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Chris Grayling: To ask the Secretary of State for Health, pursuant to the answers of 13 February 2002, Official Report, column 472W, what estimate he has made of the (a) total final cost of the financial support for nursing care based on these assessments and (b) average level of weekly support per patient assessed. 
Jacqui Smith: A total of £100 million was made available to the NHS for the remaining 6 months of the current financial year for NHS funded nursing care for self funders, including funding for continence needs. This was based on an average figure of £90 per person per week.
Jacqui Smith: It is for health authorities in partnership with Primary Care Groups/Trusts and other local stakeholders, to determine how best to meet national and local priorities for improving health, tackling health inequalities and modernising services.
Mr. Gareth R. Thomas: To ask the Secretary of State for Health what action he is taking to improve recruitment of (a) physiotherapists, (b) occupational therapists and (c) speech therapists (i) in London and (ii) in general. 
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Jacqui Smith: We are implementing a range of measures to improve recruitment and retention of all staff, including physiotherapists, occupational therapists and speech therapists. These include an increase in pay, encouraging the National Health Service to become a better employer through the Improving Working Lives and Positively Diverse programmes, increasing training commissions, reducing student attrition, running national and local recruitment and return to practice campaigns, and supporting international recruitment where appropriate. Further information on Improving Working Lives is available at www.doh.gov.uk/iwl. These measures are being implemented in London, and nationally.
Mr. Salmond: To ask the Secretary of State for Health if he will give the estimated cost to the NHS of treatment of those (a) injured and (b) killed in road traffic accidents each year since 1997; and if he will make a statement. 
Mr. Borrow: To ask the Secretary of State for Health how many patients are in hospitals in the north-west of England awaiting transfer to residential or nursing care home by social services in Lancashire. 
Mr. Hutton: The latest information available on the number of deaths occurring within 30 days of surgery, in England, for the year ending 31 March 2001 was published in February 2002. This information has been placed in the Library and can be found on www.doh.gov.uk/nhsperformanceindicators/index.htm.
Dr. Naysmith: To ask the Secretary of State for Health (1) what consideration has been given to allowing elderly and infirm people to buy aspirin in larger quantities than currently allowed; and if he will make a statement; 
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(3) if he will review the impact of the regulations on aspirin and paracetamol pack sizes on the elderly and infirm; and if he will make a statement. 
Job No: 715993 Folios: 000-000Operator: Operator No 3. Date: 08/03/02
Jacqui Smith: We introduced pack size restrictions for paracetamol and aspirin in September 1998, because of concerns about the number of deaths and serious morbidity connected with overdosing and the evidence that many patients who intentionally overdose, use products already available in the home.
The Medicine Controls Agency is monitoring the impact of the pack size measures, by examining a range of data, including hospital admissions, liver transplants and deaths from self-poisoning and will review their effectiveness once sufficient data have been collected. A study by the Centre for Suicide Research at Warneford Hospital in Oxford (reported in the British Medical Journal on 18 May 2001) has reported a fall in the number of deaths from poisoning with paracetamol alone (21 per cent. and a reduction in liver transplants (66 per cent.).
The elderly and infirm, as all other people with recurrent or long-term needs, can get up to 100 aspirin or paracetamol tablets (in packs of 32) from their pharmacist without a prescription. The restrictions governing "over the counter" sales do not apply to aspirin and paracetamol dispensed against a prescription so larger quantities can be prescribed.
Jacqui Smith: I apologise to my hon. Friend for the delay in responding to this question. I refer my hon. Friend to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.
The anti-TNF therapies are selective immunosuppressants which inhibit tumour necrosis factor. Two anti-TNF therapies, Enbrel (etanercept) and Remicade (infliximab) have been authorised by the European Commission, and are used to treat highly active rheumatoid arthritis in adults, who have failed to respond to at least two standard disease-modifying anti-rheumatic drugs.
As with all new medicines, the manufacturers of anti-TNF therapies were required to conduct extensive clinical trials, the results of which were carefully assessed by European Union regulatory authorities including the Medicine Controls Agency (MCA) before the marketing authorisations were granted. The MCA and its independent body, the CMS, evaluated any adverse effects seen during the clinical trials.
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reviewed by the Committee for Proprietary Medicinal Products (CPMP), the European advisory body on medicines safety to ensure that the potential benefits of the medicine outweigh the possible risks. Information regarding adverse effects associated with Remicade was issued to health professionals in February 2001 in the bulletin, Current Problems in Pharmacovigilance.
The known side-effects of anti-TNF medicines are included in the product information provided to doctors and patients. Based on such information and according to clinical need, these medicines are prescribed under the supervision of specialist clinicians experienced in the diagnosis and treatment of rheumatoid arthritis. Like all medicines, anti-TNF therapies will continue to be monitored by the UK MCA to ensure the risk:benefit balance continues to be favourable.
Jacqui Smith: As announced on 16 November 2000, as part of its work programme the National Institute for Clinical Excellence (NICE), has been asked to appraise the use of infliximab (Remicade) and etanercept (Enbrel) in the treatment of rheumatoid arthritis for adults and etanercept only for juvenile idiopathic arthritis (JIA). Unless there are appeals, NICE expects to issue its guidance in March 2002 for etanercept for JIA and guidance on the etanercept and infliximab for adults in April.
In 200001, 187 pre-registration midwifery training places were commissioned by workforce development confederations in the London regional office area. This is an increase of 33 training places since 19992000.
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