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Mr. Ivan Lewis: Information for patients on choice and booking is available on the www.nhs.uk website and inpatient information booklets tailored to each primary care trust (PCT) area. Patients are able to access generic advice on the issues to consider when making a choice of provider, and details of the choice options available. The provider options are accompanied by comparative performance information taken from the Healthcare Commission's performance indicator. The information is available in a range of alternative formats such as Braille, sign language video, audio, large print and in 18 different languages.
PCTs have been asked to provide additional local information and support for patients in their areas. There is also a patient opinion website at www.patientopinion.orq.uk/ where patients can access the views of others about individual providers.
No changes have been made to copyright law recently. Under the Copyright, Designs and Patents Act 1988 fair dealing with certain works, including literary works, for the purpose of non-commercial research or private study does not infringe copyright. Exceptions to copyright are under consideration as part of the current independent Review of Intellectual Property led by Andrew Gowers. The review will report to the Government in the autumn.
Mr. Lidington: To ask the Secretary of State for Health how many isolates of clostridium difficile were typed by (a) the Anaerobe Reference Laboratory and (b) other typing laboratories used by her Department (i) in total and (ii) on average per week in each year since 2003-04. 
Laboratories are invited to refer isolates of clostridium difficile for investigation of outbreaks and for cases of particular concern. The ARL began the national random sampling scheme in January 2005.
|(1) January to June only Notes: In 2003 and 2004, ARL typed an average of about 10 isolates each week. Since January 2005, ARL has typed an average of about 40 isolates each week.|
Mr. Lidington: To ask the Secretary of State for Health how many cases of clostridium difficile 027 were reported to her Department in each hospital trust during (a) 2003-04, (b) 2004-05 and (c) 2005-06; and if she will make a statement. 
However, the random sampling scheme was introduced on 1 January 2005. Typing is carried out by the Anaerobe Reference Laboratory (ARL) on a random sample of strains submitted by acute trusts. The aims of the scheme are to monitor the prevalence of different strains and their susceptibility to specific antibiotics. In the first year, 2005, of random sampling, typing results were obtained for 881 samples. A total of 25 ribotypes were detected, but over 77 per cent. of samples were one of three types (106, 027, 001). Type 027 was the second most common type, accounting for over 25 per cent. of samples.
The epidemiological and clinical significance of these findings remains unclear. There is no evidence as yet of a predictable relationship between type 027 and severity of disease. There are no comparable data for earlier years based on random sampling.
The only other data come from samples that were referred to the Laboratory in the years 1995 to 2003 for investigation when a trust had concerns about an individual case or a possible outbreak. This is a biased sample in which cases occurring as clusters or outbreaks were over represented and sporadic cases were under represented. Over 55 per cent, of samples
were type 001, and no other type accounted for 10 per cent or more cases. Type 027 was not among the 10 most common types.
Andy Burnham: The future funding of the proposed new community hospital in Malvern is a local matter to be considered by NHS West Midlands. I understand that Worcestershire primary care trust (PCT) has been informed that the capital bid made by its predecessor, South Worcestershire PCT, will be reconsidered in the second tranche of the strategic health authorities funding release in December 2006.
Dr. Murrison: To ask the Secretary of State for Health what assessment she has made of unemployment among dentists qualifying as vocational dental practitioners wishing to become general dental practitioners. 
Mr. Ivan Lewis: We are not aware of a significant number of unemployed dentists. If newly qualified dentists are prepared to look outside London and the main conurbations, they should be able to find practices with national health service contracts that have funded vacancies.
Mr. Hancock: To ask the Secretary of State for Health pursuant to the answer of 20 July 2006, Official Report, column 660W, on dentistry, what her timetable is for the (a) assessment and (b) publication of the impact of the new contractual arrangements for dental services; and if she will make a statement. 
Ms Rosie Winterton: Assessment of the impact of the new contractual arrangements is an ongoing process. We expect to see meaningful data beginning to become available in the autumn though it will take longer to measure several of the outcomes. We intend to publish a report following the first 12 months of the new arrangements.
Sir Paul Beresford: To ask the Secretary of State for Health whether his Department has met the Dental Practitioners Association since the introduction of the new NHS dental contract on 1 April; and whether any such meetings are planned. 
