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Details of the number of children diagnosed with autism since 1990 are not available. In December 2001 the Medical Research Council (MRC) published a comprehensive review of autism research, which provides an authoritative overview of the current state of knowledge on the prevalence, incidence and causes of autism. The report was commissioned by the Department and produced with the help of a wide range of experts and a "lay" group including parents and representatives of autism charities. It is available on the MRC website at "www.mrc.ac.uk".
Mr. Hancock: To ask the Secretary of State for Health (1) what correspondence he has had concerning his Department's decision to challenge the declaration of a town green in the grounds of St. James' Hospital in Portsmouth; and if he will make a statement; 
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(4) what consultation he has had with the DTLR concerning Portsmouth City Council's policy on open spaces and St. James' Hospital site; and if he will make a statement; 
(5) what assessment has been made of the compatibility between the proposed action by his Department against Portsmouth Council in regard to St. James' Hospital and the open space in cities policy; and if he will make a statement; 
(6) what action he has taken in respect of Portsmouth City Council's decision to declare a town green in the grounds of St. James' Hospital; and for what reasons. 
Portsmouth City Council as the registration authority received an application to register part of St. James Hospital, Portsmouth as a Town or Village Green, and appointed an inspector to conduct a non-statutory inquiry which the Department opposed. The Council subsequently determined to approve the application. Based on legal advice the Department has filed an application for a review of the Council's decision. It seems unlikely that the drafters of the Commons Registration Act 1965 intended it to apply to National Health Service (NHS) land.
Discussions have been held with the Department for Environment, Food and Rural Affairs (DEFRA), who are the successor to the Department of the Environment, Transport and the Regions, making representation for guidance to make it clear that NHS land within hospitals should not be subject of future applications for registration as a Town or Village Green.
The Department has not discussed with Portsmouth City Council its policy on open spaces either generally or specifically in connection with St. James Hospital. That is a matter for local discussions in the context of a planning application for development on the land remaining in the ownership of the NHS.
The area of land in the proposed Town or Village Green is largely within an area declared surplus to NHS requirements. The site has been marketed with the benefit of outline planning permission for residential development granted by Portsmouth City Council, and with open space provided in accordance with that outline consent.
Ms Blears: When a scheme is under consideration, health service staff visit the school and explain the objectives of the scheme both to parents and staff. Leaflets and letters are then issued to parents, which indicate that children who are taking fluoride tablets or drops do not need fluoridated milk and that milk without the addition of fluoride will remain available. A consent form is attached to the letter which parents have to sign before their child can receive fluoridated milk.
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Ms Blears: The design of the milk fluoridation scheme is such that it is unlikely that children will consume excess fluoride and children are not being monitored on an individual basis. However, there is general monitoring in place to evaluate the scheme. The amount of fluoride excreted in a 24 hour period gives a good indication of the amount consumed. Recently published data show that a number of children in the scheme have had their fluoride excretion levels measured and no evidence was found of any problems. In addition, fluorosis levels will be monitored in four health authorities in the scheme.
1. The Trust was established in its current form in 1992.
"Hospital Episode Statistics (HES)"
Since 1997, total health authority allocations have risen from £20.9 billion to £41.8 billion in 200203. Ringfencing within allocations is kept to a minimum to allow health authorities to manage flexibly all the resources available to them. It is for health authorities in partnership with primary care organisations and other local stakeholders to determine how best to use their funds to meet national and local priorities for improving health, tackling health inequalities, modernising services and meeting NHS Plan targets.
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Mr. Hutton: 'Achieving Excellence in Healthcare Design' is the Department's programme to deliver design excellence in national health service buildings. We are raising the profile of design, partnering with key architectural professional bodies and supporting the NHS by providing advice and guidance at key stages of the procurement process.
Each hospital embarking on a new development, however large or small, will nominate a local design champion from the Trust board to ensure that the new building provides a high quality patient-focused environment with good working conditions for staff and buildings that make a positive contribution to the local neighbourhood.
To ensure that good design is embedded within the NHS hospital building programme design proposals will be reviewed by a panel, led by NHS Estates with the Prince's Foundation, CABE (the Commission for Architecture and the Built Environment) and others. Designs will be reviewed at the earliest stages of the procurement process before a preferred bidder is chosen.
Mr. Hutton: The full implications and details surrounding the establishment of foundation hospitals are still being explored. We are working with a broad range of interested parties including 3 star trusts to take this work forward.
Mr. Hutton: The NHS Plan sets out our vision for a health service designed around the patient, offering a comprehensive range of services for everyone, using the guiding principle of providing as much care as possible as close to home as possible.
It will be for local primary care organisations, working in partnership with the new health authorities, to develop services that meet the needs of the community they serve, taking account of clinical standards and safety and the views of local people. Rural hospitals clearly have an important role to play in meeting patients' desire for care closer to home.
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