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30 Apr 2003 : Column 427W—continued
Control and Restraint Techniques
Mrs. Helen Clark: To ask the Secretary of State for Health when the results of the review by the National Institute for Clinical Excellence of the control and restraint techniques used in health settings will be (a) complete and (b) put into practice. [109316]
Jacqui Smith: The National Institute for Clinical Excellence (NICE) has commissioned the National Collaborating Centre for Nursing and Supportive Care to develop a clinical guideline on the short term management of disturbed (violent) service users in adult inpatient psychiatric settings. The guideline will cover, among other areas, the use of physical restraint. The guideline is expected to be complete by August 2004. Clinicians are expected to take NICE guidance fully into account once it is published.
East Kent Acute Hospital Services
Mr. Brazier: To ask the Secretary of State for Health what the terms of reference are of the referral of the future of East Kent acute hospital services to the independent reconfiguration Panel. [108810]
Ms Blears: The independent reconfiguration panel has been asked to provide advice about the future of acute hospital services in East Kent under the following terms:
- Whether it is of the opinion that the proposals for change set out in the decision of 25 March 2002 will ensure the provision of safe, effective and accessible healthservices for the people of east Kent. And if not, why not.
Any other observations the anel may wish to make in relation to the proposals for change.
The panel's advice as to how to proceed in the speediest and most efficient manner
in the interest of local people.
To submit its recommendations by 1 2 June 2003.
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Market Testing
Mr. Bercow: To ask the Secretary of State for Health what the estimated level of saving to the Department is from the use of market testing in 2002–03. [107761]
Mr. Lammy: The Department has not undertaken any market testing exercises in 2002–03.
MLX 291
Nick Harvey: To ask the Secretary of State for Health (1) what research his Department has undertaken on the implementation of MLX 291 by the Medicines Control Agency and its effect on (a) morbidity and (b) mortality in patient groups; and if he will make a statement; [109529]
- (2) what assessment he has made of the possibility of MLX 291 causing medicines to be decanted into unsuitable containers, with particular reference to those more easily accessible to children; and if he will make a statement; [109531]
(3) what representations he has received on MLX 291; and if he will make a statement. [109530]
Mr. Lammy: Consultation letter MLX 291 contained proposals to introduce new regulations relating to paracetamol, aspirin and iron supplements in order to take account of the British Standard on Child Resistant Packaging for non reclosable packaging for pharmaceuticals—BS 8404. It also proposed that medicines containing more than 24mg of elemental iron per unit does as well as liquid paracetamol preparations will also, for the first time, i.e. current requirements applying to reclosable containers of solid dosage and paracetamol.
The proposals contained in MLX 291 were based on advice from the Committee on Safety of Medicines (CSM) which considered published data from Hospital Episode Statistics (HES) for England and Wales and from Hospital Accident Surveillance System (HASS) data, from the Department of Trade and Industry's (DTIs) consumer safety unit. The aim of the amended legislation is to reduce or prevent toxicity from accidental drug overdose in children, which results in nearly 150 hospital admissions per week.
The existing requirements for child resistant packaging in the Medicines (Child Safety) Regulations 1975 (as amended) already contain a provision to allow patients to receive these medicines in a container which is not child resistant, if they wish to do so and make a specific request to a pharmacist or doctor to that effect. The proposed new regulations include an extended adult test on accessibility for those up to 75 years rather than 60 years of age under the old standard. There is currently no proposal to remove the existing provision to dispose these medicines in non child resistant containers given the many and various ways in which elderly patients now receive their medication, including home delivery from the pharmacy.
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The public consultation on the proposals started on 26 November and closed on 18 February 2003. A large number of responses have been received and the Medicines Commission will be consulted shortly. Once this process is complete, in accordance with the terms of the Code of Practice on Access to Government Information, the Agency intends to make copies of replies received publicly available.
