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These figures have been published in the Department of Health resource accounts. Programme budgeting data for 2007-08 are still being collected and validated, and will include primary and secondary care maternity
and reproductive health. These data will be published on the Departments website.
Maternity services have been identified as a priority for the national health service in the operating frameworks for 2008-09 and 2009-10. For the period 2008-09 to 2010-11, £330 million additional investment for maternity is included within PCT revenue allocations. PCTs were informed of their revenue allocations for 2008-09 in December 2007. The 2009-10 and 2010-11 revenue allocations were announced on 8 December 2008. It is for NHS commissioners and trusts to plan the exact spend on maternity services in each financial year to 2010-11 in line with national and local priorities and local plans, including the strategic health authority visions for maternity and the new born developed as part of the NHS next stage review.
Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 3 March 2009, Official Report, column 1478W, on maternity services: finance, how much additional funding he estimates NHS trusts in England will receive for the provision of maternity services in each year from 2008-09 to 2010-11, broken down by the element of the maternity tariff through which the additional funding will be received. 
Ann Keen: The payment by results national tariff pays national health service trusts for the amount of activity they do. Therefore the amount of additional funding that NHS trusts will receive for the provision of maternity services within the scope of the tariff in each year from 2008-09 to 2010-11 will depend on levels of activity. The latest year for which hospital activity data are available is 2007-08.
Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 3 March 2009, Official Report, column 1478W, on maternity services: finance, what percentage changes there will be to each element of the maternity tariff in each year from 2008-09 to 2010-11. 
Ann Keen: In 2009-10, Healthcare Resource Group (HRG) version 4 has replaced HRG version 3.5 as the tariff currency. There have also been structural changes to the out-patients tariff. These changes mean that it is not possible to make direct comparisons between 2008-09 and 2009-10. The 2010-11 tariff has not been published.
Ann Keen: The Medicines and Healthcare products Regulatory Agency is responsible for regulating medicines and medical devices and is responsible for branding of medicines and the tackling of counterfeiting of medicines.
Mr. Wallace: To ask the Secretary of State for Health what studies his Department has undertaken into competition in provision of pharmaceutical products by high street pharmacies and GP practices. 
Phil Hope: The Department has not undertaken a formal study. However, we sought views on a proposal to allow, where there is no convenient alternative, dispensing doctors to sell over-the-counter medicines as part of our wider consultation last autumn, Pharmacy in England: Building on strengthsdelivering the futureproposals for legislative change.
We published a partial impact assessment concerning this proposal with that consultation which includes a competition assessment that sets out our analysis of the possible effects on competition of the proposal. It is available at:
Mr. Lansley: To ask the Secretary of State for Health (1) what mechanism his Department is using to ensure that the 4,000 extra midwives to be provided by 2012 are being provided at a local level in the NHS; 
|NHS midwife headcount and projections in England|
|SHA||2006( 1)||2007( 1)||2008( 2)||2009( 3)||2012( 3)|
|(1) Actual data from work force census.|
(2) Estimate of electronic staff records plus bank staff at 30 September 2007. Actual 2008 NHS work force census figures to be published on 25 March 2009.
(3) Predictions based on current estimates and work force trends.
The NHS operating framework 2009-10 already provides a strong steer on making demonstrable overall improvements in maternity services, including 4,000 more midwives by 2012, contingent on the birth rate.
Ann Keen: The referral to the National Institute for Health and Clinical Excellence (NICE) of drugs for the treatment of very small patient populations, sometimes referred to as ultra-orphan drugs, is considered on a case-by-case basis.
The Department and NICE are currently consulting on proposed revisions to the process and criteria for selecting topics for referral to NICE'S technology appraisal work programme. The consultation document is available at:
Mr. Lansley: To ask the Secretary of State for Health pursuant to the tariff uplift breakdown for 2009-10, published by his Department on 5 February 2009, if he will place in the Library a copy of his Departments background analysis of the sum required to support compliance with the European Working Time Directive. 
Ann Keen: The European Working Time Directive (EWTD) requires a 14 per cent. reduction in the maximum working hours of doctors in training, from 56 to 48 from August 2009. This equates to the hours provided by around 4,000 doctors in training. Implementation can be through a range of measures, including additional medical work force capacity at either junior or senior level, new ways of working so that non-medical staff can take up duties currently done by doctors in training or through service redesign such as implementing hospital at night working practices.
The Department is making a total of £310 million available by 2009-10 to support implementation in recurrent PCT allocations. In 2008-09, £110 million was included in the quantum of allocation funding in all primary care trusts (PCTs) receiving revenues growth of 5.5 per cent. In 2009-10, a further £200 million has been included
in PCT revenue allocations, of which £150 million will flow through tariff income to trusts and the remaining £50 million in PCT revenue allocations will be targeted to trusts according to strategic health authority (SHA) direction to support trained doctor solutions, particularly in paediatrics and anaesthetics.
The Department has estimated that the full cost of implementation could be around £300 million per year. This calculation is based on an analysis of the difference in doctors being 100 per cent. compliant at 56 hours and 100 per cent. compliant at 48 hours, so includes a valuation of:
difference in pay to existing doctors; and
assessment of the value of hours lost.
Ann Keen: The latest assessment was made in 2008. These estimates suggested that the employment of qualified nurses (including midwives, heath visiting staff and general practitioner practice nurses) would increase from 322,182 (in full-time equivalents (FTEs)) in September 2007 to approximately 327,000 FTEs in 2008-09, 329,000 FTEs in 2009-10 and 334,500 FTEs in 2010-11. This would be a growth of almost 4 per cent. over three years.
Anne Milton: To ask the Secretary of State for Health what the attrition rate for nurse training was for the (a) first, (b) second and (c) third year of training in the latest year for which figures are available. 
Ann Keen: Obesity in adults is measured using Body Mass Index (BMI). It compares weight to height by dividing the weight measurement in kilograms by the square of the height in metres. BMI is the internationally recognised standard for identifying overweight and obesity. An adult who has a BMI equal to 30 or greater is classified as obese.
In children defining obesity is more difficult because they are growing, so both their height and weight change at the same time. In children, standard United Kingdom reference charts for weight relative to height are used which are age and gender specific.
income based jobseeker's allowance,
income related employment and support allowance, or
pension credit guarantee credit (in respect of a partner under 60 as the recipient would be exempt on age grounds); or
working tax credit with child tax credit,
working tax credit that includes a disability or severe disability element, or
child tax credit but is not eligible for working tax credit, and
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