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Iain Wright: To ask the Secretary of State for Health what plans he has to seek to ensure that pay scales on the Whitley scheme will be the same or greater following the implementation of the Agenda for Change programme after April 2006. 
Mr. Hutton: The pay banding of staff under Agenda for Change is determined by the NHS Job Evaluation Scheme, which is designed to ensure equal pay for work of equal value. In the case of the minority of individual staff whose regular pay might otherwise be lower under the new system, their pay will be protected in accordance with the arrangements agreed by the NHS Staff Council. These arrangements are set in Section 46 of the NHS Terms and Conditions of Service Handbook, a copy of which is in the Library.
Ms Rosie Winterton:
The national health service Appointments Commission was reviewed last year as part of the Department's review of its arm's-length bodies. The review recommended a change of status to executive non-departmental public body and an extended remit.
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As part of the current governance arrangements for the NHS Appointments Commission, the Department formally reviews progress in meeting annual business plan targets bi-annually. The Appointments Commission is also subject to regular audit by the Office of the Commissioner for Public Appointments.
Mr. Laxton: To ask the Secretary of State for Health if he will assess the extent to which the standards set by the Arthritis and Musculoskeletal Alliance and included in his Department's publication Supporting People with Long Term Conditions, are achieved in the NHS. 
Mr. Hutton: The Arthritis and Musculoskeletal Alliance's standards for care for people with back pain were referenced in the Department's publication Supporting People with Long Term Conditions" as an example of best practice.
Standards for Better Health", published in July 2004, sets out the national standards for national health service patients to receive effective treatment and care that conforms to nationally agreed best practice.
In line with Shifting the Balance of Power, it is the responsibility of the NHS locally to manage the delivery of these standards with the independent Healthcare Commission responsible for assessing and inspecting health care, taking into account Standards for Better Health".
Dr. Ladyman: The national service framework (NSF) is a key component of the Government's overall programme, Every Child Matters: Change for Children", which aims to improve outcomes for children, including health outcomes. Supporting Local Delivery", the delivery strategy for the NSF, described how progress would be measured. This will include internal evaluation using indicators which are under development, performance management by strategic health authorities and the inspection process. The inspectorates will be responsible for measuring progress against the NSF, to judge the contribution of services to improving these outcomes. Commencing in September this year, Ofsted, the Healthcare Commission and the Commission for Social Care Inspection will conduct joint area reviews of children's services to assess the contribution of local services to improving outcomes for children and young people.
Assessment of progress against the NSF in the national health service specifically is the responsibility of the Healthcare Commission, which has recently completed an extensive public consultation on a new system of assessing and performance rating NHS trusts in 200506.
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Dr. Ladyman: The Department is keen to encourage maximum flexibility in the setting of local targets, to ensure that they are appropriate to the needs of local communities. The Department has set out six principles for local target setting for the national health service and social care as part of its planning guidance, National Standards, Local Action".
Primary care trusts must agree appropriate local targets, in line with the six principles, with their strategic health authority, which is responsible for offering support throughout the planning process. In providing the context for these principles, the guidance states that organisations will need to be guided by the evidence set out in national service frameworks.
Ms Rosie Winterton: The Medicines and Healthcare products Regulatory Agency (MHRA), with expert advice from the Committee on Safety of Medicines (CSM), has continuously monitored the balance of risks and benefits of selective COX-2 inhibitors since they were first licensed in the United Kingdom, and has taken regulatory action to minimise risks and maximise safe use of these medicines on a number of occasions, as new evidence has emerged.
In 2004, new clinical trial evidence showing an increased risk of heart attacks and strokes with rofecoxib led the Marketing Authorisation holder to withdraw this selective COX-2 inhibitor. Subsequently, the CSM set up a working group to re-examine the cardiovascular safety of all selective COX-2 inhibitors. In addition, the UK has taken a leading role in a Europe wide review of this issue. Having reviewed all the available evidence, CSM has advised that selective COX-2 inhibitors should not be used in patients with heart disease or previous stroke, but should remain an option for other patients, with whom the balance of benefits and risk may be favourable. CSM's latest advice was communicated to healthcare professionals on 17 February 2005.
Ms Rosie Winterton: We have no plans to extend the existing list of medical conditions that give exemption from prescription charges. The list has been reviewed on a number of occasions but no clear cut case for extending it has emerged. There is no consensus on what additional conditions might be included in any revised list of medical exemptions, or how distinctions could be drawn between one condition and another.
Government policy is to help those who may have difficulty paying charges. The current exemption and charge remission arrangements are intended to ensure that
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no one need be deterred from obtaining any necessary medication on financial grounds. Consequently 86 per cent. of prescriptions are dispensed free of charge.
Ms Rosie Winterton [holding answer 18 March 2005]: The devices evaluation service is due to transfer from the Medicines and Healthcare products Regulatory Agency to the NHS Purchasing and Supply Agency in 2005. Its budget is still being finalised but will be increased from the 200405 level.
Ms Rosie Winterton: The United Kingdom has been working with other member states on the implementation of a European risk management strategy designed to strengthen drug safety monitoring by making best use of all available resource, both data and expertise. Changes proposed to legislation, which will come into force in November 2005, will further strengthen drug safety monitoring in requiring risk management plans at the time of licensing new medicines and in further strengthening the obligations on the industry to keep regulators informed of any issue that may impact on the safety of a marketed medicine.
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