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Pre-legislative Scrutiny
Mr. Lazarowicz: To ask the President of the Council if he will bring forward proposals to extend pre-legislative scrutiny. [17536]
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Mr. Robin Cook: We have increased the number of draft bills published and opened up the process of pre-legislative scrutiny. Pre-legislative scrutiny should improve legislation, but demands more effort from all those involved. I hope to see a steady increase in its use until it occurs with the majority of bills, but that will take time to develop.
Members' Computer Equipment
Mr. Peter Duncan: To ask the President of the Council what has been the average time taken to (a) deliver and (b) install standard computer equipment to hon. Members' offices in (i) the House of Commons and (ii) constituency offices; and if he will make a statement. [20696]
Mr. Robin Cook: The information the hon. Member has requested is not held in this form. It is being collated, and a substantive answer will be given as soon as possible.
HEALTH
Elective Surgery
Dr. Stoate: To ask the Secretary of State for Health (1) what progress has been made towards setting up the fast-track elective surgery centres he announced in February; and if he will make a statement; [13490]
- (2) if he will set up a dedicated fast-track elective surgery centre in the North Kent area. [13491]
Ms Blears: We announced plans for 26 diagnostic and treatment centres (DTCs) in February. This put us well on course to exceed the target of 20 schemes developed by 2004 (with eight operational) which we set out in the NHS Plan. Work on the schemes is progressing and we are confident that at least eight of them will be receiving patients by 2004.
We are now looking at ways to extend the DTC programme, including in the south-east, and if possible to bring it forward. We will consider suitable proposals which stand to benefit even more patients.
Public Service Agreements
Mr. Bercow: To ask the Secretary of State for Health if the Public Service Agreement target for March for the connection of GP surgeries using clinical computer systems to the NHSnet was met. [14906]
Ms Blears: The Public Service Agreement between the Department and Her Majesty's Treasury which formed part of the spending review 2000 did not include a specific target for connection of general practitioner surgeries to NHSnet.
The Government's information management and technology strategy for the national health service, "Building the Information Core—Implementing the NHS Plan", published in January 2001 gave the target of 95 per cent. of GP practices in England to be connected to NHSnet by end of March 2001.
At that date 93.6 per cent. of practices in England had an NHSnet connection; over 95 per cent. were connected by the end of May 2001, and at the end of October 2001, over 97 per cent.
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Mr. Bercow: To ask the Secretary of State for Health if he will make a statement on progress towards meeting the Public Service Agreement target for the connection of GP surgeries which use clinical computer systems to the NHSnet by March 2002. [14905]
Ms Blears: The Public Service Agreement between the Department and Her Majesty's Treasury which formed part of the spending review 2000 did not include a specific target for connection of general practitioner surgeries to NHSnet.
The Government's information management and technology strategy for the national health service, "Building the Information Core—Implementing the NHS Plan", published in January 2001 gave the target for all GP practices in England to be connected to NHSnet by March 2002.
At the end of October 2001, over 97 per cent. of GP practices in England were connected to NHSnet. It is expected that by March 2002, nearly all GP practices will be connected.
Mr. Bercow: To ask the Secretary of State for Health if he will make a statement on progress in meeting the Public Service Agreement target of savings from action on contractor fraud between 1999–2000 and 2001–02. [14930]
Ms Blears: The two Public Service Agreement targets for savings from action on contractor fraud are:
- (a) to recover £6 million lost to fraud by contractors, in pharmaceutical services, by the end of 2001–02, and
- (b) to prevent the loss of £9 million of national health service funds to contractor fraud, again in pharmaceutical services by the end of 2001–02.
The NHS counter fraud service (NHSCFS) inherited these targets on its formation in late 1998. Among the wide range of activity undertaken in countering fraud in the NHS they have made excellent progress in achieving these PSA targets.
The first target to recover £6 million lost to fraud by contactors in the pharmaceutical service has already been exceeded. The NHSCFS has, as at the end of October, agreed recoveries totalling £7.47 million.
The second target was to prevent the loss of £9 million of NHS funds lost to contractor fraud in the pharmaceutical service. By mid January 2002 the NHSCFS will have hard figures for the loss to fraud in this area and for the losses that have been prevented as a result of the work that has taken place.
