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Mr. Lammy: We have no plans to introduce compulsory magnetic resonance imaging (MRI) scans during post mortems. The Department has commissioned a scoping study to look at the current level of research knowledge about minimally invasive post-mortem techniques, including MRI scanning. From this it is clear that at present there is limited research evidence as to the effectiveness of these minimally invasive techniques.
(11) UPEs includes GMS Unrestricted Principals, PMS Contracted GPs and PMS Salaried GPs.
(12) Headcount Practice Nurse figures are estimated for these years.
Data as at 1 October 199799 and 30 September 200001.
Department of Health General and Personal Medical Services Statistics.
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Mr. Hutton: XDelivering the NHS Plan" confirmed our commitment to substantial increases in health service capacity. Our aim is, however, not simply to rely on expanding hospital capacity but to use the extra investment provided by the April 2002 budget to modernise the way services are provided to bring services closer to patients, expand the choices available to patients and make better use of the skills and capacity of the primary care work force.
The Department is therefore taking forward a programme to deliver a wider range of services in primary and community settings, using general practitioners and nurses with specialist skills, working from improved and modernised premises. This is expected to deliver for example, millions more out-patient appointments taking place in the community rather than in hospital.
Mr. Hutton: Primary care trusts are national health service bodies established by the Secretary of State. They are performance managed by strategic health authorities and through them are accountable to the Secretary of State.
Mr. Watts: To ask the Secretary of State for Health what recent assessment his Department has made of the effect that the provision of private medical insurance has had on the standard of health in each primary care trust. 
Mr. Hutton: Responsibility for putting in place appropriate local arrangements for vaccinations against smallpox will rest with the regional directors of public health (RDsPH). The Department of Health has recently published its draft guidance for dealing with smallpox and invited comment and discussion on the plans for dealing with any smallpox outbreak. RDsPH were involved in the drafting of the guidance. In this guidance, it is intended to establish 12 regional smallpox response groups across the United Kingdom, consisting of infectious disease physicians, paediatricians, public health physicians, microbiologists/virologists, acute care and communicable disease control nurses and occupational health staff who will be able to set up specialist care and vaccination centres for the regions in the event of a smallpox emergency.
Mr. Hutton: The strategic stock of smallpox vaccine is held centrally and arrangements have been put in place whereby the vaccine can be delivered to anywhere in the mainland United Kingdom within 24 hours of a request
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for vaccine, 365 days of the year. As smallpox has been eradicated, this is only likely to be in response to a bioterrorist incident, whereupon the Chief Medical Officer or nominated Deputy would authorise the release of vaccine.
As part of plans for dealing with any smallpox incident, it is intended to establish 12 regional smallpox response groups across the UK. The staff in these groups, consisting of infectious disease physicians, paediatricians, public health physicians, microbiologists/virologists, acute care and communicable disease control nurses and occupational health staff will be able to set up vaccination centres for the regions in the event of a smallpox emergency.
Mr. Hutton: There are no plans to vaccinate the whole population as a contingency measure against the threat of a bioterrorist incident involving smallpox. Mass vaccination of the population could be justifiable if there was a smallpox attack or outbreak but it would not be acceptable to expose people to the risk of vaccination in the absence of any possible exposure to the smallpox virus.
Smallpox vaccine has a much higher rate of serious complications than vaccines that are in regular use today. Certain groups are at even higher risk, such as those with weak immune systems or with severe eczema.
We have already announced that a small number of key frontline national health service staff and a small number of military personnel who would provide the first response in the event of a confirmed, suspected or threatened release of smallpox will be vaccinated shortly. We are discussing with other Government Departments how to identify key workers in the emergency services and agreeing circumstances and timing under which they might be vaccinated.
Mr. Hutton: The planning for the response to a mass casualty incident involves the scaling up of the normal response to a major incident. Following the September 11 2001 terrorist attack on the United States, specific guidance was issued to the national health service on the public health response to the deliberate release of chemical, biological, radiological and nuclear incidents, mass decontamination and mass casualties.
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