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Dr. Ladyman: Communications is a responsibility for the local national health service trust. However, I understand that the trust agreed a communications strategy in 2003. That strategy encompasses internal and external communications and thus covers communications with staff, patients and the public and key opinion formers or "stakeholders" which include right hon. and hon. Members.
Andrew Selous: To ask the Secretary of State for Health if he will make a statement on (a) the financial situation of and (b) the future prospects for Bedfordshire Heartlands Primary Care Trust. 
Dr. Ladyman: The annual accounts for 200304 for Bedfordshire Heartlands Primary Care Trust (PCT) show an overall deficit of £3 million. Information provided by the PCT shows it is forecasting a year end deficit in 200405 of £9.7 million.
Overspends in national health service organisations have to be paid for from within the overall NHS budget. The strategic health authority and Bedfordshire Heartlands PCT are working closely to ensure that the PCT reaches a sustainable financial position, while maintaining an appropriate and affordable level of health care for the local community. The impact and handling of any deficit will be looked at as part of this process.
While we expect overall financial balance across the NHS, this is not to say that there are no health bodies facing financial pressures. There are always pressures to be managed in year and substantial moneys have been allocated to the NHS to meet the increasing demands placed on it.
Miss Melanie Johnson:
The Health and Social Care Standards and Planning Framework, 200506 to 200708, "National Standards, Local Action", sets a national target on patient/user experience: to secure sustained national improvements in national health service patient experience by 2008, ensuring that individuals are fully involved in decisions about their health care, including choice of provider, as measured by independently validated surveys.
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The Government recognises that, although most people would prefer to remain at home rather than go into a hospice or hospital, only about 25 per cent. of cancer patients achieve a home death. We are supporting strategies that enable more patients to exercise choice in where they are cared for and die and funding specific initiatives in this area, including a £12 million investment over three years in the end of life care programme and a £6 million investment in integrated cancer care pilots. Both initiatives will enable more people to die in the place of their choice. The national cancer patient survey, conducted in 2000 prior to the launch of the NHS Cancer Plan, surveyed cancer patients' experience of care. The National Audit Office is presently undertaking a survey, "Tackling Cancer: Improving the Patient Journey", due to report in 2005, which will chart progress since 2000.
Miss Melanie Johnson: Data on the number of unpaid carers is available from the 2001 CensusTable S025 Sex and Age by General Health and Provision of Unpaid Carewhich is available from the Office for National Statistics (ONS). Advice on information for particular smaller areas is available by contacting the ONS at firstname.lastname@example.org.
Ms Rosie Winterton: It is for primary care trusts (PCTs), in partnership with strategic health authorities and other local stakeholders, to determine how best to use their funds to meet national and local priorities for improving health, tackling health inequalities and modernising services.
Between 200304 and 200506, Cotswold and Vale PCT, which commissions services from the Gloucestershire Hospitals National Health Service Foundation Trust, which is in turn responsible for the Cheltenham General Hospital, will receive an increase in its allocation of £42.2 million, equivalent to 28.87 per cent., for health care services, which includes paediatric services.
Tim Loughton: To ask the Secretary of State for Health what additional ambulance services will be available to transport child patients to the Gloucester Royal Hospital if proposals to transfer dedicated round-the-clock children's services at the Cheltenham General Hospital go ahead. 
Ms Rosie Winterton:
Following the "Shifting the Balance of Power" initiative, responsibility for local services now lies with the local national health service. It is now for primary care trusts (PCTs), in partnership with other NHS organisations in their area, to determine how best to meet national and local priorities for improving health, tackling health inequalities and modernising services, based on the specialised knowledge they have of the local community.
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However, I am informed that the Gloucestershire Ambulance Service NHS Trust has had extensive dialogue with the Gloucestershire Hospitals NHS Foundation Trust in regard to the impact of the local review of children's services. Some of the proposed developments will be introduced regardless of what changes, if any, are introduced as a result of the children's services review. Areas concerned are as follows:
In order to ensure that children receive prompt appropriate treatment for their condition, they will be assessed by ambulance service clinicians and transported to the most appropriate treatment centre. All ambulance service clinicians have recently received additional training for the treatment of children and the trust has invested in new equipment appropriate to the needs of children.
The Gloucestershire Ambulance Service NHS Trust is working with the Gloucestershire Hospitals NHS Foundation Trust to improve the equipment provided for neonates. This will include the procurement of a new incubator, which will meet the new British Standard regulations.
At least one new ambulance will be purchased and staffed 365 days a year to facilitate the transfer of children, should the need arise. In addition to this, the utilisation of all ambulances will be improved.
Mr. Laxton: To ask the Secretary of State for Health what steps his Department is taking to encourage the iron intake of children to prevent childhood anaemia; and what assessment he has made of the incidence of childhood anaemia in the last 20 years. 
Miss Melanie Johnson: The Government are committed to improve children's diet and health and action will be taken forward through the Government's recently published White Paper, "Choosing Health". Most people are able to meet their nutritional needs by eating a balanced, varied diet, including plenty of fruit and vegetables. Vulnerable children from families in receipt of the Welfare Food Scheme are provided with supplements including vitamin A, C and D. Vitamin C in particular aids the absorption of iron from the diet. Iron supplements may also be prescribed to children with iron deficiency anaemia that does not improve with appropriate dietary advice.
The Department and the Foods Standards Agency undertake regular surveys to monitor the diet and health of children. The National Diet and Nutrition Survey 2000 showed that, according to the World Health Organisation criteria based on blood haemoglobin levels, three per cent., of boys aged four to six years were anaemic, compared to one per cent., for those aged seven to eighteen years. For girls, eight per cent. of those aged four to six years, four per cent. aged seven to ten years and nine per cent. aged 1518 years were anaemic.
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