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Sandra Gidley: To ask the Secretary of State for Health if he will revise the cost rent system used to reimburse GP practices accommodation costs to ensure that facilities are not reimbursed by a number of different agencies at the same time in cases of subletting space in GP surgeries. 
Mr. Bradshaw: The National Health Service (General Medical ServicesPremises Costs) (England) Directions 2004 set out the arrangements for primary care trusts to make payments in respect of general practitioner (GP) premises costs. Direction 48 provides for those payments to be offset by any rents GPs receive from third parties for areas of premises they occupy. There is therefore no need for a revision.
Mr. Bradshaw: This information is not collected centrally. However, the Department's quarterly Access to Primary Care Survey shows that over the last year an average of 5.5 per cent. of patients were offered an evening appointment and an average of 1.25 per cent. of patients were offered an appointment at the weekend by their general practitioner surgeries.
Mr. Bruce George: To ask the Secretary of State for Health (1) what assessment has been made of the standard of care provided to patients with Gorlin Syndrome; and if he will make a statement; 
(2) what assessment his Department has made of the level of implementation of National Institute for Health and Clinical Excellence guidelines on improving outcomes for people with skin tumours; 
Ann Keen: The Department has received a very small number of representations about access to treatment on the national health service for Gorlins Syndrome patients. No assessment has been made of the standard of care provided to patients with this syndrome.
This guidance highlights a number of genetic conditions, including Gorlins Syndrome, which predispose a person to the development of skin cancer in later life and sets out recommendations for the management of people with this condition.
Specialised commissioning groups(1) have been asked to produce implementation summaries setting out how they would implement this guidance over the next three years. These plans have been submitted to the National Cancer Action Team and are being checked for compliance against the guidance.
(1) Specialised services, defined as those services provided in relatively few specialist centres to catchment populations of more
than 1 million people, are either commissioned regionally by specialised commissioning groups (SCGs) or nationally by the National Commissioning Group (NCG) depending on the rarity of the condition or treatment. 10 new SCGs were established on 1 April 2007 to commission services on a regional basis, coterminous with the 10 strategic health authorities. (This succeeds a two tier arrangement of regional (eight SCGs) and local (25 local SCGs) commissioning groups.) Services commissioned at SCG level include haemophilia, blood and marrow transplantation, secure forensic mental health, spinal cord injuries, etc.
nine regional communications managers (one per region) and three regional press officers (based in the London, eastern and west midlands regions);
five press officers based at the Centre for Infections, Colindale;
3.5 press officers based at the Centre for Radiation, Chemicals and the Environment, Chilton; and
one Head of Strategic Communications Planning: Emergency Preparedness and Response based at the Centre for Emergency Preparedness and Response, Porton.
Mrs. Dorries: To ask the Secretary of State for Health what sampling techniques were used in compiling statistical information on the health needs of Bedfordshire and Luton when allocating funds for (a) Bedfordshire Primary Care Trust and (b) Luton Primary Care Trust; and if he will make a statement. 
Mr. Bradshaw: Funding is allocated to primary care trusts (PCTs) on the basis of the relative needs of their populations. A weighted capitation formula is used to determine PCTs' target shares of available resources, to enable them to commission similar levels of health services for populations in similar need.
The Advisory Committee on Resource Allocation (ACRA) oversees the development of the weighted-capitation formula. ACRA is an independent body which has national health service management, general practitioner, and academic members. It commissions research to measure the health needs of PCTs.
The health need element of the formula, which informs the revenue allocations to PCTs in 2006-07 and 2007-08, was based upon research carried out by the allocation of resources to English areas (AREA) research team in 2001-02 and by Warwick university. The AREA research modelled need for all areas in England, and as a result a national formula was developed. A detailed description of the research techniques and the formula are published on the Department's website(1, 2) at:
Generally, the data used in this research were based on full population datasets (for example, the National Census). Statistical sampling was not required in those
cases. The significant exception was the Health Survey for England (HSE). HSE data for 1994-2000 inclusive were used and this provided a national sample size of 122,488. More details of the techniques used are provided in the document listed at point 2 as follows.
(1) Resource Allocation: Weighted Capitation Formula: Fifth edition (Department of Health).
(2) Allocation of Resources to English Areas; Individual and small area determinants of morbidity and use of healthcare resources (Sutton M, Gravelle H, Morris S, Leyland A, Windmeijer F, Dibben C, Muirhead M) Report to the Department of Health. Edinburgh: Information and Statistics Division, 2002.
Damian Green: To ask the Secretary of State for Health (1) what contact his Department has had with (a) the East Midlands Strategic Health Authority (SHA), (b) primary care trusts within the East Midlands SHA area, (c) NHS hospital trusts, foundation trusts and mental health trusts within the East Midlands SHA area and (d) right hon. and hon. Members on the effects of immigration into the region, NHS services and budgets; and if he will make a statement; 
(2) what contact his Department has had with (a) the East of England Strategic Health Authority (SHA), (b) primary care trusts within the East of England SHA area, (c) NHS hospital trusts, foundation trusts and mental health trusts within the SHA area and (d) right hon. and hon. Members on the effects of immigration into the region on NHS services and budgets; and if he will make a statement. 
