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Prodigy Pilot Study
Mr. Barron: To ask the Secretary of State for Health (1) what plans he has to review the prescribing recommendations in the Prodigy pilot study in respect of people with epilepsy who experience adverse reactions to no-branded medicines; and if he will make a statement; [3292]
- (2) what representations he has received from (a) pharmaceutical manufacturers, (b) patient groups and (c) general practitioners regarding the prescribing recommendations in the Prodigy pilot study; [3296]
(3) what plans he has to review the prescribing recommendations in the Prodigy pilot study relating to the treatment of hypertension; and if he will make a statement; [3289]
(4) what plans he has to review the prescribing recommendations in the Prodigy pilot study in respect of people with diabetes requiring animal-based insulins; and if he will make a statement. [3291]
Mr. Malone: The Prodigy project encourages comment from general practitioners taking part in the trial. Following publication of the guidelines used for phase 1 of the project, we have received a number of detailed comments from the Association of the British Pharmaceutical Industry and from patient groups. Any appropriate revisions to the recommendations will be made in the light of this information.
Hospital Doctors
Mrs. Wise: To ask the Secretary of State for Health how many doctors were employed in hospitals (a) at the latest available date (b) five years ago; and to what extent the change in numbers is accounted for by reductions in junior doctor's hours. [3277]
Mr. Malone: Information on the number of hospital doctors is published in the Department of Health's Statistical Bulletin "Hospital, Public Health and Community Health Service Medical and Dental Staff in England 1985 to 1995", copies of which are available in the Library. The overall increase between 1990 and 1995 was 6,760 doctors, a rise of 14 per cent. Between June 1991 and March 1996, the Government-funded centrally 1,339 extra posts for hospital doctors, including 1,125
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consultants, to support the reductions in junior doctors' hours.
Genetic Testing
Mr. Duncan: To ask the Secretary of State for Health what action the Advisory Committee on Genetic Testing has taken since July 1996. [3682]
Mr. Horam: The Advisory Committee on Genetic Testing met in July and in September. The committee has established two sub-groups, one on genetic testing offered direct to the public, and another on the issue of late onset genetic disorders.
The chairman of the advisory committee, the Rev. Dr. John Polkinghorne, has today written to professional, consumer, voluntary and industrial bodies requesting comments on a draft voluntary code of practice on genetic testing offered direct to the public. Copies of the document have been placed in the Library.
Pressure Sores
Mr. Alfred Morris: To ask the Secretary of State for Health pursuant to the letter of 23 July from the Minister for Social Security and Disabled Persons and other Ministers to Hon. Members, if he will make a statement on the campaign to increase public and professional awareness of pressure sores; and if he will collate statistics in respect of the incidence of pressure sores among NHS hospital patients. [1414]
Mr. Burns: I refer the right hon. Member to the reply given to him on 22 May 1996, column 217 about the collating of statistics on the incidence of pressure sores among national health service patients.
The Department has undertaken a number of recent initiatives on pressure sores. I refer the right hon. Member to the letter my right hon. Friend the Secretary of State wrote to him on 29 October 1996 on this subject.
Mr. Morris:
To ask the Secretary of State for Health what sums his Department has devoted to the prevention of pressure sores in constant prices for each of the last 10 years; and what research his Department has (a) commissioned and (b) evaluated in this area in this period. [1409]
Mr. Burns:
Complete information about expenditure on the prevention of pressure sores by the Department of Health is not available.
To help clarify the cost of pressure sores, the Department commissioned a report in 1993 from Touche Ross. The report found that there may be some small opportunity cost savings to be made for the high-risk patient groups but pressure sore prevention should be seen as a quality of care issue rather than a means of cost savings.
The Department of Health commissioned work to produce clinical guidelines for pressure sores in 1994. The
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Royal College of Nursing has been asked to redevelop the work so far.
The health technology assessment programme has commissioned a systematic review into wound care management, including pressure sore prevention. The project is on-going, with further expenditure expected this year and next.
Mr. Morris:
To ask the Secretary of State for Health is he will make a statement on the cases investigated by the Health Commissioner in (a) 1994-95 and (b) 1995-96 relating to bed sores; and what impact the commissioner's findings have had on the work of his Department. [1408]
Mr. Burns:
A number of cases investigated by the Health Service Commissioner in 1994-95 and 1995-96 involved, among other things, issues relating to pressure sores. Where the commissioner made recommendations as part of his investigation reports, the national health service bodies concerned have acted on these.
Mr. Alfred Morris:
To ask the Secretary of State for Health what sums (a) his Department and (b) the Medical Research Panel have devoted to research into (i) epilepsy and (ii) related conditions in the last 10 years in constant prices. [1410]
Mr. Burns:
Information on research commissioned by the Department of Health is contained in "The Centrally Commissioned Research Programme" and "The Centrally Commissioned Research Programme: Commissions in 1994-95", copies of which are available in the Library.
Within the national programme on implementation of research findings, there is a project looking at comparing a patient-held reminder card to a doctor-held reminder card to improve epilepsy care in the community. This is at a cost of £102,000.
