The information requested is not collected centrally. Local authorities are free to decide how best to provide care to meet the needs of their populations. They may do so by providing services directly or via contracting with independent providers of care.

In October 2011, the Department published a discussion paper. "Oversight of the Social Care Market", which outlined the issues facing the social care market and possible options for strengthening oversight of the largest and most complex providers. This has provided a valuable opportunity for us to hear views on this area and reflect on the best approach.

We have considered the responses to the consultation paper, and intend to address the issue of market oversight in the forthcoming White Paper on care and support.

I refer the hon. Member to the written answer I gave him on 24 April 2012, Official Report, columns 865-69W. The data requested for 2011-12 is expected to be made available in autumn 2012.

How much was spent by the national health service on mindfulness-based therapies is not collected centrally and neither has an estimate been made of the number of people who could benefit from receiving it. With regard to how many people have been treated using mindfulness-based therapies and the cost to the public purse of treating repeated episodes of depression by drugs, individual counselling and mindfulness-based therapy in the most recent period for which figures are available I refer the hon. Member to the written answer I gave him on 3 October 2011, Official Report, columns 1406-08W.

Figures showing how many patients suffering from repeat depression were waiting for treatment based on individual counselling and mindfulness-based therapy in the most recent period for which figures are available are not collected centrally and no national assessment of access to mindfulness based therapies has been made.

With regard to how many and what proportion of patients suffering with depression were given mindfulness-based therapies in each primary care trust area in England in the latest year for which figures are available I also refer the hon. Member to the written answer I gave him on 3 October 2011, Official Report, columns 1406-08W.

No assessment of the propensity of general practitioners (GPs) to prescribe mindfulness-based therapies has been made. It is more usually the case that patients will receive the therapy as part of their treatment by an IAPT practitioner to whom they will have been referred by their GP. For similar reasons, no estimate has been made of the proportion of GPs who regularly prescribe mindfulness-based therapy for the treatment of repeat depression.

We have not made an assessment of the potential financial savings to the NHS that may be realised by an increased take up of mindfulness-based therapy for the treatment of repeat depression. However, research has shown mindfulness-based therapy to be effective in preventing relapse after a period of depression and this is why mindfulness-based therapy is increasingly being offered as part of IAPT delivered interventions.

The National Institute for Health and Clinical Excellence (NICE) is responsible for determining the exact scope of its guidance on individual disease areas, including the specific interventions covered. Their clinical guidelines on depression in adults, published in October 2009, and common mental health disorders, published in May 2011, include recommendations on mindfulness-based cognitive therapy.

The Department has not made an assessment of the effectiveness of anti-depressants and mindfulness-based treatment in curing and suppressing depression. It is the role for NICE to assess treatments and based on their findings make recommendations to the NHS.

Government do not specify the content of training curricula for doctors. The content and standard of healthcare training is the responsibility of the independent regulatory body, the General Medical Council (GMC). Through their role as the custodians of quality standards in education and practice, the GMC are committed to ensuring high quality patient care delivered by high quality doctors and that doctors are equipped with the knowledge, skills and behaviours required to deal with the problems and conditions they will encounter in practice. Medical schools design curricula for undergraduate medical education and Medical Royal Colleges for postgraduate medical training, all to meet the standards set out by the GMC.

Annual health checks are a 'reasonable adjustment' to overcome known health inequalities faced by people with a learning disability. One of the pre requisites for GP practices taking part in the annual health checks directed enhanced service (DES), was that practice staff should attend a multi professional training session. Funding was made available to primary care trusts (PCTs) for those practices taking part in the DES. however, no additional funding was made available to PGTs to arrange training for practice staff. The Royal College of General Practitioners acknowledges that annual health checks, improved data on local learning disability populations and improved training are clear evidence of local areas responding to the recommendations of the Parliamentary and Health Service Ombudsman and the Local Government Ombudsman on healthcare for people with learning disabilities in their joint investigation "Six Lives".

We have committed to work with professional regulatory bodies and educational bodies to support improvements in the training and education of healthcare staff in relation to learning disabilities. Healthcare providers and professionals have a "duty of care", a clear moral and social responsibility to look after the people in their care effectively. This means that the wellbeing of all service users, and a commitment to treat people with dignity and respect-should be central to their work. Should providers fall seriously short of the expected standards, we will expect the full range of sanctions.

From figures obtained through the Adult Psychiatric Morbidity Survey in England 2007, 9% of people meet the criteria for the diagnosis of mixed anxiety and depression, with 2.3% meeting the criteria for the diagnosis of a depressive episode.

The Government is investing around £400 million in talking therapies over the four years to 2014-15, which will mean that an extra 1.2 million people are able to get treatment for depression and anxiety.

In 2007, the National Institute for Health and Clinical Excellence (NICE) issued a clinical guideline on the management of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).

