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Matthew Taylor: To ask the Secretary of State for Health on what dates Ministers in his Department have held meetings with members and officials of the United States Administration since 1 January 2002; where each
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meeting was held; which Ministers were involved in each meeting; which United States Administration Department attended each meeting; and which members and officials from the United States Administration attended each of these meetings. 
Ms Rosie Winterton: My right hon. Friend the Member for Darlington (Mr. Milburn) met the American Secretary of Health and Human Services, Tommy Thompson, on 22 October 2002 while attending the Commonwealth Fund International Health Symposium in Washington.
The Minister of State, Department of Health, my right hon. Friend the Member for Barrow and Furness (Mr. Hutton) attended the Global Health Security conference in March 2002, which was attended by a number of United States officials from the Health, State and Defence Departments.
Miss Melanie Johnson: The Government are very careful when considering introducing a new vaccine into the childhood immunisation schedule. We have to be sure that the vaccine is safe, and effective in preventing disease. It is also important to know how many doses that children need to be protected and at what age the doses should be given. We also need to be confident that introducing a new vaccine into the childhood immunisation schedule doses not interfere with the protection given by the other vaccines in the programme. We have to be sure that any new health intervention is cost-effective.
The independent expert advisory body, the Joint Committee on Vaccination and Immunisation (JCVI) is currently examining the evidence of the potential benefits of introducing pneumococcal conjugate vaccine to the infant immunisation schedule. What is clear is that there are many uncertainties in the evidence, in particular in measuring the burden of pneumococcal disease, and in the amount of disease that is expected to be prevented by a vaccine in both the short and longer term, because it protects against only seven of the numerous strains of pneumococcus.
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Dr. Tonge: To ask the Secretary of State for Health what assessment he has made of (a) the number of children affected by pneumococcal disease in the last year for which figures are available and (b) the severity of the disease and its complications in each case. 
Miss Melanie Johnson: The nature of pneumococcal disease makes it difficult to measure with accuracy the burden of that disease. Notifications are for pneumococcal meningitis only and these are shown in the table for 2002.
|Age||Number of cases|
Dr. Ladyman: National minimum standards have been developed for a range of establishments and agencies regulated under the Care Standards Act. The National Care Standards Commission must take the standards into account when making any decision about whether an establishment or agency conforms to the relevant statutory regulations. The standards apply irrespective of who provides the service, thus care homes run by the national health service are subject to the standards.
There are no plans to produce national minimum standards for NHS hospital accommodation although residential services provided in such establishments would come within the Commission for Health Improvement's rolling review.
Mr. Burns: To ask the Secretary of State for Health (1) how many referrals were made to (a) genito-urinary medicine clinics and (b) sexual health clinics by a general practitioner (i) after diagnosis by the GP for treatment and (ii) for diagnosis and treatment in (A) the last 12 months for which figures are available, (B) 2000 and (C) 1997; 
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(3) how many, and what proportion, of general practitioners in England do not treat patients suffering from a sexually transmitted infection; and if he will make a statement; 
(4) how many general practitioners in England provide sexual health services; how many provided them (a) in 2000 and (b) in 1997; and how many have walk-in facilities. 
Miss Melanie Johnson: These data are not collected centrally. Data are only available on numbers of referrals from general practitioners to genito-urinary medicine (GUM) clinics and this is shown in the table. GUM clinics are open-access and this data does not include the vast majority of patients who will self-refer to GUM clinics or who are advised to attend by their GP without a formal referral letter.
GPs are required to provide for the management and on-going treatment of patients who are ill, or believe themselves to be ill. Some GPs provide diagnosis and treatment for sexually transmitted infections (STIs). However, others will make an initial assessment and advise the patient to attend a GUM clinic where more specialist skills and diagnostic tests are available.
|Specialty Code||Specialty Name||GP referrals made in the Quarter|
Department of Health QM08.
Mr. Hutton [holding answer 3 December 2003]: Existing contracts between strategic health authorities and higher education institutions cover the full cost of training and top-up fees are not charged. The consultation document, Funding Learning and Development for the Healthcare Workforce, sets out our proposal for a national model contract. It is intended that this contract for national health service-funded pre-registration courses, to be introduced from 1 April 2004, will specifically prohibit the charging of top-up fees to students.
Miss Melanie Johnson: Advice from the Joint Committee on Vaccination and Immunisation (JCVI) is made public on the JCVI website, and in the book Immunisation against Infectious Diseases. If new advice
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is given that results in a new vaccination campaign, this is communicated to trusts via Chief Medical Officer/Chief Nursing Officer/Chief Pharmaceutical Officer letter.
John Mann: To ask the Secretary of State for Health whether the recommendations of the Joint Committee on Vaccination and Immunisation are endorsed by the National Institute for Clinical Excellence. 
Miss Melanie Johnson: The agendas and minutes for Joint Committee on Vaccination and Immunisation meetings are routinely sent to the National Institute for Clinical Excellence, and both committees collaborate to work on topics such as antiviral agents for influenza.
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