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Mr. Meacher: To ask the Secretary of State for Health whether, in the proposed NHS reforms outlined in Health Reform in England; update and next steps" she intends that treatment for a terminally ill patient will be supported by the tariff to be used to enable the system of payment by results regardless of how quickly or slowly the patient's health deteriorates. 
Ms Rosie Winterton: Payment by results is a prospective payment system whereby providers are funded according to the number and complexity of cases treated and on the basis of a national tariff. However, in 2006, payment by results only applies to acute hospital services provided by national health service trusts and foundation trusts. Local commissioning arrangements continue to apply to services outside the scope of payment by results, including palliative care.
Ms Rosie Winterton: We do not hold information centrally on the treatment of cancer patients. It is for individual primary care trusts to decide the level of funding they allocate locally for the treatment of cancer patients within their population.
|Wakefield West PCT|
Sandra Gidley: To ask the Secretary of State for Health pursuant to the answer of 3 November 2005, Official Report, column 1340W, on Herceptin, if she will ensure that the action plans submitted by each of the 34 cancer networks to her Department in November 2005 on how they will implement HER2 testing are (a) made public and (b) placed in the Library. 
Cancer networks were also asked to establish a baseline of their current position on HER2 testing, that is the percentage of women currently being tested. A proforma for networks to complete this baseline assessment along with an outline proposal for developing HER2 testing was circulated. It was this proforma that was returned by cancer networks to the
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cancer action team. The proformas are currently being analysed and a summary will be made available in due course.
Sandra Gidley: To ask the Secretary of State for Health pursuant to the answer of 3 November 2005, Official Report, column 1340W, on Herceptin, whether similar action plans will be published on the prescription of Herceptin and related capacity factors. 
Ms Rosie Winterton: Anyone who is not ordinarily resident in the United Kingdom is subject to the NHS (Charges to Overseas Visitors) Regulations 1989, as amended and will be liable to pay for any hospital treatment they receive unless they meet the criteria for one of several exemption categories listed in the regulations.
Initial diagnostic testing for HIV and any associated counselling are free to all irrespective of residency status. However, HIV/AIDS treatment is not, and a chargeable overseas visitor who receives HIV/AIDS treatment should be charged for it.
Guidance to the national health service is clear that treatment which, in a clinical opinion, is immediately necessary must not be withheld or delayed because of doubts about a person's chargeable status or their ability to pay. Because of the risks to both mother and baby maternity services should always be considered to be immediately necessary and never withheld. This can include treatment to prevent HIV transmission between mother and baby if that is considered to be clinically appropriate.
Mr. Lansley: To ask the Secretary of State for Health pursuant to the press release issued by her Department on 6 February 2006, which 20 trusts will receive support to reduce rates of MRSA and hospital-acquired infections during 2006; who will staff the support teams visiting hospitals with high infection rates; whether these staff will be remunerated by (a) her Department, (b) NHS organisations and (c) other sources of funding; what the total cost of operating these support teams will be in (i) 200506 and (ii) 200607; what specialist support these support teams will provide to trusts with high MRSA rates; and if she will make a statement. 
Jane Kennedy: The Department has set up specialist, targeted support (improvement teams) to reinforce those initiatives already in place throughout the national health service, which aim to reduce health care associated infections.
The teams will work with trusts that are furthest away from their Methicillin resistant Staphlococcus aureus (MRSA) reduction target. Work has begun with
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three trusts that were first to volunteer to pilot the support programmeSandwell and West Birmingham, Northumbria, and Aintree NHS Trusts. The teams will move on to support up to 17 further trusts during 200607. Selection will depend on progress towards the MRSA target and other factors. We will announce the additional trusts to join the programme at stages in 2006.
The teams comprise; a programme manager, programme analyst, infection control practitioner and specialist director for infection and prevention control/microbiologist. Staff will be remunerated through contractual arrangements with the Department.
The cost of the overall programme of support depends upon the level and complexity of the NHS's support requirements and these are presently being calculatedbased upon the outcome of the teams' diagnostic work with the three pilot sites. The Department will have calculated the likely cost of support teams by the end of the current financial year.
The objective is to assist trusts in diagnosing those issues which prevent reduction in infections and to develop practical action plans that speed-up progress. The teams will help trusts deliver such plans and put in place management/support arrangements that facilitate sustained improvement.
Chris Ruane: To ask the Secretary of State for Health what was the total research budget for developing research into medicines and treatment for (a) MRSA and (b) other hospital acquired infections, in each of the past 10 years. 
Jane Kennedy: The main agency through which the Government supports medical and clinical research is the Medical Research Council (MRC). The MRC is an independent body funded by the Department of Trade and Industry via the Office of Science and Technology. Much of the funding for new drug development is provided by the pharmaceutical industry.
The MRC funds a considerable programme of research that underpins scientific understanding of hospital acquired infections including methicillin-resistant Staphylococcus aureus (MRSA) and other antibiotic resistant pathogens. Within this portfolio there are currently no studies exclusive to MRSA.
The Department has for some years recognised the importance of the control of hospital acquired infection, and the threat to public health posed by the increase in antimicrobial resistance. As part of a wide-ranging approach to these issues, the Department set up an advisory group to identify research priorities in 1999. The group's report, published in 2001, made recommendations for future research that led to a research programme that is currently underway.
In 2003, the Department published Winning Waysworking together to reduce healthcare associated infection in England", a report that laid out a strategic approach to dealing with health care associated infections, including recommendations for further research. The report placed particular emphasis on activity aimed at preventing the occurrence and spread of infection.
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