The guideline recommends the use of cognitive behaviour therapy and graded exercise in patients mildly or moderately affected by CFS/ME on the basis that these were the interventions for which there was the clearest research evidence of benefit. A number of other treatments, including particular drugs, vitamin supplements and complementary therapies, were not recommended because there was not enough evidence to suggest that they were effective. The guideline acknowledges that there is no one form of treatment to suit every patient, and that treatment and care should take into account the personal needs and preferences of the patient.

It is important to emphasise that NICE clinical guidelines are just that-guidelines for health care professionals. Government policy is for the national health service locally to set its own priorities in response to local need and local circumstances and commission services accordingly.

Improving quality and delivering better health outcomes for patients is the primary purpose of the NHS. Accountability throughout the system needs to be focused on the outcomes of care, rather than the processes. This focus on outcomes will start at a national level with the 2012-13 NHS Outcomes Framework, which defines and will enable measurement of the key outcomes that matter to patients.

All five domains within the NHS Outcomes Framework have relevance for people living with CFS/ME and other neurological conditions. Domain two-enhancing the quality of life for people with long-term conditions as a whole-is the most immediately relevant. This reflects the fact that increasing numbers of people have multiple long-term conditions, and it is not always helpful to see their care from the perspective of a single clinical pathway. Domain two seeks to capture how successfully the NHS is supporting people with long-term conditions to live as normal a life as possible and will be measured using three outcomes:

(i) feeling supported to manage their condition-this measures how, well the NHS as a whole is doing in supporting people to look after themselves and handle the consequences of their conditions;

(ii) functional ability-this measures how well the person is able to live as normal a life as possible, and by looking at employment ties in well with the Department for Work and Pensions and the Government's wider policies about getting people back to work; and

(iii) reduced time spent in hospital-this measures how successfully the NHS manages the condition(s) by looking at unnecessary hospital admissions and excessive length of stay.

It will be the responsibility of the NHS Commissioning Board to determine how to deliver the outcomes in the NHS Outcomes Framework. The board will use the Outcomes Framework and NICE Quality Standards to develop a Commissioning Outcomes Framework and together these will be the basis for clinical commissioning groups to be held to account. The board will also support commissioning by developing detailed commissioning guidance and tools such as standard contracts and tariffs.

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a complex long-term neurological condition with a range of symptoms, with each sufferer experiencing their own personal combination. Physical and/or mental fatigue is the most well-known symptom, but others include pain, disturbed sleep, and gastrointestinal problems. Information about actual numbers of people with CFS/ME-and the funding spent on services locally-is difficult to obtain because of the problems with producing a precise definition of the illness.

The World Health Organisation classes benign myalgic encephalomyelitis and post viral fatigue syndrome under the same classification G93.3 'diseases of the nervous system'-subheading 'other disorders of the brain'. The Chief Medical Officer's Independent Working Group on CFS/ME, which reported in 2002, recognised that that there were widely different views on how symptoms are described, defined and classified, and called for a consensus to be reached on terminology and definition. While awaiting this, the group recommended that the composite term CFS/ME should be used. While this will help with gathering information from the national health service, there is still only partial information available and some local variations.

Cancer survival rates in England will continue to be assessed alongside cancer survival rates in other countries, for example through the European cancer registry-based study on the survival and care of cancer patients (EUROCARE) research project. We have been able to make very useful, up to date comparisons through the International Cancer Benchmarking Partnership (ICBP), which we have been running with Australia, Canada, Denmark, Norway, Sweden, Wales and Northern Ireland, but we have yet to determine the future for the ICBP.

I promised to update the House about ongoing activity in relation to Winterbourne View private hospital and other services for people with learning disabilities.

The House will wish to note that nine people employed at Winterbourne View hospital have pleaded guilty and have been referred for sentencing reports. A further two people have pleaded not guilty and are due back in Bristol Crown court on 6 August. Once the criminal proceedings are completed, we expect the serious case review, chaired by Dr Margaret Flynn, to be published.

The Care Quality Commission (CQC) has now completed its programme of focused inspections of 150 hospitals and care homes for people with learning disabilities. The reports from these inspections are being published in batches, and the final 10 reports were published on 9 May 2012. They can be found at: www. cqc.org.uk/LDReports?1atest. These reports have found poor practice in some of the units, and common areas of concern include limited person-centred care, limited appropriate activities and a lack of monitoring and learning from incidents of restraint. CQC will publish a summary national report of these inspections in the summer.

The final departmental review of Winterbourne View will draw its conclusions on the basis of the findings from the serious case review and evidence from the other investigations and reports that have been undertaken, and so will be published soon after the serious case review.

In recognition of the seriousness of this issue, the Department intends to publish an interim report before summer recess, based on the findings of the CQC summary report and other evidence from the engagement with key partners, which will set out proposed actions and solutions.

I will continue to update the House.

There are important mechanisms and levers within the current social care system to safeguard the interests of all those using care services.

