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Mr. Amess: To ask the Secretary of State for Health whether her Department was consulted by the Royal College of Obstetricians and Gynaecologists prior to the publication of its guidance The Care of Women Requesting Induced Abortion; and if she will make a statement. 
Mr. Lancaster: To ask the Secretary of State for Health (1) what action she is taking to ensure delivery of Milton Keynes Primary Care Trusts proposals to redesign adult mental health services; 
Caroline Flint: It is for primary care trusts in partnership with strategic health authorities and other local stakeholders to determine how best to use their funds to meet national and local priorities for improving health, tackling health inequalities and modernising services.
Caroline Flint: National health service primary care trusts are responsible for commissioning alcohol misuse treatment according to local need. The estimated annual spend on specialist alcohol treatment is £217 million.
Ms Rosie Winterton: Bevacizumab (Avastin) in combination with irinotecan, is currently licensed for the first-line treatment of patients with metastatic bowel cancer. The National Institute of Health and Clinical Excellence (NICE) is currently assessing the use of Avastin in the treatment of bowel cancer and final guidance from NICE is expected in November 2006.
In the interim period, the Department has made clear to the national health service, in guidance issued in 1999, that primary care trusts should not refuse to fund specific drugs or treatments simply because they have not yet been appraised by NICE. In these circumstances health bodies are expected to reach their own decisions on whether to use the drug based on their assessment of the available evidence.
Ben Chapman: To ask the Secretary of State for Health what discussions she has held with Bebington and West Wirral Primary Care Trust on (a) the siting of new practice clinics and (b) the provision of funding to patient groups lobbying for development in the green belt. 
Ms Rosie Winterton: No discussions have been held with Bebington and West Wirral primary care trust regarding the siting of new practice clinics and the provision of funding to patient groups lobbying for development in the green belt. The provision of local healthcare facilities is the responsibility of primary care trusts with the support of their strategic health authorities.
The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for reviewing the reclassification of the legal status of a medicinal product from prescription only to over-the-counter supply. An assessment of the suitability of a medicinal product for pharmacy or general sale list sale or supply usually
follows an application from a marketing authorisation holder. Any application to change the legal status of a particular medicine will be considered carefully against the criteria in European and United Kingdom legislation. Patient safety remains the prime consideration and any application would be required to demonstrate its safety in use and that relevant patient and professional education issues had been addressed adequately.
Mrs. Iris Robinson: To ask the Secretary of State for Health (1) what percentage of patients referred by their general practitioner with suspected breast cancer were assessed by a specialist within two weeks in each of the last three years; 
Data on waiting times for cancer treatment is not recorded in the format requested. In England, the NHS Cancer Plan introduced cancer waiting times standards of a maximum one month wait from diagnosis with breast cancer to first treatment and a maximum two months from urgent general practitioner referral to first treatment for breast cancer to be achieved from December 2001 and December 2002 respectively. In the last twelve months 98.9 per cent. of patients received treatment for breast cancer within one month of diagnosis and 98.1 per cent. received treatment within two months of urgent referral by their general practitioner.
Mr. Lansley: To ask the Secretary of State for Health, pursuant to the press release issued by her Department on 2 June 2006, on fastest treatment ever for cancer patients, on what date the decision was taken that (a) 98 per cent. compliance would constitute success in meeting the 31-day waiting time target and (b) 95 per cent. compliance would constitute success in meeting the 62-day waiting time target. 
Ms Rosie Winterton: Following discussions with the Healthcare Commission an agreement was reached on 24 June 2005 on the 5 per cent. and 2 per cent. tolerances for clinical exceptions for the 62 and 31-day cancer waiting times targets.
Ms Rosie Winterton: In May 2004, the international agency for research on cancer, part of the World Health Organisation, concluded that organised and quality controlled cervical screening can achieve an 80 per cent. reduction in the mortality of cervical cancer. Women aged 25 to 49 should be screened no more than every three years, and women aged 50 to 64 no more than every five years. This is in line with national policy on cervical screening in England.
In July 2004, Professor Julian Peto and colleagues published a paper in The Lancet, The cervical cancer epidemic that screening has prevented in the UK. The paper concluded that cervical screening has prevented an epidemic that would have killed about one in 65 of all British women born since 1950 and culminated in about 6,000 deaths per year in this the United Kingdom. 80 per cent. or more of these deaths, up to 5,000 deaths per year, are likely to be prevented by screening, which means that about 100,000 women will have been saved from premature death by the cervical screening programme by 2030(1).
(1) Peto et al, Lancet 2004; 364: 249-56.
(2) National Statistics and The Information Centre for health and social care statistical bulletin, cervical screening programme, England: 2004-05.
First is the trial of management of borderline and other low grade abnormal smears which is funded by the Medical Research Council. This study was set up to determine the most appropriate way to deal with HPV positive results and associated psychological issues. The study is due to report in 2007.
