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Beta Interferon

Mr. Webb: To ask the Secretary of State for Health what estimate he has made of the cost of beta interferon in (a) the United Kingdom, (b) other EU member states and (c) the United States; and if he will make a statement on the factors underlying the cost in each country. [129244]

Ms Stuart: The annual cost per patient of the beta- interferons in the United Kingdom is £9,320 (Betaferon), £9,490 (Avonex), £9,090 (lower dose of Rebif) and £12,070 (higher dose of Rebif).

The Department has made no studies of the cost of treatment in different countries. As far as the prices of the beta interferon medicines are concerned, the Department has information both from the manufacturers and from contacts in the health authorities of other countries. Direct comparisons of prices of products of this type are misleading because they are often supplied direct to hospitals, making list prices less significant. Furthermore, some countries include distribution costs and some aspects of care within the list price while others account for them separately.

Subject to these qualifications, it can be said that in general the annual cost of beta interferons in the UK is slightly greater than in other EU countries, reflecting currency movements since the products were introduced.

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Mr. Amess: To ask the Secretary of State for Health if he will make a statement on the guidance issued to health authorities on the use of beta interferons in multiple sclerosis pending further guidance from the National Institute for Clinical Excellence. [130246]

Mr. Denham: Until guidance is available from the National Institute of Clinical Excellence, the guidance issued by the Department in 1995, Executive Letter (95) 97, continues to apply.

Fritchie Report

Mr. Brady: To ask the Secretary of State for Health (1) when he will publish a response to the recommendations of the Fritchie report. [129395]

(2) when he will meet Dame Rennie Fritchie to discuss her report on NHS appointments. [129396]

Ms Stuart [holding answer 6 July 2000]: I set out the Department's response to the recommendations made by the Commissioner for Public Appointments, Dame Rennie Fritchie, in a letter to her dated 7th July 2000. It confirms our concern to ensure that appointments to National Health Service boards are made in a way which is seen to be both open and fair. Copies of the letter are available in the Library.

GPs (Lancashire)

Mr. Gordon Prentice: To ask the Secretary of State for Health what steps he is taking to ensure that GPs who retire in the period up to 2005 in (a) East Lancashire and (b) Pendle are replaced. [129612]

Mr. Denham: East Lancashire health authority is taking a number of initiatives in response to a study by Lancaster University relating to workforce planning for general medical and other primary care staff. The 1998 study projected data to 2003-04; these data will be reviewed in the near future and extended for a further period. Measures include:

Promoting Personal Medical Services (PMS) pilots where appropriate. There has been a very encouraging response in applications for the third wave of PMS;

Working locally through Primary Care Groups (PCGs) and with the Post Graduate Medical Centre at Manchester University to expand the number of training practices and the number of trainees in East Lancashire. Three locally trained general practitioners joined the East Lancashire list last year;

The development of a recruitment package aimed at the National Health Service in East Lancashire, but with a focus on General Practice;

Ensuring that retiring GPs give as much notice as possible (three months is the minimum) and to plan a phased approach to retirement where possible;

PCGs are encouraging practices to review their skill mix and examine alternative options for patient care e.g. greater use of nurse practitioners.

The health authority, together with Pendle PCG, is actively addressing the issue of GP retirement and subsequent recruitment. It is using all the above approaches, however, the deployment of one or more PMS pilots is regarded as a particularly appropriate solution for the area.

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Primary Care Groups and Trusts

Sir Teddy Taylor: To ask the Secretary of State for Health (1) how many primary care groups have been established in England and Wales; how many of these groups have been changed to primary care trusts; and what the estimated administrative cost is of establishing these organisations; [129475]

(2) if he will make a statement on the procedures for transferring responsibility from community care trusts to primary care trusts in respect of the services to be provided by the trusts and in particular about the arrangements for transferring responsibilities to the Southend Primary Care Trust. [129476]

Mr. Denham: 481 primary care groups became operational on 1 April 1999. Nineteen of these were approved for primary care trust status and began operating as 17 primary care trusts on 1 April 2000. Two primary care trusts merged. There are now 459 primary care groups and 17 primary care trusts in England covering a population of over 49 million.

