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Acne (Treatment)
Mr. Congdon: To ask the Secretary of State for Health what assessment his Department has made of the cost effectiveness of roaccutane as an alternative treatment for acne. [38288]
Medicines (Cost-effectiveness)
Mr. Congdon: To ask the Secretary of State for Health what are the routine procedures for assessing the cost-effectiveness of one medicine against another. [38289]
Mr. Malone: Guidance on the conduct of economic evaluations of medicines was issued jointly by the Department of Health and the Association of the British Pharmaceutical Industry in 1994. Guidance to health authorities and purchasers asks them to take account of evidence on both clinical effectiveness and cost-effectiveness in determining local prescribing policies. The clinicians who make prescribing decisions in individual cases have access to a wide range of information to help assess the relative clinical and cost effectiveness of alternative treatments.
Excimer Laser Treatment
Mrs. Clwyd: To ask the Secretary of State for Health what studies have been (a) commissioned and (b) evaluated by his Department on the safety and effectiveness of excimer laser treatment; and what (i) guidance and (ii) regulations he has issued concerning excimer laser treatment. [38673]
Mr. Horam: The Department of Health has not commissioned or evaluated any studies on the safety and effectiveness of excimer laser treatment.
The Medical Devices Agency issued guidance on the safe use of lasers in medical and dental practice in early 1996.
Part II of the Registered Homes Act 1984 and the Nursing Homes and Mental Nursing Homes Regulations 1984, taken together, require that premises using or intending to use potentially hazardous lasers, which can be used for medical treatment purposes, be registered under the Act.
Mr. Bayley:
To ask the Secretary of State for Health how many cases of (a) dysentery and (b) food
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poisoning there were in (i) York, (ii) North Yorkshire, (iii) Yorkshire and (iv) England in each year since 1990. [38926]
Mr. Horam:
The information requested is published annually in series MB2 "Communicable disease statistics". The latest available publication is series MB2 No. 21 (1994), copies of which are available in the Library.
| Dysentery | Food poisoning (All) | |
|---|---|---|
| York | 3 | 109 |
| North Yorkshire | 15 | 1,266 |
| Yorkshire(28) | 681 | 8,832 |
| England | 4,373 | 75,499 |
(28) Yorkshire is defined as the sum of North Yorkshire, West Yorkshire and South Yorkshire.
General Practitioners
Ms Harman: To ask the Secretary of State for Health how many new general practitioners have entered general practice in each of the last five years; and how many have retired. [39057]
Mr. Malone: The information is shown in the table:
| 1990 | 1991 | 1992 | 1993 | 1994 | 1995 | |
|---|---|---|---|---|---|---|
| Stock | 27,150 | 27,340 | 27,650 | 27,990 | 28,280 | 28,420 |
| Joiners | 1,380 | 1,560 | 1,440 | 1,420 | 1,480 | -- |
| New joiners | 1,160 | 1,340 | 1,210 | 1,100 | 1,270 | -- |
| Rejoiners | 220 | 220 | 230 | 320 | 210 | -- |
| Leavers(29) | 1,510 | 1,250 | 1,100 | 1,130 | 1,340 | -- |
| Change in stock | + 130 | + 310 | + 340 | + 290 | + 140 | -- |
Source:
GP Census.
Note:
(29) Information is not collected centrally on the number of GPs retiring.
Nurses
Ms Harman: To ask the Secretary of State for Health what plans he has to include nurses in the commission process of health services. [39061]
Mr. Malone: The Health Authority Act 1995 requires every health authority to make arrangements for securing professional advice.
Prescriptions
Mr. Maclennan: To ask the Secretary of State for Health when he will resume consultations with dispensing doctors on the patient signing arrangements for NHS prescriptions. [39069]
Mr. Malone: We intend to approach the General Medical Services Committee of the British Medical Association shortly.
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Diabetic Care
Ms Harman: To ask the Secretary of State for Health what progress he has made on the proposals of the British Diabetic Association and Department of Health task force to improve diabetic care. [39059]
Mr. Horam: The National Health Service Executive has disseminated the report of the Department of Health and British Diabetic Association St. Vincent joint task force for diabetes to health authorities and asked them to take account of the recommendations in planning local diabetes services. It is for local health authorities to decide on the priority they give to developing such services.
