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Mr. Marsden: To ask the Secretary of State for Health what steps he plans to take to reduce reported high exception rates to lowering cholesterol levels among patients in spearhead primary care trusts. 
Mr. Bradshaw: The latest research by the National Primary Care Research and Development Centre shows that although practices in deprived areas have slightly higher exception rates for patients than practices in affluent areas, deprivation related variation in reported quality of care for measured activities reduced during the first three years of the quality outcomes framework resulting in more equitable delivery of health care for these activities.
Nevertheless, the average rate of exception reporting is just under 6 per cent. There are considerable variations between indicators and between practices. We propose to discuss with the profession how we can minimise exception reporting (as recommended by the National Audit Office) in order to ensure that all patients who would benefit from treatment have access to it.
Mr. Lansley: To ask the Secretary of State for Health how many (a) deaths from and (b) cases of (i) clostridium difficile and (ii) MRSA there have been in each year since 1997, broken down by region. 
Mr. Bradshaw: Death certificate data published by Office for National Statistics (ONS) covers all certificates where methicillin-resistant Staphylococcus aureus (MRSA) or clostridium difficile ( C. difficile) is cited as a contributory factor to or an underlying cause of death. Death certificates do not record the place where an infection was acquired.
Many patients who become infected with a healthcare associated infection (HCAI) have other serious and
potentially fatal underlying medical conditions. Doctors do not record all diseases or conditions present at death, only those that contribute directly to it. It is a matter of individual professional judgment whether the doctor lists an HCAI as a contributory cause and this will depend, generally, on whether the doctor thinks that the patient would have survived significantly longer if they had not developed an infection.
There has been a number of initiatives to raise the profile of HCAIs and improve their acknowledgement as diagnoses in their own right. In July 2005 and October 2007 the chief medical officer reminded doctors of the importance of giving full and accurate information on the death certificate, particularly in recording HCAIs.
NHS acute trusts are required to report all C. difficile toxin positive faecal specimens and all MRSA positive blood cultures processed by their laboratories, whether clinically significant or not and whether acquired in that trust or elsewhere.
Mandatory surveillance of C. difficile infection for patients aged 65 years and over began in January 2004. Table 3 provides regional data on the number of recorded C. difficile cases for patients aged 65 years and over by calendar year 2004 to 2007.
Mandatory surveillance of C. difficile infection was extended to include data for all patients aged two years of age and over in April 2007. Table 4 provides regional data on the number of recorded C. difficile cases for patients aged 2-64 from April 2007 to March 2008.
Mandatory surveillance of MRSA bacteraemia (or bloodstream infections) began in April 2001. Table 5 provides regional data on the number of recorded MRSA bacteraemia cases by financial year from 2001-02 to 2007-08. There is no mandatory surveillance of non-bacteraemia MRSA infections, these present a significantly lower risk in terms of patient safety.
Mr. Crausby: To ask the Secretary of State for Health what estimate he has made of the number of people participating in the bowel cancer screening programme (a) in Bolton and (b) nationally. 
Mr. Bradshaw: As at 31 July 2008, uptake in the area covered by Bolton primary care trust is 50.02 per cent., with 16,252 invitation letters sent out and 8,130 testing kits returned since 12 February 2007, when the roll out of the NHS Bowel Cancer Screening programme commenced in Bolton.
Nationally, from 3 July 2006, when the first invitations to take part in the NHS Bowel Cancer Screening programme were issued, to 31 July 2008, uptake is 51.75 per cent. 1,203,015 invitation letters have been sent and 622,384 testing kits returned.
Mr. Bradshaw: Both the Department and the Medical Research Council (MRC) support research into neurodegenerative disease and dementia. The expenditure information available is shown in the following table.
|Expenditure on dementia research|
|Department( 1)||Medical Research Council||Total|
|(1) Includes Dementia and Neurodegenerative Diseases Research Network spend of £0.4 million in 2005-06 and £1.8 million in 2006-07.|
The Departmental figures for the years from 2002-03 to 2003-04 relate to national research programme expenditure on projects concerned with the diagnosis, treatment and care of people with dementia. They do not include the part of the research and development allocations made annually at that time to national health service providers and spent on dementia and other progressive neurodegenerative conditions research. That information was not collected prior to 2004-05.
