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Mr. Byrne: We have made a commitment that all national health service trusts should be in a position to apply for national health service foundation trust (NHSFT) status by 2008. To assist in that process we are rolling out a national programme to assess the readiness of all acute trusts for NHSFT status, in the context of their wider health communities. This whole health community diagnostic project will see trusts developing action plans with their strategic health authorities which set out any challenges or performance issues they need to overcome to become authorised as an NHSFT, as well as an indication of when trusts might be ready to apply for foundation status. The project will be completed by summer 2006.
Mr. Byrne [holding answer 21 November 2005]: Following the recommendation of the Healthcare Commission, the Secretary of State placed two organisations on special measures (Mid Yorkshire Hospitals National Health Service Trust and North West London Hospitals NHS Trust). The Department works with these trusts, the strategic health authorities (SHAs) and the primary care trusts to improve performance. The recommendations of the Healthcare Commission include both service quality improvements and delivering financial balance.
It is the responsibility of SHAs to deliver both overall financial balance for their local health communities and to ensure each and every body achieves financial balance. The Department works with SHAs to support them in this task. As part of this support, I have recently announced the formation of finance turnaround teams. These teams will be initially working with 63 NHS organisations. The teams will work with the chief executives of the organisations in delivering the key targets and financial stability. The chief executives will remain responsible for delivery in their organisations.
Mr. Byrne [holding answer 20 December 2005]: All national health service organisations have minimum standards of quality they must deliver, including meeting the targets for maximum waiting times. These are dramatically better than the standards of the NHS in the past and there can be no trade-off between these quality standards and removing deficits. All areas of the country have seen dramatic improvements in services, and all areas of the country will continue to see improvements as additional investment is made. Progress in a particular hospital or service has to be achieved within what is affordable, otherwise the local NHS would be spending other people's money to deliver an improved service which would be unfair to the other parts of the country.
Mr. Truswell: To ask the Secretary of State for Health how many NHS-funded operations have taken place in (a) NHS and (b) private health sector establishments in each of the last five years for which figures are available. 
Data on the number of first finished consultant episodes (FFCEs) which have taken place in centrally procured independent sector treatment centre (ISTC) schemes for the years 200304 and 200405 are shown in the table.
David T.C. Davies: To ask the Secretary of State for Health how many nurses currently on extended sick leave are within (a) six months, (b) one year, (c) 18 months and (d) two years of the official retirement age. 
Charlotte Atkins: To ask the Secretary of State for Health what steps her Department is taking to reduce the numbers of fractures due to osteoporosis in (a) women who have had previous fractures and (b) women with no previous fractures. 
[holding answer 31 October 2005]: Osteoporosis can often be prevented by a healthy lifestyle including exercise and a balanced diet and, in people at particular risk, by drug therapy. Cases of established osteoporosis can be treated both to prevent further fractures and to improve an individual's quality of life. All treatment of osteoporosis can be regarded as secondary prevention. Much of this can be managed in primary care, even in cases of advanced disease.
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The national service framework (NSF) for older people published in March 2001 required integrated falls services to be in place locally by April 2005. The NSF also provided a detailed description of what an integrated falls service should look like; the different elements and people required for integrated service planning and provision. In addition to this, to increase capacity in osteoporosis services in Dexa scanning for bone density as a guide to treatment, the Department has made £20 million available for investment in Dexa scanning services and equipment to build capacity. In 200506, £3 million has been allocated from a centrally held revenue budget for purchasing of additional scans, mainly from independent sector providers, in strategic health authorities where there are the most pressing shortfalls. Capital provision of £17 million has been made available in 200607 and 200708 to improve national health service capacity through investment in new Dexa scanning equipment.
Mr. Beith: To ask the Secretary of State for Health what discussions she has had with strategic health authorities about the funding of out-of-hours general practitioner services in rural areas. 
Mr. Byrne [holding answer 20 December 2005]: In recognition of the fact that the cost of out-of-hours services vary, in 200304, £14 million additional funding was available to support primary care trusts facing the biggest challenge in developing out-of-hours services, half to very rural and half to very urban areas. In this financial year, £11.5 million additional funding has been made available.
Mr. Byrne: In line with our guidance National Standards, Local Action" in the three years to March 2008 80 per cent. of national health service funding will go direct to primary care trusts (PCTs) to give them control in shaping services to meet local needs. PCTs, along with their local partners and stakeholders, are in the best position to judge how the available funding can be used effectively in providing a range of palliative care services for children and young people.
On 29 November, we launched a guide for the commissioners of palliative care for children and young people Commissioning Children's and Young People's Palliative Care Services". This practical guide will stimulate improvements in commissioning and promote quality care for children, young people and their families, in a range of settings, for example, palliative care at home, in hospital or in a hospice.
Children's hospice services are funded from a number of sources, including services commissioned by primary care trusts (PCTs) based on their assessment of children's needs and their priorities. They are best placed to make decisions on the local need for palliative care and are able to take into account the needs of individual families and their preferences.
In our recently published guide, Commissioning Children's and Young People's Palliative Care Services", launched on 29 November, PCTs are advised to engage with local children's hospices over the contribution hospices can make to the overall pattern of palliative care commissioned for children and young people in their localities.
Her Majesty's Treasury's 2002 cross cutting review on the role of the voluntary and community sector in service delivery recommended that funders should recognise that it is legitimate for voluntary and community sector providers to include the relevant element of overheads in their cost estimates for providing a given service under a contract or service agreement. This recommendation was drawn to the attention of primary care trust commissioners through the Chief Executive Bulletin published on 14 April 2005.
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