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21 Oct 2003 : Column 541W—continued
HEALTH
Age-related Macular Degeneration
Mr. Baron: To ask the Secretary of State for Health what estimate the Government have made of the number of people whose sight will be affected following the Government's decision to delay implementation of NICE's guidelines to make photo-dynamic therapy available to those suffering from age-related macular degeneration. [132691]
Ms Rosie Winterton [holding answer 20 October 2003]: We are not delaying implementation of the National Institute for Clinical Excellence (NICE) guidance on photo-dynamic therapy (PDT). Patients are already receiving PDT treatment on the national health service and will do so in increasing numbers in the coming months.
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In reviewing the final appraisal determination, the NICE Guidance Executive also considered whether there were grounds for advising the Department to vary the three-month direction. They considered there were grounds to do so on this occasion.
It was the Department's assessment, informed by evidence submitted to NICE, that the NHS would be unable to implement the guidance in full within the usual three-month period. We have previously varied the direction on five occasions when it was required to implement effectively the guidance to provide the service to patients.
The guidance issued to primary care trusts on PDT asks that PCTs should make funds available within nine months. We expect implementation to have been fully achieved within this time frame with all eligible patients having access to available treatment. PCTs may complete implementation earlier should their service planning enable them to do so.
Within the nine months allowed for full implementation, commissioners are expected to expand the service in a planned way to ensure there is sufficient capacity which is appropriately located to meet patient need, a fully trained workforce and access to expert diagnostic services. This will include the creation of new, and the expansion of existing, PDT centres and expert reading centres.
Community Health Councils
Mr. Baron: To ask the Secretary of State for Health what percentage of community health councils will be fully operational on 1 November; and if he will list those that will no longer be operational on that date. [132692]
Ms Rosie Winterton [holding answer 20 October 2003]: 98 per cent. of community health councils (CHCs) will still be operational on 1 November.
Three CHCs (Bassetlaw, Southern Derbyshire and Hounslow) will be closed. In these cases, arrangements have been made for members of the public to access information and advice from neighbouring CHCs.
Mr. Baron: To ask the Secretary of State for Health what the staffing level of community health councils was on (a) 1 January, (b) 1 April and (c) 1 July. [132693]
Ms Rosie Winterton [holding answer 20 October 2003]: The staffing level of community health councils (CHCs) was 732 on 1 January, 680 on 1 April and 572 on 1 July.
Mr. Baron: To ask the Secretary of State for Health pursuant to his answer of 17 September 2003, Official Report, column 843W, on community health councils, what the staffing levels on 1 November will be as a proportion of the full-time staffing strength before the decision to abolish the councils was taken. [132760]
Ms Rosie Winterton [holding answer 20 October 2003]: It is expected that about 54 per cent. of the full staff complement will be working in community health councils on 1 November.
Mental Health
Dr. Fox: To ask the Secretary of State for Health which mental health trusts are unable (a) to offer a
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crisis resolution service and (b) to provide funded accommodation for service users taken into care under section 136 of the Mental Health Act 1983. [131024]
Ms Rosie Winterton: Information is not available in the requested format. Information on the distribution of crisis resolution teams in operation on 31 March 2003 according to strategic health authority boundaries is provided in the table.
| Strategic health authority | Number of crisis resolution teams |
|---|---|
| Avon, Gloucestershire and Wiltshire | 7 |
| Bedfordshire and Hertfordshire | 2 |
| Birmingham and the Black Country | 12 |
| Cheshire and Merseyside | 2 |
| County Durham and Tees Valley | 5 |
| Coventry, Warwickshire, Herefordshire and Worcestershire | 4 |
| Cumbria and Lancashire | 2 |
| Essex | 1 |
| Greater Manchester | 3 |
| Hampshire and Isle of Wight | 2 |
| Kent and Medway | 1 |
| Leicestershire, Northamptonshire and Rutland | 0 |
| Norfolk, Suffolk and Cambridgeshire | 3 |
| North and East Yorkshire and Northern Lincolnshire | 2 |
| North Central London | 4 |
| North East London | 1 |
| North West London | 3 |
| Northumberland, Tyne and Wear | 4 |
| Shropshire and Staffordshire | 3 |
| Somerset and Dorset | 0 |
| South East London | 7 |
| South West London | 4 |
| South West Peninsula | 6 |
| South Yorkshire | 4 |
| Surrey and Sussex | 5 |
| Thames Valley | 6 |
| Trent | 4 |
| West Yorkshire | 4 |
| England | 101 |
Fabry's Disease
Mr. Hoban: To ask the Secretary of State for Health (1) how many primary care trusts pay for the prescribing of Fabrazyme; and which do not pay for it; [133575]
- (2) what guidance has been issued on the treatment of Fabry Disease; [133576]
(3) what guidance has been issued to (a) primary care trusts and (b) NHS acute hospitals trusts on prescribing Fabrazyme. [133577]
Dr. Ladyman: No central guidance on the treatment of Fabry's Disease or on the prescribing of Fabrazyme has been issued to primary care trusts or acute hospitals.
