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Sarah Teather: To ask the Secretary of State for Health how many patients have benefited from infertility treatment in (a) Brent and (b) each primary care trust in England in each year since 1997. 
Sandra Gidley: To ask the Secretary of State for Health how she plans to provide further investment in specialist old age mental health services in accordance with section 2.2.8 of Better Health in Old Age, November 2004. 
Mr. Byrne: Decisions on how funding is allocated locally for health services are the responsibility of local service planners, commissioners and providers, which can do so taking full account of local service patterns and priorities.
Through the national programme for information technology (NPfTT), the NHS Connecting for Health agency of the Department is delivering systems to change the way the national health service delivers care, and the experience of patients. It is a key
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component of delivering a modern and patient-centred NHS. NPfTT is being implemented by national application service providers, responsible for purchasing and integrating IT systems common to all users nationally; and by local service providers, responsible for supplying and integrating services and systems to perform functions in the local setting and to link to the national system.
A great many systems and services have already been put in place, including hospital-wide patient administration systems as well as many service-specific systems, in areas such as pathology, accident and emergency, maternity and mental health. For example, the programme has delivered a quality management and analysis system, providing general practitioners with evidence and feedback on the quality of care they deliver, to 8,300 GP practices covering over 20,000 registered users. Single assessment process technology is already streamlining the way personal details and care information for older people are gathered, stored and shared, so that people need only give their information once and can be certain that it will be shared appropriately by all those professionals involved in their care.
We are currently seeing a considerable acceleration in the deployment of technology across the NHS. Some patients are able to book their hospital appointments electronically. The first electronic prescriptions were issued in February 2005, with numbers set to rise significantly over the coming months. The first NPfTTdelivered picture archiving and communications systems (PACS) went live earlier this year. Around 5,500 GP sites, and 1,500 secondary care sitessome 7000 in totalhave already been connected to the new national network (N3), giving fast and reliable broadband access to over 350,000 users. Almost 25,000 clinicians are now registered users of the national care record data 'spine', almost 3,500 of them general practitioners. Over 124,000 users are now registered with Contact, the secure email and directory service for the NHS.
Delivery of new software to support payment by results is on schedule to be implemented in June 2005, and a secondary uses service that will hold anonymised and pseudonymised patient information for research, trend analysis and public health monitoring is being created. In addition, a 'Map of Medicine' software package that gives every clinician access to the overall bank of NHS clinical knowledge at the click of a button has been developed and will be incorporated into systems upgrades.
Altogether, we estimate that something over one and a half million patients have already received improved and safer care as a result of these and other NPfIT development, a figure which is increasing every week.
More detailed information about the national programme and future planned developments can be found on the NHS Connecting for Health website at: www.connectingforhealth.nhs.uk
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Mr. Byrne: There is an existing target on reducing inequalities in infant mortality. It aims at reducing the differences in infant mortality rates between children from different socio-economic groups. We have no plans to add further national targets in this area.
Norman Baker: To ask the Secretary of State for International Development what steps his Department is taking to ensure that the needs of indigenous peoples in Brazil are not compromised by the destruction of tropical rainforests. 
Mr. Thomas: The UK has committed £16 million to the £186 million multi-donor Pilot Programme for the Preservation of Brazilian Rain Forests. Part of DFID's support is provided through a trust fund managed by the World Bank and part as directly managed projects.
Through the trust fund, the UK has supported the Integrated Project for Protection of Indigenous Peoples and Lands of Legal Amazonia (PPTAL). This project, which started in 1996, helps to validate and register lands claimed by indigenous peoples through physical demarcation within the rain forest so that they can be used and protected by indigenous communities. So far a total of 35 million hectares have been demarcated (the size of the UK, Ireland and the Netherlands).
In addition, DFID supports the Indigenous Peoples Demonstration Projects, another component of the multilateral Pilot Programme for the Preservation of the Brazilian Rain Forests, in partnership with the Ministry of Environment. This programme supports activities that aim at strengthening indigenous peoples' organisations throughout Amazonia to negotiate for and manage better services for their communities. Specifically the programme provides funds and technical assistance to help preserve indigenous cultures, protect indigenous lands against encroachment from outsiders, and provide opportunities for economic development. Indigenous leaders are being trained and supported to promote their rights and entitlements to basic services, and to develop a network among themselves that can strengthen social cohesion in Amazon communities. The programme, also supported by German financial and technical assistance, helps to facilitate these new relationships with central and local governments.
