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NHS Treatment (Costs)
Mr. Andrew Turner: To ask the Secretary of State for Health (1) which categories of person, on the basis of age, marital status, duration of residence in UK, contribution record, immigration status, nationality and other characteristics, are eligible for (a) free emergency treatment in NHS hospitals, (b) free non-emergency treatment in NHS hospitals, (c) free treatment by NHS general medical practitioners, (d) free treatment by NHS dental practitioners and (e) NHS drug prescriptions; [7954]
- (2) what powers he has to recover the cost of treatment under the NHS of persons ineligible for free treatment; [7955]
(3) how much was recovered, in the last year for which information is available, of the cost of treatment under the NHS of persons ineligible for free treatment; and how much is estimated to remain uncollected. [7956]
Mr. Hutton: There is no charge for any treatment given in a hospital accident and emergency department regardless of the personal circumstances of the patient. Patients who are not normally resident in the United Kingdom may be charged for any other treatment given by an NHS trust or primary care trust if they, or the treatment they are being given, are not specifically exempt from charges under the terms of the National Health Service (Charges to Overseas Visitors) Regulations 1989, as amended. Copies of these regulations are available in the Library.
The regulations place an obligation on health authorities, NHS trusts and primary care trusts to determine if a patient should be charged for their hospital treatment and, if so, to make and recover a charge for that treatment.
There is no separately identifiable record held centrally of the amounts recovered from charge-liable overseas patients or the amount outstanding from them at any one time.
There is no charge for any treatment which a general medical practitioner regards as emergency or immediately necessary, regardless of the personal circumstances of the patient. General medical and dental practitioners have discretion to accept or reject any patient, whether ordinarily resident in the United Kingdom or not, for NHS treatment subject, in the case of dentistry, to the same charges as other UK residents. They are advised however to offer private treatment if it appears that a patient has come to the UK specifically to obtain treatment. Guidance on the eligibility of overseas patients to free primary care has been placed in the Library.
Patients who are entitled to NHS hospital treatment or who have been accepted as NHS patients by a general practitioner or dentist are entitled to prescriptions on the same basis as other UK residents.
Drugs (Children)
Dr. Evan Harris: To ask the Secretary of State for Health (1) what recent assessment he has made of drugs being used for the treatment of children which are not licensed for that purpose; [5278]
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- (2) what assessment he has made of the need for research to establish the safety and efficacy of all drugs used in the treatment of children; [5276]
(3) what estimate he has made of the number of children who (a) died and (b) were injured as a result of treatment with drugs not licensed for the treatment of children in each of the last five years; and if he will make a statement; [5274]
(4) what steps he is taking to ensure that pharmaceutical companies in the United Kingdom provide clear dosage information for children and adults on all drugs they produce; and if he will make a statement; [5275]
(5) what percentage of medicines used for treatment of children do not have a dosage approved by the Medicines Control Agency; and if he will make a statement. [5277]
Ms Blears [holding answer 19 July 2001]: We recognise the critical importance of this issue and agree that children should have access to medicines that have been fully evaluated to the same high standards of safety, quality and efficacy as those available for the adult population. The issue is not confined to the United Kingdom, but affects the whole of Europe and the United States. Medicines regulation in the UK derives largely from European legislation and an international approach to the issue is therefore needed.
We have consequently raised the profile of this issue at a European level, including taking the lead in developing a European guideline, adopted in 1997, to encourage companies to undertake appropriate clinical trials on the use of medicines in the treatment of children. This formed the basis for an international guideline, which came into operation in January in the EU, and also applies in the USA and Japan. In addition, the Council of the European Union has asked the European Commission to bring forward measures to make sure that medicines for children are fully adapted to their specific needs. We are presently waiting for their proposals. However, the Commission has stated its intention to comply with this request. The UK will play an active role in the development of this initiative to ensure that effective solutions are found.
In addition, the Committee on Proprietary Medicinal Products (CPMP), the scientific advisory committee of the European Medicines Evaluation Agency (EMEA), recognising the importance of this topic has announced its intention to set up a Paediatric Expert Group to advise the EMEA and its scientific committees on all questions relating to the development and use of medicinal products in children. The UK has nominated representatives to this Paediatric Expert Group.
In the meantime, the UK Government have taken important steps to address the issue at a national level within the existing regulatory framework. The Committee on Safety of Medicines (CSM), an independent expert committee that advises the Licensing Authority has established a Paediatric Sub-Group to provide expert advice on the regulatory strategy to improve the availability of medicines licensed for use in children. MCA now routinely asks companies for paediatric development plans where appropriate. Pharmaceutical companies are required by the Licensing Authority to provide dosage information in the Summary of Product Characteristics when a Marketing Authorisation for their
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medicinal product is granted or amended in the UK. This dosage information must be supported by the findings from clinical trials undertaken in the relevant adult or paediatric patient population.
The safety of all medicines whether licensed, used outside the terms of their licence, or unlicensed, is monitored by the Medicines Control Agency and CSM. Various data sources are used for monitoring safety including: the UK Yellow Card Scheme for reporting suspected adverse drug reactions, suspected adverse drug reaction reports from abroad, the world-wide medical and scientific literature, clinical trial reports and periodic safety updates from manufacturers. The UK Yellow Card Scheme acts as an early warning system for drug safety hazards but is not a scheme for recording all suspected adverse reactions that occur in the UK. Data from the Yellow Card Scheme cannot, therefore, provide estimates of the incidence of adverse reactions, including fatal adverse reactions occurring in children. The CSM Working Group on Paediatric Medicines also advises on the collection of information on adverse reactions in relation to unlicensed use of medicines in children.
DEFENCE
Army Strength
Angus Robertson: To ask the Secretary of State for Defence what the strength and complement is of each regiment in the UK. [6953]
Mr. Ingram: The establishments and actual strengths of each regiment based in the United Kingdom as at 1 September 2001 are shown in the table. The figures do not include the Royal Irish (Home Service), Special Forces or the Territorial Army.
(4) Establishment strength source is from Directorate of Communications Information Systems (Army)
(5) Actual strength source is from Defence Analytical Services Agency (Army)
(6) Includes Gurkha Sig. Sqn.
(7) Includes Gurkha Sig. Sqn.
(8) Includes Gurkha Reinforcement Company
(9) Includes Gurkha Reinforcement Company
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