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6 Oct 2003 : Column 1259W—continued
Alzheimer's Disease
Dr. Gibson: To ask the Secretary of State for Health (1) how many Alzheimer's patients are in (a) private and (b) NHS care homes in the United Kingdom; [129514]
- (2) how many Alzheimer's patients entered (a) private and (b) NHS care homes in the United Kingdom in each of the last three years; [129515]
(3) what the average care home costs were to the NHS for each Alzheimer's patient in each of the last three years; [129516]
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(4) how much was spent by the NHS on care home costs for Alzheimer's disease patients in each of the last three years; [129517]
(5) how many (a) moderate and (b) severe Alzheimer's disease patients were diagnosed in the United Kingdom in each of the last three years. [129518]
Dr. Ladyman: Data are not collected on the number of people with Alzheimer's disease, in the population generally or in care homes in particular, or about the care home costs of people with Alzheimer's.
Research evidence shows that about five per cent, of the population who are aged over 65 have dementia. This represents about 600,000 people in the United Kingdom. Alzheimer's disease causes up to 60 per cent. of cases of dementia.
While data are not available specifically about care home costs for people with Alzheimer's, the average weekly fee for residential care in England at March 2003 was £336.50.
Dr. Gibson: To ask the Secretary of State for Health how much was spent by the NHS on drug treatments for (a) moderate and (b) severe Alzheimer's disease patients in each of the last three years. [129519]
Dr. Ladyman: The table shows how much was spent, over the last three years, on drug treatments for mild to moderate and moderate to severe Alzheimer's disease. This data cover all prescription items that were dispensed in the community in England. This includes drugs that were prescribed in hospitals or clinics, which are dispensed in the community. However, the data do not include drugs that are dispensed in hospitals/clinics or private prescriptions.
| 2000 | 2001 | 2002 | ||||
|---|---|---|---|---|---|---|
| Drugs for dementia | Prescriptionitems (thousand) | Net ingredientcost (£000) | Prescriptionitems (thousand) | Net ingredientcost (£000) | Prescriptionitems (thousand) | Net ingredientcost (£000) |
| Drugs used for mild to moderate Alzheimer's disease | ||||||
| Donepezil Hydrochloride | 43.6 | 4,178.2 | 91.2 | 8,815.3 | 169.3 | 16,078.3 |
| Galantamine | 0.2 | 13.6 | 11.3 | 880.2 | 31.1 | 2,469.9 |
| Rivastigmine | 9.9 | 681.0 | 19.7 | 1,309.2 | 30.5 | 1,997.9 |
| Drugs used for moderate to severe Alzheimer's disease | ||||||
| Memantine Hydrochloride | — | — | — | — | 0.3 | 21.1 |
| All drugs for dementia | 53.8 | 4,872.8 | 122.1 | 11,004.6 | 231.3 | 20,567.1 |
Notes:
1. The prescription information was obtained from the Prescription Cost Analysis (PCA) system and is based on a full analysis of all prescriptions dispensed in the community, ie by community pharmacists and appliance contractors, dispensing doctors, and prescriptions submitted by prescribing doctors for items personally administered in England. Total prescriptions include not only prescriptions originating from general medical practitioners in England but also from hospital doctors, nurses, and dentists, provided they were dispensed in the community. 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. Drugs used for dementia are those defined in the British National Formulary (BNF) section 4.11 "Drugs for dementia". Drugs used for dementia have been grouped into those used for mild to moderate and moderate to severe Alzheimer's disease in line with the NICE guidance on drugs for Alzheimers disease. Please refer to the NICE website at www.nice.org.uk for more details.
3. Doctors, dentists or nurses write prescriptions on a prescription form. Each single item written on the form is counted as a prescription item.
4. Net ingredient cost refers to the basic cost (which the dispenser is reimbursed) of the drug before discounts and does not include any dispensing costs or fees.
Data Source:
Prescription Cost Analysis (PCA) data from the Prescription Pricing Authority (PPA).
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Dr. Gibson: To ask the Secretary of State for Health what instructions have been offered to PCTs regarding drug prescribing practices for Alzheimer's disease patients. [129520]
Dr. Ladyman: In January 2001, the National Institute for Clinical Excellence (NICE) recommended that donepezil (Aricept), rivastigmine (Exelon) and galantamine (Reminyl) should be made available on the national health service as one component of the management of those people with mild to moderate Alzheimer's disease.
