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Ms Rosie Winterton: The latest financial year for which the audited financial information of all national health service organisations (strategic health authorities, primary care trusts and NHS trusts) is available is 200405. A copy of this information is available in the Library. It is also available on the Department's website at: www.dh.gov.uk/PublicationsAndStatistics/FreedomOfInformation/ClassesOfInformation/fs/en.
Mr. Hepburn: To ask the Secretary of State for Health (1) how many people have been diagnosed with fibromyalgia in (a) the Jarrow constituency, (b) South Tyneside, (c) the North East and (d) England in each year since 1997; 
Caroline Flint: The systematic review of water fluoridation published by the University of York in year 2000 found no evidence of an association between water fluoridation and bone cancer. We are however aware that, on 6 June 2005, a research organisation in the United States of America, the environmental working group, published a press release asking the national toxicology program of the National Institutes of Health (NIH) to list fluoride in tap water in its report on carcinogens. The request was based on the findings of a doctoral thesis completed in 2001 by a student at Harvard School of Dental Medicine. We have been informed by the oral health division of the Centers for Disease Control that the author of the thesis has invited them to review her findings as part of the peer review process conducted before a research study is published. We have asked to be kept informed.
Mr. Burns: To ask the Secretary of State for Health whether she intends to accept the advice to Ministers agreed by the Board of the Food Standards Agency at their board meeting on 15 September in relation to their objectives for the setting of maximum permitted levels for vitamin and mineral supplements under the provisions of the food supplements directive; what her strategy is for achieving her objectives in relation to this legislation; and if she will make a statement. 
Caroline Flint [holding answer 17 October 2005]: The Chair of the Food Standards Agency (FSA) has written to the Parliamentary Under-Secretary of State for Public Health setting out the FSA's advice. Ministers will consider this advice, and a strategy will be developed following any decisions.
Ms Rosie Winterton: This Government have no plans to upgrade Clacton hospital, as the responsibility for configuration and delivery of local services is a matter for the local national health service, working in partnership with its local community.
Ms Rosie Winterton: The introduction of greater contestability across the national health service is all about giving patients faster access, increased choice, improved services, or better value for money for the taxpayer by raising productivity and innovation.
Decisions about the levels of independent sector involvement in the Hertfordshire area have been made on the basis of local capacity planning and the need to increase patient choice.
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Paul Farrelly: To ask the Secretary of State for Health (1) if she will take steps to make additional funding available to primary care trusts to enable them to fund the prescription of Herceptin for early stage breast cancer patients who have been diagnosed as likely to benefit from the drug before it officially receives a licence for early stage use; 
(2) if she will review the funding available to primary care trusts for the prescription of herceptin for the treatment of (a) susceptible early stage breast cancer patients whose consultants are willing to take responsibility for the treatment and (b) susceptible advanced stage breast cancer patients. 
Ms Rosie Winterton [holding answer 12 October 2005]: The cost of herceptin will need to be met from the existing settlement agreed with the national health service. We understood that some trusts are already under financial pressures and may have to make difficult decisions in achieving this. However, we have greatly increased NHS funding and trusts with deficits have financial recovery plans in place.
The re-negotiation of the pharmaceutical price regulation scheme in January resulted in a seven per cent. reduction in the prices of medicines. This will deliver savings of around £2 billion in the NHS over the next five years. The price of herceptin remains unchanged but savings are being delivered by reductions in other products.
The Secretary of State has asked Professor Mike Richards, the National Cancer Director, to work with the NHS to ensure HER2 testing arrangements are put in place as soon as possible, so that patients who may benefit from herceptin can be identified.
Ms Rosie Winterton: The Department published the outcome of a strategic review of national health service ambulance services on 30 June 2005, 'Taking Healthcare to the Patient: Transforming NHS Ambulance Services'. The review, led by the National Ambulance Adviser, supported by a group of stakeholders, sets out how ambulance services can be transformed from a service focusing primarily on resuscitation, trauma and acute care towards becoming a mobile health resource for the whole NHStaking healthcare to the patient in the community.
In order to realise the vision and the benefits of 'Taking Healthcare to the Patient: Transforming NHS Ambulance Services', ambulance trusts need to be of a size that enables appropriate investment in people and resources to underpin current and future services and enable the vision set out in the ambulance review to be delivered. We are therefore proposing that there should be fewer, bigger ambulance trusts and will be undertaking public consultation on these proposals this winter. These proposals, if implemented, would ensure
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resources are targeted to where they are most neededimproving patient care and supporting front-line services.
Mr. Byrne: The older people's national service framework (NSF) sets out the steps the Department is taking to improve the level of care in and outside hospital for older people. The next steps programme of the NSF is looking specifically at improving the dignity and privacy of older patients.
Care in accident and emergency (A and E) has been transformed over the last three years. In 200203 almost one in four patients spent over four hours in A and E from arrival to admission, transfer or discharge. Well over 19 out of 20 are now in and out within four hours and the majority within two hours of arrival.
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