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18 Apr 2006 : Column 228W—continued
Infant Mortality
Mr. Stewart Jackson: To ask the Secretary of State for Health what steps she is taking to reduce the incidence of infant mortality in the Greater Peterborough area; and if she will make a statement. [60871]
Ms Rosie Winterton: The responsibility for local health services now lies with the local national health service and it is for primary care trusts in conjunction with strategic health authorities and other local stakeholders to plan and develop services to meet the needs of their local populations.
The Department has an infant mortality target of a 10 per cent., reduction in the relative gap between routine and manual socio-economic groups and England as a whole from a baseline year of 1998 (the average of 1997–99) to the target year of 2010.
The Department has a number of initiatives aimed at tackling this gap in infant mortality. These include reducing maternal smoking as it is a risk factor for infant mortality, improving breastfeeding rates through a range of initiatives aimed at new and disadvantaged mothers, and improving neonatal services countrywide. In addition, the Department aims to reduce teenage pregnancy rates, since babies of teenage mothers have a
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60 per cent., higher infant mortality rate than other age groups, and offer disadvantaged families greater access to healthy foods through the healthy start scheme.
These initiatives are expected to reduce the infant mortality level nationally, including the Greater Peterborough area.
Influenza
Mr. Spellar: To ask the Secretary of State for Health pursuant to the answer of 31 January 2006, Official Report, column 464W, on influenza, what additional production capacity of influenza vaccines will the tenders give rise to in the UK; and over what time scale. [61554]
Caroline Flint: The proposal to purchase in advance the capacity needed to make pandemic flu vaccine will make sure that an effective vaccine is available for use in the United Kingdom as quickly as possible after a 'flu pandemic starts. We would envisage that such contracts will provide manufacturers with incentive to expand production capacity.
It will not be possible to give a precise indication of production capabilities for pandemic vaccine until the pandemic virus emerges.
Intensive Broiler Poultry Farming
Norman Baker: To ask the Secretary of State for Health what information she has collated on the possible health effects arising from air pollution caused by intensive broiler poulty farming. [52581]
Caroline Flint: The Department have not collated any information on the possible health effects arising form potential air pollution caused by intensive broiler poultry farming.
London Hospitals
Lynne Featherstone: To ask the Secretary of State for Health how many staff redundancies there have been in each London hospital in each of the last five years. [62507]
Jane Kennedy: This information is not collected centrally.
Lynne Featherstone: To ask the Secretary of State for Health how many wards have closed in each London hospital in each of the last five years. [62508]
Jane Kennedy: This information is not collected centrally.
Macfarlane Trust
Sir Nicholas Winterton: To ask the Secretary of State for Health (1) how much has been paid out by the Macfarlane Trust since 1988; and what proportion of the Trust's total assets such payments comprise; [61876]
(2) how many haemophiliacs infected with HIV as a result of NHS blood transfusions have received payments from the Macfarlane Trust in each year since its inception in 1988; and what assessment she has made of the efficacy of the Macfarlane Trust in providing financial support in such cases; [61877]
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(3) how many haemophiliacs infected with HIV are currently receiving payments from the Macfarlane Trust; and if she will make a statement; [61878]
(4) if she will make a statement on the future of the Macfarlane Trust. [61879]
Caroline Flint: The Macfarlane Trust was created in March 1988. The number of haemophiliacs infected with HIV as a result of national health service blood transfusions who have received payments from the Macfarlane Trust in each year since the trust's inception is shown in the table.
| Year to 31 March | Number of registrants |
|---|---|
| 1989 | 700 |
| 1990 | 674 |
| 1991 | (58)970 |
| 1992 | 947 |
| 1993 | 905 |
| 1994 | 850 |
| 1995 | 767 |
| 1996 | 731 |
| 1997 | 660 |
| 1998 | 651 |
| 1999 | 642 |
| 2000 | 579 |
| 2001 | 422 |
| 2002 | 411 |
| 2003 | 401 |
| 2004 | 396 |
| 2005 | 380 |
(58)Reflects increased registrations
From its creation in March 1988 until 31 March 2005, the Macfarlane Trust paid out £38,740,399 to haemophiliacs with HIV, infected intimates and infected widows, non-infected widows, dependants, etc. Comparisons with the trust's total assets would not be meaningful, since the Department provides additional funding to the trust, as needed.
