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House of Commons
Tuesday 31 October 1995
The House met at half-past Two o'clock
PRAYERS
[ Madam Speaker-- in the Chair ]
PRIVATE BUSINESS
London Local Authorities (No. 2) Bill
[Lords] . (By Order) Order for Third reading read.
Amendment agreed to.
Read the Third time, and passed, as amended.
Ordered,
That the Lords Message [26th October] relating to the Bodmin Moor Commons Bill [Lords] , King's College London Bill [Lords] , and the London Local Authorities Bill [Lords] be now considered.
Loch Leven and Lochaber Water Power Order Confirmation Bill
Considered; to be read the Third time.
Oral Answers to Questions
HEALTH
United Leeds Hospital Trust
2. Mr. Battle: To ask the Secretary of State for Health what assessment he has made of the impact of underfunding of the United Leeds Hospital trust in this financial year on waiting lists. [38212]
The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville): Leeds health authority is not underfunded. It has been allocated £4.5 million over and above its weighted capitation target for this year.
Mr. Battle: Does the Minister realise that Leeds local medical committee revealed in a recent survey that, contrary to his claims, orthopaedic outpatients have to wait for between 44 weeks, minimum, and 144 weeks for a first appointment? Whatever the reason for that, is it not totally unacceptable? Is it not time that the Minister took action to ensure that his health trusts provided for the health needs of our constituents--or will they be told that they must continue to suffer in silence?
Mr. Sackville: I certainly agree that a wait of 44 weeks is unacceptable; we have made that clear--to Leeds health authority, as well-- by setting a target that no one should wait more than 26 weeks. The hon. Gentleman knows that waits for orthopaedic treatment in Leeds are not new, and that action is being taken to ensure more accurate and better referring by general practitioners, taking that into account.
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The House should know, however, that those waits are not representative of waiting lists across all specialties in Leeds. I am sure that the hon. Gentleman has seen the overall figures, and he will know that 86 per cent. of patients are seen within 13 weeks and 96 per cent. within 26 weeks. That is close to the target that we set.Mrs. Roe: Will my hon. Friend confirm that the patients charter means that, for the first time ever, patients, whether in Leeds or elsewhere in the country, have a guarantee of the maximum time that they should have to wait for an NHS operation?
Mr. Sackville: My hon. Friend is absolutely right, and we look forward to all health authorities meeting those targets.
Mr. Barron: Do not patients, not only those in the United Leeds Hospital trust but in hospitals throughout the country, wait longer than the Department's patients charter standards? In the quarter ended 30 June 1995, the targets for new out-patients waiting times were not met--neither the 13-week nor the 26-week standard. Would not patients in Leeds and throughout the country be better served if some of the millions of pounds spent on internal market bureaucracy were spent instead on front-line patient care?
Mr. Sackville: Perhaps the hon. Gentleman would care to notice that, over the past year, the number of people waiting more than 12 months for non-emergency treatment in Leeds has fallen from more than 1,200 to 200. That represents considerable progress, when not only non-emergency but emergency demand has increased sharply. It is about time that Leeds and other health authorities received some credit from the Opposition.
GP Fundholding Practices (London)
3. Mr. Merchant: To ask the Secretary of State for Health how many general practitioner fundholding practices there are currently in Greater London. [38213]
The Minister for Health (Mr. Gerald Malone): Three hundred and twenty-five general practitioners' practices in Greater London are currently fundholders, serving over a quarter of the population. This is due to rise to 578 practices serving 40 per cent. of the population from next April.
Mr. Merchant: Is my hon. Friend aware of the pioneering work in fundholding being carried out by Elm House surgery in my constituency? Is he aware of the popularity of that work with patients? Does that popularity partly explain the dramatic leap in the number of applications for fundholding status in London this summer?
Mr. Malone: I am aware of the practice to which my hon. Friend refers, and I met a number of the practitioners involved when I visited Beckenham hospital in my hon. Friend's constituency some time ago. We want such services to be extended throughout London--in the teeth, sadly, of opposition from Labour.
