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17 Dec 2003 : Column 987Wcontinued
Mr. Havard: To ask the Secretary of State for Health (1) whether the National Institute for Clinical Excellence has drawn up a list of stakeholders for the technology appraisal of erythropoietin in chemotherapy-induced anaemia; and if he will publish this list; 
(3) if he will ensure that NHS trusts and primary care trusts do not limit funding for erythropoietin as a treatment for chemotherapy-induced anaemia during the National Institute for Clinical Excellence technology appraisal into its greater use. 
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Excellence (NICE) as part of its "ninth wave" work programme. The ninth wave was referred to NICE in October 2003.
All information relating to the NICE appraisal of EPO will be on its website at: www.nice.org.uk on 23 December 2003. This information will include a planned date for when the final scope and list of stakeholders for the appraisal will be published. Detailed questions about the process and timetable for technology appraisal are matters for the chief executive of NICE.
Health Service Circular 1999/176 asks national health service bodies to continue with local arrangements for the managed introduction of new technologies where guidance from NICE is not available. These arrangements should involve an assessment of all the available evidence. Funding for such treatments should not be withheld simply because of an absence of guidance from NICE.
Mr. Hutton: Patients will require information on waiting times, convenience, patient experience and clinical quality to support their choice of hospital for elective surgery. nhs.uk already provides information on waiting times and star ratings. We will develop this site to provide a wider range of information to support choice. Primary care trusts will be asked to ensure that appropriate information is also made available in hard copies and in forms which are accessible by individuals with sensory impairments.
Mr. Blizzard: To ask the Secretary of State for Health what assessment he has made of the possible impact of institutional resistance on the implementation of the Choice and Plurality policies. 
Mr. Hutton: Increasing patient choice will require a change in culture for national health service staff and indeed, for patients. Staff and patients are broadly supportive of the principle of extending patient choice. However, we need to work closely with staff and patients on the detailed implementation of our patient choice policies to ensure that we retain that support. The new financial framework, Payment by Results, will provide new incentives to providers to attract patients. Our plurality policies will help secure the capacity needed to deliver the improved waiting times patients expect, and will allow a greater range of choices for patients. The biggest safeguard against any institutional resistance, however, is likely to be the attitude of the patients themselves. The experience from London and other choice pilots is that once offered choice over where and when their treatment is provided, many patients exercise these new opportunities.
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Mr. Hutton: We recognise that patients in isolated rural communities may find it more difficult to access the same range of choices as others. We are exploring options for primary care trusts to provide greater support for patients living in more isolated rural communities. These could include peripatetic patient care advisers, the use of mobile service, for example, the mobile cataract surgery service being introduced in many areas from the spring of 2004. We will be including rural representatives of patients, patient groups and local authorities in these discussions, so that they are able to influence the Department's final policy guidance on choice at referral.
Mr. Blizzard: To ask the Secretary of State for Health what estimate he has made of the percentage occupancy rate of in-patient care which would need to be maintained to provide the capacity to enable patients to choose a health care provider. 
Mr. Hutton: We are investing in substantial and sustainable increases in national health service capacity to improve quality and allow us to deliver the shorter waiting times patients expect. Choice of hospital for patients requiring elective surgery will be introduced alongside this additional capacity. By December 2005, patients will choose at the point of general practitioner referral, so patient choice will not be directly dependent on the inpatient occupancy rate.
Miss Melanie Johnson: The focus of this work is on early diagnosis for this group of patients. The Department is investing in diagnosis, investigation and treatment of cardiac related problems. In November 2001, the Department announced £65 million from the New Opportunities Fund (NOF) and £60 million from the Department of Health to enable the rapid expansion of facilities for angiography, to fund 89 new or replacement catheterisation laboratories. 24 sets of equipment have already been delivered.
Mr. Kaufman: To ask the Secretary of State for Health when he will reply to the letter to him dated 4 November 2003 from the right hon. Member for Manchester, Gorton with regard to Mr. Alan Ryan, forwarded to him by the Department for Work and Pensions. 
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Ms Rosie Winterton: By October 2004, the size of the core Department will be reduced by 1,400from over 3,600 to 2,245a 38 per cent. reduction. Half the posts will be transferred to other national bodies, which are themselves being renewed and the remaining reduction will be achieved through changing the way we work as a Department.
The government's drive to shift the balance of power from Whitehall to staff in frontline hospitals, general practitioner surgeries, care homes, social services and the community.
The creation of new independent bodies.
Ms Rosie Winterton: The change programme currently under way in the Department will reduce its size by 1,400 posts. This is a 38 per cent. reduction in posts and will be achieved by October 2004. Some of the posts will be transferred to other national bodies, which are themselves being reviewed and efficiency savings will achieve the remaining reductions.
Nick Harvey: To ask the Secretary of State for Health (1) what provisions are in place to provide healthcare professionals with extensive and accurate information about diabetes; and if he will make a statement; 
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diagnosis and care of people with diabetes receive continuing training to ensure that they are appropriately skilled in the diagnosis and management of diabetes' (page 29 of the "Diabetes National Service Framework for Diabetes: Standards document"). Curriculum content for pre-registration education and training programmes for healthcare professionals is determined by individual higher education institutions (HEIs) in the light of recommendations from the relevant regulatory bodies. Post registration training needs for all national health service healthcare staff is determined locally through skills auditing of teams against priority local needs and through the appraisal process. In addition there are a number of central initiatives to increase healthcare professionals' access to knowledge, such as the development of the National Electronic Library for Health's specialist 'branch' library for diabetes and 'Diabetes NSF Zone' and the Department of Health's commitment to establishing a National Knowledge Service.
Structured patient education is an integral part of the diabetes NSF and its provision is a key intervention for Standard 3 of the NSF that is concerned with patient empowerment. All people with diabetes will receive a service that encourages partnership in decision-making and supports them in managing their diabetes. This is reflected in the "Planning and Priorities Framework for the NHS 200306", that includes targets for the diabetes NSF. One such target states the need for primary care trusts to update practice-based registers for people with diabetes by March 2006. This will help to ensure that they receive systematic treatment regimens and advice, including the provision of information, education and psychological support, to help them in managing their own condition.
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