There are also a number of regionally supported research projects. We do not have complete records on regional research activity but we are aware of the following:
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Mr. Alfred Morris:
To ask the Secretary of State for Health what research his Department has (a) commissioned and (b) evaluated in relation to incontinence in the last 10 years. [1411]
Mr. Burns:
The national health service research and development strategy was launched in April 1991. It is not possible conclusively to confirm the costs designated for research on incontinence before this date.
The following research has been funded by the Department of Health policy research programme:
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Mr. Burns:
The Department of Health funds several voluntary organisations through section 64 grants and has run publicity campaigns relating to incontinence since 1993-94.
A pilot project aimed to develop and evaluate the role of a nurse specialist delivering a package of information, advice and counselling to patients with newly diagnosed epilepsy at a cost of £50,000.
Collaborative care planning health outcomes contract which includes a collaborative care plan for epilepsy, which is a patient focused approach to planning care at a cost of £15,000.
The identification of the relationship between function and anatomy using 3-D fusion of SECT nuclear medicine and CT medical images which many facilitate the improvement of diagnosis and classification of brain disorders such as dementia and epilepsy at a cost of £45,000.
The Medical Research Council expenditure figures for epilepsy up to 1993-94 are:
The Medical Research Council databasing system has now changed and figures for later years cannot be accurately compared with these earlier figures. However, the MRC currently supports a wide portfolio of epilepsy-related research both through its own establishments and through grant support in universities, as follows:
1986-87: £437,000
1987-88: £446,000
1988-89: £350,000
1989-90: £310,000
1990-91: £340,000
1991-92: £381,000
1992-93: £336,000
1993-94: £472,000
Ten programmes and projects related to epilepsy, for which the total MRC funding is £4,277,000;
Five further projects of relevance to epilepsy, for which total MRC funding is £377,000;
A large programme directly related to epilepsy, for which total MRC expenditure was £940,000, was completed in January 1996.
(i) 1988-89: Total cost £40,385
An evaluation of incontinence training packages
Social policy research unit, university of York.
(ii) 1990-91: Total costs £11,000
Further analysis of Office of Population Censuses and Survey's disability survey data on incontinence
Social policy research unit, university of York.
Mr. Morris:
To ask the Secretary of State for Health if he will list his Department's budget relating to incontinence for each of the last 10 years in constant prices. [1412]
(iii) 1991-93: Total cost £90,000
The current and future role of continence advisors.
(iv) 1993-96: Total cost £181,745
Costs, effectiveness and quality in continence services
Social policy unit and centre for health economics, university of York.
(v) 1993-96: Total cost £251,183
DH post doctoral fellowship: Dr. Brenda Roe to evaluate health interventions by members of the primary health care team and continence advisory services.
(vi) 1994-95: Total cost £99,819
The development of methodologies to identify urinary incontinence and set targets for health gain.
Health and community care research unit, university of Liverpool
(vii) 1995-96: Total cost £13,000
The health technology assessment programme--a review into the use of laxatives by the elderly, and the effects on incontinence.
National health service centre for review and dissemination, university of York.
(viii) To be completed 1997: Total cost £96,000
Research into the treatment of urinary incontinence in stroke patients. University department of medicine for the elderly, university of Leicester.
(ix) To be completed 1997: Total cost £84,500
The development of an improved re-usable incontinence bed pad. The medical physics and bio-engineering department, university College, London.
NB: The costs quoted above (Nos. 1 to 4) for research projects within the social policy research unit are likely to be significantly under estimated as the costs quoted are project related costs only and do not include other unit costs such as staff costs.
| Year | Section 64 grant payments | Expenditure relating to section 64 grants Total | |||||
|---|---|---|---|---|---|---|---|
| Continence foundation £ | ERIC(11) £ | InconTact £ | Disabled living Manchester £ | Communications budget(12) £ | Publicity budget £ | £ | |
| 1987-88 | -- | -- | -- | -- | -- | -- | -- |
| 1988-89 | -- | -- | -- | -- | -- | -- | -- |
| 1989-90 | -- | -- | -- | -- | -- | -- | -- |
| 1990-91 | -- | 10,000 | -- | -- | -- | -- | 10,000 |
| 1991-92 | -- | -- | -- | -- | -- | - | -- |
| 1992-93 | 26,250 | 30,000 | -- | -- | -- | -- | 56,250 |
| 1993-94 | 60,000 | 23,496 | -- | -- | -- | 114,076 | 197,572 |
| 1994-95 | 85,000 | 10,000 | -- | -- | -- | 69,559 | 164,559 |
| 1995-96 | 85,000 | 38,000 | 25,000 | -- | (12)15,300 | 49,953 | 213,253 |
| 1996-97 | 75,000 | 26,492 | 25,000 | 16,000 | -- | 40,000 | 182,492 |
| Total | 331,250 | 137,988 | 50,000 | 16,000 | (12)15,300 | 273,588 | 824,126 |
(11) Enuresis resource and information centre.
(12) This expenditure was incurred to produce the incontinence report in conjunction with the Royal College of Physicians.
NB: The costs quoted above are likely to be significantly under estimated as they are project related and do not include other unit costs e.g. core staff costs.
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