The Prescription Pricing Authority only collects prescription information on drugs dispensed in the primary care setting. We have no record of Fabrazyme being dispensed in the community in England. Information is not collected centrally on drugs dispensed in secondary care so we would be unable to say if it had been prescribed in a hospital setting.
Although the forthcoming national service framework for long term conditions will not deal directly with Fabry's Disease it is expected to set standards that will improve support and care for people with long term conditions and disabilities.
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Neurological Conditions
Mrs. Gillan: To ask the Secretary of State for Health (1) how many people in (a) Chesham and Amersham, (b) Buckinghamshire and (c) England suffer from neurological conditions; [132329]
- (2) what plans he has to monitor the number of people with neurological conditions in (a) Chesham and Amersham, (b) Buckinghamshire and (c) England. [132330]
Ms Rosie Winterton: The information requested is not collected centrally. We do not ask the national health service to collect data on the incidence of individual conditions such as neurology because of the enormous range of conditions and diseases that exist.
I have no plans to monitor the number of people with neurological conditions. The administrative burden of developing and maintaining a diseases and conditions database would be expensive and would divert resources away from the main function of the NHS, which is the treatment of patients.
NHS Dentistry
Mr. Gordon Prentice: To ask the Secretary of State for Health how much, and what percentage, of the NHS budget was spent on NHS dentistry in (a) 1992, (b) 1997 and (c) the latest 12 months for which figures are available. [121993]
Ms Rosie Winterton: The gross national health service spend on the general dental service (GDS) and personal dental services (PDS) 1 and the proportion this represents of total gross NHS expenditure for 1992–93, 1997–98 and 2001–02 are shown in the following table.
| Gross NHS dental service expenditure(9) (£ million) | Gross NHS dental service expenditure(9) as percentage of total gross NHS expenditure | |
|---|---|---|
| 1992–93 | 1,306 | 4.4 |
| 1997–98 | 1,348 | 3.6 |
| 2001–02(10) | 1,674 | 3.2 |
(7) All years give GDS expenditure. 2001–02 also includes PDS expenditure. PDS pilots began in 1998 and a proportion of GDS expenditure was moved into a separate budget to reflect this. Spend on PDS pilots has been included in the 2001–02 figures. This includes spending on Trust-led pilots as well as PDS/GDS.
(8) Gross expenditure is the total expenditure on the service before the deduction of patient charge income.
(9) All years give GDS expenditure. 2001–02 also includes PDS expenditure. Expenditure on community and hospital dental services has not been included in this table; information on the total funding for these services is not collected centrally.
(10) Figures for 2001–02 are on a resource basis. This change in accounting practice had the effect of increasing the levels of expenditure attributed to that year. As a result the NHS expenditure total increased by about £200 million compared with the cash system used for previous years.
The amount of money drawn down through the GDS funding arrangements is determined by the amount of work dentists carry out on NHS patients. The rate of increase of spend has been moderated by an increase in the number of dentists treating patients privately. The proportionate spend on dentistry has also been affected
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by the major additional investment across the NHS in recent years; total NHS expenditure has increased at a faster rate than expenditure on dentistry.
The gross NHS GDS expenditure shown above for 2001–02 does not include the £35 million Modernisation Fund and £6 million Dentistry Action Plan Payments.
The Health and Social Care (Community Health and Standards) Bill currently before the House proposes the introduction of local commissioning for NHS dental services. Funding currently held and administered centrally would then become part of primary care trusts' general allocations. Unlike the current arrangements, resources would remain with the PCT should a dental practice reduce its level of commitment to the NHS. In the longer term, allocations will need to take oral health inequalities into account.
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