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Mr. Rosindell: To ask the Secretary of State for Health what the average waiting time is for an A and E patient to see a doctor at Oldchurch hospital in Romford; and if he will make a statement. 
Mr. Rosindell: To ask the Secretary of State for Health what plans he has to improve waiting times for patients waiting to see a doctor in the A and E department of Oldchurch hospital in Romford. 
Mr. Hutton: We are committed to resolving the issue of waits in accident and emergency and the NHS plan includes clear objectives for reducing inappropriate waits. By 2004, no patient will wait more than a total of four hours in accident and emergency from time of arrival to admission, transfer or discharge, with the average waiting time reduced to 75 minutes.
Oldchurch hospital, part of Barking, Havering and Redbridge hospitals national health service trust, has already received £868,000 from the accident and emergency modernisation fund. The trust will also receive a share of the additional £100 million announced last month to support the recently published reforming emergency care strategy.
Furthermore, efficiency within the accident and emergency department at Oldchurch hospital will be boosted by the additional £300 million announced in October to tackle nationally the persistent problem of bed blocking. Of the £100 million allocated so far, local authorities in the area have received just over £1 million.
Jacqui Smith [holding answer 14 November 2001]: There are currently no plans to introduce a national service framework for respiratory disease. The NSF for older people recognised the importance of respiratory diseases to the health and well-being of older people. The NSF provides for a 10-year developing framework for action across health and social care and within this set arthritis and respiratory disease in older people as the next priorities for future work. The focus of this will be older people, but, much like the current NSF service models on stroke and dementia, such a service model will have implications for, and apply to, all who need these services, regardless of their age.
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There is a range of Government initiatives already in place which take a preventive approach to respiratory disease and have long-term objectives to improve treatment and care. These include the investment of £53 million in smoking cessation servicessmoking is the major cause of lung cancer and chronic obstructive pulmonary disease (COPD)and asking the National Institute for Clinical Excellence to prepare clinical guidelines for the national health service for the diagnosis and treatment of lung cancer and the management and treatment of COPD.
Ms Drown: To ask the Secretary of State for Health for major capital projects over £50 million in his Department, at what discount rate the value for money test would recommend that (a) a publicly funded project became a PFI scheme and (b) a PFI project became publicly funded. 
Mr. Hutton: The decision on whether a capital investment project should test for private finance in the first place is taken early in the process, at the outline business case stage. Decisions will be based on the nature and complexity of the project, which in turn impact upon value for money factors such as the number and capability of bidders likely to be interested and the past track record of similar projects with regard to private finance initiative. Being a set constant the discount rate is not a relevant factor and is therefore not considered.
A single discount rate for all Government Departments is set by Her Majesty's Treasury. National health service trusts are therefore not required to apply different discount rates as part of their sensitivity tests in the full business case on assessing at what point a PFI option does not demonstrate value for money when compared to the public sector comparator.
It is not possible to set rates that would determine a switching value ahead of the priced bid as the exact rate will be determined by the rate of spend, exact timings of the cash flows, length of contract period and interest rates applicable at the time contracts are signed. As a general rule, compared to the current 6 per cent. rate, an increase makes revenue payments more attractive, a lower rate favours up-front capital investment.
Mr. Hutton: No changes have been made to the methods of counting the published average bed numbers since 1 May 1997. A new twice-yearly census was introduced in March 1999 to improve the availability of information on critical care. In addition, a special census of beds to inform progress on implementing capacity plans for winter was taken on 1 December 2000.
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Mr. Edwards: To ask the Secretary of State for Health what guidance he gives to (a) dentists and (b) general practitioners on removing from their lists patients who have not attended for a period of time; and what plans he has to review this guidance. 
Mr. Hutton: The Department does not issue guidance to general dental practitioners on removing patients. Under current regulations, dentists' terms of service provide that a continuing care arrangement or a capitation arrangement shall lapse at the end of the 16th month beginning with the month in which the patient was first accepted by the dentists or the arrangement was last extended. Continuing care arrangements apply to patients who are 18 years of age or older; capitation arrangements to patients who are under 18. A continuing care or capitation arrangement is extended when a patient attends the dentist for treatment or for a check-up.
The Department does not issue guidance to general practitioners on removing patients who have not attended their practice for a period of time. However, GPs' terms of service require them to invite patients for a consultation where they have not been seen for a period of three years.
Jacqui Smith: The main Government agency for research into the causes of and treatments for disease is the Medical Research Council (MRC), which receives its funding via the Department of Trade and Industry. The MRC has a large portfolio of research into epilepsy, out of a total spend of approximately £24 million on neurological diseases. The MRC always welcomes high quality applications for support into any aspect of human health and these are judged in open competition with other demands on funding. Awards are made according to their scientific quality and importance to human health.
The Department funds research to support policy and delivery of effective practice in the national health service. Research on the clinical effectiveness and cost effectiveness of new drugs for epilepsy in adult and children is currently being supported through the health technology assessment programme. Research includes a randomised controlled trial of longer-term clinical outcomes and cost-effectiveness of standard and new anti-epileptic drugs, at an overall cost of £1.3 million, together with reviews of existing research on behalf of the National Institute for Clinical Excellence.
Project details of work directly funded by the Department or supported through the NHS research and development budget can be found on the National Research Register (NRR). This is available in the Library
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