NHS Budget
4. Mr. Hoyle: To ask the Secretary of State for Health what proportion of the NHS budget was spent
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on management, administrative and clerical staff (a) in 1989 and (b) in the latest year for which figures are available. [38214]13. Mr. Miller: To ask the Secretary of State for Health if he will make a statement on the variation of the proportion of NHS trusts' budgets spent on management and administration. [38224]
The Secretary of State for Health (Mr. Stephen Dorrell): Expenditure on management and administrative staff as a proportion of total hospital and community health service expenditure was 8.8 per cent. in 1989-90 and 9.8 per cent. in 1993-94. I announced on 11 October that I am seeking a 5 per cent. cash reduction in the costs of running health authorities and in NHS trust management costs in 1996-1997 compared with planned spending in 1995-1996.
Mr. Hoyle: When the changes were made, we were promised that there would be a growth in efficiency. Instead, there has been a huge growth in bureaucracy, and resources that could have been spent on patient care and medical staff have gone to accountants and managers. How does the right hon. Gentleman account for the squandering of public money that has resulted in waste, inefficiency and more red tape?
Mr. Dorrell: That line would come a great deal better from the Opposition had it not been for the fact that they opposed the abolition of the regional health authorities, which added an extra and unnecessary tier of bureaucracy to the health service.
Mr. Miller: That line comes not just from the Opposition, as the chairman of a large trust in my area wrote to me this morning to point out the differences in the Secretary of State's position now from when he was a junior spokesman in the same Department. Will the Secretary of State now undertake unequivocally to ensure that his Department carries the can for all the inefficiencies which have been built into the system as a result of the ridiculous growth in management expenditure?
Mr. Dorrell: My position on this issue is exactly the same now as it was when I was a junior Minister at the Department of Health, and it is this--the traditional health service was under-managed. That view was shared by the right hon. Member for Derby, South (Mrs. Beckett) until she moved to her other responsibilities. We have built up the management function of the health service, and we are now requiring that management function to pass the same tests of efficiency as every other aspect of the health service.
Dame Jill Knight: Is it not the case that efficient management has achieved a much quicker input of patients and much shorter waiting lists, and that trusts hold their management costs at 3 per cent? Is that not extremely good value for money?
Mr. Dorrell: My hon. Friend is absolutely right. It is remarkable that the Opposition--or at least the Opposition's previous health spokesman --at least recognised that the traditional health service needed its management function to be strengthened, and yet opposed every single strengthening of that function. They now talk about administrative costs as though they were avoidable.
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Yet when we come forward with proposals to abolish excess administrative costs--as we did earlier this year--they oppose them.Mr. Sims: I commend my right hon. Friend for his attempts to reduce bureaucracy in the NHS. Does he agree that occasional incidents where patients are left on trolleys for unreasonable lengths of time suggest that there is scope for improvement in the quality of management? What steps is my right hon. Friend taking to achieve that improvement?
Mr. Dorrell: I announced the squeeze on 11 October because I believe that it is necessary that the management and administration functions in the health service are subject to the same efficiency drive as every other aspect of the service. My hon. Friend referred to patients waiting for admission from accident and emergency departments, and he will know that that is a specific subject on which my predecessor as Secretary of State announced a tightening of patients charter standards, which will be effective from 1 April and towards which trusts are working.
Ms Lynne: Does the Secretary of State agree that, at the same time as so much is being spent on bureaucracy and administration, it is an absolute disgrace that so little is being spent on breast cancer research-- £3 million precisely--when 300 women die of breast cancer a week? Can he make some commitment today, on the launch of the UK National Breast Cancer Coalition, that he will do something to address that problem?
Mr. Dorrell: As the hon. Lady has raised the subject of breast cancer on a question about administration costs, we might have expected her to welcome the fact that the national health service is a world leader in the development of a breast cancer screening service. It offers a service to British women that is not available in the huge majority of other equivalent countries. Why did she not mention that fact?
Mr. Atkins: Is my right hon. Friend aware that, in certain parts of England, notably Chorley and South Ribble, the increase in administrative staff that has come about as a result of the opening of Chorley and South Ribble hospital, which my right hon. Friend visited recently, goes down extremely well, is extremely popular and is further evidence of the amount of money that the Government are putting into the health service locally as well as in London?
Mr. Dorrell: My hon. Friend is right to mention the health service's investment programme. The hospital that we visited in his constituency is a result of, first, the Government's commitment to investing in the development of the NHS and, secondly, the commitment through effective management to ensure that those resources are used to deliver a high- quality service throughout the country.