Under the new system, the concept of registration no longer forms part of the remuneration arrangements. The National Institute for Health and Clinical Excellences guidelines recommend recall intervals of up to 24 months based on individual oral health. The old registration system required dentists, to maintain their registration income, to recall all registered patients at least once every 15 months regardless of their oral health. The new system removes this strait jacket and allows dentists to recall patients at intervals based on their individual oral health needs.
The Department will still be monitoring the number of patients covered by national health service primary dental services. As set out in the answer to my reply to the hon. Member for Bromsgrove (Miss Kirkbride) on 5 July 2006, Official Report, column 1218W, information will be available in due course via the NHS Business Services Authority on the numbers of patients who receive care or treatment from NHS primary care dentists on one or more occasions within a given period. This will provide a measure that is broadly similar to that of patient registration under the former system of general dental services. We expect the first information to be available later in the year.
Mr. Ivan Lewis:
The Department operates a play scheme in the London and Leeds Office. There are 24 places, allocated on a ballot system. This ensures all places are allocated fairly. In recent holiday periods, the play scheme has not been oversubscribed. There is a
short waiting list for nursery places in Quarry House Leeds. This contract is operated by the Department for Work and Pensions.
Mr. Ivan Lewis: The Department offers a range of childcare provision including subsidised playscheme places in both London and Leeds. In addition, staff have access to a nursery for pre-school children in Leeds. We also work with other Government Departments to ensure access is given to staff to fill any surplus playscheme places during holiday periods.
In addition, the Department offers staff the opportunity of claiming childcare vouchers as part of a salary sacrifice scheme. The vouchers can be used to pay for a range of approved/registered childcare provision for children up to 16 years.
Hywel Williams: To ask the Secretary of State for Health what tax efficient schemes for the purchase of bicycles her Department makes available to its employees; how many and what percentage of her Departments staff purchased bicycles through such schemes in 2005-06; whether the schemes are available through a range of suppliers; and whether arrangements are made to enable staff with disabilities to purchase adapted bicycles from a specialist supplier. 
The Department does offer interest free loans of up to £500 to all staff. Cycle parking and shower facilities are available at each of the Departments main offices as incentives to encourage people to cycle to work.
Ms Rosie Winterton:
The White Paper, Our Health, Our Care, Our Say sets out a new direction for health and social care services and we are reorganising health and social care services to focus together on prevention and health promotion. For 2008, primary care trust
local delivery plans will have to include a clear strategy for the development of preventative services, including tackling health inequalities across socioeconomic and ethnic minority groups requiring targeted, innovative and culturally sensitive responses.
The White Paper also includes details of the self-assessment, Life Check which everyone will have at key points in life. This will support individuals and communities at high risk of developing diabetes to get involved in more healthy lifestyles and environments. If the results show that a person is at risk of poor health, they will be able to talk to a health trainer about the help available from local services, specialist services, referral for further medical advice and develop a personal health plan.
Ms Rosie Winterton: Funding is made available to national health service services to implement services locally, and as a result awareness campaigns are more likely to be developed locally in primary care trusts (PCT) and hospitals rather than centrally.
Obesity is one of the major causes of type 2 diabetes. Reducing obesity is one of our key priorities and we are helping children and their parents to make a step change in their lifestyles and attitude to food and fitness through a raft of cross-Government public health measures. We are developing a new national healthy living social marketing programme which will focus on families and children under age 11 aimed at improving the healthiness of peoples lifestyles in the areas of diet and physical activity. This will be launched early in 2007. These measures will help to support the National Institute for Health and Clinical Excellence's definitive guidance on the prevention and management of obesity which is due to be published in November 2006.
Our, Our Health, Our Care, Our Say White Paper also sets out a new direction for health and social care services and we are reorganising health and social care services to focus together on prevention and health promotion. For 2008, PCT local delivery plans will have to include a clear strategy for the development of preventative services.
Mr. Davey: To ask the Secretary of State for Health which primary care trusts have refused to provide drugs that have been passed by the National Institute for Health and Clinical Excellence in the last 12 months. 
There is a statutory obligation on the national health service to provide funding for National Institute for Health and Clinical Excellence (NICE) technology appraisals within three months of the date of publication of NICE'S guidance.
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