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Mr. Gordon Prentice: To ask the Secretary of State for Health what discussions she has had with the Royal College of Nursing about her plans to give primary care trusts a solely commissioning role. 
Mr. Byrne: The Department has had several discussions with the Royal College of Nursing (RCN) on this issue, and a settlement has now been reached over judicial review proceedings that were issued by the RCN at the end of October 2005.
We do not have a policy requirement or timetable for PCTs to divest themselves of provision. We well support PCTs whether or not they divest themselves of service provision, provided that what is being offered is genuinely best for local patient care.
District Nurses, health visitors and other staff delivering clinical services will continue to be employees by their PCT, unless and until the PCT decides otherwise" and any such decisions would be driven locally following our White Paper deliberations".
Issuing an application to be granted permission to apply for judicial review is not a step the RCN took lightly. We are, therefore, pleased a settlement has been agreed with the Department of Health and especially welcome the reassurance that there is no policy requirement or timetable for PCTs to divest themselves of provision.
The RCN have been fully involved in discussions around the White Paper, which is due to be published at the end of January, and will set out a vision for the future of local health and care services that will address questions about how, when and in what settings primary care services are delivered.
John Hemming: To ask the Secretary of State for Health how many calls were made from call centres in her Department in 200405 using predictive diallers; how many such calls resulted in contact being made with the recipient without a Government agent available to talk to them; and what assessment she has made of the likely impact of Ofcom's policy on silent calls on the use of predictive diallers in departmental call centres. 
Mr. Hollobone: To ask the Secretary of State for Health what estimate her Department made prior to the change in prescription charge regulations in April 2004 of the number of additional patients per year who would become entitled to free prescriptions; and how many patients have successfully claimed exemption from prescription charges as a result of that change. 
Jane Kennedy [holding answer 25 January 2006]: Prior to the change to the prescription charge regulations in April 2004, based on a sample of low income scheme claims, we estimated that around 29,000 claims would move from partial help, which gives no entitlement to free prescriptions, to entitlement to free prescriptions.
For 200405, the latest year for which sample data are available, we estimate that around 45,000 low income scheme claims have resulted in entitlement to free prescriptions that would previously have resulted in partial help.
Mr. Lansley: To ask the Secretary of State for Health how many reviews of the prescription charging system her Department has undertaken since 1997; what plans she has to conduct further reviews of the prescription charging system; whether she will place the copies of any review of prescription charges which has been undertaken since 1997 in the Library; and if she will make a statement. 
An internal review of prescription charges was undertaken by departmental officials in conjunction with HM Treasury as part of the formulation of government policy for the 1998 Comprehensive Spending Review. This work fed into the outcome of the Comprehensive Spending Review which was published by the HM Treasury. There are no plans to undertake a further review.
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Mr. Drew: To ask the Secretary of State for Health what advice her Department issues to (a) primary care trusts and (b) general practitioners on the issue of prescriptions to patients who pay for drugs to ensure that amounts issued by practices in prescriptions are monitored. 
Jane Kennedy: The amounts of drugs prescribed or the duration of prescriptions is a decision reserved for the general practitioner who has clinical responsibility for that particular aspect of a patient's care. The Department has not issued guidance on this issue but informal advice on prescription duration and drug wastage was included in Connect bulletin number 20 issued by the National Prescribing Centre in March 2000. A copy is available in the Library.
Clive Efford: To ask the Secretary of State for Health what assessment she has made on the impact of the private finance initiative arrangements on the reference cost index of the Queen Elizabeth Hospital Trust; and if she will make a statement. 
Jane Kennedy: The Queen Elizabeth Hospital National Health Service Trust has a reference cost index score of 103 for the year 200304. This shows that it is operating at costs 3 per cent. above the national average. An organisation with costs equal to the national average for this activity will score 100. Private finance initiative costs are apportioned to activity by the trusts themselves and not separately identified in reference costs submissions.
Clive Efford: To ask the Secretary of State for Health what the basis is for the change in the discount rate on the Queen Elizabeth Hospital Trust Finance Initiative deferred asset in 200506; and if she will make a statement. 
Jane Kennedy: This is a local matter. The South East London Strategic Health Authority (SHA) has advised that following the HM Treasury's discount rate for the provisions for 3.5 per cent. and 2.2 per cent., the Queen Elizabeth Hospital Trust has applied this directive to the deferred asset created to transfer ownership of the private finance initiative hospital back to the national health service over the term of the contract. The SHA further advises that this interpretation of the guidance has recently been clarified by the Department. However, the trust is finding it difficult to contain the impact of the financial pressure resulting from this clarification which was published on 3 January with an effective date of 1 April 2005.
Clive Efford: To ask the Secretary of State for Health when the consortia refinanced the Queen Elizabeth Hospital Trust Private Finance Initiative; and what estimate she has made of the financial effect on the trust if it had shared the reduced costs. 
This is a local matter. The South East London Strategic Health Authority has advised that the Queen Elizabeth Hospital scheme has not been refinanced. It was financed with an index-linked bond. The nature of bond deals make them very hard to refinance without incurring considerable additional costs. It is therefore unlikely that a refinancing will take place as the costs will normally outweigh the benefits.
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Mr. Amess: To ask the Secretary of State for Health if she will take steps to safeguard the employment of specialist rheumatology nurses and practitioners during the reorganisation of primary care trusts. 
Mr. Byrne: The potential reorganisation of primary care trusts (PCTs) resulting from Commissioning a Patient-led NHS is currently out for local consultation. The Department has commissioned a human resource framework in support of these anticipated changes, which has been written in partnership with colleagues from the service and trade unions, through the Employers Organisation. This framework document sets out for national health service employers best practice and legal employment requirements needed to retain NHS staff during potential organisational restructuring.
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