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Mr. Caton: To ask the Secretary of State for Health what steps the Government is taking to fulfil the commitment in Building on the Best to offer all adult patients nearing the end of life, regardless of diagnosis, access to high quality palliative care to enable them to choose if they wish to die at home; and what the timescale is for these measures. 
Ms Rosie Winterton: The Government have invested an additional £12 million over three years (2004 to 2007) to deliver the end of life care programme, providing choice to those who want to die at home. This programme is providing training for staff in acute, community and care home settings so that all patients near the end of life have access to high quality palliative care and are able to choose where they receive care. This involves supporting the roll-out of three key tools, the gold standards framework, the Liverpool care pathway, and the preferred place of care.
Ms Rosie Winterton: In our Manifesto, we said we would increase the choice for patients with cancer and double the investment going into palliative care services, giving more people the choice to be treated at home. We have extended this commitment to improve end of life care for children and adults who are suffering from cancer or any life-threatening condition.
The details of delivering our manifesto commitment are being discussed with a range of key stakeholders. Along side this, the views of the public, service users and national health service staff on end of life care was one of the issues covered in the Your Health, Your Care, Your Say" consultation. We will take account of what people have said in this consultation in the way we discharge our manifesto commitment.
Lynne Jones: To ask the Secretary of State for Health pursuant to the answer of 21 November 2005, Official Report, columns 172526W, on patient choice, what communications have been sent to (a) primary care trusts and (b) strategic health authorities to convey Government policy since Sir Nigel Crisp's letter of 28 July on Commissioning a Patient-led NHS. 
Mr. Byrne: There have been two written communications issued to strategic health authority (SHA) chief executives since the publication of Sir Nigel Crisp's letter on 28 July 2005, and we have also provided SHAs with a consultation guidance document. A letter was issued on 26 August 2005, which stated that:
We expect discussions on provider functions to follow the restructuring discussion, be led by the new PCTs and to take into account any conclusions from the upcoming White Paper. Any proposals would then require a further specific consultation."
In our proposals sent out on 28 July we indicated that we were minded to require PCTs to reduce their service provision functions by the end of 2008. Since that document, we have listened to stakeholders. The policy moving forward, in relation to service provision, is that this will be a matter for PCTs to determine locally. So any move away from direct provision of services will be a decision for the local NHS within the framework set out in the forthcoming White Paper and after local consultation, including professions allied to medicine.
We will support PCTs who want to do that, but we will not instruct PCTs to do it, nor will we impose any timetable. What matters is getting the best services for each communityand that is what the White Paper will focus on."
Mr. Lansley: To ask the Secretary of State for Health what her policy is on the prescribing to a patient of a generic alternative to a branded medicine following the expiry of a patent in circumstances where they were initially prescribed a branded medicine and wish to remain on this medication. 
Jane Kennedy: Practitioners are encouraged to prescribe rationally and to make the best possible use of national health service resources. It has long been the Department's policy to encourage practitioners to prescribe drugs by their generic name, where possible, for reasons of good professional practice and because of the opportunities for more effective use of NHS resources.
Jane Kennedy: Guidance revised and issued in October 2003 entitled, The Controls Assurance Standards" included a reminder to trusts that arrangements should be in place for the collection of prescription charges as specified by the National Health Service (Charges for drugs and appliances) Regulations 2000.
Regulation 5 (1) says an NHS trust, and NHS foundation trust or a primary care trust which supplies to a patient for the purposes of his treatment, drugs, otherwise than for administration at a hospital, or appliances, shall, subject to limited exemptions make and recover from the patient a charge of £6.50.
Mr. Lansley: To ask the Secretary of State for Health if she will reconsider the pace at which primary care trusts are moved towards their target allocation under the weighted capitation formula. 
Pace of change policy is decided by Ministers for each allocations round. In 200304, the most under target primary care trust (PCT) was 22 percent., under target. For the 200608 revenue
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allocations, it has been decided to move PCTs more quickly towards their fair share of funds, and by 200708, no PCT will be more than 3.5 percent., below its fair share.
There are no plans to revisit the 200608 revenue allocations or the in pace of change. Pace of change policy for the next allocations round will be considered in light of all the circumstances at the time.
Mr. Jenkins: To ask the Secretary of State for Health how many job losses she expects as a result of the possible merger of primary care trusts in Staffordshire; what budget she has allocated for severance payments; and if she will make a statement. 
Ms Rosie Winterton:
Ministers have given the go-ahead for all 28 strategic health authorities (SHAs) to begin local consultations on boundary changes to SHAs and PCTs. Consultations started on 14 December and will continue for a period of 14 weeks, until 22 March. No decisions on boundary changes will be taken until these local consultations have been completed and their outcomes considered by Secretary of State. Until any boundary changes are agreed, it is not possible to calculate the number of job losses in any particular area.
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There will be no central fund to finance any cost of redundancy. SHAs have been asked to minimise the cost of severance and where possible, these should be financed from in-year management cost savings.
Any move away from direct provision of services will be a decision for the national health service locally, within the framework to be set out in the forthcoming White Paper and after local consultation with a range of stakeholders including staff.
Mr. Hoyle: To ask the Secretary of State for Healthwhat the (a) average and (b) target waiting time was to see a (i) psychiatrist and (ii) psychologist for (A) adults and (B) children in Chorley in each of the last five years. 
|Effective length of wait from receipt of GP written referral request to first out-patient attendance (weeks)|
|Sum of seven Trusts merged to form Lancashire Care NHS Trust|
|Quarter||0 to <4||4 to <13||13 to <26||26 plus||Median wait|
|Lancashire Care NHS Trust|
|Quarter September:||0 to <4||4 to <13||13 to <17||17 to <21||21 plus||Median wait|
|East Lancashire Hospitals NHS Trust|
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