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Tim Loughton: To ask the Secretary of State for Health (1) pursuant to the answer given to the hon. Member for Woodspring (Dr. Fox) of 2 July 2002, Official Report, column 298W, on doctors (recuitment), which developing countries have Government to Government agreements with the UK; and if he will make a statement on the policy; 
Mr. Hutton [holding answer 18 July 2002]: The Code of Practice on international recruitment states that the National Health Service should not actively recruit in developing countries. International recruitment co-ordinators in the Workforce Development Confederations work with employers to ensure they comply to the entire Code of Practice.
The Department is currently compiling a list of recruitment agencies who comply to the Code of Practice and therefore do not actively recruit in developing countries. This list will be posted on the website for employers to use when entering into new recruitment contracts.
The only Government to Government agreement we have with a developing country to recruit doctors is with India. This agreement was reached following an approach by the Indian Government who were concerned with some of the actions of recruitment agencies who were operating in India.
Mr. Burstow: To ask the Secretary of State for Health, pursuant to the statement of the hon. Member for Salford, (Ms Blears) of 13 February 2002, Official Report, column 112W, on over-medication, when he will respond to the hon. Member for Sutton and Cheam. 
Jacqui Smith: I replied to the hon. Member on 13 February 2002.
Tim Loughton: To ask the Secretary of State for Health (1) what his latest calculations are for the GP : patient ratio in (a) Worthing and (b) each PCT in Sussex; 
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(3) what monitoring is in place to make sure that funds earmarked for improving access to primary care in West Sussex are used for that purpose. 
(4) what discussions he has had with the Adur, Arun and Worthing PCT about improving access to primary care in Worthing. 
(5) What assessment he has made of routine appointment wait times at Worthing general practice surgeries. 
Ms Blears [holding answer 18 July 2002]: Information on the ratios of general practitioners (GPs) to patients is held at primary care trust (PCT) level but I am advised by the PCTs that this varies around the Surrey and Sussex Health Authority area, from 1,782 patients per GP in Bexhill and Rother PCT to 2,050 in Crawley PCT. In Worthing I am informed that the ratio is 1,885. I recognise that local GPs are under pressure and this concern is shared by Adur, Arun and Worthing PCT, which has advised me that it is concerned about the level of access to GP services in some practices. The PCT is actively working to improve the situation though a number of actions including effective use of incentive schemes.
As part of the Department's commitment to improving access to primary care nationally, we have increased the PCT primary care access fund by £83.5 million to £168 million, with at least £48 million dedicated in 200203 to improving access in primary care and implementing advanced access. Significant funding has also been made available to enhance primary care services in Worthing. The former Worthing Primary Care Group invested £235,000 in 19992000 rising to £691,000 in 200102. The provision of additional funding has made it possible to improve access to a wide range of diagnostic and treatment services, as well as providing improved audit and clinical effectiveness. Adur, Arun and Worthing PCT monitors the use of all funds allocated to practices by practice and by use. The PCT will be included in the Audit Commission's national study to review use of all earmarked funds including primary care access monies.
My right hon. Friend the Secretary of State has not had any meetings with representatives from Adur, Arun and Worthing PCT to discuss access issues. I visited Worthing in August 2001 to meet representatives from local GP practices and we discussed local issues in the course of that meeting.
Mr. Burns: To ask the Secretary of State for Health how many overseas visitors to the UK were treated by the NHS in each of the last three years for which figures are available; what the total cost was to the NHS; how many reimbursed the NHS and by how much; and how many failed to reimburse the NHS, and by how much. 
Ms Blears [holding answer 19 July 2002]: This information is not collected centrally.
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Mr. Drew: To ask the Secretary of State for Health what policies he has to increase access to NHS dentistry in Gloucestershire; and what offers he has made to private dentists to re-enter the NHS as part of this. 
Mr. Lammy [holding answer 19 July 2002]: Access to National Health Service dentistry is an important issue for this Government and we have invested over £100 million in the last 18 months to modernise NHS dentistry.
We recognise that the provision of NHS dental care in Gloucestershire has been a challenge over the last few years. During 200102 Gloucestershire Health Authority received £1.35 million for their two personal dental service pilots, £247,100 from the modernisation fund and £16,500 from the dentistry action plan fund. The Gloucestershire personal dental service pilots are a growing service and more capacity will become available over the coming months.