The market is not free to operate without any regulation, and there are a range of bodies with specific responsibilities to ensure the safety and wellbeing of people who may find themselves in vulnerable circumstances should care not be available or be of poor quality. Specifically, the Care Quality Commission regulates adult social care in England, registering all providers of care homes and monitoring compliance with essential standards; and local authorities have specific duties of care towards their local residents under Section 21(a) of the National Assistance Act 1948 and Section 47(5) of the NHS and Community Care Act 1990.

In October last year, the Department published a discussion paper "Oversight of the Social Care Market", which outlined the issues facing the social care market and possible options for strengthening oversight of the largest and most complex providers. This has provided a valuable opportunity for us to hear views on this area and reflect on the best approach.

We have considered the responses to the consultation paper, and intend to include the issue of market oversight in England in the forthcoming Care and Support White Paper.

The National Institute for Health and Clinical Excellence (NICE) is currently appraising abiraterone (Zytiga) for two separate indications. NICE is an independent body and has not yet issued final guidance to the national health service on either indication.

In the absence of final positive NICE technology appraisal guidance, primary care trusts (PCTs) are required to take funding decisions locally based on an assessment of the available evidence and to have processes in place to consider individual funding requests for drugs. Where a cancer drug is not routinely funded by a PCT, patients may be able to access it through the Cancer Drugs Fund.

We will ensure that there are arrangements in place to protect individual patients who are receiving treatment with drugs funded by the fund as the end of the fund approaches.

Work to design the role of clinical networks in the modernised national health service, led by a project team in the NHS Commissioning Board, is progressing well. Proposals describing how networks will be implemented in the new system have been developed with input from stakeholders and have been shared widely. The proposals include clear criteria for determining which networks will be prescribed by the Board for specific conditions and patient groups. A further announcement will be made shortly about the networks which are likely to be prescribed by the NHS nationally to support local commissioners and providers to improve their services. In addition, local clinical networks may be established by agreement between commissioners and providers in line with local priorities.

This information is not available in the format requested. Expenditure by health care condition is available through the national programme budgeting data collection. An estimate of the prescribing spend is incorporated in the overall figures but is not available separately.

The programme budgeting data collection began in 2003-04 and the following table shows NHS gross expenditure on cancer and tumours for England from 2003-04 to 2010-11.

In "Improving Outcomes: A Strategy for Cancer", published on 12 January 2011, we highlighted the vital role that information has to play in driving up the quality of services and outcomes and we are committed to improving the quality, transparency and availability of cancer data. From April 2012 we have mandated the collection of chemotherapy data. In time, this data collection will enable us to undertake more sophisticated analyses around the cost of cancer treatment.

The National Institute for Health and Clinical Excellence (NICE) has published a clinical guideline on the management of people with rheumatoid arthritis. This includes guidance on the early diagnosis of the condition and specifically recommends referral to a specialist for any person with suspected persistent synovitis of undetermined cause. The guideline recommends that people diagnosed with rheumatoid arthritis should have ongoing access to a multidisciplinary team, including access to a named member of the team who would be responsible for co-ordinating the care they need. A NICE quality standard, setting out the care which people with rheumatoid arthritis can expect, is included in the library of quality standards under development.

"Improving Outcomes: A Strategy for Cancer", published on 12 January, set but a commitment to establish appropriate commissioning and funding structures for molecular diagnostic testing for cancer. Molecular diagnostic testing can identify which patients are most likely to respond positively to a specific treatment, allowing treatment to be targeted or 'personalised'.

From 2013-14, we expect to introduce a new national commissioning model for cancer molecular diagnostic tests. We will work closely with the NHS Commissioning Board to ensure these services are developed as an integral part of national commissioning.

There is information available for both the public and health care professionals concerning spinal muscular atrophy available on the NHS Choices website at:

www.nhs.uk/conditions/spinal-muscular-atrophy/pages/introduction.aspx

There is also information on the NHS Evidence website, with a number of resources published by clinicians, charities and professional organisations available at:

www.evidence.nhs.uk/search?q=Spinal+Muscular+Atrophy

Furthermore, the Department has referred for development a quality standard for relatively uncommon neurological problems to the National Institute for Health and Clinical Excellence (NICE) in March 2012, following advice from the National Quality Board. The primary purpose of NICE quality standards is to make it clear what quality care is by providing patients, carers and the public, health and social care professionals, commissioners and service providers with definitions of high-quality health and social care.

I refer the hon. Member to the answer I gave him on 13 March 2012, Official Report, columns 194-95W.

In the last five years 15 people in prison have committed suicide where there was a primary diagnosis of schizophrenia or other delusional disorder.

Similar information is not available for people after they leave prison.

Former prisoners have a lower than average level of engagement with primary care services and this means they are less likely to be in touch with community and specialist mental health services. In many areas assertive outreach teams have been commissioned to improve engagement with mental health services. The Government's mental health outcomes strategy, 'No Health Without Mental Health', makes it clear that consideration of equality of access to mental health services for offenders should be part of the planning and development of services.

It is not possible to disaggregate spend on mental illness by either sex or age from the statutory accounting collected by the Department.