368 haemophiliacs infected with HIV are currently receiving payments from the Macfarlane Trust.
Maternity Services
Anne Milton: To ask the Secretary of State for Health what assessment she has made of whether payment by results has had an impact on the number of (a) home births and (b) caesarean section; and if she will make a statement. [58046]
Mr. Byrne: No assessment has yet been made on the impact of payment by results on the number of home births and caesarian sections.
Mental Health
Lynne Featherstone: To ask the Secretary of State for Health what estimate she has made of the ratio of patients aged over 80 to staff in mental health care settings in each hospital in England. [62496]
Mr. Byrne: An estimate of the ratio of patients aged over 80 to staff in mental health care settings in each hospital in England has not been made.
Mr. Drew: To ask the Secretary of State for Health what plans she has to increase partnership working between mental health trusts and drug and alcohol services. [55365]
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Ms Rosie Winterton: We are committed to modernising mental health services, and one of our national priorities is to ensure that people with severe and enduring mental illness, including those with mental illness and substance misuse illness—dual diagnosis—receive more responsive and appropriate services.
Many mental health trusts have existing partnership working with drug and alcohol services through in-house specialist substance misuse services. In addition, the mental health dual diagnosis good practice policy implementation guide recommends suitable arrangements for developing partnership services for adults with severe mental illness and substance misuse problems.
We are also promoting increased partnership working between the national health service and drug and alcohol services by responding to the advisory council on misuse of drugs (ACMD) report, published in January by the Home Office. The Department, in partnership with the Home Office, the Department for Education and Skills, the National Treatment Agency and the National Institute for Mental Health in England is supporting a number of activities which respond to the ACMD findings, including publishing research briefings for professionals and reviewing current dual diagnosis treatment interventions to inform future partnership working policy.
Mr. Amess: To ask the Secretary of State for Health how many individuals suffering from depression attempted suicide in each of the last 10 years for which information is available. [57583]
Ms Rosie Winterton: The information requested is not available.
Mr. Amess: To ask the Secretary of State for Health what research her Department has undertaken into schizophrenia in each of the last 10 years; if she will place the research in the Library; and if she will make a statement. [57588]
Ms Rosie Winterton: The main agency through which the Government supports medical and clinical research is the Medical Research Council (MRC). The MRC is an independent body funded by the Department of Trade and Industry via the Office of Science and Technology.
The MRC supports a large portfolio of research related to mental health disorders. Much of this research will be relevant to schizophrenia. A list of MRC-funded schizophrenia research projects has been placed in the Library.
The Department also funds research programmes that support policy and which provide underpinning evidence for quality improvement and service development in the national health service. Of these, the health technology assessment programme has over the last 10 years supported six projects concerned with schizophrenia. Five of these projects have been published and are available online as follows:
1. Depot antipsychotic medication in the treatment of patients with schizophrenia: (1) Meta-review; (2) Patient and nurse attitude (David) 69 pages, volume 5, number 34 www.hta.ac.uk/project.asp?PjtId=1028.
2. A systematic review of atypical antipsychotic drugs in schizophrenia (Bagnall) 204 pages, volume 7, number 13 www.hta.ac.uk/project.asp?PjtId=1235.
3. Clinical and cost-effectiveness of electroconvulsive therapy for depressive illness, schizophrenia, catatonia and mania; systematic reviews and economic modelling studies (Greenhalgh) 170 pages, volume 9, number 9 www.hta.ac.uk/project.asp?PjtId=1295.
4. Long-term outcome of cognitive behaviour therapy clinical trials in central Scotland (Durham) 174 pages, volume 9, number 42 www.hta.ac.uk/project.asp?PjtId=1081.
5. Systematic reviews of the effectiveness of day care for people with severe mental disorders: (1) Acute day hospital versus admission; (2) Vocational rehabilitation; (3) Day hospital versus outpatient care (Marshall) 75 pages, volume 5, number 21 www.hta.ac.uk/project.asp?PjtId=1018.
6. Cost utility of the latest antipsychotics in severe schizophrenia (CUtLASS): a multi-centre, randomised, controlled trial (Project not yet published—publication due date May 2006).
