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Medicine Rationing

Dr. Julian Lewis: To ask the Secretary of State for Health what his policy is on rationing of medicines in the National Health Service. [134954]

Mr. Denham: With the exception of the small number of medicines covered by schedules 10 and 11 of the general practitioner terms of service, and guided by any locally determined policies, National Health Service prescribers are free to prescribe any available medicines. In deciding on the appropriate treatment for individual patients they should take account of any local or national guidance, in particular any relevant recommendations on clinical and cost-effectiveness from the National Institute for Clinical Excellence.

Respite Care

Mr. Coaker: To ask the Secretary of State for Health what assessment he has made of the availability of respite care to the carers of children with learning difficulties; and if he will make a statement. [135536]

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Mr. Hutton: There has been no specific survey of how many learning-disabled children there are; the Office of Population Censuses and Surveys (OPCS) surveys in 1989 estimated that there were 327,000 disabled children under 16 in England and Wales. This estimate represents 3.2 per cent. of the population and is lower than other estimates. It is generally accepted that this estimate although dated, remains valid.

OPCS has also estimated that two thirds of the 110,000 most severely disabled children did not receive any support services. We can also estimate that two thirds of the most disabled 16 and 17-year-olds will receive no service--that gives a figure of about 11,500.

Of the families covered in the OPCS private households survey, only a third of the children in the 5-15 age group or their families had received a domiciliary service in the previous year, and although the rate rose to almost four-fifths among the children under five, this was mainly attributable to health visiting.

The inspection by the Social Services Inspectorate of services to disabled children and their families, published in 1998, identified a heavy demand for services in all local authorities.

The Learning Disability Strategy, to be published early next year, will address the needs of learning-disabled people of all ages. Our consultation with experts in the field and service users has emphasised the importance of increased family support.

On 27 September, my right hon. Friend the Secretary of State announced that we will increase the amount of money put aside specifically to support carers in England through the Carers Special Grant from £50 million this year to £70 million in 2001-02, £85 million in 2002-03 and £100 million in 2003-04.

This funding will more than double from £120 million this year to £290 million by 2003-04. This is an unprecedented investment in the future of some of the most vulnerable children in our country. I expect that at least £15 million of next year's special grant will be dedicated to the new priority area: disabled children. This money will be spent on a wide range of services, including both home based and respite care.

Psychotropic Medication

Dr. Naysmith: To ask the Secretary of State for Health what information he collates about the level of prescribing of psychotropic medication in residential homes; and what guidance he issues to doctors on this subject. [136015]

Mr. Hutton: Information on the level of psychotropic medication in residential homes is not available. The "Prescription Cost Analysis: England 1999", which is available in the Library, shows that in 1999, 5.6 million prescription items were dispensed in the community in England for drugs used in psychoses and related disorders. Drugs used in psychoses and related disorders are contained within the British National Formulary section 4.2.

The National Institute for Clinical Excellence (NICE) has a continuing rollover work programme appraising drugs and interventions. We are considering a number of drugs for 2000 to 2001 for NICE, and an announcement will be made shortly.

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Dr. Naysmith: To ask the Secretary of State for Health if he will issue guidance to doctors about alternatives to the prescribing of psychotropic medication for stress and minor illness. [135990]

Mr. Hutton: The National Institute for Clinical Excellence work programme includes the development of a guideline on the management of depression in the community. This will offer guidance on drug treatments and psychological therapies.

The recently published National Health Service Plan provides a model of mental health services which requires radical shifts in the current range of provision. An investment of over £300 million will fast forward the Mental Health National Service Framework and provide real choices and alternatives for service users. An example is the investment in primary care workers who will promote a range of options in the care and treatment of stress and minor illness.

