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20 Jun 2003 : Column 485W—continued
MRI Scans
Matthew Taylor: To ask the Secretary of State for Health what the average MRI scan waiting times were in England in each of the last 10 years by (a) hospital and (b) region. [119532]
Miss Melanie Johnson: Data are not collected centrally on waiting times for magnetic resonance imaging (MRI) scans. The length of time that a patient may have to wait for a scan is dependent on their clinical condition. Emergency cases need to be seen immediately. Other cases will be carried out as quickly as possible, dependent on the clinical priority of all patients waiting to be scanned.
Where a MRI scan forms part of the diagnostic process for a patient urgently referred with suspected cancer, this will be covered by the target of a maximum two months wait from urgent referral to first treatment, which will be in place for all cancers by the end of 2005.
To increase the capacity of diagnostic services, funding has been made available for the provision of new and replacement scanners. The New Opportunities
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Fund has provided funding for 57 MRI scanners and the NHS Cancer Plan has provided funding for a further 50 MRI and 50 computed tomography scanners through central purchasing programmes by 2004.
Neonatal Intensive Care
Mr. Paul Marsden: To ask the Secretary of State for Health how many neonatal intensive care cots there were in each neonatal intensive care unit at 31 March 1999. [119657]
Dr. Ladyman [holding answer 16 June 2003]: Information is not collected for each neonatal intensive care unit. The number of neonatal intensive care cots reported by each national health service trust in March 1999 has been placed in the Library. These figures are not comparable with current data on neonate intensive care cots as some NHS trusts included special care baby unit cots in error.
Travel Expenses
Mr. Burstow: To ask the Secretary of State for Health how much NHS travel expense fraud has been identified in each of the last five years. [118641]
Ms Rosie Winterton: The value of travel expense fraud identified in each of the last five years is shown in the table.
| Year | Number of cases | Value (£) |
|---|---|---|
| 1998–99 | 0 | 0 |
| 1999–2000 | 2 | 8,180 |
| 2000–01 | 6 | 14,664 |
| 2001–02 | 7 | 14,135 |
| 2002–03 | 9 | 349,295 |
The National Health Service counter fraud service, now the counter fraud and security management service, was formed in 1998, with the overall remit to tackle fraud and corruption within the NHS. It became operational in January 2000. No such figures were collated prior to its existence.
These figures should be set in the context of increasingly effective counter fraud arrangements in the NHS and an increasing proportion of NHS fraud which is being identified and stopped.
Official Spelling
Bob Russell: To ask the Secretary of State for Health if he will make it his policy that all official (a) correspondence, (b) reports and (c) documentation from his office uses the English spelling of words where this differs from the US version. [118868]
Ms Rosie Winterton: The Cabinet Office has issued guidance for Departments on the handling of ministerial and other correspondence, which emphasises that appropriate arrangements should be in place to ensure that the quality of all replies is high. It has also issued guidance on plain written English.
Departmental publications are prepared in line with the Guidance on the Work of the Government Information and Communication Service.
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Pain Management
Mr. Drew: To ask the Secretary of State for Health (1) if he will make a statement on progress being made towards the establishment of a national service framework on the control of pain; [119942]
- (2) what estimate he has made of the number of people each year who suffer from the symptoms of pain as part of their (a) illness and (b) injury. [119943]
Dr. Ladyman: In selecting a topic for and developing and implementing a national service framework (NSF), account is taken of the importance of a health issue in terms of morbidity and mortality, the scope for service improvement and the capacity of the NHS and its partner agencies to implement the framework. Work is in hand on NSFs for renal services, children's services and long term conditions. These new NSFs amount to a significant programme of quality improvement across the NHS and partner agencies. There are no plans to amend the programme at present.
Pain management is an important component of most patients' care and is provided as part of the patient's overall treatment. Data on the pain patients might experience as a reason for admission is not collected.
