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Mrs. Dorries: To ask the Secretary of State for Health what funds were spent by Bedfordshire primary care trust and its predecessors to ensure that doctors surgeries and general practices can undertake the shift in patient services from the secondary sector to primary care in each year since 1997; and if she will make a statement. 
Andrew George: To ask the Secretary of State for Health what assessment she has made of which developed countries attract the largest numbers of health care professionals from less developed countries with inadequate domestic health care systems. 
Ms Rosie Winterton: The Government do not currently collect these data. Nevertheless, the 2006 World Health Report Working Together for Health looked at patterns of health care professionals migrating to Organisation for Economic Co-operation and Development (OECD) countries. The report says that while statistics on global flows of health workers remain far from complete, nearly 25 per cent. of doctors trained in sub-Saharan Africa are working in OECD countries (from 3 per cent. in Cameroon to 37 per cent. in South Africa). Nurses and midwives trained in sub-Saharan Africa and working in OECD countries represent 5 per cent. of the current work force (again a wide range from 0.1 per cent. in Uganda to 34 per cent. in Zimbabwe). Table 5.1, a copy of which has been placed in the Library, says that among OECD countries there is a range as to the percentage of doctors trained abroad (from 4 per cent. in Portugal to 34 per cent. in New Zealand (33 per cent. for the United Kingdom) and for nurses (0 per cent. for Finland to 21 per cent. for New Zealand (10 per cent. for the UK). It is important to note that the report does not specify the number of these overseas-trained doctors and nurses who come from developing countries.
Mr. Gordon Prentice: To ask the Secretary of State for Health what assessment she has been made of the impact of clinical assessment, treatment and support services on local health economies. 
Andy Burnham: The clinical assessment, treatment and support (CATS) scheme will improve local community access to healthcare services, in line with the White Paper Our Health, our care, our say which signalled our intention to bring services closer to patients.
There is a robust process to ensure there is both local support and a capacity need for such schemes, and to reduce the risk that a scheme will destabilise existing national health service providers. An impact analysis of the scheme is currently under way, commissioned by the North West Strategic Health Authority (SHA). The SHA is working closely with the local acute trusts to ensure that any impact is managed and the positive benefits of the scheme for the whole health economy are delivered.
Andy Burnham: All independent sector providers who are awarded contracts to provide clinical assessment, treatment and support services will be registered with the Healthcare Commission under the Care Standards Act 2000 and the Private and Voluntary Healthcare (England) Regulations 2001 No. 3968.
Strict contractual performance management of independent sector treatment centres is undertaken by the Departments commercial directorate. There are also contractual and statutory reporting obligations to the Department, the Healthcare Commission and referrers.
Mr. Newmark: To ask the Secretary of State for Health what assessment she has made of the impact of the proposed independent sector treatment centre in Bocking, Braintree on the future of the proposed community hospital on the site of St Michaels Hospital, Braintree. 
Andy Burnham: The introduction of independent sector treatment centres (ISTCs) is expected to increase patient choice and accessibility across the region. It is for strategic health authorities to manage the integration of ISTC schemes with local national health service provision.
Mr. Newmark: To ask the Secretary of State for Health (1) what discussions have taken place between her Department and the Mid Essex Primary Care Trust on the location of the proposed independent sector treatment centre in Bocking, Braintree; 
(2) what consultation with Mid Essex Primary Care Trust took place before the announcement of Mercury Health as the preferred bidder for the provision of an independent sector treatment centre in Bocking, Braintree. 
Andy Burnham: Engagement with the local national health service on the Essex independent sector treatment centre (ISTC) scheme was with the local strategic health authority (SHA), not directly with the primary care trusts. At the time of Mercury Healths appointment as the schemes preferred bidder, which was agreed with the East of England SHA, the locations of the proposed ISTC sites, including a potential location in Braintree, had not been finalised.
Location proposals for the ISTC scheme were agreed with East of England SHA. It is anticipated that there will be three ISTCs in the region located in Braintree, Basildon and Southend; locations have been adopted to facilitate easier access for patients in Essex in relation to healthcare services.
Mr. Lansley: To ask the Secretary of State for Health when the National Clinical Director for Children, Young People and Maternity Services was first asked to produce her reports (a) Making it better: For children and young people and (b) Making it better: For mother and baby, published on 6 February. 
Mr. Ivan Lewis: My right hon. Friend the Secretary of State asked Sheila Shribman on 7 November 2006 to produce these reports. They are part of a series of published reports by National Clinical Directors (NCDs), setting out the clinical case for change in their respective specialties. NCDs are experts, and each oversees the implementation of a national service framework (NSF) and represents the professional and client group interests and issues in the Department. NCDs work with policy and delivery teams, clinical networks and the national health service management community to achieve joined-up action. Dr. Shribman is in charge of implementation of the NSF for Children, Young People and Maternity Services.
