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Tim Loughton: To ask the Secretary of State for Health what the purpose is of her review of the Safeguarding Children in Whom Illness is Fabricated or Induced, guidance; and if she will make a statement. 
Mr. Ivan Lewis: The guidance, Safeguarding Children in Whom Illness is Fabricated or Induced was published in August 2002, as supplementary guidance to Working Together to Safeguard Children (Department of Health,1999). The latter was revised in April 2006, to take account of the Children Act 2004.
The purpose of the Departments project is to review progress of how the guidance on safeguarding children in whom illness is fabricated or induced is being implemented within the national health service. The focus of the project is on health professionals in the context of health systems. There will also be some limited input from statutory agencies such as local authority children services which work closely with health teams on safeguarding children. The project is expected to be completed in 2007. Programme funding to continue the project in 2006-07 is not yet guaranteed.
Colin Burgon: To ask the Secretary of State for Health how many foundation trust hospitals have given undertakings in respect of Agenda for Change in their five year business plans; and what steps her Department is taking to ensure that current and future foundation trusts implement and work within the framework of Agenda for Change. 
Ms Rosie Winterton: National health service foundation trusts (NHSFTs) which became operational between 1 April and 1 July 2004 gave a commitment to implement Agenda for Change according to the same national timetable as the rest of the NHS. Applicants for foundation status thereafter were already covered by the national agenda for change agreement and therefore legally their staff on Whitley terms were entitled to the new contract and those on local contracts had to be offered the new terms and conditions. Business plans of NHSFTs are available from respective organisations.
NHSFTs are not bound by any statutory obligation to adhere to Government pay agreements. They are free to deliver healthcare without direction from central Government or performance management by health authorities. However, as independently regulated organisations with a duty to deliver on national standards and demonstrate financial viability, NHSFTs are expected to be model employers and build on their track record of maintaining and developing high standards of employment practice.
Ms Rosie Winterton: Frank was launched in May 2003. Between September 2003 and March 2006, according to the figures for which are available for those 30 months, Franks contribution to drug prevention and increasing participation in treatment was as follows:
61,887 people were provided with information about a suitable local substance misuse service;
35,910 young people and 13,280 parents discussed drug issues with Frank directly. Frank also dealt with 61,713 emails; and
there were seven million hits on the website and 344,663 hits on the drug treatment web pages. The number of hits to the Talk to Frank websites treatment/prevention pages has almost tripled since 2004.
over 2,000 stakeholders use and recommend Franks services per year; and
over 5,000 drug and young people professionals receive news and training information about Frank to support local delivery.
Ms Rosie Winterton: Those primary care trusts (PCTs) which have fewer than the average number of general practitioners (GP) per 100,000 weighted population are relatively under-provided. The White Paper Our Health Our Care Our Say further identifies from among these PCTs the 30 which have fewest GPs for their populations. These PCTs, which are listed on page 63 of the White Paper, are being encouraged to make systematic use of their new contractual freedoms to increase their primary medical care capacity.
Mr. Ruffley: To ask the Secretary of State for Health how many (a) general practitioner surgeries and ( b) single-handed general practitioner surgeries there were in each (i) region and (ii) health authority in each year since 1997. 
Caroline Flint: The information requested up to September 2005 has been placed in the Library. The data relates to strategic health authority areas in existence prior to 1 July 2006, and by primary care trust area since 2001 when they came into being.
David Simpson: To ask the Secretary of State for Health what percentage of GP practices in (a) England and (b) each region had at least 50 per cent. of their patients living three or more miles away in each of the last five years. 
Mr. Paice: To ask the Secretary of State for Health how many general practitioners per head of population there were in (a) South-East Cambridgeshire constituency and (b) England in each of the last five years. 
Ms Rosie Winterton: Information on the number of general practitioners per head of population in the South-East Cambridgeshire constituency and in England in each of the last five years is shown in the table.
|(1) General Medical Practitioners (excluding retainers and registrars) includes Contracted GPs , GMS Others and PMS Others. Prior to September 2004 this group included GMS Unrestricted Principals, PMS Contracted GPs. Notes: 1. PMS salaried GPs, restricted principals, assistants, salaried doctors (para 52 SFA), PMS other, flexible career scheme GPs and GP retainers 2. Mid-year ONS 2005 population figures for PCTs are not yet available, therefore 2004 PCT figures have been used for 2005 organisation calculations, as a result these figures are subject to change. Sources: The Information Centre for health and social care general and personal medical services statistics. 2001 Office for national statistics population census.|
Paul Rowen: To ask the Secretary of State for Health what steps are being taken by her Department to ensure that there are sufficient haematopathologists to fulfil the criteria of the National Institute for Health and Clinical Excellence improving outcomes guidance for haematological cancers. 