Race Relations
Angela Eagle: To ask the Secretary of State for Health what progress has been made in his Department and non-departmental public bodies on implementing the requirements of the Race Relations Amendment Act 2000; and if he will publish the results of the monitoring required by the Act. [117621]
Ms Rosie Winterton: The Department is committed to transforming the health and social care system so that it produces faster, fairer services that deliver better health and social care and tackle inequalities. Achieving sustainable improvements in health and services for black and minority ethnic people is an integral and vital aspect of this programme of investment and reform.
The Department's Race Equality Scheme covers the Department, Executive Agencies and the Directorates of Health and Social Care. Strategic health authorities, primary care trusts, national health service trusts and special health authorities are subject to the Race Relations (Amendment) Act 2000 and are required to publish a Race Equality Scheme setting out how they intend to promote race equality within their organisation.
The Department's strategy for meeting the needs of minority ethnic communities is to set action on race equality within the overall framework for planning and delivering the Department's priorities. The Department has a detailed programme of work under way to take forward our race equality commitments and has strengthened the arrangements for supporting and accounting for progress on race equality. A board level equality review programme has recently been carried out to develop a corporate framework for setting priorities and reviewing progress including those made in the Department's Race Equality Scheme.
On 10 March 2003, the Department published "Inside Out", a report making recommendations for improving mental health services for black and minority ethnic
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groups. The report was developed with the close involvement of local communities and black and minority ethnic stakeholders and provides part of a race impact assessment on mental health. This has provided the evidence to show that there is impact, which is adverse, disproportionate and unjustifiable in terms of the Race Relations (Amendment) Act. The Department will be taking remedial action and will be publishing a remedial action plan for consultation in 2003.
As required by its employment duties, the Department will be publishing a report later this summer on the ethnic monitoring data collected so far and also has a programme of work under way to put in place the additional monitoring arrangements required.
Regulatory Bodies
Mr. Yeo: To ask the Secretary of State for Health if he will list the (a) number of staff employed by and (b) budget of each regulatory body for which his Department is responsible in each year since 1997. [117783]
Ms Rosie Winterton: Bodies responsible for the regulation of health care professionals are self-funding by means of fees received from registrants. The Department does not collect information on their staffing levels or levels of funding.
Information on staffing levels and funding for the special health authorities and non-departmental bodies for which the Department is responsible (some of which have regulatory responsibilities) is contained in "Public Bodies", copies of which, dating back to 1982, are available in the Library.
The only current regulatory body for which the Department is responsible and which is not covered by "Public Bodies" is the Council for the Regulation of Healthcare Professionals. The Council was formally established in April 2003, has four staff and will receive funding of £625,000 from the Department in 2003–04.
Residential Homes
Mr. Cameron: To ask the Secretary of State for Health what guidance he has given to NHS trusts and others about de-registering residential homes; and what his policy is on a trust de-registering all of its homes. [119250]
Dr. Ladyman: National Health Service trusts have no function in relation to the registration of residential homes. That is a function of the National Care Standards Commission.
Seroxat
Mr. Dhanda: To ask the Secretary of State for Health (1) what plans his Department has to restrict the availability of Seroxat to (a) children and (b) adults; [119551]
- (2) what advice his Department will issue to GPs regarding the prescription of Seroxat to adults. [119552]
Ms Rosie Winterton: New data from clinical trials of paroxetine (Seroxat) in children and adolescents were received by the Medicines and Healthcare products Regulatory Agency (MHRA) at the end of May 2003. These new data have been reviewed by an expert
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working group on selective serotonin reuptake inhibitors (SSRIs) and the Committee on Safety of Medicines (CSM). The data do not demonstrate efficacy in depressive illness in this age group and show an increase in the risk of episodes of self-harm and potentially suicidal behaviour in the Seroxat group compared to placebo. Various analyses suggest that the risk of these events is between 1.5 and 3.2 times greater with Seroxat compared to placebo. On the basis of these data, the CSM has advised that Seroxat should not be used in children and adolescents under the age of 18 years to treat depressive illness. This advice was communicated to health professionals via the Public Health Link on 10 June 2003 and was placed on the MHRA website, along with information for patients. Revised patient information leaflets containing the new advice are being sent to prescribers and pharmacists.
