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Revenue Resource Allocations
Tim Loughton: To ask the Secretary of State for Health what amount in (a) real terms and (b) percentage terms of the health authority revenue resource allocations announced on 6 December are accounted for by estimated (i) salary increases for (A) pay review body staff and (B) non-pay review body staff, (ii) medical price inflation, (iii) new pension contribution rates, (iv) implementation of planned national service frameworks and (v) special arrangements for speeding up heart operations. [24328]
Mr. Hutton [holding answer 8 January 2002]: Health authority revenue allocations for 2002–03 include funding to meet increases in pay, prices and other pressures faced by all health authorities, and to implement national service frameworks, but these are not separately identified within allocations.
A small number of initiatives, including action to speed up heart operations and extend choice for those who wait longest for heart surgery, will be funded through central budgets. Details will be announced later.
Prosthetics
Bob Spink: To ask the Secretary of State for Health (1) what research is being carried out into prosthetics practice in the UK; [26586]
- (2) what research is being carried out into trans-femoral socket and limb prescription, design and delivery. [26584]
Jacqui Smith: The Department is not currently funding any research in these two areas.
However, the Department does provide support for research commissioned by charities and the research councils that takes place in the national health service. Details of on-going and recently completed research projects funded by, or of interest to, the NHS are available on the National Research Register at www.doh.gov.uk/ research/nrr.htm.
Bob Spink: To ask the Secretary of State for Health (1) if he will make it his policy to make state-of-the-art prosthetics available on the NHS to those who want them; [26611]
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Jacqui Smith: The national health service already has available to it, via contracts negotiated by the NHS Purchasing and Supply Agency, the widest possible range of prosthetic limb components available. The decision as to which type of prosthesis an individual patient receives is one that should be decided at a local level taking into account an individual's clinical circumstances.
Bob Spink: To ask the Secretary of State for Health what was the NHS prosthetics expenditure in the last financial year for which records are available per amputee; and what proportion of this expenditure was used on (a) administration, (b) prosthetics staff and (c) prosthetics. [26587]
Jacqui Smith: The Department does not collect information on the financial expenditure on each individual amputee. Expenditure is decided at a local health authority and national health service trust level.
The NHS Purchasing and Supply Agency estimate that some £23 million including value added tax was spent on prosthetic service contracts and a further £13 million including VAT was spent on prosthetic limb hardware and associated items during 1999–2000.
Bob Spink: To ask the Secretary of State for Health what assessment he has made of the impact on the UK prosthetics industry of the emigration of qualified prosthetics professionals and technicians. [26589]
Jacqui Smith: There has been no report of a significant impact on the United Kingdom prosthetic industry due to the emigration of qualified prosthetic professionals and technicians.
Bob Spink: To ask the Secretary of State for Health what training is given to orthopaedic surgeons on prosthetics and orthotics, with specific reference to the functional implications of the various levels of amputation and residual limb lengths. [26594]
Jacqui Smith: The Royal College of Surgeons is the body responsible for the training of medical students on surgery. The majority of amputations are carried out by vascular and general surgeons, and relatively few are undertaken by orthopaedic surgeons. Orthopaedic surgeons receive training on amputations and prosthetics at various stages of the medical curriculum, such as:
- Medical students receive lectures and tutorials on general surgery, and are taken to a limb fitting centre.
Basic surgical trainees will receive training from mainly vascular surgeons on the practical skills of "common amputations".
Specialist Registrars receive higher surgical training on amputation and rehabilitation, and on prosthetics and orthotics.
Jacqui Smith: The Department has not issued any guidelines to disablement services centres for the prescription and delivery of prosthetics. Prescriptions and delivery criteria are decided at a local level to take account of an individual patient's clinical need.
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Bob Spink: To ask the Secretary of State for Health what was the level of funding for prosthetics in each of the last five financial years for which records are available; and what level is anticipated for the (a) current and (b) next financial years. [26588]
Jacqui Smith: The level of funding on prosthetic services is not separately identified in health authority financial baseline allocations. But on 9 January 2001 we announced that funding for providing silicone cosmesis to prosthetic limb users was to be made available totalling £4 million over the next three years. The funding started in April 2001 with £0.5 million for 2001–02, £1.5 million for 2002–03 and £2 million for 2003–04. This was an addition to the baseline allocation.
The local health authority will decide the level of funding an individual disablement service centre receives. We would not expect the level of funding a DSC receives next financial year to be any less than invested this financial year.
