House of Commons Hansard Written Answers for 14 May 2004 (pt 12)

Hip Fractures

Rob Marris: To ask the Secretary of State for Health what steps his Department is taking to (a) raise public awareness of osteoporosis and (b) reduce the number of avoidable hip fractures. [169468]

Dr. Ladyman: A considerable amount of work is under way which will help to raise general awareness of osteoporosis, for example, The National Institute for Clinical Excellence is to develop two clinical guidelines and a technology appraisal to provide the best available evidence of what is effective in:

the assessment and prevention of falls in older people;

the assessment of fracture risk and the prevention of osteoporotic fractures in individuals at high risk; and

the prevention and treatment of osteoporosis

The clinical guideline on the assessment and prevention of falls in older people is currently out for consultation. Although osteoporosis does not cause falls it significantly increases the likelihood of a fracture when a fall happens.

The falls guideline will provide recommendations for good practice that are based on the best available evidence of clinical and cost effectiveness. It is due to be completed in August this year. A second clinical guideline has been commissioned to look at the assessment of fracture risk and the prevention of osteoporotic fractures in individuals at high risk.

We know it is the fractures which result from osteoporosis which can lead to pain, disability, greatly reduced quality of life and premature death. This guideline will look at all groups of people recognised to be at high risk of osteoporotic fracture. It will examine both interventions used to prevent an initial fracture and those used to prevent subsequent fractures where one has already occurred.

It will cover care from primary and secondary National Health Service healthcare professionals who have direct contact with and make decisions about the care of high risk individuals. It will look at areas where collaboration is needed between primary and secondary NHS services. Although it does not specifically cover areas outside the NHS, it will be relevant to practice in non-NHS residential and nursing homes, social services and the voluntary sector. This guideline will build on and where necessary extend the work already completed around osteoporosis. It is due to be completed in June 2005.

Rob Marris: To ask the Secretary of State for Health what (a) number and (b) percentage of patients who suffered a hip fracture died as a consequence of the fracture in (i) 2001–02 and (ii) 2002–03. [169469]

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Dr. Ladyman: Numbers are not available on patients who die specifically from hip fractures. However there is information on the number of deaths with the main injury of hip fracture and also with an underlying cause of osteoporosis.

Information on the number of hospital episodes of patients admitted with hip fracture is shown in the tables.
Number of deaths with underlying cause of death of Osteoporosis⁽¹⁶⁾ persons, England and Wales 2001–02

Number of deaths

2001 11,542

2002 11,605

⁽¹⁶⁾ ICD-10 codes M80-M81

Number of deaths with main injury of Hip fracture⁽¹⁷⁾persons, England and Wales 2001–02

Number of deaths

2001 2,214

2002 2,151

⁽¹⁷⁾ ICD-10 codes S72.0-S72.2

	Number of deaths
2001	11,542
2002	11,605

	Number of deaths
2001	2,214
2002	2,151

These two groups are mutually exclusive.
Count of finished admission episodes primary diagnosis hip fracture (ICD-10 diagnosis code S72)—NHS

NHS hospitals Finished admission episodes

2001–02 63,999

2002–03 70,508

Note:
Finished admission episodes—A finished admission episode is the first period of in-patient care under one consultant within one healthcare provider. Please note that number of in-patients, as a person may have more than one admission within the year.
Source:
Hospital Episode Statistics (HES) Department of Health
Ungrossed Data:
Figures have not been adjusted for shortfalls in data (ie the data are ungrossed)

NHS hospitals	Finished admission episodes
2001–02	63,999
2002–03	70,508

Immigrant Medical Inspections

Mr. Randall: To ask the Secretary of State for Health when the publication Instructions to Medical Inspectors was last updated; and if he will place a copy in the Library. [156839]

Miss Melanie Johnson: "Instructions to Medical Inspectors" was last updated in 1992. It was marked for disclosure "only to persons authorised to receive it", but it is no longer known why this restriction was placed on the document. I am arranging for a copy to be placed in the Library. We will consider the need to review the "Instructions" in the light of any decisions taken as a result of the Cabinet Office review of imported infection.

Mr. Randall: To ask the Secretary of State for Health who is responsible for making appointments of medical inspectors of immigrants; who employs them; who is responsible for the policy to be operated by medical inspectors; and what changes to these arrangements will occur if the Health Protection Agency Bill is enacted. [156841]

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Miss Melanie Johnson: Paragraph 1(2) of Schedule 2 to the Immigration Act 1971 (c.77) provides that medical inspectors for the purposes of the Act may be appointed by the Secretary of State, or in Northern Ireland, by the Minister of Health and Social Services or other appropriate Minister of the Government of Northern Ireland in pursuance of arrangements made between that Minister and the Secretary of State.

The Secretary of State's responsibilities for appointing medical inspectors in Scotland was transferred to Scottish Ministers by The Scotland Act 1998 (Transfer of Functions to the Scottish Ministers etc) Order 1999 (Statutory Instrument 1999 No. 1750).