Mr. Milburn: While the Secretary of State talks about a 5 per cent. cut in management costs, is not the reality that spending on managers has rocketed by 300 per cent. since the Government's changes to the health service? Is it not the case that millions of pounds of precious public resources continue to be lost from front-line patient services simply to finance the administration of that
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internal health market? Can the right hon. Gentleman explain how more managers but fewer nurses add up to a national health service in which the patient comes first?Mr. Dorrell: I welcome the hon. Gentleman to his responsibilities. When he has had a little more time to think about them, perhaps he would like to tell the House which of the policies espoused by the predecessor of the hon. Member for Peckham (Ms Harman) he disagrees with. Does he disagree with her acceptance of the fact that the traditional health service was under-managed, in which case he supports the investment in management in the health service, or does he disagree with the stance that she took to oppose the abolition of regional health authorities? How does it help management and administrative efficiency in the health service to insist on maintaining an outdated regional health authority structure?
Mr. Hayes: Does my right hon. Friend agree that it is outrageous that managers are the latest scapegoat for the Opposition--managers who have worked hard to bring down waiting lists to the lowest level since records began and many of whom are regraded nurses? The Opposition's proposals would bring in more bureaucracy but, worst of all, political placemen.
Mr. Dorrell: My hon. Friend is almost right, but not quite. He is wrong in his suggestion that the Opposition would change anything substantial in terms of the administrative costs of the health service. Actually, they have opposed the changes that we introduced, the effect of which is to reduce the administrative burden on the health service.
NHS Dental Practices
5. Mr. Pike: To ask the Secretary of State for Health how many NHS dental practices are no longer accepting new NHS patients. [38215]
Mr. Malone: As dentists are independent practitioners, information in this form is not available centrally. However, at June 1995, there were 15,616 dentists in England providing general dental services. I am sure that the hon. Gentleman will welcome the fact that that is 190 more than three years ago.
Mr. Pike: Whatever the Minister says, does he not recognise that it is increasingly impossible for people to get national health service dental treatment? Does he not accept that the Government are presiding over the destruction of the NHS dental service and that they need to do something about it now?
Mr. Malone: What the hon. Gentleman says is a lot of nonsense. In his own constituency, for example, there are nine dentists in four practices, who all accept NHS patients. In the adjacent village of Padiham, a further five dentists are accepting new patients. National health service dentistry is alive and well and growing in the hon. Gentleman's constituency. That is happening in the majority of places throughout the country, although in a number of isolated and difficult areas, we are seeking to encourage family health services authorities to employ salaried dentists to deal with local problems.
Mr. Nicholls: Would my hon. Friend like to remind the hon. Member for Burnley (Mr. Pike) that there is an
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overriding obligation on the national health service to provide dental services, and that if those services are not provided by local dentists because they want to operate a cartel, salaried dentists are employed by the national health service to plug the gap? I am extremely grateful to my hon. Friend for ensuring that those services are provided in Teignmouth in my constituency, and I hope that I shall not have to write to him about Newton Abbott in due course.Mr. Malone: I thank my hon. Friend. In his constituency, there is a good example of how a shortage that manifests itself locally can be tackled through the salaried dental service by the family health services authority, with determined results. I was delighted to find that there is now a mobile service at Teignmouth hospital, which has been secured for the future.
Mr. McLeish: Will the Minister apologise to the House for the fact that nearly 1 million people have been taken off NHS dentist lists in the past three years? That is an attrition rate of 6,000 a week. Does he accept that that is a scandal and tragedy for those who want access to NHS dental care? Of course, he could give an undertaking to the House today that he will once and for all put patient access and preventive health care above the dogmatic pursuit of privatisation.
Mr. Malone: As we are having a lot of welcoming of hon. Members to their portfolios, I extend a warm welcome to the hon. Gentleman to his portfolio and to the Dispatch Box. If he is going to ask me in future about deregistration of people in NHS dentistry, it would be helpful to the House if he understood, and pointed out, that registrations take place at the same time. The figure for those registered between 1992, when the deregistration campaign started, and now stands at some 27.3 million. In fact, when it comes to child registrations, the figure has gone up.
On the second point, of course oral health is an important strategy. It is widely recognised throughout the country and by dental practitioners in particular that our oral health strategy has been a success, and dentists are happy to work with the Government in taking it forward.
GP Fundholding Practices (Suffolk)
6. Mr. Spring: To ask the Secretary of State for Health what proportion of general practitioners in Suffolk are in fundholding practices. [38216]
Mr. Malone: About 30 per cent. of general practitioners in Suffolk are fundholders serving 34 per cent. of the population. A further 4 per cent. of GPs serving a further 4 per cent. of the population are preparing to join the scheme from next April.