Second is a randomised trial of HPV testing in primary cervical screening, which is funded by the Departments health technology assessment programme (HTA). This trial is investigating the use of HPV testing as a primary screening tool. The study is due to report in mid-2008.
In addition, as part of the Government-funded pilot study of liquid based cytology, the Department also piloted the use of HPV testing as triage for women with mild or borderline test results. There is currently insufficient evidence to support the use of HPV testing as a primary screening tool. However, we do not underestimate the importance of HPV in the development of cervical cancer.
Following the receipt of the independent evaluation report of the HPV arm of the pilot, the advisory committee on cervical screening has now set up a dedicated working group to advise on how best to introduce HPV testing into the NHS Cervical Screening Programme.
Mr. Baron: To ask the Secretary of State for Health what assessment she has made of the effectiveness of the Prostate Cancer Risk Management Programme; what funding has been allocated for the revision of the programme; and when this funding will be made available. 
Ms Rosie Winterton: The Prostate Cancer Risk Management Programme (PCRMP) is being reviewed based on the evidence of the evaluation of the programme, which has been carried out by the Cancer Research UK primary care education research group.
Patient information, informed decision-making and the psycho-social impact of Prostate Specific Antigen (PSA) testing (Hewitson et al, British Journal of Urology International 2005;95(S3): 16-32)
Reduction in uptake of PSA tests following decision aids: systematic review of current aids and their evaluations (Evans et al, Patient Education and Counselling 2005;58:13-26)
The results of an on-line questionnaire survey with 400 general practitioners (GPs) examining current reported PSA testing practice in primary care as well as GP attitudes towards informed decision-making and PSA testing were published in the journal British Medical Council Family Practice (Brett et al, 2005;6:24).
The report of a study to develop an understanding of what occurs in GP consultations which result in a request for a PSA test, from the perspective of the GP and the patient, is being written up prior to submitting for publication.
The PCRMP primary care packs will be rewritten based on the results of this extensive evaluation, and a consideration of any new evidence. This work will be overseen by the PCRMP scientific reference group, with close links to the prostate cancer advisory group and the National Institute for Health and Clinical Excellence prostate cancer guideline development group. The timing of the rewrite will depend on the extent of the changes to be made to the packs based on the evidence. A full consultation of the revised packs will take place. Funding will be made available to the national health service for this programme.
Tim Farron: To ask the Secretary of State for Health what consultation process her Department undertook prior to awarding Care UK a contract for the running of a general practitioner practice and walk-in centre in Barking and Dagenham. 
Strategic health authorities were asked by the Department to communicate with primary care trusts (PCTs) and gauge any interest in being involved
in the innovation in primary care contracting programme, which was announced on 29 March 2005. Barking and Dagenham PCT expressed an interest in discussing the programme further and was identified as being suitable for the programme.
Responsibility for carrying out stakeholder involvement in relation to the services the PCTs wanted to procure lay with the PCTs and confirmation that this had taken place has been secured from the PCTs.
Mr. Harper: To ask the Secretary of State for Health whether (a) the Dilke memorial hospital and (b) the Lydney and district hospital are included on the choose and book system in Gloucestershire. 
Mr. Harper: To ask the Secretary of State for Health how many (a) consultants clinics have been held and (b) patients have attended such clinics in each month since January 2005 at (i) the Dilke memorial hospital and (ii) the Lydney and district hospital, broken down by consultant specialism. 
To ask the Secretary of State for Health what percentage of dental practices in Norwich, North
have decided to opt out of the NHS in the last 12 months; and how many dentists this figure represents. 
Ms Rosie Winterton: As at 31 March 2006, there were 12 dental practices and 58 dentists within the Norwich, North parliamentary constituency working in the national health service general dental services (GDS) or personal dental services (PDS).
During the period 31 March 2005 to 31 March 2006, no dental practices left the GDS or PDS. During the same period, three dentists left the GDS or PDS, while 11 dentists joined the GDS or PDS, providing a net increase of eight dentists within the Norwich, North parliamentary constituency.
Norfolks primary care trusts (PCTs) are reinvesting with local dental practices to enable them to treat more patients. They have also made other improvements to dental services with approximately 20 extra dentists being recruited to the county, in the last two years, using the Departments international recruitment scheme.
Information on the number of dentists who have signed the new contract by 1 April 2006 is not available centrally. We do however have some provisional information that covers contracts. A contract may be for more than one dentist so cannot be broken down further to individual dentist level. The following tables show the number of new dental services contracts that were signed and rejected at strategic health authority (SHA) level and by PCTs in the Norwich, North constituency area and the percentage of dental services these rejections represent.
|SHA||Contracts signed||Contracts rejected||Units of dental activity (UDA) percentage (contracts rejected)|
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