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Mr. Stephen O'Brien: To ask the Secretary of State for Health how much his Department has spent on each stage of the independent sector treatment centres programme to date; and what percentage of contract activities such centres have undertaken at each such stage. 
Wave One £1,324.7 million and Phase Two £227.5 million (as at 31 December 2009).
Mr. David Anderson: To ask the Secretary of State for Health what support will be given to people diagnosed with chronic myeloid leukaemia if the National Institute for Health and Clinical Excellence recommends against the use of the drugs dasatinib and nilotinib. 
The National Institute for Health and Clinical Excellence (NICE) has not yet published final
guidance on the use of dasatinib and nilotinib for the treatment of chronic myeloid leukaemia (CML) that is resistant to imatinib. NICE has published draft guidance and stakeholders now have until 2 March to comment on NICE'S recommendations.
Alternative treatment options for CML that is resistant to imatinib include interferon alfa, hydroxycarbamide or best supportive care. Guidance on best supportive care for patients with CML is set out in the NICE guidance "Improving outcomes in haematological cancers", published in 2003.
Phil Hope: The most recent estimate of the cost of proposals for reform of the care and support system as set out in the Green Paper, 'Shaping the Future of Care Together', was published in the Green Paper Impact Assessment available online at:
Mr. Mike O'Brien: Where commissioners decide to procure services through competitive tender, all providers should have a fair and equal opportunity to bid. Further guidance will be set out in a revised PCT Procurement Guide, due to be published shortly.
Mr. Bailey: To ask the Secretary of State for Health what guidelines apply to the operation of the NHS as a preferred provider; and whether those guidelines make provision for mutual providers. 
"the Government is not doing a spending review at this stage."
Complaints relating to the functions of a national health service trust may be sent directly to that trust, which is responsible for investigating complaints in respect of those functions; if relevant, this includes the actions of the NHS trust board.
Complaints about the conduct or performance of the chair should be referred to the NHS trust in the first instance. If the correspondent is dissatisfied with the NHS trust's response, the matter should then be referred to the relevant strategic health authority (SHA) chair, who will investigate the matter. If an SHA chair feels the allegations are serious enough to warrant possible suspension or termination of the chair's appointment, he or she will refer the case to the Appointments Commission.
Mr. Clifton-Brown: To ask the Secretary of State for Health what the percentage change to his Department's funding for (a) NHS foundation trusts and (b) primary care trusts is between financial years 2010-11 and 2011-12; and when the trusts were notified of these changes. 
PCT revenue allocations for 2011-12 onwards are yet to be determined. However, as announced in the pre-Budget report in December of last year, front-line national health service spending will rise in line with inflation for the following two years to 2012-13.
The Department does not make allocations directly to foundation trusts. It is for PCTs to use the funding
allocated to them to commission services from foundation trusts and other providers to meet the needs of their local populations.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what assessment he has made of the effect of the points-based immigration system on the NHS's ability to recruit specialist consultants from outside the European economic area. 
Ann Keen: The national health service is able to recruit specialist consultants through the points-based system either through tier 1 or, where there is no suitable United Kingdom or European economic area applicant, through tier 2.
Mr. Swire: To ask the Secretary of State for Health what the post-operative nurse to patient ratio is for high risk operations at (a) The Royal Devon and Exeter Hospital and (b) Derriford Hospital, Plymouth. 
Mr. Stephen O'Brien: To ask the Secretary of State for Health what estimate he has made of the cost to the public purse of plans to provide specialist cancer nurses for all 1.6 million people in England who have or who have had cancer; and from which budget it will be funded. 
Ann Keen: We are investing £20 million in 2011-12 to work with Macmillan to introduce more specialist cancer nurse posts. The £20 million has been found from funding released from programmes launched by the Next Stage review, which will either have been implemented fully by 2011-12, or which funded development activities which are now reaching a planned conclusion.
Current estimates are that up to half of cancer patients do not have one-to-one support. We will be looking at possible new models of care, which will have an impact on the number of new nurses needed.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what recent estimate he has made of the number of specialist cancer nurses required to provide support at home for all 1.6 million people in England who have or who have had cancer; how many such nurses would require training; and what estimate he has made of the number of hours per week each person requiring such support would need. 