Ms Rosie Winterton [holding answer 24 July 2006]: It is for cancer networks to work in partnership with strategic health authorities and postgraduate deaneries to put in place a sustainable process to assess, plan and review their work force needs and the education and training of all staff linked to local and national priorities for cancer, including the implementation of the National Institute for Health and Clinical Excellences improving outcomes guidance.
Caroline Flint: Funding for the central budget programme was distributed as a single allocation to strategic health authorities (SHAs) on 25 July 2006. It will be for SHAs, in consultation with local stakeholders, to agree and manage how best to deploy the funding allocated to them. The Department is working with SHA chief executives to finalise the service level agreement that will set out the expected outcomes from this funding.
Mr. Stephen O'Brien: To ask the Secretary of State for Health (1) what steps her Department is taking to encourage (a) primary care trusts and (b) strategic health authorities to implement payment by results; what guidance will be given to those authorities and trusts which maintain block contracts; and if she will make a statement; 
(3) what assessment she has made of the effects of payment by results in secondary care; what consultation has taken place with health professionals on moving away from block contracts; and if she will make a statement; 
(4) what steps she plans to take to assist (a) primary care trusts, (b) NHS trusts and (c) foundation trusts to implement payments by results; and what support and guidance will be given to trusts which maintain block contracts. 
Andy Burnham: Payment by results is a national policy, and there is a mandatory tariff which applies across the whole of the NHS. The NHS in England: The operating framework for 2006/7, published in January 2006, set out the ability for strategic health authorities to agree specific local additional rules for a fixed period of time under special circumstances. Discussions on where these might be appropriate continue with the national health service.
We have a range of formal and informal evaluation tools to assist the analysis of payment by results. For example, we announced on 18 July 2006 the findings of the South Yorkshire laboratory, which tracked the progress of a health economy in which payment by results has been implemented to a faster timescale than elsewhere.
We provide a range of guidance and work with all NHS organisations and Monitor (the regulator of NHS foundation trusts) to progress the implementation of payment by results. Detailed guidance on payment by results and full copies of evaluation material are available on the Departments website at www.dh.gov.uk/pbr.
In the past, services were largely paid for through block (fixed-cost) contracts between purchasers and
providers of care. This gave few incentives to purchasers and providers to understand and respond to the needs and preferences of patients. Securing more responsive services can be achieved by strong and effective commissioning with clear functions, new skills and a focus on meeting the specific needs of the local community and groups within it.
On 13 July 2006 Health Reform in England: update and commissioning framework was published. In this document is a consultation to inform the further development of a national model contract which will be used to procure services from NHS trusts, foundation trusts, and independent and third sector providers.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what assessment has been made of the impact of maintaining block contracts on (a) practice-based commissioning and (b) patient choice; and if she will make a statement. 
Andy Burnham: Practice-based commissioning and patient choice are integral parts of the reform process that will ensure that patients and communities have their specific needs and preferences reflected in the commissioning and provision of health and social care.
Historically, block contracts gave few incentives to commissioners and providers of care to respond to the needs and preferences of patients. On 13 July 2006 Health Reform in England: update and commissioning framework was published. In this document is a consultation to inform the further development of a national model contract which will be used to procure services from national health service trusts, foundation trusts, and independent and third sector providers.
Mr. Stephen O'Brien: To ask the Secretary of State for Health whether (a) the new payment by results programme board will give guidance to health authorities which maintain block contracts after 2008-09 and (b) there will be scrutiny of health authorities to ensure that block contracts are not imposed on NHS trusts and foundation trusts; and if she will make a statement. 
The NHS in England: The operating framework for 2006-07, published in January 2006, sets out the ability for strategic health authorities (SHAs) to agree specific local additional rules for a fixed period under special circumstances. Discussions on where these might apply are continuing with the national health service.
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