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Mr. Gordon Prentice: To ask the Secretary of State for Health what steps she is taking to ensure that acute general hospitals retain the full range of medical and surgical specialisms; and if she will make a statement. 
Mr. Byrne: The National Health Service Act 1977 places a duty on the Secretary of State to provide a range of facilities and services to such extent as she considers necessary to meet reasonable requirements. The Secretary of State discharges her duties through delegation to local primary care trusts who can contract with national health service trusts, NHS foundation trusts and other healthcare providers for those services. Should an NHS organisation wish to make a significant change or variation to a service then they are required to consult with local stakeholders including the overview and scrutiny committee before reaching a final decision. In addition, the core services of NHS foundation trusts are protected when they achieve foundation status and these services can only be changed if the regulator is satisfied that any changes are in the interests of the NHS. As medical knowledge advances and new ways of working are developed it is inevitable over time that there will be changes in the location of particular services in the interests of patients.
Caroline Flint: The Department has not made an assessment of the use of the Goldman algorithm. However, the Goldman algorithm was first published in 1988 and has been superseded by other algorithms and protocols in the assessment of suspected acute myocardial infarction.
Caroline Flint: The Department collects primary care trust expenditure information on non-national health service staff. The table shows the total expenditure of agency nurses and doctors by Torbay primary care trust (PCT) for the period 200001 to 200405. This is the earliest data available as Torbay PCT only came into existence in 2000.
|Cost of non-NHS nurses||Cost of non-NHS doctors|
David Taylor: To ask the Secretary of State for Health whether (a) temporary and (b) agency staff are employed in her Department to perform roles previously carried out by permanent staff who have been made redundant. 
Jane Kennedy: According to the British National Formulary (BNF), one 500 milligram vial of Alimta costs £800. There is no information in the BNF on the average duration of a course of treatment, this will vary for individuals.
Category A which presents conditions which may be immediately life threatening and which should be responded to within eight minutes irrespective of location in 75 per cent. of cases. A fully equipped ambulance should attend incidents classified as category A within 14 to 19 minutes of the initial call, 95 per cent. of the time, unless the control room decides that an ambulance is not required.
Ambulance services are required to take patients to hospital where the need is identified by a doctor as urgent and these patients should arrive at hospital within 15 minutes of the arrival time specified by the doctor in 95 per cent. of cases.
For category C calls, this presents conditions which are not immediately life threatening or seriouslocal national health service organisations have had responsibility for managing and monitoring the ways in which local services respond to these calls, since 1 October 2004.
The ambulance review, Taking Healthcare to the Patient: Transforming NHS Ambulance Services" was published in June 2005. The review sets out recommendations which include supporting performance improvement and changes to performance requirements. The report is available in the Library and on the Department's website at: www.dh.gov.uk/assetRoot/04/ll/42/70/04114270.pdf.
The percentage of call outs which have met these targets in Torbay is not collected centrally. The data which the Department does collect on ambulance response times is published in the statistical bulletin, Ambulance services, England: 200405". This is available in the Library and on the Department's website at: www.dh.gov.uk/assetRoot/04/ll/36/79/04113679.pdf.
Charlotte Atkins: To ask the Secretary of State for Health when the NHS consultation document on the reorganisation of ambulance trusts will be issued; when the consultation will (a) start and (b) finish; and whether ambulance trusts will have an input into the drafting of the consultation document. 
Mr. Byrne [holding answer 12 December 2005]: In accordance with the written ministerial statement of 14 December 2005, Official Report, column 15253WS, consultation on the proposed reconfiguration of ambulance trusts began on 14 December 2005 and will finish on 22 March 2006. Strategic health authorities were asked to comment on a draft of the consultation document, and key stakeholders, including ambulance trusts, were involved in the preparation of Taking Healthcare to the Patient: Transforming NHS Ambulance Services", which made the original recommendation for fewer larger trusts.
Mr. Amess: To ask the Secretary of State for Health when she expects to issue a reply to the Select Committee on the Assisted Dying for the Terminally Ill Bill [Lords]; and if she will make a statement. 
Ms Rosie Winterton: The issues raised in the select committee's report were discussed extensively in a debate in the other place on 10 October, during which my noble Friend Lord Warner gave the Government's contribution.
Bill Wiggin: To ask the Secretary of State for Health what discussions the Government has had with other countries regarding the devising of measures to prevent the spread of avian influenza among humans. 
Ms Rosie Winterton: The Department is working closely with other countries and international organisations such as the World Health Organization (WHO) and the European Commission (EC), and with other international partners to support international preparedness. We are sharing information on a regional level through events such as the pandemic influenza workshop, jointly hosted by WHO and the EC in Copenhagen in October. As part of its European Union (EU) Presidency responsibilities, the United Kingdom hosted an informal meeting of EU health Ministers in October, at which Ministers stressed the importance of national plans and of EU co-ordination of pandemic preparedness. We are also working on the wider international level through the international partnership on avian and pandemic influenza through such meetings that were co-hosted by WHO, Food and Agriculture Organisation, and the World Organisation for Animal Health in November.
Ms Rosie Winterton: It is important to be clear about the differences between seasonal flu, avian flu and pandemic flu. Avian influenza is a disease which mainly affects birds. Seasonal flu refers to the virus that circulates in the human population and causes widespread illness each winter. Pandemic flu will only occur after an avian virus has mutated into a novel strain which can spread easily between humans and to which they do not have immunity.
Surrey and Sussex strategic health authority has advised that national health service organisations throughout Surrey and Sussex have robust plans in place to respond to any outbreak of infectious disease. These plans include a contingency response to any infectious pandemic, including avian flu should it ever transfer to human-to-human transmission.
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