Mr. Bercow: To ask the Secretary of State for Health if he will make a statement on progress in meeting the Public Service Agreement target of a 50 per cent. reduction in prescription charge evasion by 2002–03. [14899]
Ms Blears: On its formation in late 1998 the national health service Counter Fraud Service (NHSCFS) inherited the PSA target to reduce patient prescription charge fraud by 50 per cent. by 2002–03.
The progress of the NHSCFS has made against the target has already shown a reduction in losses to fraud in this area of 41 per cent. (£48 million) by the end of 2000–01.
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Acupuncture
Mr. Frank Cook: To ask the Secretary of State for Health (1) what additional funds are made available to general practitioners for the provision of acupuncture services as part of the treatments administered at their surgeries; [15118]
- (2) how many GPs in the NHS provide acupuncture for their patients within their practice. [15019]
Ms Blears: General practitioners are not required to provide acupuncture as part of either general or personal medical services. They are, however, able to provide acupuncture services under arrangements agreed local with the their health authority or primary care trust. They may also themselves treat patients in this way if they believe it is appropriate and they are qualified to do so. The Department does not, however, collect data on the provision of acupuncture services by general practitioners.
Derriford Hospital
Mr. Streeter: To ask the Secretary of State for Health what was the (a) income and (b) number of patients treated by Derriford hospital, Plymouth, in the last financial year. [15289]
Ms Blears: The total income of Plymouth hospitals national health service trust in the financial year 2000–01 was £188,822,000. In the same year there were 35,494 non-elective and 52,912 elective finished consultant episodes and 307,101 outpatient attendances at the trust.
Prescription Charging
Dr. Fox: To ask the Secretary of State for Health how the Prescription Pricing Authority monitors patient compliance with the prescription charging arrangements. [15325]
Ms Blears: The Compliance Unit of the Prescription Pricing Authority (PPA) is responsible for carrying out a number of checks on those patients who claim exemption from prescription charges on grounds such as age, certain medical conditions, low income or receipt of certain tax credits or benefits (such as income support). Appropriate organisations are contacted to confirm entitlement to exemption. Where the patient provides additional information to confirm their entitlement, no further action is taken. However, if it is found that a patient has incorrectly claimed exemption from prescription charges, the PPA recovers the outstanding charges and may impose a penalty charge.
Benzodiazepines
Andrew George: To ask the Secretary of State for Health (1) how many patients (a) have been prescribed benzodiazepines and (b) were considered to be clinically dependent upon them during each year since 1971; [15588]
- (2) what advice his Department issued with regard to the (a) daily dosage, (b) time limit of dosage, (c) possible
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- side-effects and (d) tendency to addiction of those prescribed benzodiazepines during the last 25 years; and what assessment he has made of such advice issued by medical advisory bodies; [15586]
(3) what recent assessment his Department has made of the impact on NHS patients of prescribing benzodiazepines; [15590]
(4) what assessment he has made of the impact of medical practice to prescribe benzodiazepines to some patients with a spectrum of mental health disorders in respect of (a) recovery from illness, (b) worsening of illness, (c) onset of known side-effects and (d) addiction to these drugs; [15587]
(5) how many (a) benzodiazepine doses have been administered and (b) prescriptions for benzodiazepines have been written for each year since 1971. [15591]
Ms Blears: The numbers of prescriptions for benzodiazepines from 1980 to 2000 are listed in the tables. However the number of prescriptions cannot be used to determine the number of patients receiving benzodiazepines. Information is not available on the number of patients considered to be clinically dependent upon benzodiazepines.
Information on the daily dosage, time limit of dosage, possible side effects and tendency to addiction of benzodiazepines is present in the Summary of Product Characteristics, and the Patient Information Leaflet, which is produced by the manufacturer and approved by the Licensing Authority. The Committee of Safety of Medicines, and previously the Committee on the Review of Medicine have issued advice on all these aspects in relation to benzodiazepines use to healthcare professionals in the United Kingdom on a number of occasions in the drug safety bulletin "Current Problems in
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Pharmacovigilance" and in the British Medical Journal. These publications are listed and copies will be placed in the Library.
