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Drug Addicts

Mrs. Lait: To ask the Secretary of State for Health what the treatment protocol is for long-term injecting drug addicts over the age of 40. [2819]

Ms Blears: Treatment is provided on the basis of clinical need. Hence, treatment of adult drug misusers should not vary according to age. Guidance on the standard to which treatment should be provided is contained within the Department of Health publication "Drug Misuse and Dependence—Guidelines on Clinical Management", which is available in the Library.

Ambitious targets have been set under our 10-year anti-drugs strategy to prevent drug misuse, and to help those with drug problems overcome them. A key target is to increase the participation of drug misusers in drug treatment programmes that have a positive effect on health and crime by 66 per cent. by 2005 and 100 per cent. by 2008.

Car Parking

Mr. Lidington: To ask the Secretary of State for Health what his policy is on the provision of car parking for (a) staff, (b) patients and (c) visitors as part of new hospital building schemes. [3223]

Mr. Hutton: The Department's policy is to require a transport plan that incorporates car parking arrangements for staff, patients and visitors as part of the business case approval process for new hospital building schemes. This will take into account local circumstances and the need to maximise accessibility by public transport to minimise the need for car parking, particularly for staff, while at the same time providing good access arrangements for emergency vehicles and those who need to use cars.

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It is also important that those considering new health facility developments have early discussions with the local authority on car park requirements and transport planning as a key part of the planning approval process.

Herceptin

Sandra Gidley: To ask the Secretary of State for Health (1) what plans he has to direct NICE to issue guidance on the use of Herceptin in combination with taxanes for the treatment of women with breast cancer who are over-expressing the HER 2 marker; and if he will make a statement; [3264]

Ms Blears [holding answers 11 July 2001]: We understand that the publication date for the National Institute for Clinical Excellence's guidance in the use of trastuzumab (Herceptin) and vinorelbine for breast cancer has yet to be confirmed but is unlikely to be before the end of the year. Once the date is confirmed, details will be published on the Institute's website. We would expect NICE guidance to relate to the current licensed uses of trastuzumab.

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We do not hold a central list of the authorities which are awaiting a decision from the National Institute before they will fund trastuzumab. However, we expect that health authorities will continue arrangements for the managed introduction of new technologies in line with Health Service Circular 1999/176 issued in August 1999, copies of which are available in the Library.

Colorectal Cancer

Dr. Evan Harris: To ask the Secretary of State for Health (1) if he will list the health authorities in England and Wales that are awaiting a decision from NICE on Irinotecan, Oxaliplatin and Raltitrexed before they will fund these drugs in the treatment of advanced colorectal cancer; [3287]

Ms Blears [holding answers 11 July 2001]: We referred the appraisal of Irinotecan to the National Institute for Clinical Excellence (NICE) on 12 July 2000.

Details of the process for a particular treatment are a matter for NICE. However, we understand that an appeal panel heard appeals against the final appraisal Determination on the use of Irinotecan, Oxaliplatin and Raltitrexed in the treatment of advanced colorectal cancer on 23 May 2001 and that the panel's decision was forwarded to the Institute on 27 June 2001. The panel's decision was distributed to consultees on 28 June and was published on the Institute's website on 2 July.

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The appraisal committee will review its final appraisal determination on the use of Irinotecan, Oxaliplatin and Raltitrexed in the light of the appeal panel's decision and recommendations. It was asked to do so on 27 June when the Institute received the appeal panel's final decision. The date on which it will meet to review its final appraisal determination is to be confirmed, as is the proposed date the Institute will issue its guidance. We understand that when these dates are agreed they will, in line with the Institute's usual practice, be published on the NICE website.

The length of time between the decision to uphold the appeal and the next review of draft guidance is a matter for NICE. It is aware that the final guidance should be issued as soon as possible but that due process should be followed.

We do not hold a central list of the authorities who are awaiting a decision from NICE before they will make these drugs available. However, we expect that health authorities will continue arrangements for the managed introduction of new technologies, in line with Health Service Circular 1999/176 issued in August 1999, copies of which are available in the Library.

Follicular Lymphoma

Dr. Evan Harris: To ask the Secretary of State for Health (1) if he will list the health authorities in England and Wales that are awaiting a decision from NICE on rituximab before they will make this drug available for the treatment of eligible patients with follicular lymphoma; [3277]

Ms Blears [holding answers 11 July 2001]: Appeals are a part of the process used by the National Institute for Clinical Excellence for developing robust and reliable guidance. Details of the process for a particular treatment are a matter for the Institute. However, we understand that an appeal panel heard appeals against the final appraisal determination on the use of rituximab for the treatment of follicular lymphoma on 21 May 2001 and that the panel's decision was forwarded to the Institute on 27 June 2001. The panel's decision was distributed to consultees on 28 June and was published on the Institute's website on 2 July.

The appraisal committee will review its final appraisal determination on rituximab for follicular lymphoma in the light of the appeal panel's decision and recommendations.

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It was asked to do so on 27 June when the Institute received the appeal panel's final decision. The date on which it will meet to review its final appraisal determination is to be confirmed, as is the proposed date the Institute will issue its guidance. We understand that when these dates are agreed they will be published on the Institute's website in line with normal practice.

The length of time between the decision to uphold the appeal and the next review of draft guidance is a matter for the National Institute. It is aware that the final guidance should be issued as soon as possible but that due process should be followed.

We do not hold a central list of the authorities who are awaiting a decision from the Institute on rituximab before they will make this drug available. However, we expect that health authorities will continue arrangements for the managed introduction of new technologies, in line with Health Service Circular 1999/176 issued in August 1999, copies of which are available in the Library.

Dr. Evan Harris: To ask the Secretary of State for Health what guidance he intends to give to health authorities following the appeal upheld against the appraisal by NICE on the use of rituximab for the treatment of follicular lymphoma and prior to formal guidance being issued by NICE. [3275]

Ms Blears [holding answer 11 July 2001]: None. We issued Health Service Circular 1999/176 in August 1999. It asks National Health Service bodies to continue with local arrangements for the managed introduction of new technologies where guidance from the National Institute for Clinical Excellence is not available at the time the technology first becomes available. It also advises that these arrangements should involve an assessment of all the available evidence.

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