Medical inspectors are employed by the National Health Service (in England, in some cases by primary care trusts and in others by the Health Protection Agency). The policy to be operated by medical inspectors is governed by the Immigration Act and Immigration Rules (HC 395 as amended) and is the joint responsibility of the Home Office (which is responsible for immigration policy) and the Department of Health and the devolved administrations (which are responsible for health policy).

Paragraph 3 of Schedule 3 to the Health Protection Agency Bill will allow the Secretary of State to direct that his function of appointing medical inspectors is also exercisable by such persons specified in the direction who exercise functions relating to health in England or Wales. The intention is to use this power to delegate the appointment of medical inspectors to the National Assembly for Wales in Wales, and to the Health Protection Agency in England. Such delegation takes

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account of the fact that arrangements for identifying medical inspectors are best made locally. The Bill does not change the responsibility for the policy operated by medical inspectors.

NHS (Road Traffic Matters)

Mr. Greg Knight: To ask the Secretary of State for Health how many persons employed by or on behalf of the NHS undertake work relating to road traffic matters, including alleged speeding offences of ambulance drivers; and what the annual salary cost thereof to public funds was in 2003–04. [171036]

Ms Rosie Winterton [holding answer 5 May 2004]: The information requested is not collected centrally.

However, the Department is aware that speeding tickets issued to ambulances on emergency journeys are creating extra administration costs in some areas. Officials have already had useful discussions with the Home Office and are working closely with them to provide a workable solution.

NHS Beds (Burnley)

Mr. Pike: To ask the Secretary of State for Health how many NHS beds were available in Burnley in each year since 1997. [167954]

Miss Melanie Johnson: Information on beds is collected on a provider basis from national health service organisations and the latest data available is for the year 2002–03. Beds data for 2003–04 will be published later this year.

Beds data for the relevant trusts is shown in the tables.
Average daily number of available beds, by sector, Burnley Health Care NHS Trust, 1996–97 to 2002–03

All specialties (excluding day only) General
and acute Acute Geriatric Mental illness Learning disability Maternity Day only

1996–97 858 659 458 201 163 0 36 51

1997–98 879 669 475 194 163 0 47 30

1998–99 838 627 627 — 163 — 48 35

1999–2000 837 626 626 — 163 — 48 33

2000–01 840 643 643 — 149 — 48 25

2001–02 810 620 620 — 141 — 49 26

2002–03 680 632 632 — — — 48 31

Source:
Department of Health form KH03

Average daily number of available beds, by sector, Blackburn, Hyndburn and Ribble Valley Health Care NHS Trust, 1996–97 to 2002–03

All specialties (excluding day only) General
and acute Acute Geriatric Mental illness Learning disability Maternity Day only

1996–97 824 588 478 110 157 — 79 57

1997–98 857 618 532 86 166 — 73 53

1998–99 824 603 511 91 150 — 72 56

1999–2000 808 604 517 87 138 — 66 67

2000–01 833 623 531 93 143 — 67 67

2001–02 825 633 530 104 122 — 70 67

2002–03 680 611 505 106 — — 70 67

Source:
Department of Health form KH03

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Average daily number of available beds, by sector, Burnley, Pendle and Rossendale PCT 1996–97 to 2002–03

All specialties (excluding day only) General
and acute Acute Geriatric Mental illness Learning disability Maternity Day only

1996–97 — — — — — — — —

1997–98 — — — — — — — —

1998–99 — — — — — — — —

1999–2000 — — — — — — — —

2000–01 — — — — — — — —

2001–02 — — — — — — — —

2002–03 — — — — — — — —

Source:
Department of Health form KH03

	All specialties (excluding day only)	General and acute	Acute	Geriatric	Mental illness	Learning disability	Maternity	Day only
1996–97	858	659	458	201	163	0	36	51
1997–98	879	669	475	194	163	0	47	30
1998–99	838	627	627	—	163	—	48	35
1999–2000	837	626	626	—	163	—	48	33
2000–01	840	643	643	—	149	—	48	25
2001–02	810	620	620	—	141	—	49	26
2002–03	680	632	632	—	—	—	48	31

	All specialties (excluding day only)	General and acute	Acute	Geriatric	Mental illness	Learning disability	Maternity	Day only
1996–97	824	588	478	110	157	—	79	57
1997–98	857	618	532	86	166	—	73	53
1998–99	824	603	511	91	150	—	72	56
1999–2000	808	604	517	87	138	—	66	67
2000–01	833	623	531	93	143	—	67	67
2001–02	825	633	530	104	122	—	70	67
2002–03	680	611	505	106	—	—	70	67

	All specialties (excluding day only)	General and acute	Acute	Geriatric	Mental illness	Learning disability	Maternity	Day only
1996–97	—	—	—	—	—	—	—	—
1997–98	—	—	—	—	—	—	—	—
1998–99	—	—	—	—	—	—	—	—
1999–2000	—	—	—	—	—	—	—	—
2000–01	—	—	—	—	—	—	—	—
2001–02	—	—	—	—	—	—	—	—
2002–03	—	—	—	—	—	—	—	—

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