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Mr. Baron: To ask the Secretary of State for Health (1) what plans she has to implement the Independent Midwives Association's NHS community midwifery model; and if she will make a statement; [16670]
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(2) what discussions she has had with (a) officials and (b) independent organisations about the possibility of implementing the NHS community midwifery model. [16671]

Mr. Byrne: Officials met with the Independent Midwives Association (IMA) on 3 August to discuss their proposal of a national health service community midwifery model. The group agreed that it would be a useful exercise to pilot the IMA model with a small group of independent midwives. The IMA was asked to put together a proposal for this pilot, which could then be discussed with primary care trusts who had expressed an interest in working with the IMA community midwifery model. This pilot is being developed.

Joan Walley: To ask the Secretary of State for Health what assessment she has made of the number of extra midwives needed to enable full choice by 2009 in the NHS of where and how women will give birth. [23150]

Mr. Byrne: The Government's manifesto stated that by 2009, all women will have choice over where and how they have their baby and what pain relief to use.

The numbers of midwives needed is a matter for local determination, but the number of students entering midwifery training was 2,374 in 2004–05 compared with 1,652 in 1996–97 and the vacancy rate for midwives was 1.8 per cent. in 2005 compared with 3.3 per cent. in 2004.


Mr. Austin Mitchell: To ask the Secretary of State for Health what the MRSA rates per thousand patient beds were for acute hospitals with (a) above and (b) below average levels of bed utilisation in each year since 2000. [20505]

Jane Kennedy: The information is not available in the requested format.

Mr. Austin Mitchell: To ask the Secretary of State for Health what assessment she has made of a possible relationship between higher rates of bed utilisation and the incidence of MRSA. [20506]

Jane Kennedy: As part of its programme to reduce health care associated infections, the Department is working on an internal desk analysis of hospital organisation specialty mix and methicillin resistant Staphylococcus aureus (MRSA). This indicates a statistical correlation but bed occupancy is only one of the factors that influences infection rates. The Department acknowledges the importance of assessing the impact of initiatives on the incidence of MRSA.

NHS Ambulance Trusts

Mrs. Spelman: To ask the Secretary of State for Health if she will make a statement on her plans to re-structure NHS ambulance trusts. [24593]

Mr. Byrne: The Department published the outcome of a strategic review of the 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
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care towards becoming a mobile health resource for the whole NHS—taking healthcare to the patient in the community.

The review will realise a range of benefits for patients; and staff including:

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 will ensure resources are targeted to where they are most needed—improving patient care and supporting front-line services. A three-month statutory consultation on the reconfiguration of ambulance trusts is expected to commence early next month.

NHS Expenditure

Dr. Richard Taylor: To ask the Secretary of State for Health what percentage of the NHS budget was spent on administrative costs in (a) 1975 and (b) 1995; and what estimate she has made of the likely percentage after the full implementation of payment by results. [20360]

Mr. Byrne: National health service administrative cost expenditure was not collected prior to 1996–97. Payment by results does not introduce new administrative costs into the NHS but creates incentives for organisations to improve the efficiency of existing administrative functions.

Mr. Amess: To ask the Secretary of State for Health what the spending on the national health service in England (a) in cash terms, (b) adjusted for retail price inflation and (c) adjusted for inflation in NHS costs has been in each year since 1975. [20167]

Mr. Byrne: The required run of national health service expenditure figures is shown in the table.
NHS total net expenditure: England—1975–76 to 2004–05 (2004–05 prices)
£ billion

Net NHS expenditure actual(80)Net NHS expenditure 2004–05 pricesNet NHS expenditure adjusted by HCHS pay and price inflation
RB stage one(82)
RB stage two(83)(5508390084)

1. Expenditure pre 1999–2000 is on a cash basis.
2. Expenditure figures from 1999–2000 to 2002–03 are on a stage one resource budgeting basis.
3. Expenditure figures from 2003–04 to 2004–05 are on a stage two resource budgeting basis.
4. The resource budgeting stage two actual net expenditure figures shown for 2003–04 to 2004–05 are consistent with the 2005 departmental report.
5. Figures are not consistent over the period (1971–72 to 2004–05), hence no comparisons should be made across different periods.
6. Table is based on 2004–05 prices using the gross domestic product deflator series as at 28 September 2005.
7. Hospital and Community Health Services (HCHS) pay and price inflation is a weighted aveage of two separate inflation indices, the pay cost index (PCI) and the health service cost indes (HSCI). Up to and including 1984–85, pay inflation was calculated using the pay settlements. From 1985–86 the PCI measures pay inflation in the HCHS. The PCI is itself a weighted average of increases in unit staff costs for each of the staff groups within the HCHS sector. Pay cost inflation tends to be higher than pay settlement inflation, because of an element of pay drift within each staff group. Pay drift is the tendency for there to be a gradual shift up the incremental scales, and is additional to settlement inflation.
8. The HSCI is calculated monthly to measure the price change for each of 41 sub-indices of goods and services purchased by the HCHS. The sub-indices are weighted together according to the proportion of total expenditure which they represent to give the overall HSCI value. The pay cost index and the health service cost index are weighted together according to the proportion of HCHS expenditure on each. This provides an HCHS combined pay and prices inflation figure.

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