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Mr. Stephen O'Brien: To ask the Secretary of State for Health what steps his Department has taken to initiate the integration of Picture Archiving and Communications Systems images into the Care Records Service. 
Mr. Bradshaw: Making electronic images captured via picture archiving and communications (PACS) systems, a component part of the national health service care record has been a core objective since the inception of the PACS project. Now that PACS systems have been deployed into every acute trust, the key integration challenge is how to integrate images and their related radiology reports so that the two are always associated.
Full integration of radiology reports and digital images to support clinical care represents a major development task and is incorporated in the requirements of our local service providers (LSP) and their respective solutions.
Mr. Lansley: To ask the Secretary of State for Health (1) on what date the UK authorities were informed by Novartis that a staphylococcus aureas bacterial contamination had been found in a sample of the solvent used in meningitis C vaccine outside the UK; 
(2) how many samples of meningitis C vaccine have been additionally tested for sterility in the UK following notification by Novartis of contamination of a sample elsewhere than in the UK; and when such tests were (a) begun and (b) completed; 
Dawn Primarolo: The Department was informed by Novartis on 23 February 2009 that staphylococcus aureu s bacterial contamination had been found in samples of the solvent used in meningitis C vaccine. The material in question had not been distributed in the United Kingdom but came from the same manufactured batches that had been distributed in the UK. The Department reminded Novartis of its statutory responsibility to inform the Medicines and Healthcare products Regulatory Agency (MHRA). Novartis contacted the Defective Medicines Report Centre (DMRC) at MHRA on 24 February by telephone initially, then followed up with an e-mail.
On the evening of 25 February 2009 a chief medical officer (CMO) message was sent via the central alert system (formerly known as the public health link) as a class 1, immediate action alert, for immediate cascade (within six hours) to relevant health professionals, including general practitioners (GPs) and practice nurses, accident and emergency departments and community pharmacists. At the same time a pager message was also sent that evening to all recipients of the CMO message, instructing them to immediately cascade this information to all relevant health professionals. Local immunisation co-ordinators are direct recipients of CMO messages via the central alert system, and would have received the electronic alert that night.
The Departments immunisation team separately contacted all primary care trusts immunisation co-ordinators on the evening of 25 February and informed them of the GP surgeries in their areas that had received the batches to be withdrawn.
The MHRA has arranged for additional sterility tests to be carried out on the affected solvent batch in the UK. A total of 120 solvent samples will be tested. The MHRA is awaiting delivery of test samples. Sterility testing takes at least 14 days, so the date on which the tests are completed will depend on when the samples are put on test. The MHRA understands that Novartis are testing an additional 360 solvent samples. Novartis testing started on 26 February 2009 and will be completed on 13 March 2009.
Ann Keen: Although there is no cure for myasthenia gravis, those living with this condition are able to access the full range of national health service health and social care, as well a range of treatments that can control the distressing symptoms of this condition for most people. These can include the use of anticholinesterase drugs such as pyridostigmine, the surgical removal of the thymus gland, and drugs such as prednisolone (a steroid) and azathioprine that suppress the immune system.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what the (a) capital and (b) revenue costs of the implementation of picture archiving and communication systems in England have been since the inception of the NHS National Programme for IT. 
Mr. Bradshaw: The Departments central expenditure on picture archiving and communications (PACS) systems provided under national programme for information technology contracts has been on central development and management costs, and the cost of cluster-level data stores. The total of these costs, to 31 January 2009, are in the following table.
|Development/management costs||Data stores|
Mike Penning: To ask the Secretary of State for Health what procedures are in place in his Department to ensure the accuracy of literature it produces relating to the provision of NHS services. 
Mr. Bradshaw: Individual directorates within the Department are responsible for the content and accuracy of the literature they produce, including that relating to the provision of national health service (NHS) services. Where relevant, officials work closely with NHS colleagues. Approval procedures may vary in detail from directorate to directorate but will always include sign-off of content by a senior policy official.
Mike Penning: To ask the Secretary of State for Health what recourse is available to individuals who dispute the accuracy of written information and literature produced by his Department on the provision of NHS services. 
Mr. Bradshaw: Individuals who wish to comment on the accuracy of written information and literature by the Department on the provision of national health service services may write to the Department in the normal way.
Should they wish to make a formal complaint, they may do so to the Departments customer service centre. Each complaint is investigated thoroughly, and if upheld, recommendations are made internally to ensure that future service is improved. Wherever possible, the Department aims to respond to complainants within 20 working days.
If a complainant is unhappy with the Departments response they may ask their Member of Parliament to request that the parliamentary and health service ombudsman investigates the complaint and the way it was handled. The ombudsman carries out independent investigations into complaints about Government Departments.
