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Ms Rosie Winterton: It is important to be clear aboutthe differences between seasonal influenza, avian influenza and pandemic influenza. Avian influenza is a disease which mainly affects birds. Seasonal influenza refers to the virus that circulates in the human population and causes widespread illness each winter. Pandemic influenza 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.
All primary care trusts and health organisations are required to develop and maintain local contingency arrangements to respond to any influenza outbreak, including a pandemic and those plans are currently being audited.
James Duddridge: To ask the Secretary of State for Health what procedure is in place to treat people exposed to potential cases of Avian influenza; which treatments are available; and what time scale has been set within which such treatment should be administered. 
Ms Rosie Winterton [holding answer 29 November 2005]: 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.
In the event of a confirmed outbreak of Avian influenza, all those who have been exposed, or at risk of exposure will be offered anti-viral therapy and seasonal influenza vaccine, as appropriate, within 24 to 48 hours of disease confirmation.
Antiviral drugs and seasonal influenza vaccine will be made available through the Health Protection Agency's local health protection units in collaboration with the national health service, similar arrangements will apply in Wales and Scotland.
Mr. Lansley: To ask the Secretary of State for Health what the Government's policy is on the provision and specialised cancer and cardiac care services at the St.Bartholomew's site as part of a dual site operation at the Barts and the London NHS Trust; and if she will make a statement. 
In line with our policy of Shifting the Balance of Power", the relevant local national health service organisations will need to plan their services within the framework of the NHS Plan and other national documents, such as the improving outcomes series of cancer service guidance and the national service framework for coronary heart disease, to meet the needs of the population they serve.
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Mr. Lansley: To ask the Secretary of State for Health (1) what response her Department's access and capacity review yeam made to the full business case for redevelopment at the Barts and the London NHS Trust; 
Jane Kennedy [holding answer 19 January 2006]: No estimate of capacity requirements for Barts and the London NHS Trust have been made centrally. Capacity planning is the responsibility of strategic health authorities (SHAs) in conjunction with their primary care trusts; NHS trusts; and other relevant stakeholders in their local health economies. SHA level capacity plans are taken forward through the Department's local delivery planning process.
The Department's access directorate undertook an assessment of the Barts and the London NHS Trust private finance initiative scheme in October 2005. The assessment found that the bull business case for the scheme took into account the expected impact of the key elements of the capacity planning agenda and was broadly consistent with national assumptions and projected local capacity requirements. To supplement this work, the Secretary of State has asked the SHA to commission an independent review to ensure we have the right balance of cancer and cardiac services in North East London.
Mr. Baron: To ask the Secretary of State for Health what steps her Department is taking to prepare for increases in demands placed on NHS bowel cancer services as a result of the roll-out of the National Bowel Cancer Screening Programme. 
Training in endoscopy (bowel scoping) is vital to the diagnosis of bowel cancer. To prepare for the bowel cancer screening programme, we have built on the training established as part of the NHS Cancer Plan. A national training programme has been established, with three national and seven regional centres, to train medical staff, general practitioners, nurses and other health professionals to carry out vital procedures for diagnosing bowel cancer. By increasing the pool of staff able to undertake endoscopy and colonoscopy procedures, waiting times will be reduced and services made more convenient.
The National Institute for Health and Clinical Excellence (NICE) produced updated guidance, Improving Outcomes in Colorectal Cancers" (May 2004). This guidance is aimed at helping those involved in planning, commissioning, organising and providing bowel cancer services to ensure that services are
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configured to ensure appropriate high quality services. Implementation of NICE guidance is a developmental standard as set out in National Standards Local Action (July 2004). The Healthcare Commission is responsible for assessing progress of healthcare organisations towards achieving developmental standards.
Steve Webb: To ask the Secretary of State for Health if she will make a statement on progress being made on (a) achieving the Government's commitment for all people with breast problems to be seen by a specialist within two weeks and (b) making HER2 testing available for all women diagnosed with breast cancer. 
Ms Rosie Winterton [holding answer 19 January 2006]: The Department has assessed the need for additional staff required to meet the commitment and we have commissioned skills for health, which is the Sector Skills Council for Health, to develop competencies in breast assessment. Once these competencies are agreed they could be used to develop training programmes to increase the number of breast assessment staff. Skills for health are engaging with a wide range of stakeholders in the development and piloting of the competencies including charities, Royal colleges, professional groups and national health service organisations.
It is very important that we identify those patients who are HER2 positive so that all the appropriate treatment options can be considered for them. Professor Mike Richards, the National Cancer director, is working with Cancer Networks to ensure that facilities are put in place to enable women who need it to be tested. This work is ongoing.
Sir Paul Beresford: To ask the Secretary of State for Health pursuant to the written ministerial statement of 9 November 2005, Official Report, column 17WS, on national health service dentistry, how many new dentists each primary care trust will be receiving. 
The total has increased slightly from 1,453 to 1,459, reflecting the fact that the data includes dentists recruited via local buy back at the end of October 2005. The published figure included dentists recruited at the end of September 2005 as October data had not been received at the time of the announcement.
Mr. Lansley: To ask the Secretary of State for Health whether primary care trusts will be able to commission dental services from providers not operating under general dental services contracts and personal dental services agreements from April 2006. 
Ms Rosie Winterton:
Primary care trusts (PCTs) must use their powers under section 16CA of the National Health Service Act 1977 to provide or secure the provision of primary dental services within their area to meet all reasonable requirements. Primary dental
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services may only be provided under a general dental services contract, a personal dental services agreement or by the PCT itself under section 16CA(2) of the 1977 Act.
Miss McIntosh: To ask the Secretary of State for Health pursuant to her oral answer of 20 December 2005, Official Report, columns 170405, on dentistry, if she will make it her policy to ensure that private dentists may be sued for medical negligence on the same terms as NHS dentists. 
Ms Rosie Winterton: Private dentists may be sued on the same basis as national health service general dental practitioners. In July 2005, an Order amending the Dentists Act was made to empower the General Dental Council to make it a condition of registration that every dentist, whether practising privately or in the NHS, has adequate and appropriate indemnity cover. This provision will come into force in the summer, once the General Dental Council has made rules on the detail of this requirement.
Ms Rosie Winterton: Most primary dental care services are provided within the general dental service (CDS), which is currently a demand led service where expenditure is mainly determined by the activity of dentists rather than set by a fixed budget allocation. Net expenditure on the GDS in England in 200405 amounted to £1,246 million.
In 200405 the Department made an additional £262 million pounds available to primary care trusts (PCTs) to support the net cost (after taking account of dental charge income from patients) of personal dental service pilots. In addition, the Department distributed a total of £24 million revenue funds to help PCTs with particular dental access difficulties support local access and quality initiatives, and £35 million was distributed amongst all PCTs to fund capital grants to dental practices to improve access and practice facilities.
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