NHS Dental Treatment

Mr. Edward Davey: To ask the Secretary of State for Health (1) how many dentists were registered to treat NHS patients in each year from 1992 to 1999 (a) by parliamentary constituency, (b) in Greater London and (c) in England and Wales; [135780]

(2) what was the average number of patients registered with an NHS dentist in each year from 1992 to 1999 (a) by constituency, (b) in Greater London and (c) in England and Wales. [135781]

Mr. Hutton: The number of principal dentists on a health authority (HA) list (Family Health Services Authority (FHSA) for 1992 to 1995) in the General Dental Services at 30 September in each of the years 1992 to 1999 is shown in tables by (a) health authority (b) in Greater London, defined by HAs indicated and (c) in England and Wales. The tables have been placed in the Library.

The average number of patients registered with a principal dentist in the General Dental Services at 30 September in each of the years 1992 to 1999 is shown in tables by (a) health authority (b) in Greater London, defined by HAs indicated and (c) in England and Wales. This has been obtained by dividing the number of registrations by the number of principal dentists on a HA list.

Registration numbers from December 1997 are affected by the shortening of the registration period to 15 months. Previously the period was 24 months for adults, while children's registrations expired at the end of the following calendar year if the patient had not visited their dentist in the meantime. Registration numbers between 1992 and 1999 were also affected by administration changes.

Data are not available by parliamentary constituency.

Mr. Jim Cunningham: To ask the Secretary of State for Health if he will make a statement on dental services (a) nationally and (b) in Coventry South. [136590]

Mr. Hutton: On 28 September 1999, my right hon. Friend the Prime Minister announced that within two years there would be access to NHS dentistry for everyone who wants it via NHS Direct. The dental strategy,

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"Modernising NHS Dentistry--Implementing the NHS Plan", published on 19 September 2000, shows how that pledge can be met. The strategy focuses on the areas of access, quality and oral health and is supported by £100 million new funding. Responsibility for dentistry is devolved to health authorities and they will be performance managed on service provision in their area.

There are 24 practices in Coventry still accepting new patients for NHS dental treatment. A dental access centre across five sites in Coventry and Warwickshire is due to open soon. Dental access centres provide a complete range of dental services, including routine and urgent care. People do not need to register to see a dentist at a centre, and centres have extended opening times.

Departmental Studies

Mr. Harvey: To ask the Secretary of State for Health what studies his Department has (a) commissioned and (b) undertaken in the last five years on the management or administration of (i) National Health Service pensions, (ii) general procurement, (iii) National Health Service payroll and (iv) drug procurement; and if he will place copies of these reports in the Library. [135763]

Mr. Denham: A prior options review of the NHS Pensions Agency, which administers the NHS pensions scheme, was completed by the Department of Health in 1998. A copy of that report was placed in the Library.

On general procurement, the then Secretary of State my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) and the then Chief Secretary of the Treasury, my right hon. Friend the Member for Darlington (Mr. Milburn) who is now the Secretary of State for Health, commissioned a review of NHS procurement by a team from the Cabinet Office Efficiency Unit as part of the 1998 Comprehensive Spending Review settlement. The team reported to Ministers in November 1999. Copies are available in the Library.

The Department has not commissioned or undertaken any reports during the last five years on the management or administration of the NHS payroll service.

In November 1999 the Department commissioned a fundamental review of arrangements for the supply of generic medicines to National Health Service community pharmacies and dispensing doctors. The review was carried out by Oxford Economic Research Associates (OXERA) and their final report was submitted in September 2000. As a next step the Department intends to issue proposals for longer-term arrangements for the generics supply chain, drawing on OXERA's work, for discussion with interested parties, along with a summary report of the factual basis of OXERA's findings. A copy of the proposals and the summary report will be placed in the Library.

In relation to branded medicines the Department produced the third Report to Parliament on the Pharmaceutical Price Regulation Scheme. I refer the hon. Member to the reply given by my hon. Friend the

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Parliamentary Under-Secretary of State for Health, the Member for Birmingham, Edgbaston (Ms Stuart), on 20 December 1999, Official Report, column 420W.

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