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Peter Luff: To ask the Secretary of State for Health if her Department will examine the methods used by the resource allocation formula for primary care trusts to assess the health needs of rural areas. 
The formula is continuously overseen by the advisory committee on resource allocation (ACRA). ACRA is an independent body, made up of national health service managers, academics and general practitioners. ACRA's objective is to ensure equity in resource allocation.
Rurality has been looked at by ACRA on a number of occasions. A wide ranging review of the weighted capitation formula was undertaken by ACRA, prior to the 200304 revenue allocations to primary care trusts. As a result of this review, the formula takes account of the effects of access, transport and poverty in calculating health need in rural areas.
Mr. Byrne: The national service framework (NSF) for children, young people and maternity services recommends that a family is visited at home by the health visitor or midwife when a child is around 12 days old, to assess the health of the child and family. It also recommends that a child receives a physical examination when they are between six and eight weeks old. This should concentrate on the child's eyes, heart and hips and is normally carried out by the general practitioner or the health visitor. Where a family requires more support or has complex needs the health visitor should offer further visits.
A health visitor based in a Sure Start children's centre would also have regard to the advice set out in the NSF. They may also have other contacts with families during the post-natal period through the various programmes delivered at the centre.
Mrs. James: To ask the Secretary of State for Health what guidance her Department has issued to NHS hospitals on the provision of support to terminally ill patients without next of kin at the time of death. 
Ms Rosie Winterton:
No guidance has been issued to national health service hospitals on the provision of support specifically for terminally ill patients without next of kin at the time of death. However, the National Institute for Health and Clinical Excellence's guidance on supportive and palliative care, issued in 2004, provides recommendations for the provision of optimal care for those who are dying. This guidance also endorses several tools to support the provision of high
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quality and responsive care for people at the end of life. These tools: the gold standards framework, the Liverpool care pathway, and the preferred place of care, are being rolled out nationally as part of the Government's end of life care programme, which is running for three years from 2004 to 2007.
The Department also issued advice for the NHS, When a Patient Dies", which sets out the principles and key elements of good bereavement services. This includes advice that all those involved in the death of a patient should work in partnership to ensure a coordinated response that meets individual needs.
Mr. Paterson: To ask the Secretary of State for Health what the relationship is between the National Institute for Health and Clinical Excellence, the European Medicines Evaluation Agency and the EU Committee on Medicinal Products for Human Use. 
Jane Kennedy: The National Institute for Health and Clinical Excellence provides advice to the national health service in England on the clinical and cost effectiveness of selected new drugs once they are licensed by the Committee for Medicinal Products for Human Use, a committee of the European Medicines Agency.
Mr. Byrne: The Department is currently collating the responses of a service-wide listening exercise on proposed principles and definitions to underpin the 18-week patient pathway commitment. The discussion document Commissioning an 18 week patient pathway proposed principles and definitions" is available at www.18weeks.nhs.uk/documents/Principles_definitions.pdf and has been placed in the Library. Paragraphs 57 to 59 of this document address patient pathways, which involve multiple organisations. Paragraph 77 refers to the need for commissioners to manage the hand-offs between organisations. The outcome of the listening exercise and the final principles and definitions will be published in 2006.
Mr. Lansley: To ask the Secretary of State for Health what estimate she has made of the average length of time women wait for their first appointment to test whether they are carrying the BRCA1 or BRCA2 gene. 
The first appointment with the clinical genetic service will be to assess the individual's risk of carrying a mutation in the BRCA1 or BRCA 2 genes based on a detailed investigation of their family history. A key part of the process is the gathering of accurate information about occurrence and age at onset of any relevant cancers in the family before a meaningful first appointment can take place to assess whether it would be appropriate to offer a genetic test. This can take some time.
The ability to test for breast cancer pre-disposition genes has led to a significant increase in workload for genetic services. We are working with commissioners and providers of genetic services to ensure that patients are being appropriately referred into services and that testing capacity is increased.
Mr. Hollobone: To ask the Secretary of State for Work and Pensions what opportunities are made available by his Department in Kettering constituency to retrain, reskill or educate local adult residents for paid employment. 
The Secretary of State has asked me to reply to your question concerning what opportunities are made available by his Department in the Kettering constituency to retain, reskill or educate local adult residents for paid employment. This is something that falls within the responsibilities delegated to me as Chief Executive of Jobcentre Plus.
Jobcentre Plus in Kettering offer training courses which are available to unemployed people in Retail and Customer Service, Fork Lift Licence (counterbalance and ach), and Basic Skills (literacy and numeracy). A Basic Employability course is available and addresses various barriers to employment facing people who have been out of work for some time.
For those eligible for help under the New Deal programmes, assistance is available with jobsearch skills (C.V. writing, application form completion, interview techniques) and courses are also offered with work experience undertaken in the voluntary sector.
In addition, we are working with key local employers from the logistics sector to develop a tailor-made work preparation course for customers unemployed for six months or more. This will focus on the key skills needed to work in this environment.
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