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Dr. Ladyman: By 2005 there will be a further four new Treatment Centres in the eastern region of England providing services for NHS patients. In addition further investment is being made in expanding NHS hospital services at four main sites.
Dr. Ladyman: We are making good progress in developing the national service framework for long-term conditions which will focus on improving services for people with neurological conditions. We plan to publish the framework in December 2004 for implementation from 2005. Only yesterday, I met the Chairs of the External Reference Group to discuss progress, and I expect to receive final advice from the group in the spring.
Dr. Ladyman: National Health Service funding is available through negotiation between children's hospices and primary care trusts, which are responsible for funding health care for their resident population. There are no limits to the amount of funding which may be provided; this is for local decision.
Ms Rosie Winterton: Guidance on the prescribing of benzodiazepines is provided in the British National Formulary, which is sent to all doctors within the National Health Service and on the Internet at Electronic Medicines Compendium. The guidance has been reiterated in the Chief Medical Officer's Update
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Miss Melanie Johnson: The Government takes the issue of tackling obesity in children very seriously. Prevention is the best long-term approach, by improving diet and promoting physical activity. Strategies are being developed through the Food and Health Action Plan that promotes healthy diet and the Activity Co-ordination Team that promotes physical activity.
Miss Melanie Johnson: Together with my right hon. Friend the Minister for Sport, I chair the cross-Government Activity Co-ordination Team, which is preparing a delivery plan on how the Government will increase physical activity in England. We aim to publish a consultation document on physical activity proposals in April as part of the Public Health White Paper consultation process.
I have also commissioned 10 Local Exercise Action Pilots across England, which are currently under way. These will evaluate a range of different methodsand establish which are most effectivein driving up sustained physical activity rates across the population.
Dr. Ladyman: The Domiciliary Care Agencies Regulations 2002 and National Minimum Standards for Domiciliary Care came into force on 1 April 2003. People using domiciliary care services are protected for the first time by a regulatory framework.
Progress on the target to increase by March 2006 the number of those supported to live intensively at home to 30 per cent. of all those being supported at home or in residential care, is encouraging. The percentage has risen by nearly two points from 27.2 per cent. to 29 per cent. in 200203.
20. Mr. Andrew Turner: To ask the Secretary of State for Health if he will make a statement on the cost of travel and accommodation for (a) patients undergoing tertiary treatment and (b) their relatives or carers. 
Ms Rosie Winterton: Patients eligible under the NHS Low Income Scheme are entitled to full or partial reimbursement of their costs to hospital under the Hospital Travel Cost Scheme. The transport costs of an escort may also be reimbursed, but not the cost of accommodation, or any cost associated with relatives.
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Mr. Hutton: Primary care trusts are working with general practitioners and other organisations to develop out-of-hours services that meet national quality standards and local needs. With more direct control over the way these services are commissioned and provided they will be able to ensure they are better integrated with other unscheduled care services.
22. Mr. McWalter: To ask the Secretary of State for Health what assessment he has made of the number of trauma consultants needed by the NHS in 2010; and how many such consultants there were on the latest date for which figures are available. 
Mr. Hutton: As at 30 June 2003, there were 1,396 consultants in trauma and orthopaedic surgery, an increase of 32 per cent. since September 1997. We are planning to increase trauma and orthopaedic consultant numbers by a further 9 per cent. between March 2004 and March 2006.
Mr. Hutton: From April 2004, the Commission for Healthcare Audit and Inspection will take over the responsibility for performance rating the national health service. It will be up to CHAI to determine what form performance assessments will take in the future.
Dr. Ladyman: While we welcome new developments that improve our understanding of distressing conditions like Crohn's disease, we would need to see a rigorous scientific and clinical analysis of this particular procedure, and its outcomes, before we could judge whether it was suitable for NHS patients with Crohn's disease.
The assessment of new treatments is a gradual process. Evidence from clinical trials may suggest that a new treatment is effective. Further research is then undertaken to provide substantive evidence around issues like long-term safety, before moving to the implementation stage. We have to await evidence provided by the medical and research community before we implement new procedures and treatments.
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Ms Rosie Winterton: National health service trusts are responsible for ensuring that their staff are suitably trained and qualified to perform their duties. Ambulance staff employed on emergency driving duties receive initial driving training, are required to satisfy proficiency standards and to receive periodic refresher training to maintain proficiency in accordance with a national syllabus and standards.
Mr. Burstow: To ask the Secretary of State for Health what guidance his Department has published on the vision levels that ambulance drivers need to achieve and on how frequently they should receive eye checks. 
Ms Rosie Winterton: Through its occupational health service each national health service trust is responsible for setting and monitoring staff health standardsincluding eyesightand for ensuring that they conform to driver licensing requirements and relevant occupational health guidance.
Ms Rosie Winterton: Ambulance drivers are required to hold the driving licence appropriate to the class of vehicle they drive and to undertake training and an assessment as part of their initial and refresher training. Information on success or failure rates is not held centrally.
Ms Rosie Winterton: It is the responsibility of each national health service trust to investigate any accidents, alleged failure or misconduct on the part of its staff and where necessary to instigate disciplinary action in accordance with its local procedures.
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Ms Rosie Winterton: The mandatory requirement is that ambulance drivers are required to hold the driving licence appropriate to the class of vehicle they drive. In addition, ambulance drivers engaged on emergency duties should undertake specialist driver training in an accredited driving school as part of the basic ambulance training course. This requirement has been in place since 1968, when the responsibility for ambulance services rested with local government.
Mr. Burstow: To ask the Secretary of State for Health how many accidents involving ambulances there were (a) in total and (b) involving fatalities, in each year since 1997 in (i) England and (ii) each ambulance trust; and if he will make a statement. 
Dr. Murrison: To ask the Secretary of State for Health what targets for ambulance 999 calls in rural areas have been set; and what the latest figures for performance against these targets are. 
Information about performance of ambulance trusts is published annually in a statistical bulletin. The latest data are in "Ambulance Services, England: 200203". A copy of the bulletin is available in the Library and on the Department's website at: www.doh.gov.uk/public/sb0313.pdf
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