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To ask the Secretary of State for Health whether the funding allocated by the Department to
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multiple sclerosis specialist nurses for the financial year 200506 has been confirmed in writing to the primary care trusts concerned. 
Dr. Ladyman: Funding for multiple sclerosis (MS) specialist nurses' posts already established under the MS risk-sharing scheme is included, on a recurrent basis, within primary care trust (PCT) revenue resource allocations. Eight PCTs were invited to apply for funding to support the establishment of additional posts, from 200506. These PCTs will be advised of the position of their bids on completion of an on-going review of all Departmental central budgets.
Mr. Lansley: To ask the Secretary of State for Health how many NHS choice pilots schemes have been subject to formal external evaluation; what plans he has to distribute the results of these evaluations to (a) primary care trusts and (b) strategic health authorities; and what plans he has to commission external projects to evaluate other NHS choice pilots. 
Mr. Hutton: The coronary heart disease choice pilot was formally evaluated by the Picker Institute in 2003. The largest choice pilot, the London patient choice project, has been formally evaluated by three separate organisations on different strands of its work. The final reports on the London pilot will be available shortly for circulation.
The Department commissioned the research organisation Dr. Foster to undertake a research study on the implications of offering choice in three strategic health authoritiesTrent, Dorset and Somerset, Norfolk, Suffolk and Cambridgeshire. The findings of this research have been shared widely and are available under patient choice research on the Department's website at www.dh.gov.uk/policyandguidance/patientchoice/fs/en.
Evaluation of the south cataract choice pilot will be starting shortly and the findings will be available later this year. In addition to these formal evaluations, the pilots have generated valuable learning for the implementation of choice which is being shared with primary care trusts and strategic health authorities. Other national health service choice pilots are evaluated locally.
Mr. Lansley: To ask the Secretary of State for Health what steps he is taking to encourage general practitioners to use choose and book; and what plans he has to monitor the use by general practitioners of choose and book. 
The Department is running an intensive programme of stakeholder engagement and communications with general practitioners and other primary care stakeholders to explain how the choose and book service will work and its benefits for national health service patients and for general practices. This includes choose and book demonstrations, peer-to-peer meetings and workshops to encourage GP involvement.
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The Department is currently working with the NHS to develop a monitoring framework. This will enable primary care trusts (PCTs), strategic health authorities and the Department to monitor progress in driving forward the use of the choose and book system for GP referrals to consultant outpatient appointments.
On 19 January 2005, my right hon. Friend, the Secretary of State, announced a £95 million incentive scheme to recognise and reward the key role that PCTs will need to play in engaging primary care stakeholders and encouraging and supporting general practitioners to use choose and book.
Mr. Lansley: To ask the Secretary of State for Health what plans he has to (a) monitor and (b) support the ability of primary care trusts to commission services as patient choice is introduced. 
Mr. Hutton: The Department issued a self-assessment and planning tool to local health communities in August 2004 to help establish local baselines and monitor subsequent progress in delivering patient choice and booking. This included a number of measures to assess preparedness for commissioning services from a range of providers to support patient choice. The tool also enables the national choose and book team to target support to local health communities on the basis of their relative preparedness.
Mr. Lansley: To ask the Secretary of State for Health what steps he is taking to ensure that the ability of patients to exercise choice in the provider of their elective surgery does not exclude hard-to-reach groups. 
Mr. Hutton: It is the responsibility of primary care trusts (PCTs) to provide or arrange targeted support for patients to help them make their choice of hospital. This support needs to be appropriate to the needs of the PCT's local population. The range of services PCTs should consider includes direct support from general practitioners and practice staff and support from the patient advice and liaison service.
Where PCTs identify particular needs for support, they may need to consider additional investment to support choice through use of voluntary sector organisations and/or specialist patient care advisers.
To support this, the Department is developing guidelines for PCTs wishing to contract with voluntary and community sector organisations to provide advocacy and support to patients to help them make a choice of hospital. We are also working with a range of stakeholders to better understand the information and support needs of patients at risk of exclusion. The results of this work will allow us both to develop appropriate information at national level and to support the national health service in implementing choice equitably for their local populations.
Mr. McWalter: To ask the Secretary of State for Health what assessment he has made of the extent to which the needs of those who suffer from Parkinson's disease are being met; and what assessment he has made of the extent to which nursing specialists can contribute to the meeting of these needs. 
Dr. Ladyman: The national service framework (NSF) for long-term conditions, due to be published soon, will have a particular focus on the needs of people with neurological diseaseincluding those with Parkinson's disease. As part of the work in producing this NSF, an external reference group drawn from service users and carers as well as professionals and voluntary groups has advised on the content.
The Department has commissioned the National Institute of Clinical Excellence (NICE) to develop guidelines for the diagnosis, management and treatment of Parkinson's disease in primary and secondary care. Due to be published in 2006, they will provide guidance on the care pathway for treating Parkinson's disease and getting the balance right between primary and secondary care interventions.
The development of Parkinson's disease nurse specialists (PDNS) has been a key step forward in providing better care closer to home for those with this disease. The Parkinson's Disease Society has published a report, Changing RolesThe Impact of Parkinson's Disease Nurse Specialists", showing that PDNSs improve the quality of life for individual patients and their families and carers, without raising the cost of care.
Dr. Ladyman: It is for local government employers to determine the rates of pay for workers in the social care sector and to encourage their private and voluntary sector partners to offer comparable terms and conditions of service.
Local authorities and health trusts are required to work together to develop and co-ordinate services to support people in all aspects of independent living in the community.
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