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Ms Blears [holding answer 15 November 2001]: The appointment of the chief executives designate of strategic health authorities was through a process of open competition. The chief executives posts were advertised nationally. The appointment process included the NHS chief executive, regional commissioners from the national health service Appointments Commission, the directors of health and social care in the Department, patients' representatives and the health authority chairs designate. The NHS chief executive had overall responsibility for the process. Chief executives will be formally appointed to health authorities on the basis of their franchise plans, following the establishment of the new health authorities in April. Franchise plans will specify how chief executives propose to deliver the functions for which the health authorities are responsible.
Mr. Hood: To ask the Secretary of State for Health what the outcome was of the Health Council held in Brussels on 15 November; what the Government's stance was on each issue discussed, including its voting record; and if he will make a statement. 
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The Council reached political agreement to adopt a common position on the directive setting standards of quality and safety for blood and blood components. Although a few member states were disappointed that there were no strict requirements for donations to be voluntary and unpaid agreement was reached on an acceptable compromise form of words.
In the orientation debate on the directive on tobacco advertising and sponsorship all the delegations, which spoke, stressed the need to ensure that its basis be legally sound so that it is not struck down by the European Court Judgment as the previous directive had been. The UK, along with other member states expressed support for the directive. The UK raised concerns that global sponsorship should benefit from derogation until 1 October 2006. The UK also mentioned the need to ensure that the directive was compatible with other legislation pertaining to e-commerce. There was some discussion of the scope of the directive and Commissioner Byrne explained that it did not cover indirect advertising. Some states felt the advertising ban should not apply to local press and publications. There was no opposition to the inclusion of advertising for cigarette papers within the scope of the ban.
Member states discussed the health aspects of bio-terrorism agreed presidency conclusions on the need for a comprehensive programme of co-operation in this area; strengthening existing networks and exploring other opportunities to ensure a coherent approach in support of national plans.
Commissioner Byrne made a statement on recent developments in cross-border healthcare. Member states expressed concern over recent ECJ rulings that treaty provisions on freedom to provide services applied to health services, which had previously been thought to lie outside treaty competence. The Commission called for further discussions on the detail and will produce a discussion document for the Spanish presidency conference in February. The UK explained that the rulings had implications for domestic legislation, to which we were responding, and that there was a need to look further at competence boundaries. Other member states were of the same opinion.
Commissioner Byrne gave an update on preparations for the next round of negotiations on the World Health Organisation framework convention on tobacco control. He indicated that the Community position on agriculture subsidies would need to be updated to take account of references to phasing out of tobacco subsidies in the communication to Gothenburg on sustainable development. The planned Commission communication on 'Health and Poverty policy' will help pave the way for financial support for implementation of the convention in developing countries.
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Commissioner Byrne explained that the Scientific Committee investigating the impact of electro-magnetic fields thought there may be a link with DNA damage and multiple exposure, but there was insufficient evidence as yet. The Commission will recommend further studies to fill the knowledge gaps.
Tim Loughton: To ask the Secretary of State for Health what the average patient consultation times were in each health authority area for (a) general practitioner and (b) hospital consultant appointments in the last 12 months for which figures are available. 
Mr. Hutton: [holding answer 29 November 2001]: The data are not collected either routinely or by health authority. The latest figure available, for general practitioners only, was in the GP Workload Survey of 199293. This showed the average GP consultation time with a patient was 8.4 minutes.
Mr. Bercow: To ask the Secretary of State for Health if he will make a statement on progress in meeting the Public Service Agreement target of efficiency and other value for money gains in personal social services expenditure of two per cent. in 19992000 and 200001 and three per cent. in 200102. 
Jacqui Smith: Information provided by councils during in-year monitoring suggests that for social services in England the estimated efficiency gain was 2.1 per cent. for 19992000, 2.3 per cent. for 200001 and 2.5 per cent. for 200102. The total estimated efficiency gain over the three years was therefore 7.1 per cent, all but meeting the total of the efficiency targets over three years of 7.2 per cent.
Mr. Burstow: To ask the Secretary of State for Health, pursuant to his answer of 15 October 2001, Official Report, column 1042W, concerning the report, "Removing Barriers", which of the report's recommendations were acted upon and with what result. 
Jacqui Smith [holding answer 5 November 2001]: The two recommendations included in the report which related to the Department of Health were that there should be additional funds provided to local authorities and there should be a dialogue between the Department of Work and Pensions, the Local Government Association and the Department.
Jacqui Smith: We recognise the importance of improving and maintaining the mobility and safety of older people. A number of initiatives within both health and social care will contribute to these aims. Of prime importance are the National Service Frameworks for Older People and Coronary Heart Disease, which stress the importance of physical exercise. Other initiatives of particular importance to older people include intermediate
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care and the integration of community equipment services. Also, to reduce the incidence of serious injuries caused by falls in older people, the Department is funding several pilot schemes that help frail older people in nursing homes and sheltered accommodation improve their ability to walk without falling.
Mr. Flight: To ask the Secretary of State for Health what his latest assessment is of the average (a) private, (b) public and (c) total spending on health in EU member states expressed as a percentage of GDP; and what he expects those figures to be in 200405. 
OECD data 2001
There are no projections for changes in the balance between public and private health care spending. There is no evidence to suggest that in 200405 the average total health spending as a percentage of gross domestic product will be any different to current levels.
Mr. Rosindell: To ask the Secretary of State for Health what assessment he has made of the average time ambulance crews have waited over the last 12 months with the patients they have brought to the accident and emergency unit at Oldchurch hospital in Romford. 
Mr. Hutton: Ambulance crews wait longer at Oldchurch hospital before they are ready to go to their next call than at other London hospitals. While it is not acceptable that patients are kept waiting before being booked in at accident and emergency, they are receiving medical care during this time.
The London Ambulance Service (LAS) is working together with the local NHS organisations to further improve turnaround times. The LAS records turnaround times as the time taken from the crew arriving at the hospital to telling central ambulance control that they are ready to receive another call. This includes any time taken to complete paperwork on the patient, clean the vehicle, do a clinical handover to A&E staff or have a bathroom break.
A process mapping exercise being undertaken by Barking and Havering health authority to look at patient access to A&E to see where are the hold-ups in the system.
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On 25 October 2001, my right hon. Friend the Secretary of State announced a £118 million investment for reducing long waits in A&E. This includes £50 million to implement the reforming emergency care strategy and £40 million to fund an additional 600 A&E nursing posts. Out of this money, Barking, Havering and Redbridge Hospitals national health service trust will receive £154,206 this year to provide additional nurses for its two A&E departments and a further £632,243 next year.
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