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Mr. Davey: To ask the Secretary of State for Health what short-term contingency measures are being implemented to address deficiencies in the number of qualified rehabilitation workers who assist blind and partially sighted people in England. 
Mr. Byrne: Rehabilitation services for blind and partially sighted people are provided by local health and social care bodies. It is for those organisations to commission appropriate services based on local need. This would include the number, training and composition of teams available to provide rehabilitation for blind and partially sighted people.
Mr. Brady: To ask the Secretary of State for Health (1) what discussions her Department has had with (a) Trafford Healthcare NHS Trust and (b) Greater Manchester Strategic Health Authority regarding the provision of local breast care services for the residents of Altrincham and Sale; 
Mr. Byrne [holding answer 13 October 2005]: The National Burn Care Group reported in 2001 and made many recommendations for how this care could be improved. The work now under way is designed to implement the recommendations in particular how burns services should be stratified. This is a complex exercise being undertaken by the national health service. The need to ensure a transparent and evidence-based process has required a greater level of analysis and discussion with burns services than originally envisaged. The options sub-group of the national burn care group are not now anticipating making recommendations before spring 2006 with a public consultation likely in summer 2006.
Tony Baldry: To ask the Secretary of State for Health how many people are expected to be treated at the independent treatment cataract units in (a) Oxfordshire and (b) England in the first year of operation. 
Mr. Byrne: The service commenced in February 2004 for the mobile cataract units and is still operational. During the first year of operation (February 2004 to January 2005) over 10,776 patients received speedier service due to the additional capacity delivered through this contract, none of which were in Oxfordshire.
Mr. Byrne: The current contract with Netcare for the provision of cataract procedures via two mobile units is for five years. The decision about whether to renew this contract will be decided at a later date.
Tony Baldry: To ask the Secretary of State for Health how much it has cost on average to treat a patient at independent treatment scheme cataract units in (a) Oxfordshire and (b) England since they were established. 
Mr. Byrne: The average cost of a cataract procedure cannot be disclosed as the information is commercial in confidence. The contract represents good value for money, being substantially less than the national health service equivalent cost.
Mr. Lansley: To ask the Secretary of State for Health what steps she is taking to improve rates of diagnosis of coeliac disease; what steps she is taking to improve the standard of care given to those with coeliac disease; and how many people have been diagnosed as having coeliac disease in each year since 1997. 
It is the role of primary care trusts (PCTs) in partnership with local stakeholders to decide what services to provide for their populations, including those with coeliac disease. They are best placed to understand local health care needs and commission appropriate services to meet them.
Strategic health authorities and PCTs have all received the national service framework (NSF) for long-term conditions. While the NSF is principally concerned with improving health and social care services for people with a long-term neurological condition, it will address issues common to all people with a long-term condition to improve their quality of life and promote independence.
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Mr. Lansley: To ask the Secretary of State for Health what steps she is taking to ensure that those who have difficulty communicating with others are able to access the communication aids they need. 
Mr. Byrne: The Department sets targets for councils and primary care trusts to integrate their community equipment services and in April 2005, 98 per cent. of services were integrated with their partners. This high degree of integration should allow local partners to provide a cohesive response to people with communication difficulties who are assessed as requiring equipment.
Providing appropriate communication aids for people with speech impairments is clearly an important part of meeting the needs of an individual. Local service providers undertake the assessment of an individual's needs. It is the service provider's responsibility to ensure that the person has access to the communication aids and equipment to meet their assessed need.
Andrew Rosindell: To ask the Secretary of State for Health how many researchers have been funded by her Department for the purpose of finding a cure for cystic fibrosis; and at what cost in the last five years. 
Julia Goldsworthy: To ask the Secretary of State for Health what the average life expectancy is of people with Down's syndrome; and what estimate she has made of the average total cost of health care for each person with Down's syndrome over their whole lifetime. 
Mr. Byrne: The information requested is not centrally collected. However, over 80 percent. (25,679) of general practitioners are currently registered to use choose and book and about 760 general practitioner practices are making referrals using the choose and book system.
Mr. Lancaster: To ask the Secretary of State for Health whether the Department has established a recommended charging scale for work undertaken by GPs when filling out forms for patients referred by private insurance companies. 
There is a list of prescribed medical certificates at Schedule 4 in the national health service general medical service Contracts Regulations 2005, which the general practitioner must provide free of charge under the NHS. All other certificates, including filling out forms for patients referred by private
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insurance companies, are undertaken as private work and the GP can charge a fee, the level of which is a matter between doctor and patient.
Mr. Hunt: To ask the Secretary of State for Health (1)what recent estimate her Department has made of the number of deaths caused by misdiagnosis by general practitioners; and if she will make a statement; 
Jane Kennedy: The Department does not routinely collect information centrally about misdiagnosis by general practitioners. However, the Government established the National Patient Safety Agency in July 2001 to improve the safety of national health service patient care and to set up a national reporting and learning system (NRLS) for adverse events. This system has now been rolled out across the NHS.
No cases have been reported to the NRLS to date where the patient died as a result of misdiagnosis reported to the NRLS. However, the NRLS has received only a relatively small number of incidents from primary care. Two deaths have been reported where there was a delay in diagnosis, one as a result of delay on the part of the patient.
GPs are expected to learn in training the skills needed to deal with all their patients, including effective diagnosis. Government do not specify the content of the GP training curriculum. This is the job of the Postgraduate Medical Education and Training Board (PMETB), which is the competent authority for postgraduate medical training in the United Kingdom. PMETB is an independent professional body.
All GPs are also subject to annual appraisal. This involves the GP discussing their practice with a trained appraiser against the headings of the General Medical Council's (GMC) Good Medical Practice" guidance. Agreed areas for improvement are taken forward into a personal development plan which informs the doctor's training and development, which is reviewed over the following year. More serious concerns are dealt with outside of this process through a number of local and national arrangements, including retraining or reference to the GMC.
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