- Current Problems in Pharmacovigilance 1978—thrombophlebitis associated with diazepam.
British Medical Journal, 1980: 910–912. Systematic review of benzodiazepines.
Current Problems in Pharmacovigilance 1981—Unexpected severe psychotic effects with Halcion.
Current Problems in Pharmacovigilance 1985—Respiratory depression and hypotension with Midazolam (Hypnovel).
Current Problems in Pharmacovigilance 1988—Benzodiazepines, dependence and withdrawal symptoms.
Current Problems in Pharmacovigilance 1995—Side effects may impair driving.
Current Problems in Pharmacovigilance 1997—Avoid benzodiazepines during pregnancy and lactation as they may cause side effects in the exposed babies.
Mental Health Foundation 1994 "Guidelines for the Prevention and Treatment of Benzodiazepine Dependence".
Department of Health 1999 "Drug misuse and dependence—guidelines on clinical management".
British National Formulary 2001.
No recent assessment has been made of the impact on national health service patients of prescribing any particular group of psychiatric drugs. Volume of benzodiazepine prescribing in the community is monitored and the measure has been included as a high level performance indicator.
No assessment has been made of the impact on medical practice of prescribing benzodiazepines, nor has any assessment been made of the impact of the information and advice provided on medical practice.
The number of prescriptions dispensed in the community for benzodiazepines in England since 1980 is given in the tables. Data prior to 1980 are not available. Information about drugs prescribed and dispensed in hospitals is not available.
| 1980 | 1981 | 1982 | 1983 | 1984 | 1985 | 1986 | 1987 | 1988 | 1989 | 1990 | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Temazepam | 1,014 | 1,709 | 2,431 | 2,896 | 3,378 | 5,133 | 5,802 | 6,242 | 6,129 | 5,946 | 5,985 |
| Diazepam | 7,300 | 6,604 | 5,812 | 5,147 | 4,449 | 4,374 | 4,217 | 4,071 | 3,622 | 3,331 | 3,147 |
| Nitrazepam | 7,362 | 6,910 | 6,596 | 5,912 | 5,368 | 5,001 | 4,657 | 4,383 | 3,850 | 3,523 | 3,188 |
| Lorazepam | 2,033 | 2,487 | 2,928 | 2,957 | 2,736 | 2,590 | 2,607 | 2,395 | 1,756 | 1,452 | 1,227 |
| Chloridiazepoxide | 1,834 | 1,694 | 1,516 | 1,294 | 1,112 | 1,007 | 893 | 816 | 697 | 604 | 548 |
| Oxazepam | 587 | 675 | 654 | 612 | 561 | 609 | 646 | 621 | 511 | 406 | 399 |
| Lormelazepam | — | 32 | 163 | 346 | 442 | 122 | 160 | 191 | 194 | 169 | 163 |
| Clonazepam | 40 | 48 | 55 | 72 | 77 | 93 | 99 | 107 | 111 | 111 | 127 |
| Loprazolam Mesylate | — | — | — | 2 | 50 | 19 | 71 | 125 | 127 | 144 | 160 |
| Clobazam | 275 | 330 | 381 | 378 | 396 | 109 | 42 | 39 | 48 | 59 | 53 |
| Triazolam | 402 | 795 | 855 | 782 | 906 | 1,200 | 1,468 | 1,576 | 1,635 | 1,530 | 1,513 |
| Alprazolam | — | — | — | 127 | 261 | 63 | — | — | — | — | — |
| Bromazepam | — | — | 9 | 76 | 151 | 32 | — | — | — | — | — |
| Clorazepate Dipotassium | 945 | 930 | 971 | 971 | 1,016 | 216 | — | — | — | — | — |
| Flunitrazepam | — | — | 7 | 86 | 188 | 54 | — | — | — | — | — |
| Flurazepam Hydrochloride | 1,885 | 1,833 | 1,860 | 1,700 | 1,628 | 376 | — | — | — | — | — |