More than 75 per cent. of the Department's own expenditure on health research is devolved to and managed by NHS organisations. Details of individual projects, including a large number concerned with schizophrenia, can be found on the national research register on the Department's website at www.dh.gov.uk/research.
Tim Loughton: To ask the Secretary of State for Health how many patient episodes took place in each mental health trust in (a) 2005–06, (b) 2004–05 and (c) 2003–04. [60290]
Ms Rosie Winterton: Information on the number of admissions under mental illness specialties in each national health service trust in 2003–04 and 2004–05 has been placed in the Library. This information is not yet available for the current financial year.
Tim Loughton: To ask the Secretary of State for Health how many (a) crisis resolution, (b) early intervention and (c) assertive outreach teams are operating from each mental health trust. [60308]
Ms Rosie Winterton: The latest data available are at March 2005.
The number of assertive outreach, early intervention and crisis resolution teams in England at 31 March 2005 by mental health trust are shown in the table. All primary care trusts that provide mental health services are included in the table.
—" denote no teams in place
Source:
Durham mapping exercise
18 Apr 2006 : Column 234W
Tim Loughton: To ask the Secretary of State for Health what estimate she has made of the expenditure by each mental health trust on agency staff in the 2005–06 financial year. [60310]
Ms Rosie Winterton:
No estimate has been made. Actual expenditure in 2004–05 on all agency staff costs by each national health service trust providing health and social care services for people with mental health problems is shown in the table.
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Source:
Annual Financial Returns of NHS Trusts and Annual Financial Returns of Primary Care Trusts.
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Tim Loughton: To ask the Secretary of State for Health (1) what the average waiting time for patients referred for (a) psychotherapy and (b) cognitive behavioural therapy was in the last period for which figures are available; [60311]
(2) what the longest time is that a patient has waited for (a) psychotherapy and (b) cognitive behavioural therapy in each mental health trust in the last 12 months; [60318]
(3) how many patients waited longer than (a) six months and (b) 12 months for (i) psychotherapy and (ii)cognitive behavioural therapy in each mental health trust in the last 12 months; [60319]
(4) what the waiting time is for (a) psychotherapy and (b) cognitive behavioural therapy in each mental health trust. [60320]
Ms Rosie Winterton: The Department does not routinely collect information on waiting times for appointments for treatments such as psychotherapy and cognitive behavioural therapy. Data are collected only for consultant-led services, but not when services have been provided by other mental health practitioners.
Information is available for estimated average waiting times from general practitioner written referral to first outpatient appointment with a psychiatric consultant in each mental health provider trust in each of the last five years and has been placed in the Library. The data are broken down into categories of provider trust, strategic health authority and Government office region where possible.
Tim Loughton: To ask the Secretary of State for Health what the medical vacancy rate is in each mental health trust; and how many consultant vacancies there are in each mental health trust. [60321]
Ms Rosie Winterton: Information on the three-month vacancy rate and the number of consultant vacancies in each mental health trust is available in the Library.
Tim Loughton: To ask the Secretary of State for Health if she will list the mental health trusts which are operating restrictions on recruitment. [60541]
Ms Rosie Winterton:
The Department does not prescribe recruitment policies for trusts. These are decided locally, so this information is not collected centrally.
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Keith Vaz: To ask the Secretary of State for Health what plans her Department has for reforming the process of treatment of mental illness in prisons; and if she will make a statement. [60637]
Ms Rosie Winterton: Prison Health, a joint Home Office and Department of Health unit, has been working since 2000 to improve health care provision for prisoners. It has led and managed a work programme to modernise services, step up national health service engagement and improve performance monitoring. The responsibility for commissioning health services, including mental health services, in the publicly run prisons will have fully transferred from the Prison Service to NHS primary care trusts by April 2006.
Mental health services for prisoners have been a key part of these reforms. The Department is investing nearly £20 million a year in NHS mental health in-reach services for prisoners. These are community mental health teams working within prisons and are now available in 102 prisons, with some 360 extra staff employed. By the spring, every prison in England and Wales will have access to these services.
