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Dr. Naysmith: To ask the Secretary of State for Health what estimate she has made of the proportion of annual NHS expenditure on (a) breast cancer drugs and (b) all cancer drugs which will be required to fund the provision of Herceptin as set out in the National Institute for Health and Clinical Excellences Final Appraisal Determination; and what estimate she has made of the cost to the NHS of providing Herceptin in each of the next three financial years. 
For the year ending September 2005 approximately £630 million was spent on cancer drugs prescribed in hospitals and in the community. We can not provide an estimate of the expenditure on drugs
used in the treatment of breast cancer since some of the drugs can be used for a variety of cancers. The data held give no indication of why a drug has been prescribed so the cost of breast cancer drugs cannot be estimated reliably.
The cost of providing Herceptin, for a 12 month course, to all patients with early stage breast cancer for whom it is clinically appropriate is estimated at around £100 million a year. The National Institute for Health and Clinical Excellence will be publishing, as part of its guidance on Herceptin, a cost impact report to help the national health service manage the implementation of the guidance.
Julia Goldsworthy: To ask the Secretary of State for Health (1) which hospital trusts (a) provide family history clinics offering screening to women with a high risk of breast cancer and (b) have withdrawn such clinics in the last two years; 
(2) how many primary care trusts (PCTs) commission family history clinics offering screening to women at high risk from breast cancer; and which PCTs have withdrawn the commission of these services in the last two years. 
Ms Rosie Winterton: The Department does not hold information centrally on specific clinics offered by individual trusts or funded by individual primary care trusts (PCTs). The provision of services is a matter for agreement between trusts and their commissioning PCTs and the strategic health authority for the area, in consultation with local stakeholders. Plans for services should take into consideration local needs and priorities while ensuring they meet core national standards for the delivery of health services.
The National Institute for Health and Clinical Excellence (NICE) published a clinical guideline on familial breast cancer in May 2004. They recommended that appropriate facilities should be developed locally to meet the needs of women at risk of familial breast cancer and that women at moderate risk or greater should receive annual mammography from age 40. NICE clinical guidelines are covered by the Departments developmental standards, standards which the national health service is expected to achieve over time. The Healthcare Commission has responsibility for assessing progress towards achieving these standards.
Anne Milton: To ask the Secretary of State for Health what the average interval was between screenings for breast cancer in (a) Guildford and Waverley Primary Care Trust, (b) Surrey and (c) England in each year since 1997. 
Ms Rosie Winterton: The average intervals between screenings for breast cancer by local screening units is not collected centrally. However, national health service cancer screening programmes requested data from the NHS breast screening programme on the percentage of local screening units achieving the 36-month national standard between screens for quarter four 2005-06, that is from January to March 2006.
The NHS Cancer Plan, published in 2000, stated that we would extend invitations for breast screening to women aged 65 to 70 and introduce two-view mammography at all screening rounds. Thanks to the efforts of the staff in the screening programme, these targets have now been achieved in all local breast screening units. The expansion is already showing an effect, with nearly 12,000 cancers diagnosed by the programme in 2004-05, an increase of 40 per cent. on 2001 when the expansion began.
However, the changes together represent a 40 per cent. increase in the workload of the programme. We are aware that this has had an impact on some services maintaining the three-year interval for screening and we are taking steps to bring all screening intervals back to three years.
The Departments cancer programme board, chaired by the National Cancer Director Professor Mike Richards, has taken a particular interest in this area. The board is considering a course of action with the support of the Departments recovery and support unit.
Mr. Sheerman: To ask the Secretary of State for Health what programmes are in place to assist cancer patients with the financial effects of their illness; and if she will take further steps to lessen such effects. 
Ms Rosie Winterton: Financial assistance is available to patients through the hospital travel costs scheme and the national health service low income scheme. Patients with cancer, as with any serious illness, may also be eligible for benefits support from the Department for Work and Pensions.
The Government recognise that finance is an issue of great importance to people with serious illness. Departmental officials are working with those in the
Department for Work and Pensions, which has the expertise and knowledge to inform people about arrangements for claiming benefits and their entitlement to different benefits, to take steps for patients to be signposted to the assistance that is available.
