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Mrs. Calton: To ask the Secretary of State for Health (1) what research his Department has (a) commissioned and (b) evaluated on the success of trials involving digital hearing aids in the 20 trial hospitals under the Government pilot programme; 
(2) what research his Department has undertaken to assess the possibility of establishing a system to enable members of the public to purchase digital hearing aids at the cost price through the NHS; and if he will make a statement. 
Jacqui Smith: The Department has commissioned the Institute of Hearing Research to evaluate the "modernising NHS hearing aid services" project. The final evaluation report will be available next year.
The Department is not conducting research to evaluate allowing people to pay for digital hearing aids on the national health service. NHS hearing aid services, which include hearing tests, hearing aids and follow up care, are available free to children and adults who are resident in the United Kingdom.
Dr. Evan Harris: To ask the Secretary of State for Health what preliminary evaluation of the first wave sites in the digital hearing aid trial he has received; and if a copy will be placed in the Library. 
Jacqui Smith: The Department has received interim evaluation reports based on data collected from a relatively small sample of patients from the Institute of Hearing Research in July and October. The evaluation is still ongoing, so reports have not been placed in the Library.
The final evaluation report will be available next year.
Mrs. Brooke: To ask the Secretary of State for Health what timescale his Department is working under to extend the pilot programme of provision of digital hearing aids to the rest of the NHS; and what plans his Department has made regarding the future funding of digital hearing aids on the NHS between 200203 and 200304. 
Jacqui Smith [holding answer 6 November 2001]: The Department expects to make decisions about extending the modernisation of national health service hearing aid services to other audiology departments from 200203, and about future funding of digital hearing aids on the NHS, in the light of the research evaluation which is being carried out by the Institute of Hearing Research.
Twenty NHS trusts in England are fitting digital hearing aids as part of the "modernising NHS hearing aid services" project.
Dr. Iddon: To ask the Secretary of State for Health if he will make a statement on his policy relating to the British Medical Association's guidance on withholding and withdrawing life-prolonging medical treatment; and what observations he has sent to the Association on this subject. 
Ms Blears: The document issued by the British Medical Association aims to identify the range of clinical, ethical and legal factors which need to be considered in making decisions on withdrawing and withholding
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medical treatment. It covers also potential procedures, including consulting the health care team and seeking a second opinion where necessary, which may assist in ensuring high quality decision-making in this area.
The guidance is a helpful contribution on this subject for practitioners. We have not made any observations to the association on this subject and have no plans to do so.
Mr. Kevan Jones: To ask the Secretary of State for Health (1) if he will list the (a) individuals invited for interview by the NHS Appointments Commission for the post of chair of the North Durham NHS Trust and (b) reasons for their selection for interview; [R] 
(3) what reasons were given by the NHS Appointments Commission for not reappointing Mr. Kevin Earley to the post of chair of the North Durham NHS Trust. [R] 
Ms Blears: Appointment of chairs of national health service trusts is the responsibility of the NHS Appointments Commission. The appointments process they follow has been published and has been approved by the Commissioner for Public Appointments. It is an open and transparent process but rightly protects the identity of individual candidates and the assessment of their performance at interview or elsewhere. I understand that the Appointments Commission drew the advertisements for this appointment to the attention of local hon. Members and local authorities, but in accordance with their agreed procedures, did not consult on the appointment.
Rachel Squire: To ask the Secretary of State for Health what estimate he has made of expenditure in each of the last three financial years on NHS treatment of smoking- related illnesses. 
Ms Blears: Treating illness and disease caused by smoking is estimated to cost the national health service up to £1.7 billion every year in terms of general practitioner visits, prescriptions, treatment and operations.
Mr. Truswell: To ask the Secretary of State for Health (1) what representations he has received regarding public funding of air ambulance services; and if he will make a statement; 
Ms Blears: We have received a number of letters of support from a wide variety of organisations suggesting that there should be public funding of air ambulances. Evidence supporting the introduction of air ambulances in the national health service, however, is not convincing. In 1995, the Department commissioned Sheffield University to report on air ambulances. The report failed to show benefits which would justify NHS investment. However, in recognition of the growing public interest in this
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subject, further research has been commissioned into the contribution made by air ambulances in the care and transportation of seriously ill patients in a modern NHS. The Department will review the position on this issue when the outcome of this further research is available.
Information on the funding of individual air ambulance services is not collected centrally.