The Department of Health and the Home Office produced joint guidance in November 2005 to help facilitate quicker transfers to hospital for people whose mental health difficulties mean they are too ill to remain in prison. This guidance, The transfer of prisoners to and from hospital under sections 47 and 48 of the Mental Health Act (1983)", is available on the Department's website at www.dh.gov.uk/assetRoot/04/12/36/31/04123631.pdf
Keith Vaz: To ask the Secretary of State for Health what research her Department has evaluated concerning the effects on people with mental illnesses of being in prison; and what assessment her Department has made of that research. [60638]
Ms Rosie Winterton: There is currently little information about the impact of imprisonment on people with mental health problems. In 2003, a small focus group study 1 looked at the influence of environmental factors on mental health within prisons.
The national forensic mental health research and development programme is currently funding two research projects; one on factors mediating the effect of prison on mental health, and another on the effect of prison on mental health in young offenders institutions in the North West region. Both are due for completion in summer 2008. Further details are available on the programme's website at www.nfmhp.org.uk.
1 Nurse, 1., Woodcock, P. and Ormsby, J. (2003) Influence of environmental factors on mental health within prisons: focus group study. BMJ, 327, 480–485
Tim Loughton: To ask the Secretary of State for Health what recent assessment her Department has made of the length of time it is appropriate for mentally ill patients to be detained without leave to appeal against their detention. [62240]
Ms Rosie Winterton:
No patient detained under the Mental Health Act is ever detained without a right to seek a review of the lawfulness of their detention. All civil patients have a right to apply to a mental health
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review tribunal directly, and patients detained for assessment can apply once in the first 14 days of their detention.
A period of assessment, under normal circumstances, will last no longer than 28 days. Patients who are detained for treatment have a right to apply once every six months in the first year of their detention and once a year thereafter. There is a further safeguard for patients who do not, for whatever reason, exercise their right to apply to the tribunal. For civil patients the safeguard of a referral by the hospital managers is initiated at six months into their detention for treatment. For patients who are subject to a hospital order, or who are transferred from prison to hospital, a first referral is at three years.
Patients transferred from prison to hospital by the Secretary of State may, if subject to restrictions, apply to the tribunal once in the second six months of their first year of detention and once a year thereafter. If they are transferred without restrictions or if their restrictions expire while in hospital, they may additionally apply to the tribunal within the first six months of their transfer or the expiry of the restrictions.
Tim Loughton: To ask the Secretary of State for Health whether she plans to conduct a consultation exercise on her new mental health proposals prior to their publication; and what consideration she has given to those who will be consulted. [62245]
Ms Rosie Winterton: We have spent the last seven years consulting on possible changes to the Mental Health Act 1983 and there has been pre-legislative scrutiny. The changes that we are now planning to make to the Mental Health Act 1983 are within the wide range of issues that we have previously consulted on.
We made a commitment last year to extend consultation for the race equality impact assessment. There are no current plans for other formal consultation exercises.
Annette Brooke: To ask the Secretary of State for Health how many exercise referrals have been prescribed by general practitioners for the treatment of mild to moderate depression in each year since 2001; and if she will make a statement. [59432]
Ms Rosie Winterton: This information is not held centrally. The Choosing Health" White Paper recognises that regular physical activity reduces the risk of depression and has positive benefits for mental health including reduced anxiety, enhanced mood and self-esteem.
Annette Brooke: To ask the Secretary of State for Health what assessment her Department has made of the National Institute for Health and Clinical Excellence guidelines for advising or prescribing physical activity as partial treatment for mild to moderate depression; and if she will make a statement. [59433]
Ms Rosie Winterton:
No assessment has been made of the National Institute for Health and Clinical Excellence (NICE) guidelines on depression for advising or prescribing physical activity as partial treatment for mild to moderate depression. Local national health service bodies should review their policies against NICE
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guidelines and put in place the services recommended. NICE guidelines state that patients of all ages should be advised of the benefits of following a structured and supervised exercise programme of typically up to three sessions per week of moderate duration (45 minutes to one hour) for between 10 and 12 weeks.
Annette Brooke: To ask the Secretary of State for Health (1) what assessment her Department has made of the waiting times for (a) NHS counselling services and (b) cognitive behavioural therapy for (i) adults and (ii)children and young people with mild to moderate depression; and if she will make a statement; [59527]
(2) what research her Department has undertaken on the extent of regional differences in (a) referrals and (b) waiting lists for (i) cognitive behavioural therapy and (ii) counselling on the NHS for treatment of mild to moderate depression; and if she will make a statement. [59529]
Ms Rosie Winterton: Information about waiting times for counselling or cognitive behavioural therapy services is not available in the requested format, because the data are available only for consultant-led services. Since the majority of referrals for psychological therapies are to other mental health professionals, such as to clinical psychologists or psychotherapists, the data do not capture the waiting times for these services accurately.