Parkinson's Disease
Mr. Paul Marsden: To ask the Secretary of State for Health how many people suffer from Parkinson's disease in Shrewsbury and Atcham. [109680]
Mr. Lammy: Neither national nor local statistics are collected on how many people suffer from Parkinson's disease in Shrewsbury and Atcham.
Mr. Bercow: To ask the Secretary of State for Health if he will make a statement on the incidence of Parkinson's Disease in the United Kingdom in each of the last 10 years. [110323]
Jacqui Smith: The information that is available is shown in the table and relates to finished consultant episodes (FCEs) involving Parkinson's Disease. A FCE is defined as a period of patient care under one consultant in one health care provider. The figures do not represent the number of patients suffering from Parkinson's Disease, as one person may have several episodes within a year.
| Number | |
|---|---|
| 1991–92 | 12,031 |
| 1992–93 | 11,483 |
| 1993–94 | 10,764 |
| 1994–95 | 9,731 |
| 1995–96 | 10,627 |
| 1996–97 | 10,855 |
| 1997–98 | 11,281 |
| 1998–99 | 10,389 |
| 1999–2000 | 10,099 |
| 2000–01 | 9,495 |
| 2001–02 | 9,420 |
Notes:
1. ICD10 codes G20-G22 have been used from 1995–96, ICD9 code 332 was used in previous years.
2. Data in this table is grossed for both coverage and unknown/invalid clinical data, except for 2001–02 which are ungrossed.
3. The main diagnosis is the first of seven diagnosis fields in the HES data set, and provides the main reason why the patient was in hospital during the episodes.
Source:
Hospital Episodes Statistics (HES), Department of Health.
Prescription Charges (Fraud)
Dr. Evan Harris: To ask the Secretary of State for Health if he will estimate the total cost to the NHS in England of (a) prescription charge evasion fraud and (b) measures to help reduce prescription charge evasion, including payments to pharmacists, in real terms, in each year since prescription charges were introduced; and if he will make a statement. [109544]
Mr. Lammy: The National Health Service Counter Fraud and Security Management Service (NHS CFSMS) has an on-going programme of highly accurate
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risk measurement exercises (accurate to plus or minus 1 per cent.) designed to reveal levels of losses and, through repeated exercises, reduction in such losses. The National Audit Office have audited this process and are satisfied to its accuracy. Phase one of these exercises (examining patient fraud losses) included pharmaceutical patient fraud. The following table details the results.
| Year data selected | Fraud losses |
|---|---|
| 1998–99 | 117 |
| 1999–2000 | 69 |
A statistically valid sample of those prescriptions prescribed during March 2003 has been taken for a further measurement exercise to be completed. Further fraud reductions are anticipated and the figures will be produced later this year.
There was no accurate measurement of pharmaceutical patient fraud prior to the commencement of these exercises in 1998–99.
Point of dispensing (PoD) checks were introduced in all community pharmacies on 1 April 1999 to help deter this type of fraud. The check requires pharmacists to ask patients, who are claiming free prescriptions, if they have evidence to support their claim to exemption from prescription charges.
In 1998–99, pharmacists received an addition to their global sum, of £1.85 million, for set-up costs to enable PoD checks to commence. In 1999–2000, a sum of £12.25 million, (at 1998–99 prices) for undertaking PoD checks was incorporated within the overall figure, representing 1.67 per cent. of the global sum. This sum covers pharmacists' NHS remuneration and has been uprated annually since then. The proportion for PoD checks is not separately identified.
Where a patient wrongly fails to pay any amount in respect of NHS charges or obtains goods or services to which they are not entitled, the amended National Health Service Act 1977 (sections 122A and 122B) provides for a civil penalty charge to be imposed. The penalty charge is calculated as five times the recoverable amount, up to a maximum of £100, in addition to the original charge. In cases of non-payment a surcharge of up to £50 may be imposed. Between 1 August 2001 and 31 March 2003 £1,362,000 has been recovered through the penalty charge system.
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