Dawn Primarolo: Ministers have regular meetings with hon. Members and other stakeholders about health services in England. There is also a regular flow of correspondence from across the country including the East of England and East Midlands areas.
The Department is supporting local national health service organisations engage within regional strategic migration partnerships which provide a single multi-sector, multi agency forum to consider the impacts of migration as they affect regional areas. Funding of £20,000 is available in both 2007-08 and 2008-09 to help with co-ordination arrangements.
Discussions are shortly to start with the East Midlands Government Office and the Local Government East Midlands about this. Also, this work is being taken forward in partnership with the East of England Regional Assembly, the East of England Government Office and Suffolk primary care trust.
Mr. Bradshaw: We understand from the Chairman of the Healthcare Commission that at present the Healthcare Commission currently employs three full-time press officers and one full-time media relations manager, all who are based at the Healthcare Commissions head office at Finsbury Tower, London.
Greg Clark: To ask the Secretary of State for Health what the most recent average waiting time is for (a) audiology appointments and (b) the issue of a digital hearing aid in Tunbridge Wells constituency. 
Total waiting for an audiological assessment: 1,765 with 1,060 waiting over 13 weeks.
Total waiting for an audiological assessment: 116,915 with 63,161 waiting over 13 weeks.
Stephen Hammond: To ask the Secretary of State for Health what assessment he has made of the National Institute for Health and Clinical Excellence's preliminary recommendation of 7 August 2007 on percutaneous coronary intervention; and if he will make a statement. 
Dawn Primarolo: The National Institute for Health and Clinical Excellence (NICE) is reviewing its October 2003 guidance on the use of drug-eluting stents for the treatment of coronary artery disease. NICE is currently considering the responses it has received from stakeholders during the recent consultation on its draft recommendations. As NICE has not yet issued final guidance it would be inappropriate for us to comment further at this stage.
Dawn Primarolo: The National Institute for Health and Clinical Excellence has recommended three drugs used for the treatment of hepatitis C: pegylated interferons, interferon alfa and oral ribavirin. The estimated costs of these drugs dispensed in hospitals and in the community in the financial year 2005-06 was £24.4 million.
Pegylated interferon alfa-2a may also be used to treat chronic hepatitis B. Interferon alfa-2a and 2b may also be used to treat chronic hepatitis B and some malignant diseases, such as certain forms of leukaemia. It is not possible to identify these costs separately.
1. These data have been collated by the Information Centre for Health and Social Care.
2. The source of data on hospital prescribing is Â(c) IMS HEALTH: Hospital Pharmacy Audit. The cost of the medicines is estimated at NHS list price and not necessarily the price that the hospital paid.
3. Data on community prescribing are taken from the Prescription Cost Analysis system, supplied by the Prescription Pricing Division of the Business Services Authority. Estimated costs are based on Net Ingredient Cost (NIC). NIC is the basic cost of a drug. It does not take account of discounts, dispensing costs, fees or prescription charges income.
Mr. Bradshaw: There is no current nationally agreed definition of what constitutes a district general hospital, although the term is in common use and is generally employed to describe large hospitals which are not teaching hospitals.
Information identifying individual hospital sites by parliamentary constituency is not collected centrally. However, a series of fact sheets on the Department's website does identify the headquarters' address of each national health service trust in this manner. The information is available at:
NHS organisations will decide locally what constitutes the best configuration of healthcare services for their populations. In some localities, services may be provided in large centralised hospitals, while others may offer the same services in the community.
Mark Pritchard: To ask the Secretary of State for Health what estimate he has made of the number of wards in acute hospitals in England which will need to be temporarily closed to be deep cleaned. 
Ann Keen: The delivery of any deep-clean process is entirely a matter for local determination and will be affected by a range of local factors and considerations. It is not therefore possible to provide any estimate of the number of ward closures which may be required. However, we would expect all trusts to organise this programme in such a way that it minimises impact on service delivery and inconvenience to patients.
Mr. Gray: To ask the Secretary of State for Health pursuant to the answer of 18th July 2007, Official Report, column 456W, on Hospitals: Ministers of religion, what guidance he has issued on the responsibilities of NHS trusts to provide for the spiritual care of patients; and when budgetary control was devolved to NHS trusts in relation to these matters. 
Ann Keen: The Department issued guidance to national health service trusts in November 2003. Meeting the Religious and Spiritual Needs of Patients and Staff sets out a framework for the context and provision of chaplaincy and spiritual care services throughout the NHS that meet the needs of today's multi-cultural and spiritually diverse society.
NHS organisations have always been responsible for the provision of chaplaincy and spiritual care services. Funding for this is built into financial allocations to primary care trust, who commission hospital services on behalf of patients. Shifting the Balance of Power, published in 2002, empowered NHS trusts to give front line staff more say in how resources are allocated and services are delivered locally.
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