Mr. Spring: Is my hon. Friend aware of the increase in services to patients from GP fundholders in Suffolk, including the provision of surgery -based physiotherapy, new equipment for electrocardiograms and to test for glaucoma as well as additional support for community nursing services? Does my hon. Friend agree that this attests to the tremendous success of GP fundholding not only in Suffolk but right across the country?
Mr. Malone: Yes, I agree with my hon. Friend that GP fundholding introduces a tremendous new range of services for patients at local level. I have visited
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fundholding practices in East Anglia and would add to what my hon. Friend said by pointing out that many out-patient services are now provided in the context of a primary care setting, which is extremely important in rural constituencies.Children's Homes
7. Ms Coffey: To ask the Secretary of State for Health what plans he has to improve the quality of care provided by small unregistered children's homes. [38217]
The Parliamentary Under-Secretary of State for Health (Mr. John Bowis): Responsibility for the care of children rests with the placing local authority.
Ms Coffey: As the Minister will be aware, the recent study by the social services inspectorate showed that a high proportion of private, small, unregisterable children's homes did not meet acceptable standards. The Minister has the power to legislate to ensure that those homes are properly inspected and registered, as happens with all other children's homes. Why will he not do so when his own inspectors have told him that children are at risk in those homes?
Mr. Bowis: As the hon. Lady knows from our persistent duet across the House on the subject, this is a matter that our overall review of inspection will be considering. In the meantime, she is quite wrong to suggest that the social services inspectorate report did anything other than highlight some good practice among small children's homes as well as some poor practice. It also highlighted that the failure was of local authorities to use their powers under the placement of children regulations --regulations designed to protect children wherever they may be placed.
Lady Olga Maitland: Will my hon. Friend confirm that his Department will keep constant vigilance over local authority social services, reminding them of their statutory duty to carry out rigorous inspections of children's homes?
Mr. Bowis: Yes, my hon. Friend is right. Sadly, we have recently seen the results of occasions on which such duties have not been carried out properly. There is a duty on local authorities to inspect and visit children's homes, and a responsibility on elected councillors to ensure that that happens. Everyone associated with a child in the care of any local authority anywhere has a responsibility to ensure that the child is safe and protected and that, if the child needs help, help is brought to him or her.
GP Fundholding
8. Mr. Hinchliffe: To ask the Secretary of State for Health if he will make a statement about the future of general practitioner fundholding. [38218]
10. Mr. Hanson: To ask the Secretary of State for Health what percentage of general practitioners in the United Kingdom are currently fundholders. [38220]
Mr. Dorrell: General practitioner fundholding is central to our plans for the future of the national health service. We expect more than half the GPs in the country
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to be fundholders from next April and I recently announced a further extension of the total purchasing pilots.Mr. Hinchliffe: Can the Secretary of State explain why my constituents who are waiting for certain treatment at Pinderfields hospital, Wakefield, are asked whether they are the patients of fundholding or non-fundholding GPs? Why does it appear that fundholding patients are able to get certain treatments, which are being denied to patients of non- fundholding GPs? Will he join me in welcoming the fact that the Labour party is committed to ensuring that patients are treated on the basis of clinical priority and, as a consequence, will get rid of fundholding once and for all?
Mr. Dorrell: As we are in the business of welcoming hon. Members to different parts of the House, I begin by welcoming the hon. Gentleman to a position on the Opposition Back Benches--one of his own choice. It no doubt allows him to tease out some of the differences about fundholding among those on the Opposition Front Bench, which he previously had to obscure from the world.
The hon. Gentleman asked whether I welcome the fact that those on the Opposition Front Bench are committed to ensuring that care in the national health service is available on the basis of clinical need. He will have seen that precisely that commitment is given by the Government Front Bench. In terms of the hon. Gentleman's constituents, that commitment was given to the hon. Gentleman by both Wakefield health care trust and the Wakefield fundholders in exercising choice in the use of their funds.
Mr. Hanson: Will the Secretary of State confirm that the two-tier system--the inefficient, bureaucratic system referred to by my hon. Friend the Member for Wakefield (Mr. Hinchliffe)--also costs an additional £200 million in bureaucracy? Will he welcome the Labour party's commitment to abolish fundholding and put that money back where it belongs, into patient care?
