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Norman Lamb: To ask the Secretary of State for Health what incentives there are for general practitioners to set up practices in deprived areas under each of the primary medical services contracts. 
Mr. Bradshaw: Under the national General Medical Services contract general practitioner practices are intended to receive income based on a weighted capitation, needs-based formula. However, the impact of the minimum practice income guarantee negates much of the agreed equitable funding incentive that rewards practices based on patients needs. That is why we remain committed to delivering a fair funding system to all primary medical care contractors.
Under other local primary medical care contracts (Personal Medical Services, Alternative Provider Medical Services and Primary Care Trust Medical Services) PCTs have more flexibility to negotiate and agree locally funding arrangements that better match patient needs and resourcing to ensure the services provided meet those needs. Guidance to PCTs makes it clear however that they must contract with all providers on a fair and equitable basis.
Norman Lamb: To ask the Secretary of State for Health how much the minimum practice income guarantee cost in (a) cash and (b) real terms in current prices in each year since 2004; what plans he has for the future of the guarantee; what assessment he has made of its effects on funding levels in deprived areas; and if he will make a statement. 
|Minimum practice income guarantee spend|
|Financial year||Cash||Real terms|
NHS Employers are currently discussing with the BMAs General Practitioners Committee how best to achieve and implement a more equitable funding system for the provision of primary medical care services. These discussions include the possible timescale for, and any funding that may be needed to support, the phasing out of the MPIG.
The impact of MPIG on funding levels in deprived areas has been considered within the assessment of general practitioner contract reform within the Primary and Community Care Strategy. This assessment has not been published as contract negotiations are ongoing. Moving to a fair and equitable weighted capitation formula will ensure more resources are allocated to practices based on the needs of the patients they are responsible for.
To ask the Secretary of State for Health what the average number of general
practitioners per 100,000 population was in each primary care trust, in each of the last five years, broken down by index of deprivation decile. 
Mr. Bradshaw: The average number of general practitioners per 100,000 population in each primary care trust in each of the last five years is in the table which has been placed in the Library. The information requested is not available broken down by index of deprivation decile.
The consultation Building on Strengthsdelivering the futureproposals for legislative change began on 27 August 2008 and provides everyone with an opportunity to contributepatients, the NHS, contractors and healthcare professionals alike. Any final decisions will be taken in the light of the responses and the feedback received. The consultation, together with the relevant impact assessments, is available on the Department's website at
Sir John Stanley: To ask the Secretary of State for Health (1) whether it is his policy that GP practices with dispensaries will be required to re-apply for permission for their dispensaries to continue; 
Kate Hoey: To ask the Secretary of State for health what assessment he has made of the likely effects of the removal of the one mile rule on the number of (a) dispensing doctors and (b) patients able to fulfil prescriptions at dispensing doctors' practices. 
Mr. Bradshaw: The White Paper Pharmacy in England: Building on Strengthsdelivering the future promised to consult further on a number of proposals. Building on Strengthsdelivering the futureproposals for legislative change was published on 27 August 2008.
As part of this consultation, we have put forward options for possible reform of general practitioner dispensing arrangements on which we are seeking views.
We have no preferred option at this stage nor have we come to a view as to whether any reform of these particular arrangements is necessary. The accompanying impact assessments to the consultation document consider the likely effects of each of these options.
Mr. Breed: To ask the Secretary of State for Health if he will consider introducing mandatory post-mortem tests for (a) carbon monoxide poisoning and (b) poisoning by toxins resulting from the products of combustion. 
Coroners, who are independent judicial office holders, are required to investigate all deaths where the cause of death is believed to be violent, unnatural or a sudden death of unknown cause. Coroners have the power, under the Coroners Act 1988, to order both post mortem examinations and special examinations (including histopathology and toxicology), as and when they consider it necessary, in order to establish the cause of death. It is for the coroner to decide whether tests for carbon monoxide poisoning and poisoning by toxins resulting from the products of combustion would be justified in the light of the available facts in each individual case.