Ann Keen: In November 2008, the Department set out the vision for developing quality indicators including outcomes of care, where available, and using them to improve the quality of services in the national health service in Measuring for Quality Improvement (MQI)The Approach. A copy of this document has been placed in the House of Commons Library.
MQI aims to support measurement at every tier of the NHS from national to local clinical team level, making available measures that already exist, enabling data to be collected and analysed, and facilitating new indicator development.
The Department is currently collating feedback on measurement requirements from a range of NHS and professional organisations and will shortly be publishing an assured menu of available quality indicators for use at local level.
Mr. Lansley: To ask the Secretary of State for Health with reference to his Departments implementation update for the European Working Time Directive, published on 30 January 2009, what comprehensive position statements on Working Time Directive readiness by specialty for each trust his Department has received from strategic health authorities; and if he will place a copy of each in the Library. 
Ann Keen: The majority of United Kingdom doctors in training already work within the current hours requirement. The over riding objective of the UK Government in their health policy is to ensure the quality and safety of patient care.
The Government are working together with health services and the representatives of the medical profession on the European Working Time Directive solutions. Clinical leadership is key to achieving a positive outcome.
Mr. Lansley: To ask the Secretary of State for Health what estimate he has made of the number of NHS organisations that will request exclusions and derogations from the requirements of the EU Working Time Directive in the next 12 months. 
Mr. Lansley: To ask the Secretary of State for Health what estimate he has made of the percentage of hospital trusts which meet the requirements of the European Working Time Directive with which they must comply by August 2009. 
There is an absolute commitment to support the national health service in achieving compliance with the
European Working Time Directive by 1 August 2009. The expectation is that all services will strive to be fully compliant and all but a very few services with special difficulties will be compliant by this date.
Mr. Lansley: To ask the Secretary of State for Health what statistical analysis his Department has (a) commissioned and (b) evaluated on the effects of the EU Working Time Directive on the NHS. 
Ann Keen: The Department has requested data from strategic health authorities (SHAs) to try to gain the most accurate picture of European Working Time Directive compliance across the national health service through the quality assurance process.
Mr. Lansley: To ask the Secretary of State for Health on what measures and under what budgetary headings the funds allocated by his Department to support implementation of the EU Working Time Directive in 2009-10 will be spent. 
the services are planning to be compliant by 1 August 2009;
the services have a sustainable plan to meet compliance after 1 August 2009 and it has been agreed that their special difficulties warrant inclusion in the Working Time Regulation schedule; and
the services are already compliant but require ongoing support for this to continue.
John Bercow: To ask the Secretary of State for Health (1) what recent discussions he has had with (a) the Chief Executive of the Ealing Primary Care Trust and (b) the Chief Executive of the Royal Free Hampstead NHS Trust on the future of the Nuffield Speech and Language Unit; 
(4) what the total cost to the public purse of (a) the suspension of activities at the Nuffield Speech and Language Unit, (b) the two previous consultations and (c) the current pre-consultation process has been; 
(5) what alternative provision his Department has made for children with severe speech and language disorders following the suspension of activities at the Nuffield Speech and Language Unit in July 2007. 
The information requested is not held centrally and there have been no recent discussions or
timetable set centrally. It is for primary care trusts in partnership with local stakeholders, including practice based commissioners, local government and the public to assess the needs of their local population and to commission services accordingly. This process provides the means for addressing local needs within the health community including the provision of speech and language therapy.
Mr. Sanders: To ask the Secretary of State for Health (1) what assessment he has made of trends in the volume of work undertaken by school nurses in the last five years; and if he will make a statement; 
Ann Keen: No assessment of the volume of work has been made centrally. It is for primary care trusts (PCTs) in partnership with local stakeholders to assess the needs of their local population and to commission services accordingly. This process provides the means for addressing local needs within the health community including the provision of school nursing services.
The Public Health White Paper, Choosing Health: Making healthy choices easier, published in November 2004, included the commitment to provide new funding so that by 2010 every PCT, working with childrens trusts and local authorities, will be resourced to have at least one full-time, year-round, qualified school nurse working with each cluster or group of primary schools and the related secondary school, taking account of health needs and school populations. It is for individual PCTs to determine how to use the funding allocated to them to commission services to meet the health care needs of their local populations.
Linking primary schools to their nearest secondary school gives 3,300 clusters in England. The 2007 workforce census showed there were 3,162 (2,232 full-time equivalent) qualified nurses working in school health services, an increase of 753 or 31.25 per cent. since 2004. Of these, there were 1,227 (893 whole-time equivalent) nurses with the post registration school nurse qualification. This is an increase of 371 or 43.3 per cent. since 2004. In addition, the number of nurses working in the community increased by 28,235 (37 per cent.) between 1997 and 2007.
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