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Dr. Ladyman [holding answer 4 April 2005]: The information requested is not held centrally. The complex nature of the delivery of cancer services means that we are unable to accurately monitor expenditure. It is for primary care trusts in partnership with strategic health authorities and other local stakeholders to determine how best to use their funds locally to meet national priorities for cancer services.
Mr. Burstow: To ask the Secretary of State for Health when the Commission for Social Care Inspection will publish its report on the use of medication in care homes following up on the report of the National Care Standards Commission. 
Dr. Ladyman [holding answer 4 April 2005]: The Chair of the Commission for Social Care Inspection has advised that a report on the use of medication in care homes is due for publication in December 2005.
The Department has set out a framework for the national health service for continuous improvement in the overall quality of care people receive, including children, in Standards for Better Health". Underpinning this is clinical governance, including clinical audit, which provides
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healthcare organisations, including primary care trusts, with a systematic means of ensuring compliance with their statutory duties. The Healthcare Commission has recently completed an extensive public consultation on a new system for assessing and performance rating NHS trusts in 200506 against these standards.
The national service framework for children, young people and maternity services requires each health economy to develop a managed local children's clinical network to review and meet the needs of the local population.
As set out in National Standards, Local Action", strategic health authorities (SHAs) are responsible for developing healthcare improvement plans in their local areas and making sure that local health services, including children's services, commissioned by primary care trusts are of a high standard and are performing well.
The Better Metrics" project offers primary care trusts a range of clinical measurements of performance for local target setting, which is available on the website of the office of the SHAs at www.osha.nhs.uk
Miss Melanie Johnson:
The Department will be represented at the conference by, among others, chief executive Sir Nigel Crisp and chief nursing officer, Christine Beasley. The Department is an active partner in the summit.
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Dr. Ladyman: The Commission for Social Care Inspections became operational on 1 April 2004. The Commission for Social Care Inspection's budget for 200405 was £147.2 million. Subject to audited accounts, it is currently estimated that the budget will be spent in full.
Dr. Ladyman: The Commission for Social Care Inspection charges registration fees and annual fees, which are set by central Government. Since the commission became operational on 1 April 2004, its fees have not changed. An increase across the board of 20 per cent. will come into effect on 1 April 2005.
Tim Loughton: To ask the Secretary of State for Health if he will list the responsibilities of the Commission for Social Care Inspection (CSCI) which are not due to be merged into the Healthcare Commission in the proposals announced with the Budget; what estimate he has made of the likely change in (a) costs and (b) jobs arising from the merger; what the duties of staff employed by the CSCI are; and which duties are likely to be merged into the Healthcare Commission. 
Dr. Ladyman: Subject to further review, we expect the duties of both commissions to remain in place after the merger takes effect. Those duties are as set out in theHealth and Social Care (Community Health and Standards) Act 2003. The merger will allow a reduction in costs through more efficient administrative arrangements. The detailed staffing and financial implications will be considered as part of the process of planning and implementation.
Sarah Teather: To ask the Secretary of State for Health when he will reply to the letter regarding Mrs.Faye Daniel sent to his Department on 30 April 2004 by the hon. Member for Brent, East, reference: DC/Daniel/30/04/04. 
John McDonnell: To ask the Secretary of State for Health what action the Government have taken to combat Crohn's disease in terms of (a) treatment, (b) support for sufferers and (c) research into (i) the causes of and (ii) a possible cure for the condition. 
Dr. Ladyman: The national service framework (NSF) for long-term conditions was published on 10 March. While the NSF principally focuses on services for people with neurological conditions, brain and spinal injury, it will help ensure that all people with a long-term condition are supported to live as full and independent life as possible.
Responsibility for the treatment and support for patients with Crohn's disease in England rests with primary care trusts (PCTs), which are responsible for deciding which health services the local population requires, and ensuring that these services are provided.
In May 2002, the National Institute for Clinical Excellence (NICE) issued guidance on the clinical and cost effectiveness of the drug Infliximab in the treatment of severe Crohn's disease. The national health service is statutory obliged to provide funding for treatments and drugs recommended by NICE within three months of publication of its guidance.
Mr. Jim Cunningham: To ask the Secretary of State for Health what discussions his Department has held with representatives of elderly patients suffering from dementia regarding the provision of services; and if he will make a statement on the availability of resources to assist the long-term care of those suffering from dementia. 
Dr. Ladyman: The Department and its Ministers meet regularly with organisations representing the interests of those with dementia. My right hon. Friend, the Secretary of State met with the Alzheimer's Society on 22 March 2005 to discuss with them the draft guidance on the use of Alzheimer's drugs, issued on 1 March 2005 for consultation by the National Institute for Clinical Excellence (NICE).
For the period 200304 to 200708, expenditure on the national health service in England will increase on average by 7.2 per cent. a year over and above inflation. We are also making available an additional £1 billion over the three years 200304 to 200506 for social services that will benefit carers and the training of support staff. As the majority users of these services, older people, including those with dementia, will particularly benefit.
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