Current estimates are that up to half of cancer patients do not have one-to-one support, which could mean that we would need to double the number of people who provide such support. We are currently carrying out a detailed assessment of work force needs. This includes considering different possible models and
levels of support, which may vary according to where someone is on the patient pathway.
Mr. Stephen O'Brien: To ask the Secretary of State for Health when he expects to introduce free prescriptions for all those with long-term medical conditions; and what his most recent estimate is of the cost to his Department. 
Mr. Mike O'Brien: Professor Gilmore has now submitted his report on exempting people with long-term conditions from prescription charges to the Department. The recommendations are currently being considered. The cost of introducing the new exemption will depend on how the changes are phased in. We will publish our response shortly.
Mrs. Ellman: To ask the Secretary of State for Health what progress he has made in his consideration of proposals for the rebuilding of the Royal Liverpool Hospital; and if he will make a statement. 
Mr. Mike O'Brien: The Outline Business Case (OBC) for the £453 million private finance initiative proposal to redevelop Royal Liverpool university hospital is currently with the Department for approval. Subject to approval by departmental officials and Ministers the OBC will then go to the Treasury for approval.
Mr. Stephen O'Brien: To ask the Secretary of State for Health pursuant to the answer of 8 December 2009, Official Report, column 294W, on social services, if he will place in the Library a copy of the legal advice. 
Phil Hope: Legal advice to the Government is confidential, and is covered by legal professional privilege. This enables the Government to obtain full and frank legal advice. For this reason, the Department does not intend to publish any legal advice it has received on this matter.
Sir Nicholas Winterton: To ask the Secretary of State for Health if he will introduce (a) an audit of stroke care for children and (b) a national registration system for childhood stroke; and if he will make a statement. 
Ann Keen: It is for the Healthcare Quality Improvement Partnership (HQIP) who manage the National Clinical Audit and Patient Outcomes Programme (NCAPOP) on behalf of the Department to invite applications for new clinical audits each year, subject to the funding being available. The details are on their website at:
All new applications are considered by The National Clinical Audit Advisory Group (NCAAG), which advises the Department on the NCAPOP. NCAAG has set out advice on the criteria to be used to prioritise topics for new national clinical audits. This is available from the Department's website at:
Sir Nicholas Winterton: To ask the Secretary of State for Health what recent financial support his Department has provided for research into the causes, outcomes and treatment of childhood stroke. 
Gillian Merron: Two National Institute for Health Research (NIHR) biomedical research centres(1) are undertaking research on aspects of childhood stroke. Their estimated spend on the topic is £370,000 over the two years 2007 to 2009.
The Medical Research Council (MRC) meanwhile is not funding research specifically relating to the condition. However, the MRC funds a broad portfolio of more general stroke related research on which £10.1 million was spent in 2008-09. It includes basic and underpinning research that may increase understanding of the condition in childhood.
(1) Hammersmith Hospitals and St. Mary's Hospital National Health Service Trusts/Imperial College London; and Great Ormond Street Hospital for Children NHS trust/University College London Institute of Child Health.
Sir Nicholas Winterton: To ask the Secretary of State for Health (1) when his Department expects to implement in full the Royal College of Physicians' clinical guidance on childhood stroke; and if he will make a statement; 
Ann Keen: Implementation of the Royal College of Physicians' clinical guidance is a local responsibility. It is for commissioners, in consultation with their providers, to specify services for their local populations on the basis of need, including children and young people.
The Government's policy document, 'Healthy lives, brighter futures: the strategy for children and young peoples health', raises awareness of the need to address rare and complex conditions in childhood and includes a commitment to make sure that, by 2010, all children with complex health needs will have individual care plans to support co-ordinated care. Work is in hand to ensure this commitment is met.
Support for the carers of children with complex conditions is a key feature of care plans. We are moving towards a situation where families can expect 24/7 access to advice and support from Community Children's Nursing Teams; a single lead professional for the family,
who can liaise with the various agencies involved in delivering national health service care; and an integrated package of care.
As a further step, the Department will shortly publish the final version of the National Framework for Children and Young People's Continuing Care. This will help with assessing the continuing health care needs of children and young people, and with considering the bespoke packages of care that will be required to meet those needs.
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