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Mr. Burstow: To ask the Secretary of State for Health what assessment he has made of the representations from the London borough of Merton to call in the reconfiguration decisions made by the local NHS; and if he will make a statement. 
Dr. Ladyman: The Secretary of State has received a referral from the London borough of Merton on the reconfiguration decisions made by the local national health service. We will now consider the issues raised before responding.
Mr. Jack: To ask the Secretary of State for Health if he will place in the Library a copy of the research carried out for his Department by Warwick university in connection with its calculations of the market forces factor adjustment as it affects hospitals in Lancashire and Greater Manchester. 
[holding answer 22 March 2005]: The most recent research carried out on behalf of the Department by university of Warwick, Institute for Employment Research, on the market forces factor, was published in March 2002.
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Mr. Jack: To ask the Secretary of State for Health what the differences were between the methodology of the market forces adjustment factor for (a) 200405 and (b) 200506; what effect this has had on the allocation of funds to the hospital trusts in Blackpool and Preston; for what reasons Blackpool and Preston have different allocations; and when the trusts received details of their 200506 allocations using the revised market forces adjustment factor. 
Mr. Hutton [holding answer 22 March 2005]: The Payment by results market forces factor (MFF) used in 200405 was updated for 200506 to take account of the most recently available data on earnings, expenditure, land values and building costs. Following advice to Ministers from the independent Advisory Committee on resource allocation, we also made a change to the methodology to make it more sensitive to cost pressures within individual primary care trust areas, rather than the larger areas previously used. Full details are available on the Department's website at: www.dh.gov.uk/assetRoot/04/10/02/99/04100299.pdf.
In 200405, the MFF was a determinant of the prices paid by primary care trusts (PCTs) to national health service trusts for only 48 groups of procedures (known as healthcare resource groups). In 200506, the scope of payment by results will be increasing to cover the whole of elective in-patient care for NHS trusts. PCTs will pay the same national tariff to any trust with which they commission, and an allocation for the MFF for elective care will be made to providers directly from the centre. 200506 will be the first year in which such allocations will be made.
The Department provided details of the 200506 MFF allocations to the NHS on 21 February 2005. There are three reasons why Blackpool, Fylde and Wyre hospital NHS trust (Blackpool) would have a different MFF allocation to Lancashire teaching hospitals NHS trust (Preston): differences in their volume of elective activity (more activity requires more funding); differences in the case mix of that activity (more complex activity requires more funding), and differences in the MFF itself (trusts located in more expensive areas require more funding). The 200506 MFF for Lancashire teaching is 1.1 per cent., higher than for Blackpool largely because the MFF allows for higher general wage pressures in Preston.
Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 18 March 2005, Official Report, column 518W, on NHS spending, if he will provide the figures for each year since 199697, at (a) real and (b) nominal prices, broken down by (i) hospital expenditure, (ii) community services expenditure, (iii) ambulance services expenditure and (iv) administration expenditure. 
It is not possible to break down the figures given in the earlier answers into the categories requested as the accounts of primary care trusts and health authorities do not include this analysis.
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Mr. Lansley: To ask the Secretary of State for Health what discussions he has had with the National Institute for Clinical Excellence on its draft guidance which does not recommend Aricept, Exelon and Reminyl for treatment of Alzheimer's disease. 
Ms Rosie Winterton: The Department has corrected press misrepresentation and informed the National Institute for Clinical Excellence (NICE) that it would be responding to NICE's draft consultation document. The position was restated in a recent debate in Westminster Hall, Official Report, columns 93101WH, which outlined a number of points the Government later made in their response. A copy of the response is available in the Library and on the Department's website.
John Mann: To ask the Secretary of State for Health what qualifications are required of members of the clinically-led Direct Access Management Team for drug treatment established by Nottinghamshire Drug Action Team for the management of general practitioners; and what criteria his Department uses in reaching decisions on funding the clinical management of primary care. 
Dr. Ladyman [holding answer 23 March 2005]: The qualifications required for any clinically-led service are specifically addressed in 'Models of Care', the national framework document for the treatment of adult drug misusers, which was published by the National Treatment Agency (NTA) in 2002. Models of Care (NTA, 2002) clearly states that
A professional should only assess a drug or alcohol misuser or a particular need if they have the required level of competence to do so. Where medical intervention is required for substitute prescribing, an appropriately trained doctor must assess the substance misuser".
All central funds have been placed into one budget, the drug pooled treatment budget (PTB). In addition to this, approximately £200 million of mainstream local expenditure is spent on drug treatment. Drug action teams (DATs) are responsible for assessing local need and then commissioning services accordingly, using the drug pooled treatment budget and other mainstream funds. There are no central funds or grants available for individual projects.
Allocations to local DATs from the PTB are made on a formula basis that recognises key deprivation factors, ensuring the money goes to the areas most in need. Year-on-year increases in PTB funding will see the budgets of every drug action team increase by approximately 55 per cent. by 2008.
Mr. Hutton [holding answer 10 March 2005]: From 1 April 2004, responsibility for funding the bursaries for nurses returning to work in the national health service has been devolved to primary care trusts. (PCTs). This gives PCTs the flexibility to determine the appropriate investment for return to practice, working in partnership with strategic health authorities and other local stakeholders. Furthermore, we are allocating historic levels of funding to PCTs to ensure the NHS secures the workforce necessary to deliver improved services. For the three-year revenue allocations to cover 200304, 200405 and 200506, PCTs received an average cash increase of 9.22 per cent., 9.55 per cent. and 9.32 per cent. This is an average over the three years of 30.83 per cent. For the recent round of allocations to cover 200607 and 200708, PCTs received average cash increases of 9.2 per cent. and 9.4 per cent. This is an average over the two years of 19.5 per cent.
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