Mr. Lansley: To ask the Secretary of State for Health when a patient is treated in a GP-led health centre without being registered there, by what mechanism the centre will be paid for that patients treatment. 
Mr. Bradshaw: This is a local contractual matter for each primary care trust, who have been advised to make payments on a similar basis to that whereby existing general practitioner practices receive funding for treating such patients e.g. based on the volume of patients treated at a fixed price.
Mr. Lansley: To ask the Secretary of State for Health what the evidential basis is for the statement that there is significant variation in practice in care relating to (a) cataracts, (b) fractured neck of femur, (c) cholecystectomy and (d) stroke care, as referred to on page 55 of High Quality Care for All, Cm 7432. 
Mr. Bradshaw: Evidence gathered by the NHS Institute for Innovation and Improvement and published as part of its Focus on High Volume Care series shows that there is a significant variation in practice in care for these four areas. A copy of the NHS Institutes latest report Focus on High Volume Care: Update has been placed in the Library.
Mrs. Maria Miller: To ask the Secretary of State for Health what guidance his Department provides to primary care trusts on (a) the recommended caseload levels of health visitors and ( b) the timing and frequency of visits made by health visitors to families with children under the age of five. 
Mr. Bradshaw: There are no central recommendations for health visitor caseloads. While the updated Child Health Promotion Programme, launched on 17 March 2008, identifies health visitors as the lead practitioners in promoting the health of children below the age of five, it is for local commissioners to commission services according to local needs. There is no central guidance about numbers of health visitors or about the timing and frequency of visits in different circumstances.
Mr. Fallon: To ask the Secretary of State for Health pursuant to the answer of 6 March 2008, Official Report, column 2734W, on hearing aids: waiting times, what the average waiting time for all audiological assessments, including assessment for digital hearing aids, has been in (a) West Kent and (b) Eastern and Coastal Kent Teaching Primary Care Trust area in the period since 1st January 2008. 
Mr. Bradshaw: The following table shows the average (median) waiting times for all audiological assessments, including assessment for digital hearing aids, in West Kent Primary Care Trust (PCT) and Eastern and Coastal Kent Teaching PCT areas in each month from January to June 2008, which is the most recent information available.
|Average (median) wait, in weeks, for audiological assessment, January to June 2008.|
Department of Health form DM01 - Diagnostic Monthly.
Mr. Bradshaw: No estimate has been made of the cost to the national health service of ending charges for car parking at all NHS hospitals. In England, hospital car parking charges are decided locally by individual trusts to cover the cost of running and maintaining a car park. If charges were not imposed, such costs would need to be funded from resources currently used to provide healthcare to patients.
All trusts should have exemption and concessionary schemes in place to ensure that patients and carers who visit hospital regularly are not disadvantaged. They should also have sustainable public transport plans in place for staff and visitors.
Mike Penning: To ask the Secretary of State for Health what breakdown in points allocation was awarded to (a) Gardasil and (b) Cervarix under the criteria and weighting system for evaluation of the contract to supply a human papilloma virus vaccine. 
Mr. Bradshaw: The points allocated to Gardasil and Cervarix under the award criteria for the Human Papillomavirus vaccine are commercial-in-confidence. I refer the hon. Member to the written answer I gave my hon. Friend the Member for Norwich, North (Dr. Gibson), on 16 July 2008, Official Report, column 531W, which outlines the award criteria and their weightings for this contract.
Mr. Greg Knight: To ask the Secretary of State for Health how many reports his Department has commissioned from the Independent Reconfiguration Panel in the last 12 months; and in what percentage of these cases the Panel made recommendations which differed from the proposals being made by the relevant NHS trust. 
Mr. Bradshaw: Between September 2007 and September 2008, the Secretary of State asked the Independent Reconfiguration Panel (IRP) to review the following referrals from local Overview and Scrutiny Committees:
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