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Mr. Flight: To ask the Secretary of State for Health what assessment he has made of the impact of the introduction of (a) the new general practitioner contract and (b) the four-hour waiting time target for accident and emergency attendances on the demand for accident and emergency services. 
Ms Rosie Winterton: The available evidence shows no relationship between the new general practitioner contract and demand for accident and emergency (Aand E) services. Rising demand for emergency care is a trend that long predates this change or the four hour A and E target.
Factors involved in recent reported rises in demand include the better range of services now available, together with the improved reporting and increased patient satisfaction that the progress in cutting A and E waits has delivered.
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Mr. Michael Foster: To ask the Secretary of State for Health how many patients have been treated in accident and emergency departments in hospitals in Worcestershire in each year since 1997; and if he will make a statement. 
Dr. Ladyman: Data were not collected centrally on an individual trust basis prior to 200001. The table shows the number of first attendances, follow up attendances and total attendances for the Worcestershire Acute Hospitals National Health Service Trust from 200001 up to and including the second quarter of 200405.
|First attendances||Follow up attendances||Total attendances|
|200405 quarters 1 and 2(39)||66,892||2,006||68,898|
Ms Rosie Winterton [holding answer 9 February 2005]: In line with our policy of Shifting the Balance of Power, decisions about the configuration of local health services are made locally by primary care trusts in partnership with strategic health authorities and other local stakeholders. This process provides the means for addressing local needs within the health community, including the provision of accident and emergency services.
|Up to Q2 200405||200304||200203||200102||200001|
|RA4||East Somerset NHS Trust||19,941||39,884||39,784||39,379||37,813|
|5FW||Somerset Coast PCT||15,324||28,801|||||||
|5K1||South Somerset PCT||1,092||1,834||867|||||
|RBA||Taunton and Somerset NHS Trust||24,155||44,994||74,946||76,024||73,632|
|5FL||Bath and North East Somerset PCT||16,289||28,383||14,473||13,850|||
|5M8||North Somerset PCT||4,681||9,374|||||||
Miss Melanie Johnson:
The alcohol harm reduction strategy for England takes a cross Government approach to reducing harm caused by alcohol. Data is listed from hospital episode statistics where the primary diagnosis or cause code shows incidence of alcohol-
21 Feb 2005 : Column 131W
related problems available specifically for the age range 'under 60s'.
|F10.4Withdrawal state with delirium||858|
|F10.7Residual and late-onset psychotic disorder||52|
|F10.8Other mental and behavioural disorders||52|
|F10.9Unspecified mental and behavioural disorders||506|
|K70Alcoholic liver disease||9,543|
|T51Toxic effect of alcohol||1,424|
|X45Accidental poisoning by and exposure to alcohol|||
Dr. Gibson: To ask the Secretary of State for Health (1) if he will make a statement on the availability, in advance of the outcome of the appraisal by the National Institute for Clinical Excellence, of Ebixa on the NHS for advanced Alzheimer's disease; 
(2) what guidance he has issued to (a) primary care trusts and (b) other funding organisations regarding the availability, in advance of the outcome of the appraisal by the National Institute for Clinical Excellence, of Ebixa on the NHS for advanced Alzheimer's disease; and if he will make a statement; 
Ms Rosie Winterton:
National Institute for Clinical Excellence (NICE) Appraisal Guidance No. 19, relating to the use of Donepezil, Rivastigmine, and Galantamine for the treatment of patients with mild to moderate
21 Feb 2005 : Column 132W
Alzheimer's disease, was issued in January 2001. This guidance is currently under review, and the revised version due for publication in July 2005 will include an assessment of Memantine Hydrochloride (Ebixa).
In August 1999, the Department issued Health Service Circular 1999/176, which asks national health service bodies to continue with local arrangements for the managed introduction of new technologies where guidance from NICE is not published at the time the technology first becomes available in the United Kingdom. These arrangements should involve an assessment of the available evidence.
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