The NHS enjoys very good working relationships with the whole dental community in Gloucestershire, both salaried and private dentists, with much collaborative planning continuing to take place to increase access to dentistry for Gloucestershire's population.
Mr. Oaten: To ask the Secretary of State for Health what the annual expenditure by the NHS Litigation Authority on clinical negligence claims was in each year since 1995. 
Mr. Lammy [holding answer 19 July 2002]: According to the National Audit Office summarised accounts for the National Health Service (England) expenditure for claims and associated costs for clinical negligence for the latest years available is set out in the following table:
Mr. Oaten: To ask the Secretary of State for Health what factors are used to calculate levels of clinical negligence insurance premiums paid by NHS trusts and primary care trusts to the NHS Litigation Authority. 
Mr. Lammy [holding answer 19 July 2002]: The National Health Service Litigation Authority assesses each year, using actuarial analysis, the total pool of cash required to administer the clinical negligence scheme for trusts for the following financial year. This global pool is then translated into an individual contribution per member trust by calculating a weighted risk exposure for each trust and then allocating a charge accordingly.
In short the risk exposure is calculated by assessing annually the levels of key staff involved in delivering clinical care across major service delivery areas.
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Mr. Oaten: To ask the Secretary of State for Health how much was paid by English (a) NHS trusts and (b) primary care trusts to the NHS Litigation Authority in the form of clinical negligence insurance premiums in each year since 1995. 
Mr. Lammy [holding answer 19 July 2002]: Contributions to the clinical negligence scheme for trusts for each year were as follows:
|Year||NHS Trust £000s||PCT £000s||Total|
The figures were taken from the National Health Service Litigation Authorities final accounts and represent the actual amounts billed, not necessarily the amounts that were physically paid and received.
Mr. Oaten: To ask the Secretary of State for Health what the net present value of outstanding clinical negligence claims against the NHS in England was in each year since 1995. 
Mr. Lammy [holding answer 19 July 2002]: In the National Health Service summarised accounts (England), the National Audit Office includes figures for the provisions for clinical negligence in relation to all current claims and potentially successful claims (which may arise from incidents which have been incurred but not reported). The figures for this for each year were as follows:
Mr. Oaten: To ask the Secretary of State for Health how deficits in the NHS Litigation Authority budget for clinical negligence compensation are financed; and how surpluses are disposed of. 
Mr. Lammy [holding answer 19 July 2002]: The NHS Litigation Authority does not account on an income and expenditure basis so does not have surpluses and deficits. It is controlled on its overall spending, which includes provisions for future liabilities that are met if and when they materialise, from cash financing agreed with Her Majesty's Treasury and voted by Parliament in estimates.
Mr. Oaten: To ask the Secretary of State for Health when he will publish the Government's White Paper on Clinical Negligence. 
Mr. Lammy [holding answer 19 July 2002]: The chief medical officer (CMO) is producing a report for the Government on the options for reform of the system for dealing with clinical negligence. It is expected that this will be presented to Ministers in the course of the summer
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and will form the basis for published proposals later on this year. Neither Ministers nor CMO have yet to come to final conclusions.
Tim Loughton: To ask the Secretary of State for Health how many and how much ex-gratia payments have been paid to NHS patients for NHS clinical negligence in the last (a) five, (b) 10 and (c) 20 years. 
Mr. Lammy [holding answer 18 July 2002]: National Health Service bodies make ex-gratia payments in a range of circumstances. Figures for these payments are reflected in individual NHS body's accounts, however, they are not collated centrally.
Tim Loughton: To ask the Secretary of State for Health if he (a) has met and (b) plans to meet consultees to the White Paper on Clinical Negligence Reform. 
Mr. Lammy [holding answer 18 July 2002]: I have asked the Chief Medical Officer (CMO) to lead a wide ranging review of options for reforming the way clinical negligence cases are handled. As part of this work, the CMO and the officials assisting him have met with representatives of several of the organisations that responded to our "Call for Ideas" on clinical negligence reforms. The CMO is now preparing a report with recommendations for reform, which I will be considering over the summer. Once the outcome of this work is published we will consider any further requests for meetings we may receive.
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