Mr. Burstow: To ask the Secretary of State for Health, pursuant to his answer of 29 October, Official Report, column 559W, on the community care services special grant, if he will list the sources of the money allocated by his Department which previously were not earmarked for social services. 
Jacqui Smith [holding answer 5 November 2001]: The £300 million allocated to councils over this year and next is additional funding for social care. £80 million of this funding has been provided by the Department for Transport, Local Government and the Regions, and a further £20 million from Her Majesty's Treasury. The remaining £200 million will be found from unallocated funds within the Departmental expenditure limit.
Harry Cohen: To ask the Secretary of State for Health what the average cost per hospital meal is (a) before and (b) after the implementation of the Government's better hospital food programme; and if he will make a statement. 
Ms Blears: The better hospital food programme, announced in the NHS Plan, is designed to improve the quality and availability of food in hospitals. It is a long term programme, the first stage of which requires hospitals, by 31 December 2001 to ensure that their meal services meet or exceed required standards and meet nutritional requirements, to provide a 24-hour catering service so that patients can obtain food when they need it, to adopt the national design for menus, and to provide on their menus dishes designed for the National Health Service by the team of leading chefs.
The initial stage of the programme is therefore about bringing standards up to the required level in places where they do not currently meet these.
The costs of each component part of the programme will vary from hospital to be hospital, and will be affected by a range of factors including current levels of investment in catering services, the type of catering service in use and the number of patients choosing dishes designed by the leading chefs.
Since hospitals are not required to implement the programme until 31 December 2001, and because at this stage costs will vary considerably, precise details regarding the average additional costs are not currently available. These will become available in the coming months.
Once standards have been brought to a more equal level across the service, it will be easier to accurately forecast any additional costs of future improvements.
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Mr. Wareing: To ask the Secretary of State for Health (1) what Government bodies and agencies deal with matters referred to in the Chief Medical Officer's advice of January relating to the removal, retention and use of human organs and tissue from post-mortem examination; what work has been undertaken by them; and what further work remains for them to do; 
(3) what recent research he has undertaken on international practice relating to the removal, retention and use of human organs and tissue; and if he will make a statement; 
(4) what action he proposes to take to put into practice the recommendations of the Chief Medical Officer in respect of the removal, retention and use of human organs and tissue; 
(5) what work has been done on the recommendation from the Chief Medical Officer for a review of the legislation on organ donation; and when he is planning to begin consultations. 
Ms Blears [holding answer 5 November 2001]: We are committed to implementing the Chief Medical Officer's recommendations on the removal, retention and use of human organs and tissue made in the light of the Redfern and Kennedy reports. The Department is principally responsible for this programme. We have established the Retained Organs Commission as a special health authority to oversee, among other things, the return of organs and tissue to families who want that to happen. The Home Office is leading a review of the coroners' system which was set up in July this year. Close links are being maintained between the two Departments and with the Commission.
As part of the implementation programme, we shall shortly be consulting publicly on a number of documents, including codes of practice on communications with families about post mortems and on the import and export of body parts. Linked to the Department's wider "Good Practice in Consent" initiative, we shall be piloting consent forms for hospital post mortems and for consent to the post-mortem removal, retention and use of organs and tissue where such actions are not required by the Coroner. We shall be seeking views also on an interim statement on the use of organs and tissue, based on the current law.
For the medium to longer term, the Department is leading a comprehensive review of the law in England and Wales which will examine, among other things, the taking, storage and use of organs and tissue from the living and the dead and options for future regulatory control. We shall be issuing an initial consultative paper on the review in the near future.
As part of the review we shall be gathering further information about how these matters are treated in other countries, notably elsewhere in the European Union, in North America and in parts of the Commonwealth.
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We do not now propose to legislate separately to amend the Human Tissue Act 1961 to clarify that consent must be sought from those with parental responsibility for the retention of organs or tissue from post mortem on children beyond the time necessary to establish the cause of death. This proposal, as well as our intention to introduce a penalty for non-compliance, will be considered as part of the comprehensive review.
We are aware that many families affected by organ removal and retention may require a range of support, including psychological support, from the statutory and voluntary services. On the advice of the Chief Medical Officer, we have made a clear commitment to improve bereavement services. We shall be considering what else may need to be done to meet individual and family needs; and whether the Department needs to commission any research or other survey on psychological aspects. The consultative process will have an important part to play here.
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