In addition, a diabetes subgroup of the clinical outcomes group has been set up to develop service guidance for purchasers, based on the recommendations of the task force. The subgroup's membership includes representatives of health authorities and trusts, nurses, general practitioners, patients, and the British Diabetic Association. The subgroup expects to complete its work by the end of 1996.
Pharmaceutical Price Regulation Scheme
Mr. Bayley: To ask the Secretary of State for Health, pursuant to paragraph 2.7 of his Department's report on the pharmaceutical price regulation scheme, on what basis his Department agreed 20 per cent. as the allowable level of research and development costs. [39022]
Mr. Malone: The research and development carried out in the United Kingdom rose steadily through the 1970s and early 1980s. The Government agreed with the Association of the British Pharmaceutical Industry in 1986 that support for research and development would be maintained at the then current level of around 20 per cent. of pharmaceutical sales to the national health service. That agreement was continued in 1993.
Mr. Bayley: To ask the Secretary of State for Health if he proposes to publish a report to Parliament on the pharmaceutical price regulation scheme annually. [39032]
Mr. Malone: Following the first report to Parliament, submitted in May, I plan to make further reports on a regular basis.
Mr. Bayley: To ask the Secretary of State for Health, pursuant to paragraph 1 of his Department's report on the pharmaceutical price regulation scheme, what factors underlay the discrepancy between the companies' figure for total home profits and the Department's outturn figures. [39031]
Mr. Malone: Under paragraph 4.8 of the pharmaceutical price regulation scheme, the Department may question any figures which do not appear to be consistent with the requirements of the scheme. The difference between the company figures and the outturn figures shown in table 1 of the report to Parliament reflects the figures accepted in negotiation as reasonable for the national health service and the taxpayer to bear.
Mr. Bayley: To ask the Secretary of State for Health if he will supplement the information provided in his Department's report on the pharmaceutical price regulation scheme in respect of the nature of the research and development work carried out with funding provided under the scheme. [39001]
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Mr. Malone: The pharmaceutical price regulation scheme does not provide funding for research and development, but allows as a cost a proportion of companies' spending. Research priorities are determined by the companies.
Mr. Bayley: To ask the Secretary of State for Health what assessment he has made of the factors underlying the sums spent by the United Kingdom relative to those spent by its major competitors on pharmaceutical research related to worldwide pharmaceutical development. [39023]
Mr. Malone: The "Research and Development Scoreboard", published earlier this month, shows that expenditure on research by the pharmaceutical industry in the United Kingdom is comparable to its major competitors worldwide.
Mr. Bayley: To ask the Secretary of State for Health, pursuant to paragraphs 2.4.1 and 2.4.2 of his department's report on the pharmaceutical price regulation scheme, if he will make a statement on the criteria used by his Department when it agreed a profitability range of 17 per cent. to 21 per cent. return on capital; what criteria are used to determine where on the range an individual company is placed; how the profitability of companies covered by the scheme compares with movements in the FT500 index; and how his Department measures the degree of a company's long-term commitment to the United Kingdom pharmaceutical market. [39029]
Mr. Malone: The range of target profitability under the pharmaceutical price regulation scheme allows pharmaceutical companies to earn profits in line with the average profitability of companies in other sectors of United Kingdom industry. The range was established taking account of the FT500 index, and is subject to review in the light of movements in that index, but was agreed in negotiation with the industry, not by a set formula. Individual companies are placed within that range in the light of factors which they can show to demonstrate their long-term commitment to supplying the medicines which the national health service needs. These factors are established and assessed in negotiation.
Mr. Bayley: To ask the Secretary of State for Health, pursuant to his Department's report on the pharmaceutical price regulation scheme what factors underlay his Department not being able, at 30 April, to finalise agreed outcome figures on the annual financial returns from companies for (a) 1992, (b) 1993 and (c) 1994; how many companies are outstanding for each year; and what action his Department is taking to finalise outcome figures more quickly. [39030]
Mr. Malone: Clearance of annual financial returns is dependent on completing negotiations with companies, which may be both complicated and time consuming. In addition there has been delay due to the extra work arising from the negotiation of the new pharmaceutical price regulation scheme in 1993 and from subsequent policy initiatives. On 30 June 1996 six AFRs from 1992, 14 from 1993 and 35 from 1994 remained unfinished.
Steps are being taken to clear this backlog.
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