Information regarding local health groups in Wales can be obtained by contacting the Welsh Assembly.

Primary care groups perform functions formerly discharged by their parent health authorities. They are funded to do so by the health authority from within existing resources in their unified budget allocations. Central support was provided to health authorities in 1998-99 to help them to establish primary care groups. This funding was released by the ending of the general practitioner fundholding scheme.

In 1999-2000, health authorities receive £25,000 towards the cost of developing each primary care trust proposal which goes to consultation. Each primary care trust that is approved receives central funding towards its preparatory and development costs--£100,00 for a Level 3 primary care trust and £175,000 for Level 4 primary care trust.

Every health authority is required to conduct a local consultation on each prospective primary care trust. The consultation typically lasts between six weeks and three months. A report is presented to my right hon. Friend the Secretary of State which includes details on the proposal itself, the health authority's view on the proposed primary care trust and its state of readiness, the proposed establishment and operational dates and a summary of the consultation results which identifies the community services, currently provided by the local community National Health Service trust, to be provided by the prospective primary care trust. These services reflect the views of the local community and other stakeholders.

Information on the consultation process is contained in Health Service Circular 1999/207 "Primary Care Trusts: Consultation on Proposals to Establish a Primary Care Trust". Copies have been placed in the Library.

Southend Primary Care Group became a Level 3 primary care trust from 1 April 2000 and will be consulting on moving to Level 4 from April 2001. The remaining six primary care groups within South Essex Health Authority are aiming to move to trust status in April 2001. This may

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then result in five Level 4 primary care trusts in South Essex. External consultants are currently facilitating a local review of how clinical and support services provision may change. Local priorities, including services to be managed by each primary care trust, will be included in the consultation documentation. The consultation is likely to run from 1 August to 31 October. No transfer of community services will be made until primary care trust Level 4 status is achieved following successful consultation with wide stakeholder support.

Edgware Community Hospital

Mr. Dismore: To ask the Secretary of State for Health what services are now available at Edgware Community Hospital; how many people used each of those services in the last year; and if he will make a statement. [129948]

Mr. Denham: Services currently available at Edgware Community Hospital are:

Adolescent psychiatry


Cardiology testing


Children's services


Consultant-led outpatients services


Day surgery


Dietetics


Birth Centre


Intermediate care beds


Mental health services for adults, including in-patient facilities


Occupational therapy


Pathology and blood tests


Pharmacy


Physiotherapy


Specialist services (e.g. rehabilitation following brain injury)


Speech and language therapy


Urgent Treatment Centre for Minor Injuries

X-ray and ultrasound.

A primary care walk-in centre will open at the end of August 2000.

During 1999-2000 there were 30,000 attendances at the urgent treatment centre, 80,000 outpatient attendances across a range of specialties, 3,200 attendances for day surgery and 28,940 diagnostic tests. 228 births took place at the Edgware Birth Centre and there were 219 admissions to the general practitioner admission unit.

Jean Brett

Mr. Hinchliffe: To ask the Secretary of State for Health if he will review the case of Jean Brett, following the report by Conciliation Connections, a copy of which has been sent to him; and if he will make a statement. [130029]

Ms Stuart: The Conciliation Connections report recommendations were considered and accepted by Mount Vernon and Watford National Health Service Trust (now part of West Hertfordshire Hospitals NHS Trust) at a public trust board meeting. As recommended in the report the trust has apologised, carried out an audit into the work of the consultant's department to ensure that no unnecessary operations were being performed and made an offer of compensation.

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Recently the Chief Medical Officer requested the Eastern Regional Office to review the file notes; the conclusion was that no further action be taken.

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