Directions have been issued obliging health authorities and primary care trusts to provide appropriate funding for treatments recommended by NICE. The directions came into effect on 1 January 2002.
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Anaesthetists
Mr. Hoban: To ask the Secretary of State for Health how many (a) consultant and (b) other anaesthetists there were in England in each of the last five years. [129601]
Mr. Hutton: The information requested is shown in the table.
The number of consultants in anaesthetics (including intensive care) increased by 33.5 per cent., between September 1998 and March 2003.
The total number of doctors in anaesthetics (including intensive care) increased by 21 per cent., between September 1998 and September 2002.
| 1998 | 1999 | 2000 | 2001 | 2002 | March 2003 | |
|---|---|---|---|---|---|---|
| All staff | 6,817 | 7,010 | 7,264 | 7,680 | 8,233 | n/a |
| Consultant | 2,978 | 3,168 | 3,322 | 3,595 | 3,874 | 3,977 |
| Associate Specialist/Staff Grade | 625 | 681 | 754 | 817 | 885 | n/a |
| Registrar Group | 1,629 | 1,621 | 1,646 | 1,686 | 1,758 | n/a |
| Senior House Officer | 1,274 | 1,248 | 1,288 | 1,378 | 1,498 | n/a |
| House Officer | 1 | 13 | 21 | 14 | 31 | n/a |
| Hospital Practitioner/Clinical Assistant | 309 | 278 | 233 | 188 | 179 | n/a |
| Other Hospital grades | 1 | 1 | 0 | 0 | 0 | n/a |
| Other CHS grades | 0 | 0 | 0 | 2 | 8 | n/a |
(68) As at 30 September each year except for 2003, which is as at 31 March.
n/a—not available
Source:
Department of Health medical and dental workforce census.
Ancillary Services
Helen Jones: To ask the Secretary of State for Health what the rate of pay per hour is for (a) cleaners and (b) porters in each acute trust; and which of these trusts have contracted out (i) cleaning and (ii) portering services. [129688]
Dr. Ladyman: Rates of pay for cleaners and porters are not identified separately in the national health service staff earnings survey. Cleaners and porters directly employed by trusts are paid in accordance with national agreements reached by the ancillary staffs' Whitley Council or in accordance with agreements reached locally. The current Whitley rates of pay are set out in advance letter (ASC) 1/2003, a copy of which is available in the Library.
On the subject of trusts where these services have been contracted out, I refer the hon. Member to the reply I gave her today.
Helen Jones: To ask the Secretary of State for Health which companies have contracts with NHS acute trusts for carrying out (a) cleaning and (b) portering services; which trusts have contracts with each company; what the commencement date of each contract was; and what the duration of the contract is in each case. [129689]
Dr. Ladyman: A number of companies have contracts with national health service acute trusts for the provision of domestic services.
Information requested relating to each contract—including the specific services provided and the duration—is not collected centrally.
Anti-TNF Therapy
Keith Vaz: To ask the Secretary of State for Health for what reason anti-TNF therapy is not available to patients in the Leicester area. [131094]
Dr. Ladyman: Tumour necrosis factor (TNF) therapy has been available to patients in the Leicestershire area since 2002, in line with the National Institute for Clinical Excellence timescale for implementation. It is provided by the University Hospitals of Leicester National Health Service Trust for those patients who meet the criteria which has been agreed by the Trust and the primary care trusts in the area.
Keith Vaz: To ask the Secretary of State for Health how many requests for anti-TNF treatment he has received in the last 12 months. [131095]
Dr. Ladyman: We estimate that there has been around 170 letters from right hon. and hon. Members and the public on this subject. There have also been several Parliamentary Questions on anti-TNF therapy and there was an adjournment debate on the care and treatment of rheumatoid arthritis in July.
Keith Vaz: To ask the Secretary of State for Health if he will estimate the cost of providing anti-TNF treatment per patient. [131096]
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Dr. Ladyman: In their appraisal of these drugs, the National Institute for Clinical Excellence estimated the costs per patient using the Monthly Index of Medical Specialities, September 2001. Updated costs from the September 2003 edition show that Etanercept costs £178.75 per week when administered at a dose of 25 mg. twice weekly, equivalent to £9,295 per annum. Infliximab costs £451.20 per vial, equivalent to £12,182 in the first year and an average of £8,798 in subsequent years.
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