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We have also discussed implementation of our response to the Crisp report with a variety of stakeholders, particularly the British Medical Association (BMA)—and we are working together to develop a joint approach to develop consensus on issues such as the recognition of international experience where it meets professional training requirements. The BMA has already hosted one meeting for stakeholders—and we expect another to follow shortly. We have had meetings with the Tropical Health Education Trust since the launch of the report.

The Department of Health (DH) and the Department for International Development (DfID) are in the process of finalising arrangements for the tendering of the framework and one-stop shop that we described in our response to Lord Crisp's report. DfID is working on the best mechanism for the £1.25 million links fund. The results of the independent links evaluation will help determine how best to use this money—and the draft report has recently been shared with DH and DfID. We will be discussing the government response to Lord Crisp's report, and how we can take forward a marketing strategy as part of the framework, at a future meeting of the National Health Service strategic health authority chief executives.

We have also engaged with stakeholders through two meetings in the past month, one hosted by the Royal College of Physicians and a second by the Faculty of Public Health. There will also be discussion with stakeholders at this year's Faculty of Public Health Annual Meeting in June in Cardiff.

Finally, DH and DfID will also be attending a meeting to mark the 20th anniversary of the Tropical Health Education Trust. This will provide a further opportunity to take these areas forward with interested stakeholders.

Health: Community Pharmacies

Lord Morris of Manchester asked Her Majesty's Government:

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The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): As now, the Government will determine the fees and allowances for the national elements of the community pharmacy contractual framework, the essential and advanced services, in negotiation with the Pharmaceutical Services Negotiating Committee. Primary care trusts (PCTs) are not able to vary nationally agreed fees and allowances.

The Government will continue the current arrangements with appliance contractors.

The Government will also continue to monitor overall expenditure on fees and allowances and agree, with the appropriate bodies, any in-year adjustments that may be necessary to ensure PCTs achieve broad balance.

Health: Prescribing and Dispensing

Baroness Cumberlege asked Her Majesty's Government:

The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): Section 233 of the Local Government and Public Involvement in Health Act 2007 amends Section 242 (public involvement and consultation) of the National Health Service Act 2006. Section 233 of the Local Government and Public Involvement in Health Act 2007 is not yet in force. The current duty to “involve and consult” arises under the existing Section 242 of the NHS Act 2006.

Section 242 of the National Health Service Act 2006 requires certain NHS bodies, including primary care trusts (PCTs), to make arrangements to secure, whether directly or through representatives, users’ involvement in and consultation on:

the planning and provision of services;development and consideration of proposals for change in the way those services are provided; anddecisions made by that body which affect the operation of services.

Decisions about allowing general practitioners to dispense medicines may give rise to a change in the provision of services and may involve development and consideration of proposals for change by the PCT in the way those services are provided. That would give rise to the duty to involve and consult under Section 242. Where there is no material change to the way in which services are provided, the Section 242 duty would not be triggered.

The Local Government and Public Involvement in Health Act 2007 amendments to Section 242 do not change the way in which it applies to decisions about allowing doctors to dispense medicines—these may still fall within the meaning of Section 242. The amendment supports the view that the duty to involve

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and consult under Section 242 should only be triggered where there is a material change to the way in which services are provided, by clarifying that it applies where changes have an “impact on the manner in which services are delivered or the range of services provided”. This would mean that, where changes are made to lists of dispensing doctors, involvement or consultation would be required where those changes do impact on the manner in which pharmaceutical services are delivered or the range of services provided. However, this would not cover, for example, a change of personnel only.

Israel and Palestine: Gaza

Lord Hylton asked Her Majesty's Government:

Baroness Crawley: The World Food Programme (WFP), the United Nations Relief and Works Agency (UNRWA) and other humanitarian agencies are able to deliver essential food aid into Gaza through the crossings from Israel. An airlift into Gaza, which does not have a functioning airport, is not an option. Our focus should be on increasing the humanitarian and commercial items imported into Gaza and working towards the reopening of the crossings on a permanent basis.

The UK continues to fund humanitarian assistance through UNRWA, the International Committee of the Red Cross and the European Commission's PEGASE mechanism. Despite ongoing constraints to their operations due to the violence, the access restrictions and the recent fuel crisis, humanitarian agencies continue to meet emergency needs on the ground. Together UNRWA and WFP provide food aid to over 1 million people in Gaza.

Many Palestinians requiring urgent medical treatment in Israel have been evacuated to hospitals in Israel, east Jerusalem, Egypt and Jordan, although not all cases are allowed out of Gaza and some patients are delayed at crossings.

