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Osteoporosis

Mr. Barker: To ask the Secretary of State for Health whether the clinical guidelines on the assessment and prevention of falls in older people will include information on osteoporosis; and if he will make a statement. [31464]

Dr. Kumar: To ask the Secretary of State for Health for what reason osteoporosis has been left out of NICE's scope for the development of a clinical guideline on the assessment and prevention of falls in older people. [32856]

Ms Blears [holding answer 4 November 2001]: I apologise to the hon. Members for the delay in responding to this question. I refer the hon. Members to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

Following its consultation on the scope of the guideline I understand that NICE decided that osteoporosis could not be given proper consideration as part of a guideline on falls prevention. However, we are considering a proposal for a separate clinical guideline on osteoporosis.

"The Bulletin"

Dr. Murrison: To ask the Secretary of State for Health if he will list the respondents that have expressed concerns over the capacity and capability of primary care trusts to

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handle the functions to be devolved from the existing health authorities after April, according to Issue 7 of The Bulletin dated January 2002. [34139]

Mr. Hutton: I apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

In the "Shifting the Balance of Power" discussion period, over 400 responses were received from existing primary care trusts (PCTs), health authorities, national health service trusts, local representative committees, voluntary organisations, community health councils, local authorities, universities, royal colleges, major national representative bodies and numerous individuals. Several of these respondents were concerned to some extent that PCTs would not have the capacity or capability come April to undertake their new functions effectively. However, these concerns were raised in the summer of 2001, since then much progress has been made in the development and implementation of PCT policy.

It would be wrong to expect PCTs to manage their enhanced role and new functions without support. That is why a number of central initiatives, for example the national primary and care trust development programme, have been established to help PCTs develop the expertise and the capacity they will need to take on these functions.

At a local level PCTs are being encouraged to develop collaborative working arrangements with each other to pool knowledge, and share capacity and expertise.

Dr. Murrison: To ask the Secretary of State for Health what progress has been made under the comprehensive development programme referred to in Issue 7 of "The Bulletin" dated January 2002 in ensuring that primary care trusts are able to handle functions devolved from health authorities. [34138]

Mr. Hutton: I apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

To ensure that primary care trusts are able to handle functions devolved from health authorities in April 2002, a number of central support and development initiatives were established through the primary care trust development programme, the leadership centre, the National Health Service appointments commission and the Modernisation Agency.

A framework of organisational and person competencies for PCTs and their staff has since been identified after an extensive listening exercise with PCTs and other key stakeholders. This will shortly be available to all PCTs to use as self-assessment tool to help determine the organisation's competence and enable PCTs to build and develop the capability and capacity to deliver on their enhanced role. A series of events have also been held for PCT chief executives and some other senior staff to develop the ideas of PCTs collaborating on areas where self sufficiency is not possible. As a result network arrangements are being put in place over the country.

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Appropriate induction and development programmes have also been developed for PCT non executive directors and similar programmes for other leaders are in progress. A number of specialist groups have been established to look in more detail at PCTs' competence on issues such as dentistry and nursing while teams of PCT leaders have also been recruited to look at the major PCT competencies in more detail.

As more staff are in place and PCTs take on their new functions, development programmes will continue apace. Indeed, the primary care trust development programme has a three year future already planned out. PCT development will be linked increasingly to development initiatives for the new health authorities to ensure that changes across the NHS are delivered in a whole systems way.

Intermediate Care

Mr. Burstow: To ask the Secretary of State for Health how many of the intermediate care joint investment plans have been agreed as set out on page 172 of the National Service Framework for Older People milestones. [34024]

Jacqui Smith [holding answer 7 February 2002]:I apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

In the light of Shifting the Balance of Power and a government wide drive to reduce levels of bureaucracy, a new approach to planning in the national health service NHS) is being developed.

Chief executives of the new strategic health authorities (StHAs) will be accountable for delivery of national priorities as part of three-year franchise agreements with the Department. Franchise agreements will be underpinned by an annual delivery agreement (ADA) that outlines the actions and investments required to deliver on the commitments outlined in the Planning and Priorities Framework (2002–03), of which the development of intermediate care services is a key deliverable. Taken together, the components of StHA franchise agreements, including the ADA, will form the key instrument of accountability between the NHS and the Department.

In the light of these changes and the commitment by Departmental boards to reduce the health and social care planning burden, the NHS will no longer be required to produce either older people's or intermediate care joint investment plans. Any local planning of intermediate care services for 2002–03 that has already taken place will feed in to the new planning arrangements.

This does not mean that the NHS will cease to plan or invest jointly-it will. Crucially though the quality and effectiveness of that planning will now become the responsibility of the StHAs, who will be responsible for ensuring that adequate mechanisms are set in place at a PCT and trust level to ensure effective joint investment and planning.

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NHS Employment Costs

Mr. Peter Duncan: To ask the Secretary of State for Health what is the estimated additional cost to the NHS in England and Wales of the changes to employers' national insurance contributions for 2002–03. [34436]

Mr. Hutton [holding answer 7 February 2002]: I apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

We are not aware of any changes to employer's national insurance contributions which will give rise to additional costs to the NHS in 2002–03.

NHS Organisation

Mr. Heald: To ask the Secretary of State for Health what plans he has to merge (a) existing and (b) proposed NHS (i) national directors posts, (ii) commissions, (iii) offices, (iv) types of trust, (v) types of authority, (vi) groups, (vii) boards, (viii) committees, (ix) forums, (x) councils and (xi) bodies. [35493]

Mr. Hutton [holding answer 12 February 2002]: I apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

Proposals for changes to existing NHS bodies were set out in "Shifting the Balance of Power—Securing Delivery", published in July 2002 and "Shifting the Balance of Power—The Next Steps" published in January 2002, copies of which are available in the Library.

GP Targets

Mr. Heald: To ask the Secretary of State for Health what targets he has set for general practitioners to achieve (a) now and (b) by 2004. [36894]

Mr. Hutton: I apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.

The general practitioner (GP) pay system includes incentives for GPs to deliver targets on childhood immunisation and cervical cytology. These have been a feature of the pay system since 1990. The NHS plan sets targets for modernising primary care services where GPs are expected to contribute to their achievement, including in particular, the access target that by 2004 patients should be able to see a GP within 48 hours or another health professional within 24 hours. None of these targets are, however, for GPs to achieve on their own. It is for primary care trusts locally to lead, organise, support and resource delivery of the NHS plan targets for primary care.

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