Brazil has reduced the rate of HIV infections since 1997 and there has been a relative stabilisation of the epidemic has been observed. Current
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estimates indicate that about 650,000 people in the 1549 age group of the population are infected. HIV/AIDS is prevalent in all regions of the country but has spread beyond groups at particular risk such as men who have sex with men and injecting drug users. Heterosexual transmission is now responsible for a growing share of HIV infections, with women increasingly affected. Data indicate that risk increases with illiteracy, low levels of education, and poor environments such as urban slums. Although national HIV prevalence among pregnant women has remained stable at below 1 per cent. for the past five years, considerably higher levelsup to 6 per cent.have been found in some states.
The role of injecting drug use in Brazil's epidemic remains significant. In some areas, drug users constitute at least half of the AIDS cases reported by state Ministries of Health. Harm reduction programmes have been associated with a steep drop in HIV prevalence among injecting drug users in recent yearsby 40 per cent. in some cities such as Salvador in the poorer north of the country. In the south of the country, however, rates remain high suggesting that prevention programmes need to continue to target injecting drug users.
The Brazil national AIDS programme has recently stepped up its drive to identify and treat other Sexually Transmitted Infections (STIs), particularly neo-natal syphilis, which will have an important impact in the poorest parts of the country. Brazil's media make a strong contribution to prevention programmes and the recent policy decision to refuse US$24 million of funding from the United States Agency for International Development (USAID) because of conditions attached that would preclude effective working among sex workers demonstrates that Brazil is committed to making universal access achievable.
Progress in containing the epidemic can be attributed to strong policy implementation by the National AIDS Programme and the Ministry of Health in the following ways: Brazil provides universal access to Anti-Retroviral Vaccines (ARVs) that are free of charge; the national AIDS programme supports well-designed and targeted information, education and communication programmes to help prevent infection and support people living with AIDS; there is wide and informed involvement of civil society and faith-based groups; and there is a strong focus on sexual health especially for young people.
Brazil is sharing its expertise (and in some cases ARVs free of charge) with other countries in Latin America, Central America, the Caribbean, and Portuguese-speaking African countries through technical co-operation funded by the Brazilian Government with support from donors such as DFID.
DFID has committed £16 million to the £186 million multi-donor Pilot Programme for the Preservation of Brazilian Rain Forests (PPG7). Through this, DFID has been actively involved in the preparation of a proposal for a law on the management of public forests. If approved and implemented, this law is expected to reduce deforestation significantly.
The one on-going DFID PPG7 project is the Indigenous Peoples Demonstration Project which is enhancing the capacity of indigenous peoples' organisations throughout Amazonia to preserve indigenous cultures, protect indigenous lands against encroachment from outsiders, and to identify and generate opportunities for economic development for a total community of 250,000 indigenous peoples.
DFID has just completed a number of other projects to support the efforts of the Brazilian Government to reduce deforestation of tropical rainforest. These included the testing of new ways to involve local people in managing natural resources and the environment; support for the assessment of the impact that managing the forest has on the genetic diversity of tree species; and helping Brazilian institutes of higher education include subjects that are more relevant to working with poor people whose lives depend on sustainable forests.
DFID is also contributing through multilateral organisationsin particular, by its contribution to the European Commission's Asia Latin America programme which supports projects in the Amazon; and its membership of the World Bank which, for example, approved a $0.5 billion loan last year to promote environmental sustainability in Brazil. DFID is a major contributor to the Global Environment Facility (GEF) that is creating and maintaining protected areas in the Amazon through the Amazon Region Protected Areas Programme (ARPA).
DFID also provides support to civil society organisations involved in forest management in Brazil. DFID's commitment of £800,000 a year for 200506 and 200708 to the World Wildlife Fund under a Partnership Programme Agreement for Latin America and Caribbean will enhance their work in Brazil.
Future DFID support for efforts to combat deforestation will be through our contributions to multilateral organisations working in the region. Further details of DFID's future role in the region are set out in the document entitled "Regional Assistance Plan for Latin America 20042007". I have arranged for copies of this document to be placed in both Libraries of House.
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