| Ketazolam | 37 | 105 | 135 | 138 | 118 | 27 | — | — | — | — | — |
| Medazepam | 198 | 176 | 159 | 140 | 108 | 25 | — | — | — | — | — |
| Prazepam | — | — | 12 | 55 | 55 | 12 | — | — | — | — | — |
| Total | 23,912 | 24,329 | 24,544 | 23,962 | 22,999 | 21,062 | 20,662 | 20,565 | 18,680 | 17,274 | 16,510 |
| Annual change (percentage) | — | 1.7 | 0.9 | -2.4 | -4.0 | -8.4 | -1.9 | -0.5 | -9.2 | -7.5 | -4.4 |
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| 1991 | 1992 | 1993 | 1994 | 1995 | 1996 | 1997 | 1998 | 1999 | 2000 | |
|---|---|---|---|---|---|---|---|---|---|---|
| Temazepam | 6,428 | 6,914 | 6,651 | 6,345 | 6,063 | 5,540 | 5,252 | 5,043 | 4,878 | 4,697 |
| Diazepam | 3,254 | 3,225 | 3,220 | 3,288 | 3,411 | 3,600 | 3,798 | 3,989 | 4,108 | 4,293 |
| Nitrazepam | 3,186 | 3,074 | 2,902 | 2,721 | 2,582 | 2,539 | 2,426 | 2,333 | 2,210 | 2,095 |
| Lorazepam | 1,137 | 1,018 | 932 | 867 | 818 | 785 | 758 | 743 | 728 | 715 |
| Chloridiazepoxide | 542 | 503 | 467 | 449 | 438 | 428 | 423 | 414 | 402 | 384 |
| Oxazepam | 378 | 352 | 328 | 311 | 300 | 304 | 306 | 300 | 289 | 272 |
| Lormelazepam | 181 | 215 | 218 | 208 | 201 | 234 | 249 | 252 | 246 | 210 |
| Clonazepam | 137 | 144 | 152 | 160 | 168 | 181 | 196 | 213 | 231 | 253 |
| Loprazolam Mesylate | 195 | 239 | 230 | 219 | 213 | 221 | 215 | 211 | 200 | 191 |
| Clobazam | 66 | 67 | 67 | 68 | 70 | 74 | 74 | 82 | 85 | 93 |
| Triazolam | 1,123 | — | — | — | — | — | — | — | — | — |
| Alprazolam | — | — | — | — | — | — | — | — | — | — |
| Bromazepam | — | — | — | — | — | — | — | — | — | — |
| Clorazepate Dipotassium | — | — | — | — | — | — | — | — | — | — |
| Flunitrazepam | — | — | — | — | — | — | — | — | — | — |
| Flurazepam Hydrochloride | — | — | — | — | — | — | — | — | — | — |
| Ketazolam | — | — | — | — | — | — | — | — | — | — |
| Medazepam | — | — | — | — | — | — | — | — | — | — |
| Prazepam | — | — | — | — | — | — | — | — | — | — |
| Total | 16,626 | 15,751 | 15,167 | 14,638 | 14,266 | 13,905 | 13,698 | 13,580 | 13,378 | 13,204 |
| Annual change (percentage) | — | -5.3 | -3.7 | -3.5 | -2.5 | -2.5 | -1.5 | -0.9 | -1.5 | -1.3 |
Notes:
1. The prescription information was obtained from the Prescription Cost Analysis (PCA) system. Please note that the data up to 1990 are not strictly consistent with data from 1991 onwards. Figures for 1980–90 are based on fees and on a sample of 1 in 200 prescriptions dispensed by community pharmacists and appliance contractors only. Figures for 1991 onwards are based on items and cover all prescriptions dispensed by community pharmacists, appliance contractors dispensing doctors and prescriptions submitted by prescribing doctors for items personally administered. Also included are prescriptions written in Wales, Scotland, Northern Ireland and the Isle of Man but dispensed in England. The data do not cover drugs dispensed in hospital or private prescriptions.
2. Benzodiazepines are those drugs defined within the British National Formulary sections 4.1.1, "Hypnotics", 4.1.2. "Anxiolytics", and 4.8. "Antiepileptics".
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