Amputees
Bob Spink: To ask the Secretary of State for Health how many amputees there are in England. [26593]
Jacqui Smith: The latest collection of data from the year 1998–99 reported that there were 51,498 patients with amputations in contact with their national health service limb centre in England.
Bob Spink: To ask the Secretary of State for Health what guidelines have been issued on the use of ischial containment sockets for amputees. [26585]
Jacqui Smith: The Department has not issued any central guidelines for the issue of ischial containment sockets. Ischial containment sockets for amputees are issued on the basis of a clinical decision made by the multi-professional team at a national health service trust.
Bob Spink: To ask the Secretary of State for Health how many amputations have been carried out in each of the last five years for which records exist, as a result of necrotising fasciitis. [26592]
Jacqui Smith: The information requested is not available centrally.
Fraud
Mr. Menzies Campbell: To ask the Secretary of State for Health what estimate his Department has made of the cost to its budget since 1 May 1997 of fraud; and if he will make a statement. [27300]
Mr. Hutton: The figures requested are in the table.
| Year | Amount |
|---|---|
| 1997–98 | 61,415.25 |
| 1998–99 | 66,897.29 |
| 1999–2000 | 48,148.81 |
| 2000–01 | 56,831.99 |
The Department of Health now has a Directorate of Counter Fraud Services staffed by professionally trained and accredited counter fraud specialists.
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Children at Risk
Dr. Fox: To ask the Secretary of State for Health (1) what recent steps have been taken to ensure co-ordination between local authorities' social and educational services with regard to supporting children at risk; [27358]
- (2) what measures the Government are taking to protect children identified as being at risk. [27240]
Jacqui Smith: The safeguarding of children at risk is a high priority for us. That is why over the last few years we have introduced new legislation, new guidance, new structures and new policy initiatives to make children safer and to ensure that there is a proper focus on children at the very heart of Government. These measures include:
- The Care Standards Act 2000 to improve the inspection and regulation of children's care services, and the Protection of Children Act 1999 which makes it much more difficult for unsuitable people to work with children;
Revised core inter-agency child protection guidance: Working Together to Safeguard Children (1999) and the new Framework for the Assessment of Children in Need and Their Families (2000);
New guidance focusing on Safeguarding Children Involved in Prostitution (2000) and a National Plan for Safeguarding Children from Commercial Sexual Exploitation (2001);
A Minister for Young People—my right hon. Friend the Member for Southampton, Itchin (Mr. Denham)—and a new Cabinet Committee focusing on Children and Young People's issues;
The first ever national Children's Rights Director for England—Roger Morgan—to act as a powerful champion for some of the most vulnerable children in our country;
The establishment of the Children and Young People's Unit, which is responsible for ensuring the coherence of Government polices that affect all children and young people under 19;
Radical new initiatives such as the £885 million Quality Protects programme, Sure Start and Connexions.
Co-ordination of the planning and delivery of services by education and social services departments is a key element of the Government's five year £885 Quality Protects programme, which is improving the management and delivery of children's services. The Government have published Objectives for Children's Social Services. The Department's public service agreement contains targets including improving the educational outcomes of children in need and children looked after. Local authorities have to produce annual QP management action plans (MAPs) on how they are moving towards the achievement of these objectives. The national overview report of local authority's QP MAPs published in October 2001 reported in relation to services for children in need
- " . . . in general there is plenty of evidence of good collaboration between education and social services; and as these partnerships develop the focus of their work is beginning to broaden"
and
"closer partnerships in a range of contexts are beginning to draw social work expertise and the needs of vulnerable children onto agendas which in the past might have been seen as 'purely educational'".
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-
In October 2000, the Department of Health and Department of Education and Employment jointly issued "Guidance on the Education of Children and Young People in Public Care". The national overview report shows that for looked after children
"MAPS this year included considerable evidence of joint working between education and social work staff, designed to support the education of looked after children."
Learning disability partnerships boards have been set up in local authority areas to oversee and advise on the implementation of the adult aspects of "Valuing People". Membership should include representation from a range of statutory sector interests, including social services and education. Guidance issued to local councils in August said that one member should be appointed to be a champion for child/adult transition issues. The guidance adds that boards will need to develop effective links with other agencies whose responsibilities are relevant to implementing valuing people; these will include Connexions partnerships, local learning partnerships, further education colleges, and education institutions.
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