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The role of the Children's Rights Director, located within the National Care Standards Commission, was established by the Care Standards Act 2000. The primary role is to safeguard those children who are in receipt of a range of regulated services. These services include those provided by children's homes, independent fostering agencies, local authority fostering services, the welfare aspects of boarding schools and, in due course, residential family centres, voluntary adoption agencies and local authority adoption services.
The White Paper, Modernising Social Services, reminded local authorities of the need to ''provide reliable and sufficient out of hours services''. In October 1999 the social services inspectorate published a report of its inspection of social services out of hours services entitled Open All Hours. The report encouraged social services managers to review their out of hours provision and contained guidance on providing out of hours services.
Mr. Hoyle: To ask the Secretary of State for Health (1) how many Spanish nurses have worked in the NHS in each of the last three years in (a) the UK, (b) Lancashire and (c) the Lancashire Teaching Hospitals Trust; 
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Mr. Hutton: Over the last two years, the Department has been working closely with the Ministrio de Sanidad y Consumothe Spanish Ministry of Healthto give Spanish nurses the opportunity to come and work in England.
Between January 2001 and October 2002, 508 Spanish nurses have taken up positions as a result of this government to government initiative. We do not routinely collect information about overall numbers of international recruits into the National Health Service, including those from Spain
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Lancashire organisations that have participated in the recruitment are Trafford General Hospital NHS Trust, Stockport NHS Trust and Trafford Acute NHS Trust. The Department does not have information on numbers currently working in NHS hospitals.
Miss McIntosh: To ask the Secretary of State for Health what the total running costs of NHS organisations serving (a) the Vale of York constituency and (b) North Yorkshire were in 1997; and what the total is now. 
|NHS Organisation||1997 (#m)||20022003 (#m)|
|North Yorkshire Health Authority||5.9||N/A|
|North & East Yorkshire & Northern Lincolnshire Health Authority||N/A||4.0|
|Harrogate Health Care NHS Trust||3.164||3.558|
|Scarborough and North East Yorkshire Healthcare NHS Trust||3.441||3.816|
|York Health Services NHS Trust||5.273||5.0|
|Hambleton and Richmondshire Primary Care Trust||N/A||1.890|
|Craven, Harrogate and Rural District Primary Care Trust||N/A||1.980|
|Selby and York Primary Care Trust||N/A||4.320|
|Scarborough, Whitby and Ryedale Primary Care Trust||N/A||2.225|
North & East Yorkshire & Northern Lincolnshire Heath Authority.
The 20022003 costs relate to anticipated expenditure at 31 March.
Any comparisons between 1997 and 2002 would be influenced by inflation and the transfer of Trust management costs into PCTs where services have transferred, e.g. community and mental health services.
In addition, following the changes resulting from shifting the balance of power, the North & East Yorkshire & Northern Lincolnshire Health Authority (HA) covers a much wider geographic area than the former North Yorkshire HA. Many of its functions have been devolved from the former regional office of the Department.
Mr. Norman: To ask the Secretary of State for Health what assessment he has made of the implications of extending the Working Time Directive to junior doctors (a) for medical workforce planning and (b) on their training; and if he will make a statement. 
Mr. Hutton: The impact of the European Working Time Directive (EWTD) has been taken into account with the planned expansion in the consultant workforce. The NHS Plan makes a commitment to 1,000 more specialist registrars by 2004. In addition, we have introduced a ''floors and ceilings'' flexibility to allow the National Health Service with an initial ceiling of an additional 540 posts for the period of 20022004 and this will reviewed later this year.
Many solutions to achieve EWTD compliance for junior doctors will involve other professions. Large increases in the nursing workforce and allied health professions have already been achieved and there is a commitment to maintain these levels of growth. These increases in the non-medical workforce will support the development of the non-medical practitioner roles required. The main impact of these practitioners will be in reducing the need to cover at senior house officer level.
It will be inevitable that the changes needed to achieve EWTD compliance will significantly affect the working patterns of doctors in training and also change the traditional one-to-one relationship between a training grade doctor and their consultant.
The Department is currently undertaking a consultation exercise on the Chief Medical Officer's report Unfinished Business: Proposals for reform of the Senior House Officer grade. The report provides proposals for reform of postgraduate medical training, taking into account that proposed reform would be introduced at the same time as implementation of the EWTD. The report argues that the EWTD and training reform are mutually dependentthe EWTD will require reform in training, which in turn can support implementation of the Directive.
A key proposal in Unfinished Business is that new and shorter higher specialist training programmes should be introduced which would lead to the award of an earlier certificate of completion of specialist training (CCST) for those satisfactorily completing training in the ''generalist'' elements of a specialty. This would have the effect increasing the flow of trained doctors.
The Department will be working with the Deans and the Royal Colleges to ensure that NHS trusts are supported in delivering training with good advice on training models and as a first step the Conference of
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Postgraduate Medical Deans (COPMED) has produced a document Liberating Learning. This sets out approaches to providing training in the EWTD context.
Mr. Norman: To ask the Secretary of State for Health what discussions his Department has had with representatives of the British Medical Association concerning derogations for junior doctors from the Working Time Directive; and if he will make a statement. 
Mr. Hutton: The Department of Health and the health departments of the devolved administrations have, on several occasions over the past year, held discussions with the British Medical Association junior doctors' committee about derogations for junior doctors from the European Working Time Directive (EWTD). Discussions came to a halt in July as the two sides did not reach a collective agreement on derogation. The Government intends to derogate for junior doctors from the EWTD by amending the 1998 Working Time Regulations.
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