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Midwives
Ms Diana R. Johnson: To ask the Secretary of State for Health how many vacant midwife posts there are in (a) the North and East Yorkshire and Northern Lincolnshire Strategic Health Authority area and (b) the East Hull and West Hull Primary Care Trust area; and what plans her Department has to recruit more midwives into the NHS in North and East Yorkshire and North Lincolnshire. [65437]
Mr. Ivan Lewis: The information requested is shown in the table. Individual national health service
organisations are responsible for the recruitment of midwives. I am advised that Hull and East Yorkshire Hospitals NHS Trust is able to deploy staff flexibly to cover vacancies, and is planning to recruit to five of the vacant posts. North and East Yorkshire and Northern Lincolnshire Strategic Health Authority is continuing to commission training programmes for registered midwives at the Universities of Hull and York in order to maintain future supply.
NHS Finance
Mark Simmonds: To ask the Secretary of State for Health what additional funding has been provided to implement Agenda for Change in the Trent Strategic Health Authority in each financial year since 2004-05; and what such funding is planned for each year to 2008-09. [67849]
Ms Rosie Winterton: The funding for Agenda for Change is included in the unified primary care trust
(PCT) revenue allocations that cover the full range of services commissioned by PCTs. It is for PCTs to decide how their allocations can be used in the most effective way.
Opportunities for Volunteering Scheme
Dr. Whitehead: To ask the Secretary of State for Health what allocation of grants has been made from the opportunities for volunteering scheme in 2006-07. [68942]
Mr. Ivan Lewis: The Department of Health has allocated £6.7 million to its opportunities for volunteering scheme for 2006-07. Funds will be distributed through grants to individual volunteering projects by the scheme's 16 voluntary sector national agents.
Osteoporosis
Mr. Austin Mitchell: To ask the Secretary of State for Health how many primary care trusts have an integrated falls and osteoporosis service. [69580]
Mr. Ivan Lewis: The information requested is not held centrally.
Mr. Hancock: To ask the Secretary of State for Health if she will make it her policy to include chiropractors in the musculoskeletal services framework being developed by her Department; and if she will make a statement. [68440]
Mr. Ivan Lewis: We have recently consulted with a wide range of stakeholders, including the General Chiropractic Council, on the framework. We will review and revise the framework in the light of the contributions received from all stakeholders before publication later this year.
Palliative Care
Mr. Drew: To ask the Secretary of State for Health how much each primary care trust has allocated to palliative care for 2006-07. [67638]
Ms Rosie Winterton: The Department does not routinely collect the data requested. Primary care trusts are responsible within the national health service for commissioning and funding services for their resident population, including palliative care.
Mr. Maude: To ask the Secretary of State for Health what the process is for commissioning children's palliative care; and what plans she has for the reform of these arrangements. [36730]
Mr. Ivan Lewis: “National Standards, Local Action” published in July 2004 recommends that primary care trusts (PCTs) will need to take into account specialist services, which can only be commissioned effectively on a pan-PCT or broader basis. PCTs, with the support of strategic health authorities (SHAs), are expected to act collaboratively to secure these services and their improvement.
Last November, we published “Commissioning Children's and Young People's Palliative Care Services” which gives commissioners important advice about the key aspects of children's palliative care, both general and specialist, which will improve the quality of service provision and promote quality of care for children, young people and their families in a range of settings, for example palliative care at home, in hospital or in a hospice.
On 22 March a series of eight regional events were launched to bring PCT commissioners, hospital and community services and voluntary organisations to promote local networks to commission and deliver improved quality and choice in palliative care services for children and young people.
The Government's White Paper “Our health, our care, our say” (copies are available in the Library) reaffirms our manifesto commitment to double funding for end of life care to enable more people to have a choice about where to die. For children this includes palliative care, quite often a lifelong need and not just end of life care. The White Paper includes additional commitments on:
provision of emergency, home-based respite care;
expert carers programme;
carers helpline, where the hospice movement will play an important role; and
an audit of services by PCTs against the national service framework standard for disabled children and young people and those with complex health needs, agreeing funding, models of service and commissioning arrangements with SHAs.
Patient Transport Costs
Mr. Stewart Jackson: To ask the Secretary of State for Health how much was spent on private sector transportation of patients in the (a) Peterborough and Stamford Hospitals NHS Foundation Trust area and (b) Norfolk, Suffolk and Cambridgeshire Strategic Health Authority area in the last year for which figures are available; and if she will make a statement. [67480]
Ms Rosie Winterton: The information requested is not collected centrally by the Department. This information is collected individually by each national health services trust through their accounting procedures.
Photodynamic Therapy
Mr. Baron: To ask the Secretary of State for Health (1) what steps she is taking (a) to raise awareness and (b) to promote the use of photodynamic therapy for skin cancer patients; [68771]
(2) what plans she has to ask the National Institute for Health and Clinical Excellence to issue further guidance on the use of photodynamic therapy for skin cancer patients; [68772]
(3) what assessment she has made of (a) the relative costs and (b) the patient benefits of (i) photodynamic therapy treatment and (ii) other treatment options for skin cancer patients; [68773]
(4) what plans she has to commission research into the efficacy of photodynamic therapy for skin cancer patients. [68774]
Ms Rosie Winterton [holding answer 8 May 2006]: It is the responsibility of clinicians to discuss with patients appropriate treatment options for their particular condition. However, the National Institute for Health and Clinical Excellence (NICE) was set up in 1999 to issue clinical guidance to support the national health service including: interventional procedure guidance to assess if a procedure is safe for routine use in the NHS; technology appraisals to assess if a treatment is clinically and cost effective; clinical guidelines to advise on the diagnosis and management of certain conditions; and cancer service guidance to advise on how services should be organised to ensure good outcomes for patients.
In February 2006, as part of its programme of work on interventional procedures, NICE issued guidance on the use of photodynamic therapy (PDT) in the treatment of non melanoma skin tumours. It noted that the procedure was generally safe and did not cause major problems although, in theory, it could start off cancerous changes in the skin. It recommended that when doctors use this procedure for people with basal cell carcinoma, Bowen's disease or actinic keratosis, they should be sure that the patient understands what is involved and consents to the treatment and that the results of the procedure are monitored. NICE also noted that there is not much information available on how well the procedure works in people with squamous cell carcinoma. There is a relatively high chance that the carcinoma will return after treatment, and there is a risk that the carcinoma will spread and become more dangerous. NICE has said that patients need to understand these risks before they agree to have PDT. They also need to understand that further treatment may be necessary.
Also in February 2006, NICE published guidance on "Improving outcomes for people with skin tumours, including melanoma". This guidance includes recommendations on the management of patients with suspected precancerous or cancerous skin lesions. It describes PDT including the advantages and disadvantages of this type of treatment and notes that, at present, there is little information available on long-term cure rates. It does however recommend that a number of surgical and non-surgical procedures for the treatment of skin cancer, including PDT, should be available for use by clinicians in relevant teams, subject to locally agreed standards of competence.
There are no plans to ask NICE to produce additional guidance on this treatment.
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