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Mr. Sanders: To ask the Secretary of State for Health what steps his Department has taken to implement the National service framework for long-term conditions; and what assessment he has made of his Departments effectiveness in doing so. 
Ann Keen: Responsibility for implementing the national service framework (NSF) for long-term conditions rests with local health and social care organisations. The NSF has a 10-year implementation phase, with the expectation that health and social care organisations plan and deliver service improvements in line with local priorities and needs over the period of implementation.
The National Service Framework for Long Term Conditions: National Support for Local Implementation, published in May 2008, provides an overview of the resources, tools and guidance provided by the Department and others to support local implementation of the NSF. A copy has been placed in the Library.
Nick Harvey: To ask the Secretary of State for Health how his Department plans to implement the national stroke strategy in rural areas; and how much funding has been provided to that end in 2009-10. 
Ann Keen: Primary care trusts receive funding to commission services according to local needs and priorities. Extra funding has gone to national health service primary care trusts to implement, among other things, the stroke strategy and additional central funding over three years is available to help accelerate improvements in services, including those in rural areas. There are 28 stroke networks in England within the Stroke Improvement Programme, which are helping to develop innovative solutions to local problems, including issues of rurality.
Commissioners and service providers locally will need to ensure they take into account the challenges posed by rural locationsfor example in ensuring that patients have access to time-critical services such as thrombolysis.
Mr. Jenkin: To ask the Secretary of State for Health what the reasons are for the time taken to make available the national pandemic influenza service; on what date he expects the service to be available; and what contingency arrangements have been made for circumstances in which swine influenza spreads at a rate more rapid than that assumed for the purposes of his Department's existing arrangements for the distribution of antiviral treatments. 
Gillian Merron: With an innovative system such as the full national pandemic flu service it was essential that there was rigorous scrutiny to ensure that the system would both work and offer value for money to the United Kingdom taxpayer. This inevitably led to some delays in signing the contract with British Telecom. The contract for the development of the system was signed with BT in December 2008.
The contingency arrangements, should the current outbreak spread at a more rapid rate, are that an interim national pandemic flu service has been put in place to supplement the assessment and authorisation processes. The interim service has been tested and consists of a phone service that the public can access through a single 0800 number, and a supporting website application. That will mean that people can have their symptoms assessed either over the phone or online. If it is established that they have developed swine flu, they will be issued with an authorisation number that they will then be able to use to access antivirals in a timely and appropriate way.
Gillian Merron: Immunisation against tuberculosis (TB) is provided by the Bacillus Calmette-Guerin (BCG) vaccination. The BCG vaccine has been shown to be 70 to 80 per cent. effective against the most severe forms of the disease, such as TB meningitis in children. It is less effective in preventing respiratory disease, which is the more common form in adults. There are few data on the effectiveness of BCG vaccination when it is given to persons aged 16 or over.
The Solicitor-General: The Crown Prosecution Service works closely with other criminal justice partners to provide individually tailored support for all witnesses. The Crown Prosecution Service published its policy on Prosecuting Crimes Against Older People in July 2008. Support for elderly and vulnerable witnesses can include specialist advocacy services and a range of special measures; for example the appointment of intermediaries, or the giving of evidence by live-link from the witness' own home.
16. Simon Hughes: To ask the Solicitor-General how many prosecutions have been discontinued on the advice of the Crown Prosecution Service on the first day set down for the trial in each of the last three years for which figures are available. 
The Solicitor-General: The Crown Prosecution Service maintains records of attrition at various points in the criminal process in both the magistrates court and the Crown court. These records do not include a discrete count of the number of cases discontinued on the first day set down for trial. It is therefore not possible to accurately answer the hon. Member's question. However, it is clear that there have been significant improvements in the level of attrition over the period in question.
Angela E. Smith: Details of consultations carried out by Cabinet Office during the 2007-08 financial year are available in the Cabinet Offices Annual Report and Accounts 2007-08 which is available in the Libraries of the House for the reference of Members.
Gregory Barker: To ask the Minister for the Cabinet Office pursuant to the Answer of 6 May 2009, Official Report, column 170W, on departmental recruitment, what progress has been made on consideration of whether a revised version of the European Fast Stream should be reintroduced for 2010. 
Angela E. Smith: Discussions are continuing between interested Government Departments as to whether a revised version of the European Fast Stream should be reintroduced for 2010 and what form it would take.
Mr. Stephen O'Brien: To ask the Minister for the Cabinet Office how many people died of each malnutrition condition, identified by its ICD-10 code, in each strategic health authority area in each year since 1997. 
As National Statistician, I have been asked to reply to your recent question asking how many people died of each malnutrition condition, identified by its ICD-10 code, in each strategic health authority area in each year since 1997-98. (279247)
The attached tables provide the numbers of deaths where (a) malnutrition was the underlying cause of death (Table /), (b) malnutrition was mentioned anywhere on the death certificate (Table 2), and (c) effects of hunger was mentioned anywhere on
the death certificate (Table 3), for persons resident in each strategic health authority in England, for the years 1997 to 2008 (the latest year available).
Effects of hunger, as the effects of malnutrition may be reported on a death certificate, is never recorded as the underlying cause of death, because it is defined by the International Classification of Diseases as a secondary cause only.
Figures in Table 2 include those reported in Table 1. Tables 2 and 3 include deaths where malnutrition and effects of hunger respectively were a complication of a different underlying cause (for example cancer of the stomach).
|Table 1: Deaths where malnutrition was the underlying cause of death( 1) , strategic health authorities in England( 2) , 1997 to 2 008( 3,4)|
|Strategic health authority||1997||1998||1999||2000||2001||2002||2003||2004||2005||2006||2007||2008|
|(1 )Cause of death was defined using the International Classification of Diseases, Ninth Revision (ICD-9) codes 260-269 for the years 1997 to 2000, and the International Classification of Diseases, Tenth Revision (ICD-10) codes E40-E46 for 2001 onwards. The introduction of ICD-10 in 2001 means that the numbers of deaths from each cause before 2001 are not completely comparable with later years.|
(2) Based on boundaries as of 2009.
(3) Figures are for deaths registered in each calendar year.
(4) Figures for deaths registered in 2008 are provisional.
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