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Dr. Iddon: To ask the Secretary of State for Health what plans he has to discuss the costs of drugs used in the treatment of HIV and hepatitis C infections with representatives of the Pharmaceutical Industry. 
Ms Stuart: I have no such plans. The prices of branded medicines are controlled indirectly by the Pharmaceutical Price Regulation Scheme (PPRS) which limits the profits which companies can make from the sale of these products to the National Health Service. Companies have freedom of pricing within this ceiling on overall profits. A new scheme was introduced in October 1999 under which the prices of medicines covered by the PPRS were reduced by 4.5 per cent. overall giving savings to the NHS of around £200 million per year. Copies of the agreement, containing full details, are in the Library.
At the same time, hospitals can aggregate their purchasing power for these products and the NHS Purchasing and Supplies Authority then competitively tenders this business on their behalf. In some cases hospitals themselves negotiate direct with the pharmaceutical industry.
Mr. Harvey: To ask the Secretary of State for Health what estimate he has made of the cost of restoring free dental examinations to (a) all adults, (b) all those over the age of 65, (c) all those over the age of 60 and (d) all those over the age of 55 years; and if he will make a statement. 
Mr. Hutton: About a quarter of dental examinations carried out on adults in the General Dental Service have either no patient charge or else the patient pays a reduced charge. Making dental examinations free to all adults would reduce patient charge revenue in England by:
|Adults||Annual reduction in patient charge revenue|
|Age 18 and over||75|
|Age 65 and over||13|
|Age 60 and over||19|
|Age 55 and over||26|
The total cost of making the change would exceed the reduction in patient charge revenue because additional demand would be stimulated for dental examinations and there would be some additional dental treatment.
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age of 65, (c) all those over the age of 60 and (d) all those over the age of 55 years; and if he will make a statement. 
Mr. Hutton: In April 1999 we made everyone aged 60 and over eligible for a free, National Health Service sight test. Children, people on low incomes and people suffering from or predisposed to eye disease are also eligible. Our estimates of the costs per annum of extending eligibility further are £75 million for all adults and £15 million for people aged 55 and over.
Mr. Harvey: To ask the Secretary of State for Health what estimate he has made of the cost of restoring free prescriptions to (a) all adults, (b) all those over the age of 65, (c) all those over the age of 60 and (d) all those over the age of 55 years; and if he will make a statement. 
Ms Stuart: The cost of restoring free prescriptions to all adults would be £380 million a year. The cost of restoring free prescriptions to all adults aged 55 and over is estimated to be £70 million a year. Those who are over the age of 60 are already exempt. These figures relate solely to the loss of patient charge revenue and make no allowance for any increase in the number of prescription items that might result from this change.
Mr. Jim Cunningham: To ask the Secretary of State for Health what steps are being taken to ensure that people with responsibilities as carers are not discriminated against in the labour market. 
Mr. Hutton: I refer my hon. Friend to the reply given to him the Parliamentary Under-Secretary of State for Education and Employment, my hon. Friend the Member for Barking (Ms Hodge) on 6 November 2000, Official Report, columns 41-42W.
Miss McIntosh: To ask the Secretary of State for Health what representations he has received on the impact on civilian patients of the closure of the Duchess of Kent military hospital; and if he will make a statement. 
Mr. Hutton: The decision to close the Duchess of Kent military hospital, Catterick was made by the Ministry of Defence following extensive local consultation. Since the closure on 1 July 1999, 13 representations concerning the future provision of treatment for civilian patients have been made to the Secretary of State for Health by hon. Members and by the general public.
Ms Stuart: The National Health Service Plan sets out the new structures which will be set in place to extend and increase patient and citizen empowerment across all sectors of NHS. Chapter 10 of the NHS Plan announced the establishment of a Patient Advocacy and Liaison
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Service in every trust. At the moment we are conducting a major exercise to take the views of stakeholder groups nationally and locally on the specific details of how the new arrangements will be set up and co-ordinated in practice. The results of this exercise will be disseminated in the New Year.
Mr. Hutton: On 31 March 1999 there were 3,532 nursing care places in 126 nursing care homes in Gloucestershire. Information on the number of beds on 31 March 2000 will be published shortly in "Community Care Statistics: Residential Personal Social Services, England, 2000".
The demand for nursing home beds varies on a daily basis but is currently at high levels. Gloucestershire Social Services and local National Health Service bodies are working together to develop a whole systems approach to the commissioning of nursing home care.
Mr. Burstow: To ask the Secretary of State for Health when he will conclude his consideration of models of assessment of people's care needs; and if he will list the models under consideration. 
Mr. Hutton [holding answer 6 November 2000]: In line with the National Health Service Plan, we aim to introduce a single assessment process for health and social care for older people by April 2002, with protocols to be agreed locally between health and social services. Initially this will be introduced for those older people who are most vulnerable, for example those living alone, or recently discharged from hospital or entering residential or nursing care. Work on developing the assessment process is being taken forward as part of the development of the National Service Framework for older people.
With regard to nursing care, the NHS will make an assessment of the nursing care requirements of nursing home residents. The Department is working in close consultation with a number of organisations on a standardised approach for this part of the assessment process, which will be ready for implementation in October 2001. There are a range of nursing assessment tools currently available, though each is likely to require some development to deliver the outputs needed.
Helen Jones: To ask the Secretary of State for Health (1) what steps he is taking to ensure that the new Patient Advocacy and Liaison Service will be independent of the NHS trusts in which it operates; 
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(3) who will set targets for and monitor performance of staff employed in the Patient Advocacy and Liaison Service. 
Ms Stuart [holding answer 6 November 2000]: Chapter 10 of the National Health Service Plan announced the establishment of a Patient Advocacy and Liaison Service (PALS) in every NHS trust. At the moment, we are conducting a major exercise to take the views of stakeholder groups nationally and locally on the specific details of how the new arrangements set out in Chapter 10 of the NHS Plan should be set up and co-ordinated in practice. The accountability arrangements and performance standards for PALS and PALS staff will be considered as part of this exercise. Also, the issue of independence will be resolved. A clear statement on the outcome of the exercise will be given in the new year.
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