Mr. Dorrell: I shall certainly make no commitment to abolish fundholding because to do so would put back the cause of patient care. The evidence is clear. The Opposition keep calling for extra research because they do not like the results of the research that has already been carried out. It shows clearly that, for a small increase in transaction costs, we deliver substantial savings and improved patient care. That is the result not of the Government's assessment but of repeated independent assessments of the effect of fundholding.
Mr. Key: My right hon. Friend will be aware that the majority of fundholders in my constituency provide a better service for their patients. However, will he now look at a problem that has arisen and advise my national health service trust? Where that trust literally runs out of money, it is beyond doubt and political banter that patients suffer because non-fundholders cannot have equal access to the national health service trust.
Mr. Dorrell: With respect, my hon. Friend must face the fact that the resources available to treat patients, whether of fundholding practices or not, are exactly the same. The assurance given to patients of fundholding GPs, by both trusts and GPs, fundholding and non-fundholding alike, is that access to urgent and
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emergency care is dealt with from a single waiting list. The availability of non-urgent care within the health service reflects different purchasing decisions taken not merely by different fundholders within the health service but by different health authorities within the health service. That is part of the exercise of local choice, exercised in the interest of all patients of the NHS.Mr. Congdon: Does my right hon. Friend agree that firm evidence now suggests that devolving financial power to GPs has enabled them to deliver improved care to their patients? Does he agree that the best means of improving the position of all patients would be to extend GP fundholding to them, thereby levelling up rather than levelling down, as espoused by the Labour party?
Mr. Dorrell: I entirely agree with my hon. Friend's desire to take the benefits that come from fundholding and generalise them. I entirely agree that that is surely how, in practice, one continues the rate of improvement of patient care within the NHS. Those who argue that we should abandon fundholding must explain to what is now a majority of GPs in the NHS why it is in their interests and those of their patients to abandon a scheme that has been shown by repeated analysis to deliver better value care and better quality care not merely to fundholding patients but to all NHS patients.
Ms Harman: Is the Secretary of State aware of the situation in his own Minister of State's constituency? Although the patients of GP fundholding practices get their hip replacements in less than 10 months, the patients in non-fundholding GP practices have been told by the Winchester and Eastleigh Health Care trust that they will have to wait 18 months or more. What does he say to those patients who are in pain and have been told that they have got to wait more than 18 months, while other patients are treated in less than 10 months? Is that not evidence of a two- tier system and of the unfairness of Tory health reforms? Will he join me in thanking Dr. Andy Coates, all the local GPs and the local NHS hospital trust for working together to try to mitigate the unfairness of those Tory health reforms?
Mr. Dorrell: One of the things that the Labour party must get used to about its new health spokesman is that she cannot see an elephant trap without walking into it. What has happened in Winchester blows sky high her theory that fundholders do not work for the benefit of all NHS patients. The deal to which the hon. Lady referred clearly reveals that the GPs of the district, fundholders and non-fundholders, are working together to deal with a problem that has emerged in the district, and was caused by an 8 per cent. increase in accident and emergency admissions. I do not remember that the hon. Lady predicted that. What has happened in the constituency of my hon. Friend the Minister of State is evidence that the case of the Labour party is wrong--fundholders do not desert NHS patients. All the GPs of that district have worked together to look after all the local patients, as the hon. Lady had the grace to admit in the closing sentence of her question.
Mr. Day: Does my right hon. Friend agree that, if the Opposition were correct in their assumption that patients registered at fundholding practices benefit far more than other patients, surely the obvious answer is for the Opposition to see to it that that successful mode of GP practice is extended throughout the NHS?
Mr. Dorrell: My hon. Friend is not only right, but echoes the views of the majority of GPs operating in
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the NHS. That is why the predecessor of the hon. Member for Peckham, the right hon. Member for Derby, South (Mrs. Beckett), found herself faced with a rather hostile audience when she recently attended the fundholding doctors conference. She had to explain to those doctors why the Labour party is committed to abolishing a scheme that allows the majority of GPs in Britain to improve the health care available to their patients.Drug Abuse
9. Mr. Flynn: To ask the Secretary of State for Health what new proposals he has to reduce abuse of prescribed drugs. [38219]
Mr. Bowis: Any drug, prescribed or otherwise, can cause serious harm if misused. We will take whatever action is necessary to tackle the misuse of drugs. Recent measures have dealt with the serious problem of temazepam misuse.
