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5 Jan 2004 : Column 204Wcontinued
Brian Cotter: To ask the Secretary of State for Health on what basis it was decided that a threshold of 15,000 square metres should be used to determine which shopping developments should be exempt from full entry requirements in relation to his Department's proposals for the deregulation of pharmacy services. 
Ms Rosie Winterton: The object in choosing shopping developments of 15,000 square metres or more was to include developments which currently attract many consumers but which may have limited retail pharmacy provision.
If a development provides relatively self-contained facilities (that is, shoppers visit retail outlets in that development but tend not to venture into adjacent local neighbourhoods) the current Regulations impose restrictions on competition and access to national health service services by people choosing to visit the development.
Exempting such pharmacies will offer the prospect of immediate improvements in access to pharmaceutical services at a time and place which patients and consumers choose with the impactif anyon existing pharmacies diluted over a wide geographic area.
The consultation document, 'Proposals to Reform and Modernise the NHS (Pharmaceutical Services) Regulations 1992', was published on 29 August 2003, with the consultation period running until 21 November
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Sandra Osborne: To ask the Secretary of State for Health (1) when the Joint Committee of Vaccination and Immunisation will meet (a) to review the clinical trials and (b) to decide on a policy on whether to include the pneumococcal conjugate vaccine into the childhood immunisation programme; 
the optimal schedule of this vaccine in infants;
whether there is a need for a booster dose of vaccine in the second year of life to maintain protection; and the impact that introducing this vaccine to the childhood schedule has on the level of protection given by the other vaccines.
The independent expert advisory body, the JCVI, is currently examining the evidence of the potential benefits of introducing pneumococcal conjugate vaccine to the infant immunisation schedule. What is clear is that there are many uncertainties in the evidence, in particular in measuring the burden of pneumococcal disease, and the amount of disease that is expected to be prevented by a vaccine in both the short and longer term because it protects against only seven of the numerous strains of pneumococcus.
Encouraging data is emerging from the United States on the impact the conjugate vaccine has had on reducing pneumococcal disease both in the children immunised and also in adults. The JCVI is assessing the evidence as it develops.
Dr. Tonge: To ask the Secretary of State for Health what assessment he has made of the comparative costs of (a) vaccinating children against pneumococcal disease and (b) treating the disease and its complications. 
Miss Melanie Johnson: Studies are in place to assess the cost effectiveness of introducing pneumococcal vaccine into the childhood immunisation schedule by investigating the burden of pneumococcal disease in the United Kingdom and how much of this is vaccine preventable. The ongoing studies take into account the cost of treating the disease and its complications.
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Tim Loughton: To ask the Secretary of State for Health what the average cost of NHS prescriptions has been in each of the last six years; and how much of this was recouped by prescription charges. 
|Number of prescription items (millions)||Net Ingredient Cost(£ millions)||Average NIC per item (£)|
|Community pharmacists and appliancecontractors only|
|Total charged||Total exempt||Total|
|Total charged||Total exempt||Total|
1. Total charged includes 'charge at point of dispensing' and 'prepayment certificates'.
2. Total exempt includes 'exempt and NHS Low Income Scheme', 'no charge contraceptives' and 'personally administered' drugs.
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Mr. Burstow: To ask the Secretary of State for Health what protocols written by his Department govern incentives received by (a) general practitioners and (b) other prescribing staff to prescribe certain prescriptions; how compliance with these protocols is monitored; and if he will make a statement. 
Ms Rosie Winterton: Primary care trusts (PCTs) in England may run prescribing incentive schemes to encourage the quality and cost-effectiveness of prescribing in general practice. Incentive payments generated through such schemes should be used for the benefit of the patients.
Mr. Hutton: The Commission for Health Improvement is responsible for conducting reviews and investigations of health care for which national health service bodies or service providers have responsibility. This responsibility encompasses the review or investigation of health services for prisoners where these are commissioned or provided by primary care trusts.
Ms Rosie Winterton: The national health service complaints procedure does not currently extend to health care provided in prison. However, with the forthcoming transfer of prison health commissioning responsibility from the Prison Service to the NHS, prisoners will have access to the NHS complaints process where services are commissioned by the NHS.
Ms Rosie Winterton: The "National Confidential Inquiry into Suicide and Homicide by People with Mental Illness" recommended that all discharged in-patients who have severe mental illness or a recent history of deliberate self-harm should be followed up within one week.
Dr. Ladyman: All prisons and their local national health service partners undertake regular joint assessments of prisoners' health needs and are responsible for providing, through local delivery plans, any additional services that may be required to meet unmet need identified during the assessment process.
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The Department of Health and the Home Office have commissioned, for completion in spring 2004, a health strategy for older prisoners. This will include recommendations on the location and type of residential accommodation needed by older prisoners, the nature of the prison regime, and individual healthcare planning and throughcare arrangements. It will also identify the core principles that should apply to the management of older prisoners throughout their period in custody, including the transfer to residential or nursing homes of prisoners with degenerative diseases.
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