT
Wolverhampton City PCT
Worcestershire PCT
NHS: Finance
Jim Shannon: To ask the Secretary of State for Health what discussions he has had with his counterparts in the devolved assemblies to ensure that NHS funding formula is used effectively for those who are vulnerable and elderly. [150893]
Dr Poulter:
Officials of the Scottish and Northern Irish devolved Administrations are members of the Advisory Committee on Resource Allocation's (ACRA) Technical Advisory Group (TAG). ACRA is an independent expert committee that is responsible for
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developing formulae to support the distribution NHS funding to clinical commissioning groups and to upper tier local authorities for their public health responsibilities. Until January 2012 the Welsh Assembly was also represented on ACRA.
Departmental officials have presented ACRA's recommendations to the Scottish Government's Technical Advisory Group on Resource Allocation.
Membership of ACRA and TAG is being reviewed to ensure it is fit for purpose, including ensuring an effective interchange of ideas between the countries of the United Kingdom.
NHS: Reorganisation
Miss McIntosh: To ask the Secretary of State for Health what provision is made for patient representation to the NHS under his planned reforms. [150915]
Dr Poulter: NHS England is committed to putting patients and their carers at the centre of everything it does. Patients, their relatives and carers, as well as patient groups, voluntary organisations and other representatives, have been heavily involved in helping to design and make decisions on key policy areas within NHS England to date. This will continue and strengthen as NHS England takes on its full responsibilities.
NHS England will develop a strategy to ensure that patients, are included in strategic decision-making, in partnership with voluntary organisations and other key partners, later this year.
Healthwatch is the new, independent, consumer champion for health and social care. Local Healthwatch organisations will give citizens and communities a stronger voice to influence and challenge how health and social care services are delivered. As a member of the health and wellbeing board, Local Healthwatch will ensure that what matters to local people is at the heart of the local decision-making processes. Local Healthwatch will gather views and experiences from local people on their health and care services and present this evidence to commissioners and providers of local services.
Healthwatch England, using evidence from local Healthwatches and other sources, will provide advice to the Secretary of State for Health, NHS England, Monitor, the Care Quality Commission and English local authorities.
Getting feedback from patients and using it to improve services is an important responsibility of all organisations providing NHS services. From 1 April 2013, the Friends and Family Test is now allowing all patients using acute inpatient and accident and emergency services to rate the care they received. Results will allow hospitals to be more responsive, patients to compare services and commissioners and the public to hold services to account.
John Stevenson: To ask the Secretary of State for Health how many hospital trusts are subject to merger. [151402]
Anna Soubry: Foundation trusts are autonomous organisations and Monitor has been formally consulted in relation to the proposed mergers for Royal Bournemouth and Christchurch NHS Foundation Trust and Poole NHS Foundation Trust; Medway NHS Foundation Trust with Dartford and Gravesham NHS Trust; Kings College Hospital NHS Foundation Trust and Princess Royal Hospital (part of South London NHS Trust).
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The Trust Development Authority (TDA) is currently assessing the 2013-14 plans submitted by all NHS trusts. There are a number of NHS trusts where the current working assumption is that some organisational transaction, including the merger model, is likely to be required to support securing high quality services for local people. These are:
Dartford and Gravesham NHS Trust
Ealing Hospital NHS Trust
Epsom and St Helier University Hospitals NHS Trust
George Eliot Hospital NHS Trust
North Cumbria University Hospitals NHS Trust
North Staffordshire Combined Healthcare NHS Trust
North West London Hospitals NHS Trust
Northampton General Hospital NHS Trust
South London Healthcare NHS Trust (new organisational form instigated via the unsustainable provider regime)
West Middlesex University NHS Trust
Weston Area Health NHS Trust
Subject to the TDA determining that these NHS trusts will proceed upon an organisational transaction, there will then be a number of stages to effect the change including the necessary stakeholder consultation.
John Stevenson: To ask the Secretary of State for Health how many clinical commissioning bodies there will be from 1 April 2013. [151422]
Anna Soubry: There are 211 clinical commissioning groups (CCGs). CCGs will commission the majority of healthcare services except for specialised services and primary care, which will be commissioned by NHS England.
Rushanara Ali: To ask the Secretary of State for Health what steps his Department is taking to promote cohesion and collaboration between clinical commissioning groups. [151605]
Anna Soubry: The National Health Service Act 2006 as amended by the Health and Social Care Act 2012 allows for clinical commissioning groups (CCGs) to cooperate, delegate and share some of their commissioning functions with other groups by entering into joint or lead commissioning arrangements.
NHS England is responsible for supporting CCGs and holding them to account for improving patient outcomes. It has worked with CCGs during their development and establishment to ensure that they have robust collaborative arrangements in place for working with other CCGs and local authorities. CCGs will not be able to take on their full commissioning functions until NHS England is satisfied that they have met this key criterion. NHS England will continue to work with CCGs to ensure the commissioning of services is carried out effectively and encourage collaborative arrangements between CCGs where appropriate.
NHS: Work Experience
Rehman Chishti: To ask the Secretary of State for Health for which healthcare professionals his Department is considering the introduction of compulsory work experience before they receive NHS funding for their training. [150965]
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Dr Poulter: The initial Government response to the report of The Mid Staffordshire NHS Foundation Trust Public Inquiry, “Patients First and Foremost”, outlines how pilot schemes will be developed; primarily for potential nursing students, to undertake up to a year's work placement as a healthcare assistant to better prepare them for the demands of a national health service funded training programme and subsequent career as part of the NHS workforce.
Health Education England, the new national body responsible for NHS workforce development and training, are currently working with key partners to develop a pilot programme.
Northern Ireland
Dr McCrea: To ask the Secretary of State for Health what recent discussions he has had with the Health Minister in the Northern Ireland Executive. [150920]
Anna Soubry: The Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), along with officials from the Department, met the Minister of State, Northern Ireland Office, my hon. Friend the Member for Hemel Hempstead (Mike Penning), on 4 February.
Officials from the Department discuss a wide variety of policy areas with colleagues in Northern Ireland as appropriate. These policy areas include rare diseases, genomics/genetics, immunisation and sexual health.
Nurses
Rehman Chishti: To ask the Secretary of State for Health what steps he plans to take to provide employment opportunities in the NHS to accommodate the expected increase in short-term healthcare assistants once changes to nursing training are introduced. [151769]
Dr Poulter: Health Education England will initially be piloting pre-degree work experience. Evaluation from the pilots will indicate any impacts on the health care support worker workforce.
Opiates
Dr Huppert: To ask the Secretary of State for Health what assessment he has made of (a) the relative mortality risks and (b) the relative risks associated with misuse and diversion of the use of methadone and buprenorphine in medically assisted treatment for opioid dependence. [152070]
Anna Soubry: It is the role of each responsible clinician to decide which drug is clinically most appropriate for the treatment for opioid dependence following careful assessment of, and discussion with each client. It expected that these decisions should be in line with clinical guidance. The National Institute for Health and Clinical Excellence guidelines recommended the use of both methadone and buprenorphine for the treatment of opioid dependence, but made clear the need for clinicians, to make sure that each patient is aware of all the risks associated with this treatment, both to themselves and to others.
Clinical guidelines for drug treatment recommend that most new patients being prescribed methadone or buprenorphine should take their daily doses supervised
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by a pharmacist (or other professional) for around three months. One of the key reasons for this practice is to reduce diversion of substitute drugs into the illegal market. It has also been shown to reduce drug-related deaths. The responsible clinician can decide to relax, stop, or re-start supervised consumption depending on their patient's progress in tackling their drug dependency.