Through our diplomatic efforts we continue to press Israel to ensure its actions do not worsen the suffering of ordinary Palestinians. We also condemn attacks by Palestinian militants—their actions perpetuate the cycle of violence and aggravate the humanitarian situation.

Lord Hylton asked Her Majesty's Government:

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Baroness Crawley: The quartet (European Union (EU), the United States, Russia and the United Nations) remains heavily engaged in the peace process and improving the situation in the Occupied Palestinian Territories. Most recently the quartet met in London on 2 May. They noted their deep concern over the humanitarian conditions in Gaza, called for continued humanitarian assistance to be provided to Gaza without obstruction, and for an end to all violence. The quartet was also represented at the ad hoc liaison committee meeting on 2 May where the UN presented an update on the current situation in Gaza.

The Palestinian Coastal Municipalities Water Utility (CMWU) reports that up to 60 million litres of raw and partially treated sewage is discharged into the Mediterranean every day and that 90 per cent of mains water is polluted. The World Health Organisation reports that sea water in several areas of the Gaza coastline is polluted. CMWU works closely with the United Nations Children's Fund to address the sewage situation and minimise risks to public health. Some drugs and essential medical items are in short supply in Gaza and up to 76 per cent of the population is partly dependent on food aid, most of which is provided by the UN.

Many countries, including members of the EU and the quartet, continue to press for an end to the violence and the access restrictions that intensify the suffering of ordinary Gazans. On 24 April, the EU issued a statement where it urged regular and unrestricted delivery of fuel supplies to Gaza, and condemned attacks by Palestinian militants. The UK and the international community provide substantial levels of humanitarian assistance.

Lord Hylton asked Her Majesty's Government:

Baroness Crawley: I pay tribute to the groups behind the report and to the many NGOs, UN agencies and others for their considerable efforts to provide humanitarian support to the people of Gaza. My honourable friend Shahid Malik, Parliamentary Under-Secretary of State for International Development, has met the NGOs which wrote the report to discuss their insights into the situation in Gaza.

We remain gravely concerned by the humanitarian situation in Gaza and we fund humanitarian support to meet the urgent needs created by the ongoing violence. The priority is to reopen the crossings and we have urged all parties to find a solution for doing so. The Foreign Secretary and I raise this regularly with the Israeli Government and it was a key message at the quartet and ad hoc liaison committee meetings that the UK hosted in London earlier this month. We have also condemned attacks by Palestinian militants on the Gaza crossings, which only worsen the humanitarian situation.

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Israel and Palestine: Projects

Baroness Tonge asked Her Majesty's Government:

Baroness Crawley: The Department for International Development (DfID) provides humanitarian support to the Occupied Palestinian Territories through the UN and ICRC, and provides support aligned with the priorities of the Palestinian Authority, as set out in its Palestinian Reform and Development Plan. We carefully assess all of our assistance to ensure that our aid is not used to assist or maintain the situation created by the construction of the Israeli separation barrier inside the Occupied Palestinian Territory, including in and around east Jerusalem.

Northern Ireland: Bill of Rights

Lord Laird asked Her Majesty's Government:

Lord Rooker: The appointment of policy committees was a matter for the Bill of Rights Forum. The work of the forum was independent from government and no advice was given on this matter.

Prisoners: Escapes

Lord Marlesford asked Her Majesty's Government:

The Parliamentary Under-Secretary of State, Ministry of Justice (Lord Hunt of Kings Heath): The table below shows the number of prisoners still at large following an escape from a closed prison or abscond

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from an open prison for the time periods shown. Both escapes and absconds have been falling for over a decade, with the current low levels having been sustained for some years now. A more rigorous and professional attitude to security by staff has helped in this reduction. Attempted escapes from prisons over the same period shows little in the way of reduction.

Time Period at Large (months)Unlawfully at Large Following EscapeUnlawfully at Large Following Abscond






















Railways: Electrification

Lord Bradshaw asked Her Majesty's Government:

Lord Bassam of Brighton: The Government committed in last year's rail White Paper, Delivering a Sustainable Railway, to keep the case for electrification under review. Since then, the Secretary of State for Transport has invited Network Rail to lead work on the development of our understanding of the complex options that may be needed in the future, in the context of the Department for Transport’s wider strategic planning process. The department also continues to work closely with the rail industry to explore how to improve the affordability of electrification schemes.

The Government's immediate priority is to tackle congestion, and £10 billion has been committed for this purpose in the period to 2014. Should the case for further electrification be proven, it is likely to feature as part of the Government's specification for the next control period, between 2014 and 2019.

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