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Norman Baker: To ask the Secretary of State for Health if she will estimate the cost to the national health service of providing treatment to patients suffering illnesses provoked partly or wholly by emissions from fuel products in the last financial year for which figures are available. 
Caroline Flint: This information is not collected directly as it is not possible to identify individual patients affected by air pollution. The link between air pollution and hospital admissions is derived from statistical correlations between daily air pollution levels and routine daily statistics on total respiratory hospital admissions. The national health service costs given as follows should be regarded only as rough estimates based on average figures.
The Department's committee on the medical effects of air pollutants (COMEAP) estimated in 1998 1 that there were 10,500 respiratory hospital admissions (additional or brought forward) per year due to PM 1 0 (PM 1 0 refers to the mass of particles less than 10 mm in diameter per cubic metre of air) in urban areas of Great Britain. The equivalent estimate for sulphur dioxide (SO 2 ) was 3,500 respiratory hospital admissions.
Assuming that two thirds of the PM10 2 and the vast majority of SO 2 in urban areas is due directly or indirectly to fuel emissions from transport or from industry, as a rough estimate it can be assumed that up to around 10,500 respiratory hospital admissions in urban areas of Great Britain may be related to emissions from fuel products.
The Department's ad-hoc group on the economic appraisal of the health effects of air pollution estimated in 1999 that the average cost of an emergency respiratory hospital admission was around £1,400. This gives a rough estimate of NHS costs due to emissions from fuel products of up to £14.7 million (£17.3 million in 2004 prices). This is an upper bound assuming that all
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respiratory hospital admissions are additional rather than simply brought forward as a result of higher air pollution days. The estimate does not include respiratory hospital admissions due to ozone 3 as an estimate of the proportion of ozone formed from fuel product precursors was not easily available. The estimate also does not include NHS costs of cardiovascular hospital admissions due to PM 1 0 or NHS costs of exacerbations of respiratory symptoms due to SO 2 or PM 1 0 .
2 This includes PM 1 0 derived from transport, from industry and from Europe (itself mainly derived from transport and industry). It excludes the coarse fraction of PM 1 0 (mainly coarse dust and sea salt).
Mr. Lansley: To ask the Secretary of State for Health (1) whether additional resources will be provided to (a) primary care trusts and (b) other NHS organisations when levels (i) 1, (ii) 2, (iii) 3 and (iv) 4 of the Heatwave Plan for England are reached; 
Caroline Flint: The assessment has included an assessment of the adequacy of existing resources to do all that is necessary to implement levels 1 and 2 without diverting them from existing commitments. The resources required to implement levels 3 and 4 are a function of the length, severity and geographical spread of a heat wave.
There will be no additional resources made available from central departmental budgets for implementation of any level of the Heatwave Plan for England, apart from those already identified to print and distribute copies of the advice leaflets and secure proper surveillance from the Meteorological Office, NHS Direct and the Health Protection Agency. Many of the actions required at level 1 and 2 are being taken anyway as part of normal care, and all of them can reasonably be thought of as essential contributions to emergency planning required by 'duty of care'.
National health service organisations and local authorities are expected to include in their financial planning the need to fund contingencies, of which costs associated with levels 3 and 4 of the Heatwave Plan are an example, along with those arising from, for example, widespread flooding.
Mr. Hayes: To ask the Secretary of State for Health if she will make a statement on the application to mobile roadside cafés of (a) smoking and (b) health and safety regulations relating to food preparation. 
Caroline Flint [holding answer 23 May 2005]: All mobile roadside cafés in which food is prepared must meet the requirements of the Food Safety (General Food Hygiene) Regulations 1995. Local authority environmental health officers will inspect these vehicles to ensure that they meet the requirements of the Regulations. Guidance on compliance with these requirements indicates that smoking in food handling areas is strictly prohibited.
Mr. Prentice: To ask the Secretary of State for Health how many foreign nurses were employed in the NHS in Lancashire (a) in 1997, (b) in 2001 and (c) on the latest date for which figures are available; and what percentage of the total those numbers represents in each case. 
Mr. Hancock: To ask the Chancellor of the Exchequer if he will commission research into the (a) reasons for and (b) level of unavoidable miscellaneous charges made by banks, with particular reference to (i) survey fees, (ii) booking fees, (iii) arrangement fees, (iv) higher lending charge fees and (v) sealing of deeds fees; and if he will make a statement. 
Mr. Lewis: As my hon. Friend, the former Financial Secretary (Stephen Timms), said in his answer on 18 March 2005, Official Report, column 479W, the Government have no plans to commission research into miscellaneous charges made by banks. However, following the Cruickshank Report, in pre-Budget report 2003 the Government asked the Office of Fair Trading (OFT) to take on an enhanced role in relation to payment systems for a period of four years. The OFT have established the Payment Systems Task Force, which is working to resolve competition, efficiency and incentive issues relating to payment systems. The Taskforce has recently agreed that a faster payments service be introduced for telephone banking, internet banking and standing order payments, and plans to examine a number of other topics including cheques, price efficiency and access and governance of the UK's major payment schemes.
Sir Gerald Kaufman: To ask the Chancellor of the Exchequer when he will reply to the letters from the right hon. Member for Manchester, Gorton with regard to (a) Mr. and Mrs. Tiplady dated 4 April and (b) Mr. J. H. Edwards dated 1 March. 
I replied to the right hon. Gentleman's letter concerning Mr. Edwards on 5 April and my right hon. Friend the Paymaster General will be writing to him shortly about the case of Mr. and Mrs. Tiplady.
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Mr. Boswell: To ask the Chancellor of the Exchequer in what circumstances deaths may be certified by persons who are not medically qualified; and what arrangements are made for the clinical audit of such certification, including stated cause of death. 
As National Statistician and Registrar General for England and Wales, I have been asked to reply to your recent Parliamentary Question asking in what circumstances deaths may be certified by persons who are not medically qualified; and what arrangements are made for the clinical audit of such certification, including stated cause of death. (66)
Before a death can be registered in England and Wales, the cause must be certified by a doctor who attended the deceased during his or her last illness, or by a coroner. Coroners need not be medically qualified. They are required to be qualified either as doctors or as lawyers: most hold legal qualifications and some have both.
Once a death has been referred, it is the responsibility of the coroner to decide what investigation is required. Coroners can only certify the cause of death for the purposes of registration if they have had a post mortem performed by a pathologist, or held an inquest, or both.
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