Seroxat is not licensed for use in those under 18, but it is used in this age group outside its licensed indications where prescribes make a judgment on their own responsibility that it is the right treatment for a particular patient.
SSRIs, including Seroxat, have been under close continuous review by the MHRA and the CSM for a number of years. The product information for SSRI antidepressants already contains advice that suicidal thoughts and behaviour are likely to increase in the early stages of treatment of depression (as with all antidepressants) and patient information leaflets already contain advice to seek medical attention urgently in the event of such symptoms.
The CSM formally reviewed the issue of suicidal behaviour with SSRIs most recently in December 2001 and concluded that the evidence was not sufficient to confirm a causal association between SSRIs and suicidal behaviour, although an effect in a small high-risk population could not be ruled out. The CSM has advised that Seroxat is an effective treatment for adults with depressive illness and anxiety disorders and that the benefits of treatment outweigh the risks.
The expert working group of the CSM will examine urgently what implications, if any, these new findings from clinical trials in children have for the use of Seroxat in adults and for other SSRIs.
Mrs. Calton: To ask the Secretary of State for Health (1) what plans he has to expedite the review of (a) Seroxat and (b) other selective serotonin reuptake inhibitors; [119777]
- (2) what plans he has to improve the warnings given to (a) prescribers and (b) the public about the (i) side-effects and (ii) withdrawal effects of (A) Seroxat and (B) other selective serotonin reuptake inhibitors; [119778]
(3) what plans he has to improve the effectiveness of the Yellow Card scheme for reporting adverse side-effects of drugs; [119779]
(4) if he will withdraw Seroxat from use for new prescribing pending a review of its and other SSRI anti-depressants' safety. [119780]
Dr. Ladyman: A new expert group of the Committee on Safety of Medicines (CSM) has been convened to further review the safety of selective serotonin re-uptake inhibitors (SSRIs) and to ensure the advice in the
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product information for both patients and prescribers is optimal for the safe use of these products. This group has been asked to examine what implications, if any, the CSM's recent advice on the use of Seroxat in children have for the use of Seroxat in adults and for other SSRIs. The timetable for the group's programme of work has been planned with a view to the availability of advice as promptly as possible, commensurate with a full and detailed consideration of the evidence including the experiences of patients. As part of its initial considerations, the group has advised on strengthened advice on side effects and withdrawal reactions for inclusion in the patient information leaflet on Seroxat. Product information for other SSRIs will also be considered.
The advice of the CSM, most recently in 2001, is that the benefits of Seroxat, when used in adults for licensed indications, outweigh the risks. Regulatory authorities world-wide have also taken a similar position. Depression and anxiety disorders are serious conditions that can cause severe suffering and are associated with an increased risk of suicide. The availability of effective treatments is critically important. In the absence of evidence indicating that the risks of using Seroxat in adults outweigh the benefits, it would be difficult to justify withdrawing the medicine from use.
The Yellow Card Scheme is recognised to be one of the best in the world in terms of the level of reporting, has a proven track record of identifying new drug safety hazards and enables the monitoring of all medicines, including Seroxat, in clinical use. The effectiveness of the Scheme is under continuous review by the Medicines and Healthcare products Regulatory Agency and the CSM. From April 2003, the first phase of patient reporting of suspected adverse drug reactions via NHS Direct was introduced. When fully rolled out in England and Wales, this will enable the first hand experiences of patients to be utilised in the identification and assessment of drug safety issues. Other measures to further strengthen the Yellow Card Scheme include a new regional monitoring centre, established in Scotland last year and the inclusion of education on yellow card reporting in the training of nurse prescribers.
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