Mr. Marsden: To ask the Secretary of State for Health (1) how many (a) carers of people with a learning disability, (b) children with a learning disability and (c) adults with a learning disability in Lancashire receive a short break service; 
(2) how many hours short break service, on average, were provided on behalf of people with a learning disability in Lancashire who received the care component of disability living allowance at the (a) highest, (b) middle and (c) lowest rate in the last period for which figures are available; 
Anne Milton: To ask the Secretary of State for Health how many and what percentage of women attended cervical cancer screening in (a) Guildford, (b) Guildford and Waverley Primary Care Trust, (c) Surrey and (d) England in each of the last five years. 
Ms Rosie Winterton: The available requested information is in the table. Data are not held centrally for Guildford alone or for Surrey alone. Data on the other countries of the United Kingdom are a matter for the devolved administrations.
|Guildford and Waverley primary care trust (PCT)||Surrey and Sussex strategic health authority (SHA)||England|
|Eligible population (thousand)||Coverage (percentage less than 5 years since last adequate test)||Eligible population (thousand)||Coverage (percentage less than 5 years since last adequate test)||Eligible population (thousand)||Coverage (percentage less than 5 years since last adequate test)|
Prior to 2002-03 Guildford and Waverley PCT and Surrey and Sussex SHA were not in existence. Coverage in England was 81.6 per cent. in 2001-02 and 83 per cent. in 2000-01
Statistical Bulletin: Cervical Screening Programme, England: 2000-01, 2001-02, 2002-03, 2003-04, 2004-05
Mr. Stephen O'Brien: To ask the Secretary of State for Health (1) what elements have changed from being funded by Connecting for Health to being funded by departmental central budgets since the inception of Connecting for Health; 
Caroline Flint: None in both cases. However, in 2005-06 NHS Connecting for Health funded a proportion of the cost of running the choose and book management service, which is otherwise funded from the Department's central budgets. The sum involved was £1.57 million.
Dr. Murrison: To ask the Secretary of State for Health what assessment she has made of the effect on (a) the throughput of and (b) access to NHS dentistry of the implementation of the new dental contact and agreement on 1 April; and if she will make a statement. 
Ms Rosie Winterton: Management information indicates that, as at 1 April 2006, primary care trusts (PCTs) had commissioned services representing around 96 per cent. of previous levels and had begun steps to commission additional services, both to replace the small minority of contracts rejected and to expand service provision.
The recent reforms are designed to support PCTs in improving access to services in a number of ways. First, the resources now devolved to PCTs represent a £400 million increase in investment compared with 2003-04. Second, when a dentist chooses to stop providing national health service services locally, the
money spent on these services now remains with the local PCT so that it is spent on commissioning new services from other dentists to replace lost capacity. Third, the new contractual arrangements are based on the expert clinical guidelines produced by the National Institute for Health and Clinical excellence. These recommend that dentists recall patients at intervals of between three and 24 months depending on their oral health needs. In our view, this is likely to mean that many patients with good oral health who have traditionally attended at typically six-monthly intervals will not need to attend as frequently as they have done in the past. This will free up additional capacity and enable dentists to treat a greater range of patients.
Mr. Hollobone: To ask the Secretary of State for Health what assessment she has made of the impact of the new dental contracts on the provision of domiciliary dental care and the provision of dental care to people living in care homes. 
Ms Rosie Winterton: The funding devolved to primary care trusts (PCTs) for commissioning primary dental care services from April 2006 built on all such expenditure during the reference period of October 2004 to September 2005, including expenditure on domiciliary services. The new arrangements give PCTs greater flexibility to commission and develop domiciliary dental services and other primary care services to reflect local needs.
Ms Rosie Winterton: Data on the number of general dental services (GDS) or personal dental services (PDS) practices that have left the national health service are not collected centrally. However, the number of practice addresses at the end of each year is known.
|General dental services (GDS) and personal dental services (PDS): Number of GDS or PDS dental practice addresses by London borough as at 31 March each year|
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