Mr. Flynn: As 200 people died last year as a result of paracetamol use--twice the number of people who died as a result of heroin use--and 30,000 people were admitted to hospitals as a result of paracetamol overdoses, what is the Minister doing to unblock the ban on the sale of the safe paracetamol that includes an antidote that prevents liver damage? Is it not true that drug companies are campaigning against safe paracetamol because they know that the only way in which to market the safe product is to draw attention to the deadly peril of the existing paracetamol products?
Mr. Bowis: We will always look at the safety of medicines as the subject is brought to our attention, and there are proper procedures for considering such matters. The hon. Gentleman is trying to confuse several types of drugs that could be perfectly safe if used properly, but can be very dangerous if misused. That is why we have taken action on temazepam. I should have thought that he might start by welcoming the steps taken when a drug is perceived to be a danger to the public--the fast steps to remove the gel-filled capsules and to reschedule that drug.
Many issues surround the hon. Gentleman's messages about drugs. On the whole, his message that cannabis, for example, is something to be taken without hesitation is something that the House would reject.
Mr. Fabricant: In that very connection, I was wondering what representations my hon. Friend has received from the shadow Secretary of State for Transport, the hon. Member for Birmingham, Ladywood (Ms Short), regarding cannabis, and has she said whether or not she inhales?
Mr. Bowis: I would say to my hon. Friend, to the hon. Member for Ladywood and to Opposition Front Benchers that, if they came with me and saw some of the results of cannabis use, if they came and saw children trying to find the courage to say no to drugs, if they came and saw young people struggling to get out of the black hole into which they have fallen as a result of trying drugs--and trying cannabis among them--they would know that they are not helped by the Labour party's line of "soft on drugs, soft on
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criminal abuse of drugs", as expounded by the hon. Member for Ladywood in her capacity as a member of the shadow Cabinet.Mr. Flynn: In view of the disgracefully complacent and libellous nature of the Minister's reply, I intend to raise that matter on the Adjournment.
Prescription Prices
11. Ms Church: To ask the Secretary of State for Health what has been the increase in real terms in the price of prescriptions since 1978; and if he will make a statement. [38221]
Mr. Dorrell: Roughly eightfold.
Ms Church: Does the Secretary of State share the anxieties of the British Medical Association and general practitioners in my constituency that, when low-income patients have been prescribed two or more items, they actually ask their GP which of the items is the most important for them to take? Does the Minister not understand that, when two items are required, a matter of £10.50, or three items, a matter of £15.75, that is not an inconsiderable chunk out of the family budget for many of my low-income constituents? Will he join Labour Members in requesting a review of the prescription system so that we have a much more equitable system for low- income families?
Mr. Dorrell: I shall take the Labour party's commitment to a review of the prescription system a great deal more seriously when Labour Members tell us what the results of that review will be. In the meantime, the hon. Lady's low-income constituents are protected by the exemptions that already exist, which cover more than 80 per cent.--more than four out of five--of all prescriptions dispensed.
Mr. Nigel Evans: Will my right hon. Friend give a commitment that the money raised through the increase in prescription charges this year, which I believe to be £300 million, will go directly to front-line health services? That could pay for about 75,000 hip replacement operations or 235,000 cataract operations.
Mr. Dorrell: My hon. Friend expresses precisely the dilemma confronted by any of those Labour Members who may think that we could afford to do without prescription charges. Those charges are part of the financing of the health service--my hon. Friend has the right number: £300 million is raised by prescription charges and is invested in precisely the sort of patient care that he described.
Mr. Galbraith: What is the Government's position on the prescription of beta-interferon? As the Secretary of State knows, that is a drug of unproven value and its unrestricted prescription would hinder future knowledge of it. We may never find out whether it--or, indeed, any of the other available drugs--is of any value.
Mr. Dorrell: As the hon. Gentleman knows, the drug has not yet been granted its market licence. We have been working closely, both with the patients' organisations and with the profession, against the possibility that the drug will receive a licence. If it receives a licence, we have agreed with them protocols
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to ensure that the drug is available from those clinicians who are best qualified to make judgments about which patients are most likely to benefit from it.Waiting Times
12. Mr. Mark Robinson: To ask the Secretary of State for Health what progress has been made in reducing waiting times in Somerset and the south- west. [38222]
Mr. Sackville: Excellent progress has been made in reducing waiting times in Somerset and the south-west generally. At 31 March 1995, there was no one waiting more than 12 months for non-urgent treatment in Somerset and only 66 patients waiting that long for treatment in the south and west region.
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