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Sandra Gidley: To ask the Secretary of State for Health what funding will be provided for increasing the proportion of older people being supported to live in their own home by one per cent. annually in 2007 and 2008; and what form that support will take. 
Mr. Byrne: One of the Department's public service agreement targets states that, by March 2008, the number of people supported intensively to live independently at home, as a proportion of all those supported intensively at home or in residential care, should increase to 34 percent., increasing the proportion of older people being supported to live in their own home by one per cent, annually in 2007 and 2008.
The Spending Review 2004 settlement, announced by my right hon. Friend, the Chancellor of the Exchequer, will provide sufficient resources to meet this target. Spending on adult social services is set to rise from £10.7billion in 2004 to £12.5 billion in 200708. It is for local authorities to decide how best to deploy their resources to meet their targets.
Mr. Boswell: To ask the Secretary of State for Health how many primary care trusts had established an integrated falls and osteoporosis service by 1 April as set out in Standard Six of the National Service Framework for Older People. 
Mr. Byrne: At the end of March 2004, 88 per cent. of primary care trusts indicated that they had met the milestone. The Department is working with strategic health authorities to ensure that those who have not complied do so as soon as possible.
Mr. Byrne: The national service framework for older people clearly states that, following a fall, general practitioners should take responsibility for assessing risk of osteoporosis and identifying those who need prevention or treatment and then make a referral to an appropriate specialist service.
The National Institute for Health and Clinical Excellence (NICE) recently issued an appraisal of drugs used in the secondary prevention of osteoporotic fractures in post-menopausal women. NICE is also appraising drugs used in the primary prevention of osteoporotic fragility fractures in postmenopausal women, due to be published in September 2005. A clinical guideline on the assessment of fracture risk and the prevention of osteoporotic fractures in individuals at high risk is being produced and is due for publication in February 2006. The NICE appraisals and guideline mentioned apply to all national health service organisations, including primary care trusts.
Jonathan Shaw: To ask the Secretary of State for Health what steps are being taken to ensure that primary care trusts continue to work towards meeting the milestones relating to osteoporosis outlined in standard six of the national framework for older people. 
Mr. Byrne: Since April 2004, the Department has been monitoring progress towards the milestone in the national service framework for older people, requiring all localities to have an integrated falls service in place by April 2005. This includes the risk assessment, prevention and treatment of osteoporosis.
Around 95 per cent. of primary care trusts (PCTs) have told us that they have now met the milestone. The Department continues to have discussions with the strategic health authorities representing those PCTs that have not yet met the target, to ensure that they do so as soon as possible.
Dr. Stoate: To ask the Secretary of State for Health what the total cost to Dartford, Gravesham and Swanley Primary Care Trust of providing out-of-hours care to patients was (a) in the last financial quarter and (b) has been since April 2004. 
Caroline Flint: The information requested is not collected centrally. We expect primary care trusts (PCTs) to fund out-of-hours services through their general funding allocations. In 200405, Dartford Gravesham and Swanley PCT received £214.2 million and in 200506, it received £233.3 million.
Damian Green: To ask the Secretary of State for Health what response she has made to the British Association of Physicians of Indian Origin on its recommendations on visas for overseas doctors; and if she will make a statement. 
The British Association of Physicians of Indian Origin has raised concerns about immigration rules relating to doctors who are seeking employment in the United Kingdom. The Department is discussing these views with the Home Office.
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Jane Kennedy: The Government have never required the national health service to provide statistics on the number or nationality of overseas visitors treated under the provisions of the NHS (Charges to Overseas Visitors) Regulations 1989, as amended, or on the costs of treatment. It is therefore not possible to provide the information requested.
Jane Kennedy: The Department conducted an internal review of the operation of the national health service hospital charging arrangements for overseas visitors prior to consulting on amendments to the NHS (Charges to Overseas Visitors) Regulations 1989 during the autumn of 2003. A further small internal review of implementation of the changes to the regulations subsequently introduced was conducted during the late spring and summer of 2004. No specific external research was commissioned as part of either of these exercises.
Jane Kennedy: No one in need of immediately necessary care will ever be refused treatment. However, under the provisions of the National Health Service (Charges to Overseas Visitors) Regulations 1989, as amended, overseas visitors may be required to pay for any national health service hospital treatment provided, if they are not covered by any of the exemptions from charges also set out in the regulations.
NHS trusts are required to establish whether a patient is a chargeable overseas visitor and if so to make and recover a charge for any NHS hospital treatment provided. Where treatment is not urgent, trusts are encouraged to obtain a deposit equal to the estimated cost of treatment before treatment begins. Immediately necessary treatment must be provided without delay, with charging issues resolved later.
Mr. Amess: To ask the Secretary of State for Health what guidance she (a) has issued and (b) plans to issue to primary care trusts on providing palliative care services; and if she will make a statement. 
Ms Rosie Winterton:
The Government recognises the importance of providing effective and efficient palliative and specialist palliative care services. That is why we commissioned the National Institute of Health and
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Clinical Excellence (NICE) to produce guidance on supportive and palliative care. This was published on 24 March 2004. The 34 cancer networks in England are now developing action plans to ensure that this is implemented, which will be monitored by strategic health authorities. In addition, further guidance on the development of specialist palliative care services was provided when the £50 million central budget for specialist palliative care was established in 200304.
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