The Department does not collect expenditure data at the level that would be required to provide details of spend on particular dementia types. Details of individual projects supported in the NHS in the period in question can be found on the archived national research register at:
Mr. Bradshaw: A draft of a National Dementia Strategy was published on 19 June for consultation. The consultation closes on 11 September 2008 and we will carefully consider all the responses we receive before deciding the final shape of the National Strategy, and what resources are available to support its implementation. As part of this consultation we have invited views on a dementia research summit for funders, charities and industry to review how all parties can work together to deliver a programme of research into prevention, cause, cure and care and, separately, a review of the use of anti-psychotic drugs for people with dementia.
To ask the Secretary of State for Health how much his Department has spent on research into
the causes and treatment of dementia in each of the last five years; and what the projected level of spending on such research is for the next three years. 
|Expenditure on dementia research|
|Department||Medical Research Council||Total|
The departmental figures for the years from 2002-03 to 2003-04 relate to national research programme expenditure. They do not include the part of the research and development allocations made annually at that time to national health service providers and spent on dementia and other neurodegenerative conditions research. That information was not collected prior to 2004-05.
Implementation of the Department's research strategy Best Research for Best Health is being managed by and through the National Institute for Health Research (NIHR) and has resulted in an expansion of our research programmes and in significant new funding opportunities for health research. Awards are made after open, competitive, peer review. Future levels of expenditure on dementia will be determined by the success of relevant bids for NIHR funding. A number of those made over the last two years have already been successful.
Mr. Bradshaw: In order to identify and spread good practice the Department will evaluate how local commissioning is working in terms of the patient experienceboth access and quality of services, and the incentives it offers to increase access and encourage prevention and health promotion, as well as treatment. The Department will also set out a vision for national health service dentistry in five years time. The evaluation will take place over the next few months and will be completed by the end of the year.
Following a recent consultation exercise on how to count the dental work force carried out by the NHS Information Centre, these figures are based on a revised methodology. The new measure of national health service dentists counts the number of dental performers with NHS activity recorded via FP17 claim forms in each
year. The NHS Information Centre has published figures for the years ending 31 March 2007 and 2008.
Dentists who had activity recorded against them via FP17 forms in a year, but none the following year are recorded as a leaver in their last year of activity. Information on the numbers of leavers is only available at present for 2006-07. Information on the number of leavers for 2007-08 will be available only after the end of 2008-09.
The number of dentists who left the NHS in 2006-07 and those who joined the NHS in 2007-08 are available in Table 33 of the report. The numbers of dentists in 2006-07 and in 2007-08 and the difference between the two years are available in Table 32 of the report which is also available on the Information for Health and Social Care website at:
Mike Penning: To ask the Secretary of State for Health if he will make an assessment on the potential of video-conferencing to (a) facilitate the deregulation of dental care and (b) allow dental hygienists to deliver a greater proportion of treatment with remote diagnosis by dentists. 
Mr. Bradshaw: This is an interesting suggestion, which we will bring to the attention of the General Dental Council (GDC). The GDC is responsible for the regulation of dentists and dental care professionals (DCPs) including dental hygienists. The GDCs rules currently require that dental hygienists work to a treatment plan prepared by a dentist. However, in the spring, the GDC issued a consultation paper on the scope of practice of DCPs which invited comments on what additional training would be required to allow dental hygienists to see patients directly. The results of the consultation will be considered by a newly constituted GDC, which will be established in 2009.
Mr. Betts: To ask the Secretary of State for Health what his Departments policy is on improving the energy efficiency of the buildings which it (a) rents and (b) owns; what changes there have been in the energy efficiency of such buildings in the last (i) five and (ii) 10 years; and whether his Department has adopted targets on energy efficiency improvements in the buildings it occupies over the next (A) five and (B) 10 years. 
This Department supports and aims to meet the Governments targets to reduce carbon
emissions and improve the energy efficiency of the Government estate. While our energy efficiency (measured as consumption per m(2)) has reduced over the period, to date largely due to our policy of closing buildings and concentrating more staff in our remaining estate.
We are committed to achieving the current Government targets to improve our energy efficiency by 15 per cent. by 2010, and 30 per cent. by 2020, relative to 1999-2000. We are working with the Carbon Trust to identify energy saving measures, and to implement a Carbon Management Programme throughout our core estate and in our arms length bodies.
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