Mr. Brady: To ask the Secretary of State for Health what the net cost or benefit to the UK was of reciprocal arrangements for reimbursing the costs of treatment of EU citizens treated in other member states (a) in total and (b) in respect of each member state in the most recent year for which figures are available. 
Ms Rosie Winterton: The table shows, in resource terms, the estimated net costs to the United Kingdom of the European Union reciprocal arrangements for health care. These are net health care claims estimated in accordance with existing arrangements under the regulations. These figures reflect the fact that more people go abroad (to work, retire or go on holiday) than come to the UK.
|Estimated net claims by other European Economic Area member states during 2005|
|In sterling (Thousand)|
1. The information is compiled in line with the requirements of Government Accounting 2000 and National Audit Office (NAO) and used for Resource Accounting and Budgeting (RAB) purpose during 2005-06.
2. Figures are in thousands and rounded to the nearest thousand.
3. Any necessary additional resource adjustments would be included in future years e.g. other new member states.
4. We have waiver arrangements with a number of member states which means they have agreed to bear the costs of each others insured persons, for example Denmark and Luxembourg.
Mr. Gordon Prentice: To ask the Secretary of State for Health whether the setting up of clinical assessment, treatment and support clinics in Lancashire and Cumbria will improve accessibility for patients. 
Andy Burnham: Clinical assessment, treatment and support services in Cumbria and Lancashire will provide more services closer to patients homes and reduce the number of appointments a patient needs to attend before hospital treatment.
Mr. Gordon Prentice: To ask the Secretary of State for Health when the need for the clinical assessment, treatment and support scheme in Lancashire and Cumbria was first identified; and how the need was tested and assessed. 
Andy Burnham: The need for clinical assessment, treatment and support (CATS) services for Cumbria and Lancashire was identified two years ago by the former Cumbria and Lancashire Strategic Health Authority following the success of a similar scheme in Greater Manchester.
It is estimated that across the north-west the number of patients waiting for treatment needs to be reduced from 119,000 to 65,000 in order to achieve the 18-week maximum waiting time from general practitioner referral to treatment by the end of 2008. A combination of pathway reform, demand management and additional activity such as that offered through CATS is required to achieve this reduction in waiting list numbers.
Mr. Gordon Prentice: To ask the Secretary of State for Health whether (a) GPs in Lancashire and Cumbria will be able to choose not to refer patients and (b) patients in that area will be able to choose not to go to a clinical assessment, treatment and support service. 
Andy Burnham: Decisions about where patients are referred for treatment will continue to be made by patients and their general practitioners (GPs). The clinical assessment, treatment and support services in Cumbria and Lancashire will provide an additional referral option for patients and their GPs.
Mr. Gordon Prentice: To ask the Secretary of State for Health how much Netcare will be paid over its five- year contract to deliver clinical assessment, treatment and support services in Lancashire and Cumbria. 
Andy Burnham: No contract has been awarded for clinical assessment, treatment and support services in Cumbria and Lancashire. The commercial terms between the Department and Netcare are still subject to negotiation.
Mr. Gordon Prentice: To ask the Secretary of State for Health what interaction GPs will have with healthcare professionals staffing clinical assessment, treatment and support schemes in Lancashire and Cumbria. 
Andy Burnham: The Cumbria and Lancashire clinical assessment, treatment and support scheme is an integrated scheme between primary and secondary care. Communication between all health care providers in the local health economy is important to achieving this. Local clinicians have already been engaged with the schemes preferred bidder to this end, to achieve an integrated pathway for patients.
Mr. Gordon Prentice: To ask the Secretary of State for Health (1) from where staff working in clinical assessment, treatment and support service clinics in Lancashire and Cumbria will be recruited; 
Andy Burnham: The contract for clinical assessment, treatment and support (CATS) services is still under negotiation. All independent sector health care providers awarded contracts under phase 2 of the Independent Sector Treatment Centre procurement are required to comply with the policy of additionality which exists to ensure the conservation of national health service clinical skills in key professions.
As contract negotiations are still ongoing, precise staff numbers, experience, and skills sets are not finalised. However, it is thought that the scheme could employ approximately 150 whole-time equivalent clinical and non-clinical staff.
An independent sector provider awarded a contract to provide CATS services would be required to produce a workforce strategy, which would set workforce protocols. The protocols would be reviewed and approved by the Department.
The independent sector providers workforce policies are required to comply with all applicable and current United Kingdom employment legislation and departmental guidance and to demonstrate workforce best practice. In addition, independent sector providers are required to comply with the provisions of Safer RecruitmentA Guide for NHS Employers (May 2005).
Mr. Ivan Lewis: The total number of home help hours delivered during the year is not collected centrally. The number of hours of home help delivered in England during a sample week in September of each year from 1997 to 2005 is shown in the table.
|Estimated number of contact hours of home help delivered during a sample week, September|
|Number of hours|
| Notes: 1. The table contains estimates for missing data. 2. Households receiving home care purchased with a direct payment are excluded. Source: HH1 return.|
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