In line with our manifesto commitment, we are embarking on a new programme to provide improved services for people with mild to moderate psychological needs, by extending the availability of psychological therapies of proven effectiveness and connecting interventions currently or potentially available in the workplace, in primary care and other community resources.
Mr. Stewart Jackson: To ask the Secretary of State for Health what funding her Department has allocated in 2006–07 for young people in the Cambridgeshire and Peterborough area with mental health problems. [60938]
Ms Rosie Winterton: Revenue allocations are made directly to primary care trusts (PCTs) on the basis of the relative needs of their populations and are determined using a weighted-capitation formula. This is a fair funding formula that directs funding to those areas of greatest need. The mental health needs index in the weighted capitation formula recognises the mental health needs of young people, students, the homeless and refugees.
On 9 February 2005, PCTs were informed of their revenue allocations up to 2007–08. The 2006–07 and 2007–08 revenue allocations represent £135 billion investment in the national health service, £64 billion to PCTs in 2006–07 and £70 billion in 2007–08.
It is for PCTs to determine how to use the funding allocated to them to commission services to meet the health care needs of their local populations.
No final decisions have yet been made on what additional funding for child and adolescent mental health services (CAMHS) PCTs may receive in 2006–07
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from the Department, over and above what they might already decide to dedicate from their baseline allocations.
Cambridgeshire county council will receive £549,734 and £560,733 in 2006–07 and 2007–08 respectively and Peterborough council £292,823 and £298,684 for the development of CAMHS in collaboration with local CAMHS partners which will include their partners in local PCTs.
Dr. Evan Harris: To ask the Secretary of State for Health what plans she has for (a) formal consultation, (b) informal consultation and (c) parliamentary scrutiny of the new proposals to amend the Mental Health Act 1983. [62214]
Ms Rosie Winterton: We have spent the last seven years consulting on possible changes to the Mental Health Act 1983 and there has been pre-legislative scrutiny. The changes that we are now planning to make to the Mental Health Act 1983 are within the wide range of issues that we have previously consulted on.
We made a commitment last year to extend consultation for the race equality impact assessment. There are no current plans for other formal consultation exercises.
Mr. Burstow: To ask the Secretary of State for Health what assessment she has made of the impact of short-term commissioning arrangements for specialist mental health services on recruitment and retention of staff; and if she will make a statement. [54792]
Ms Rosie Winterton: No such assessment has been made by the Department. Through the commissioning arrangements available to them, primary care trusts (PCTs) can secure the full range of mental health services to meet their populations' needs. Unified allocations are given to PCTs for three years to enable them to plan their finances and commission services in a way that will deliver improvements in performance and workforce planning.
Lynne Jones: To ask the Secretary of State for Health what assessment she has made of the impact on mental health services of the implementation of payment by results. [58766]
Ms Rosie Winterton: Payment by results (PbR) has not yet been introduced for mental health services, and the Department is exploring the feasibility of doing so. We expect to publish a report later this year, outlining our plans for PbR in 2007–08 and beyond, and this will include an update on our plans for PbR in relation to mental health.
Annette Brooke: To ask the Secretary of State for Health what assessment she has made of the number of mental health therapists which will be needed to meet the demand for their services in the next five years; and if she will make a statement. [60242]
Ms Rosie Winterton:
The Department has made no formal assessment. However, compared to work force levels in 1997 the mental health work force has increased its capacity to provide psychological therapies: since 1997, there are now 75 per cent. more clinical psychologists, 125 per cent. more qualified psychotherapists, 50 per cent.
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more consultant psychiatrists, 20 per cent. more mental health nurses, and 23 per cent. more art/music/drama therapists.
We have also created a new role, the graduate primary care mental health worker, trained in brief therapy techniques of proven effectiveness, such as cognitive behavioural therapy (CBT), to help general practitioners provide mental health interventions in a range of primary care settings. At the end of March 2005, there were 648 graduate workers employed in the national health service, and this number will increase further when current trainees qualify. All of these professions can provide CBT.
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