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Multiple Sclerosis
Jackie Ballard:
To ask the Secretary of State for Health (1) if he will commission research into the mechanisms of central fatigue in multiple sclerosis; [81343]
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Ms Jowell:
The Government fund health and medical research in a number of ways.
The Department funds research and development to support its work on policy development and evaluation in health and social care. The Department also manages the National Health Service research and development levy which is used to support research and development of relevance to the National Health Service in hospitals, general practice and other health care settings, and to fund the NHS research and development programme. In addition, the Medical Research Council (MRC)--which receives most of its income via grant-in-aid from the office of my right hon. Friend the Secretary of State for Trade and Industry--funds medical research as part of the Government's funding of the science and engineering base.
Priorities for departmental research and development support for the development of policy are determined through discussion with policy colleagues, the Departmental Research Committee and Ministers. In the NHS R&D Programme, priorities take account of widespread consultation with those using, delivering and managing services, within a framework overseen by the Central Research and Development Committee for the NHS. In all cases, priorities for our budgets reflect analysis of the burden of disease, potential benefits, Government priorities and take account of the responsibilities and work of other funders.
Management of much of the research supported by the NHS R&D Levy is devolved and details of expenditure at project level are not collected routinely by the Department.
Project details of work directly funded by the Department or supported through the NHS R&D Levy can be found on the National Research Register (NRR). This is available in the Library and most medical libraries on CD Rom, and on the Internet: http://www.doh.gov.uk/nrr.htm. The NRR also contains many details of projects/trials funded by the MRC and other funders.
Within our programmes of research there is nothing specifically relating to clinical psychology or the mechanism of central fatigue.
The Department is currently considering work to look at care packages for those with multiple sclerosis, and has funded a study entitled "Health and independence through education: a controlled evaluation", which aims to assess the value of education in promoting health and independence for people with progressive neurological disorders such as MS.
We have asked those who manage the priority setting process to ensure that the mechanism of central fatigue in multiple sclerosis is included in consideration of future research priorities.
The Medical Research Council support for research into MS and associated demyelinating diseases was estimated at £640,000 in 1997-98. This work covered both basic and applied research.
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In addition, the MRC funds a considerable amount of basic underpinning research in broad related areas such as immunology and cellular medicine.
The MRC always welcomes high quality applications for support into any aspect of human health and these are judged in open competition with other demands on funding. In addition, regional offices of the NHS Executive run response mode funding schemes to which applications of relevance to the NHS can be made. Awards are made by both the NHS and the MRC according to the scientific quality and importance of proposals.
Mr. Pike:
To ask the Secretary of State for Health what assessment he has made of the rates of (a) schizophrenia and (b) depression among (i) Afro-Carribeans and (ii) the British white population. [81415]
Mr. Hutton:
We are aware of research that shows that African-Carribeans are diagnosed as suffering from schizophrenia 3 to 6 times more often than the white population. Although the reasons for this are not clear cut, a recent survey published by the Policy Studies Institute showed the annual prevalence of non-affective psychosis was somewhat less than twice as high as the white population. Research also shows that the incidence of depression is probably under diagnosed for those from ethnic minorities. In 1994 the first national psychiatric morbidity survey revealed that about 1 in 7 adults aged 16-64 had suffered some sort of neurotic problem in the week prior to interview. The most frequent disorder was mixed anxiety and depressive disorder (71 per 1000).
Mr. Efford:
To ask the Secretary of State for Health what representations he has received regarding geographical inequality in renal provision; and what measures he plans to address the problem in the next three years. [81439]
Mr. Hutton:
We have received a number of representations and are aware of the variations in provision. We acknowledge the concerns which have been expressed and we are taking steps to address them.
Centrally issued guidance on specialist commissioning and the National Priorities Guidance have both emphasised the need for health authorities and National Health Service trusts to review the existing provision of renal services and to plan for and to commission increased and equitable high-quality provision.
We are planning to issue guidance shortly which will be designed to provide further advice and assistance to health authorities and National Health Service trusts. This guidance will include information from a survey of renal services which is being carried out to ascertain the current position.
Mr. Efford:
To ask the Secretary of State for Health what representations he has received regarding the establishment of a national renal service framework; and if he will make a statement. [81441]
Mr. Hutton:
A rolling programme of national service frameworks (NSFs) was launched in April 1998. The first two frameworks being developed are on coronary heart
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disease and on mental health; these will be followed by NSFs on older people (spring 2000) and diabetes (spring 2001).
The suggestion that renal services should be the subject of a national service framework was raised by representatives of the National Kidney Federation at their meeting last year with my noble Friend the Baroness Hayman. Since then, an Early Day Motion supporting this proposal has been tabled by the hon. Member for Oxford, West and Abingdon (Dr. Harris). There have also been twenty-one letters of support from hon. Members to Ministers. There are currently no plans for a national service framework for kidney disease. It is likely, however, that the diabetes NSF will look at some aspects of renal provision as renal failure is a complication of diabetes.
We will continue to work with the professional and voluntary groups concerned to look at ways in which we can develop and improve the provision of services for people with kidney disease.
Mr. Efford:
To ask the Secretary of State for Health what is the projected increase in the next three years in the number of kidney patients (a) nationally, (b) regionally and (c) in Bexley and Greenwich District; and what steps he intends to take to meet such increases in demand. [81440]
Mr. Hutton:
The provision of renal replacement therapy (dialysis and transplantation) for people with end-stage renal failure (ESRF) has increased year on year. From 1993 to 1995 the number of patients in England receiving treatment for ESRF rose by 20 per cent.--nearly 4,000 additional patients.
The projected increase in demand for such services is estimated at 9 per cent. per annum. Though this figure is not broken down by region, it is likely to be higher in areas where there is a high population of elderly people or a high proportion of people from ethnic minorities. A revision of the epidemiological needs assessment (published in 1994) will be issued soon, setting out the current level of need and taking ethnicity into account.
Guidance issued in October 1998 on commissioning arrangements for specialist services identified renal services as a priority, and emphasised the need for health authorities to plan on a long-term basis for the needs of their populations. In addition, a Health Service Circular on renal services will be published in the next few months; this will make clear the need for Health Authorities to review levels of renal services and to plan to meet the expected increase in demand.
Bexley and Greenwich Health Authority is a constituent member of the South East Thames Renal Steering Group. The group has carried out a study into the projected demand for renal services across the south east Thames area. Its work has resulted in the decision to open a satellite renal unit at Greenwich, and a further satellite unit at Lewisham is planned.
Mr. Efford:
To ask the Secretary of State for Health what representations he has received advocating the
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establishment of a transplant commission to review the organ procurement system; and if he will make a statement. [81442]
Mr. Hutton:
We have received one representation from the Royal College of Surgeons. A College working party has reviewed the provision of organ transplantation in England and Wales, and in its report has recommended the establishment of a National Transplant Service. We are grateful to the Royal College of Surgeons for the work done by the working party in analysing the problems and producing its report which will be taken into account in the current review of the United Kingdom Transplant Support Service Authority. This review is wide-ranging and will be determining what central support transplant services require, including the issue of organ procurement, and how this is best delivered.
(2) what research his Department has (a) commissioned and (b) evaluated into the impact of clinical psychology in the management of multiple sclerosis. [81344]
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