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National Institute for Clinical Excellence
Mr. Harvey: To ask the Secretary of State for Health how many drugs have been evaluated by NICE; and how many are being evaluated. [111423]
Mr. Denham: The National Institute for Clinical Excellence's first work programme was announced on 4 November last year and includes 13 appraisals of drugs or groups of drugs. NICE has so far completed the fast track appraisal of the flu drug zanamivir (Relenza), and the remainder are currently being evaluated.
Contraceptive Drugs
Mrs. Ann Winterton: To ask the Secretary of State for Health what was the cost to the NHS of emergency contraceptive drugs in each of the years 1990 to 1997. [113166]
Yvette Cooper:
The available information is shown in the tables.
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| Number | Net ingredient cost | |
|---|---|---|
| Year | (000s) | (£000) |
| 1990 | 189.6 | 274.5 |
| 1991 | 232.8 | 337.5 |
| 1992 | 272.2 | 391.8 |
| 1993 | 313.3 | 450.8 |
| 1994 | 363.8 | 520.8 |
| 1995 | 475.4 | 678.5 |
| 1996 | 565.6 | 900.2 |
| 1997 | 552.8 | 897.7 |
Notes:
1. The prescription information was obtained from the Prescription Cost Analysis (PCA) system. Please note that the data in 1990 are not strictly consistent with data from 1991 onwards. Figures for 1990 are based on fees and on a sample of 1 in 200 prescriptions dispensed by community pharmacists and appliance contractors only. Figures for 1991 onwards are based on items and cover all prescriptions dispensed by community pharmacists, appliance contractors dispensing doctors and prescriptions submitted by prescribing doctors for items personally administered. The data do not cover drugs dispensed in hospital, Family Planning Clinics, or on private prescriptions.
2. The net ingredient cost (NIC) is the basic cost of a drug and does not take account of discounts, dispensing costs, fees or prescription charges income.
| Hormonal emergency contraceptive | ||
|---|---|---|
| Number | Assumed net ingredient cost(20) | |
| Year | (000s) | (£000) |
| 1990 | 45.5 | 63.7 |
| 1991 | 63.0 | 88.2 |
| 1992 | 76.7 | 107.4 |
| 1993 | 92.2 | 129.1 |
| 1994 | 112.1 | 156.9 |
| 1995 | 157.6 | 220.6 |
| 1996 | 193.7 | 271.2 |
| 1997 | 205.1 | 287.1 |
(20) Costs are calculated using the assumption that the cost of hormonal emergency contraceptives used in Family Planning Clinics is the same as that for Schering PC4 prescribed in the community.
Source:
KT31
Department of Health Statistics division SD2B
Psychiatric Secure Beds
Mr. Hancock: To ask the Secretary of State for Health what (1) analysis he has made of the shortage of secure beds in psychiatric hospitals broken down by (a) region and (b) trust; what plans he has to meet the shortfall; and if he will make a statement; [113592]
- (2) what have been the locations of the secure places in the mental health service provided in the last six months; what plans he has to increase the number in the next financial year; and if he will make a statement. [113564]
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Mr. Hutton: As the consultation document on the findings of the National Bed Enquiry shows, there is a significant shortage of medium secure provision across the country.
The immediate priority is to use the additional investment through the National Health Service modernisation fund to enable the development of balanced mental health systems. In this first year, NHS Modernisation Fund investment has been targeted where the need is greatest. This has resulted in plans for significant numbers of extra secure beds.
During 1999-2000, £14.5 million of the Fund was allocated to improve overall secure capacity by increasing the number of medium and low secure places, and intensive care beds in mental health services. By April 2001 the intention is to have an extra 250 NHS secure places in addition to the 221 places funded in 1999-2000, exceeding the target set out in Mental Health National Service Framework of 300 extra places by April 2002.
I will write to the hon. Member giving details of the exact locations of where these places have been provided in the last six months.
Mr. Lilley:
To ask the Secretary of State for Health (1) what rights general practitioners have to refer patients to hospitals other than those with service agreements with their primary care group on non- medical grounds; [113860]
(3) what measures exist to discourage general practitioners from referring patients to hospitals other than those with service agreements with their primary care group; [113861]
(4) in what circumstances a patient may receive out of area treatment. [113857]
Mr. Denham:
Long-term service agreements should reflect the views of all local general practitioners and their community health colleagues in primary care groups (PCGs). These arrangements do not impinge on the clinical responsibility of GPs and consultants to make appropriate referrals.
PCGs do not alter the National Health Service (General Medical Services) Regulations 1992 which state
15 Mar 2000 : Column: 236W
There is no formal prior approval mechanism for referrals under the OAT arrangements. Local accountability arrangements should be in place to govern the way PCGs, primary care trusts and GPs refer patients in general. These may also include agreed protocols about referrals to highly specialised services and the way that the OAT arrangements are utilised.
Under the OAT arrangements, each NHS trust has a main commissioner. The main commissioner is funded for OATs through a non-recurrent adjustment to allocations as part of the overall process for setting cash limits for the financial year. NHS trusts are funded by their main commissioners.
Mr. Lilley:
To ask the Secretary of State for Health how many out-of-area treatments there have been since April 1999 (a) in England, (b) in West Hertfordshire Health Authority, (c) in East and North Hertfordshire Health Authority, (d) of patients resident in West Hertfordshire Health Authority area in other areas and (e) of patients resident in East and North Hertfordshire Health Authority area in other areas. [113852]
Mr. Denham:
The monitoring of out-of-area treatments and other referrals is a matter for local management. This information is not collected centrally.
Mr. Lilley:
To ask the Secretary of State for Health what measures he plans to take to reduce the average waiting time for drug treatment programmes. [113955]
Mr. Denham:
We have made available an additional £70.5 million over three years for health authorities and local authorities to expand treatment services for drug misusers. This is intended to support a step change in services, whereby waiting times will be cut and equity of access achieved. We have this week launched a campaign to recruit an additional 300 drugs counsellors for the health service, prison service, probation service, police, voluntary sector and local authorities.
Mr. Lilley:
To ask the Secretary of State for Health how many people are on waiting lists for methadone maintenance or withdrawal programmes; and what is the average waiting time for treatment. [113957]
Mr. Denham:
The information requested is not available centrally. Information is available from the Regional Drug Misuse Databases on the number of users presenting to services for treatment and the drugs misused. Reliable information is not available centrally on waiting times for treatment. Revised clinical guidelines for the treatment of drug misusers were issued last year which recommend that methadone maintenance treatment should form an important part of drug misuse services. Substantial additional resources are being allocated to health authorities and local authorities to expand treatment services and thus cut waiting times and achieve equity of access to treatment services.
(2) what arrangements have been made to remunerate hospitals for treating patients referred to them by general practitioners exercising their legal right to select a hospital with no service agreement with their local primary care group; [113855]
general practitioners may arrange for the referral of patients, as appropriate, for the provision of services.
The arrangements for out of area treatment (OATs) are set out in HSC 1999/117 "The New NHS: Guidance on Out of Area Treatment". Copies are available in the Library. The OAT arrangements are used where pre-arranged service agreements are impractical. They are primarily for emergency situations, but also for cases where a patient's personal circumstances, such as the need to recuperate with a faraway relative, require referral outside the normal arrangements.
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