---

7 Jan 2004 : Column 386W—continued

State Pension

Steve Webb: To ask the Secretary of State for Work and Pensions if he will estimate the annual cost to the Exchequer, net of savings in means-tested benefits and additional income tax revenue, of paying state pensions in full at the rate of a Category A pension to every UK pensioner aged (a) 80 or over and (b) 75 or over, regardless of their contribution record. [145437]

Malcolm Wicks: The annual cost to the Exchequer from April 2004, net of savings in income related benefits and additional income tax revenue, of paying the state pension in full at the rate of a Category A pension to every UK pensioner aged:

(a) 80 or over is £0.66 billion


(b) 75 or over is £1.20 billion


1. Figures are in 2003–04 price terms rounded to the nearest £10 million.

2. Gross costs are estimated by the Government Actuary's Department and are consistent with Budget 2003 assumptions.

3. The additional costs take into account income related benefit offsets, which are calculated using the DWP policy simulation model and April 2004 benefit rates.

4. Additional income tax revenue is estimated by the Inland Revenue using 2004 tax rates

Recruitment Advertisements

Miss Kirkbride: To ask the Secretary of State for Work and Pensions how much has been spent on recruitment advertisements in the press, broken down by publication, by (a) his Department, (b) quangos under the Department and (c) non-departmental Government bodies under the Department (i) in the last year and (ii) since 1997. [145810]

Maria Eagle: Information about recruitment advertising costs is not collected centrally and could be obtained only at disproportionate cost.

HEALTH

Alzheimer's Disease

Mr. Baron: To ask the Secretary of State for Health (1) how much the NHS spent on anticholinesterase inhibitors for people with Alzheimer's disease in each year since 1997; [144843]

(2) what steps are being taken to ensure that people in long-term care with Alzheimer's disease are assessed for use of anticholinesterase inhibitors; [144844]

(3) what plans he has to re-issue guidance to trusts to ensure that local decisions about whether to prescribe Ebixa on the NHS for people with moderate to severe Alzheimer's disease are not postponed in the absence of guidance from the National Institute for Clinical Excellence. [144845]

7 Jan 2004 : Column 387W

Dr. Ladyman [holding answer 18 December 2003]: The number of prescription items dispensed in the community for drugs for dementia and the associated net ingredient cost, for each year since 1997, are shown

7 Jan 2004 : Column 388W

in the table. Information is not collected about the number and costs of drugs for dementia dispensed in acute and mental health trusts.

Number of prescription items and the associated net ingredient cost for drugs for dementia, dispensed in the community in England, 1997 to September 2003

Drugs for dementia	April to December 1997	1998	1999	2000	2001	2002	January to September 2003
	Net ingredient cost (£000)
BNF chemical name
Donepezil Hydrochloride	656.8	1,919.2	2,917.4	4,178.2	8,815.3	16,078.3	16,829.7
Galantamine	—	—	—	13.6	880.2	2,469.9	2,834.8
Memantine Hydrochloride	—	—	—	—	—	21.1	392.9
Rivastigmine	—	29.2	297.0	681.0	1,309.2	1,997.9	2,262.3
All drugs for dementia	656.8	1,948.4	3,214.4	4,872.8	11,004.6	20,567.1	22,319.8
	Number of prescription items (Thousand)
Donepezil Hydrochloride	7.2	20.2	30.4	43.6	91.2	169.3	181.3
Galantamine	—	—	—	0.2	11.3	31.1	36.2
Memantine Hydrochloride	—	—	—	—	—	0.3	4.7
Rivastigmine		0.4	4.2	9.9	19.7	30.5	32.3
All drugs for dementia	7.2	20.7	34.6	53.8	122.1	231.3	254.5

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, i.e. 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 for dementia are those defined in the British National Formulary (BNF) section 4.11.

3. The Net Ingredient Cost refers to the cost (which the dispenser is reimbursed) of the drug before discounts and does not include any dispensing costs or fees. It does not include any adjustment for income obtained where a prescription charge is paid at the time the prescription is dispensed, or where the patient has purchased a pre-payment certificate.

People in long-term care with Alzheimer's disease have the same access to drugs for dementia as people living elsewhere. If appropriate, those involved in their care will refer them as necessary for assessment by specialist mental health teams.

In August 1999 the Department issued Health Service Circular 1999/176 which asks national health service bodies to continue with local arrangements for the managed introduction of new technologies where guidance from the National Institute for Clinical Excellence (NICE) is not available. These arrangements should involve an assessment of all the available evidence. Funding for treatments, such as Ebixa, should not be withheld simply because of an absence of guidance from NICE.

Autism

Tim Loughton: To ask the Secretary of State for Health how many children in (a) England and (b) Wales have been diagnosed with autism on the latest date for which figures are available. [145690]

Dr. Ladyman: Details of the number of children diagnosed with autism are not available. The Medical Research Council (MRC) published a comprehensive review of autism research in December 2001 which provides an authoritative overview of the current state of knowledge on the prevalence, incidence and causes of autism. The report was commissioned by the Department of Health. It is available on the MRC website at: http://www.mrc.ac.uk/pdf-autism-report.pdf

The report says that according to recent reviews, there appears fairly good agreement that autism spectrum disorders affect approximately 60, and more narrowly defined autism 10–30 per 10,000 children under eight.

In February 2002, we allocated a further £2.5 million to the MRC to help them to take forward their programme of work on autism. Between December 2002 and July 2003, the MRC held a series of four seminars to encourage the development of good quality applications for autism research funding. Topics covered in the seminars were gut and the developing child; brain and mind (neuropsychology and neuroimaging); autism in populations and outcome measures for interventions in children and adults. On 11 July 2003, the MRC held the first of their annual fora for autism research "Breaking barriers, building bridges", in conjunction with the National Autistic Society, to bring together ideas stimulated by the previous four seminars.

The MRC will be taking decisions on the allocation of research project funding for further autism studies in early 2004.

Questions on the numbers of autistic children in Wales are a matter for the National Assembly for Wales.

Blood Products

Nick Harvey: To ask the Secretary of State for Health (1) what the Government's objective was in purchasing an American blood bank; and if he will make a statement; [144110]

7 Jan 2004 : Column 389W

(2) what factors led to the Government's decision to purchase an American blood bank; and if he will make a statement; [144111]

(3) what comparisons he has made between the safety of blood available from the American blood bank it has purchased and blood available in the UK; and if he will make a statement. [144112]

Miss Melanie Johnson: On 17 December 2002, following thorough options analysis work and detailed market research, the Department purchased the largest remaining independent United States plasma collector Life Resources Incorporated. The objective was to secure long-term supplies of non-United Kingdom blood plasma to ensure that the global plasma shortage would not reduce the availability to National Health Service patients of life-saving plasma products such as immunoglobulins and clotting factors. Large volumes of plasma are required for medicinal product manufacture, especially immunoglobulm.

The NHS has been using US-sourced plasma since 1998 because of the unknown and unquantifiable risk of transmission of vCJD through blood. At the time Life Resources Inc. was purchased, the US had no reported cases of BSE or CJD and was the only country able to supply the quality and quantity of plasma required. The US also has a well-established pool of donors, a well-regulated environment and a developed collection industry. The Government are aware of the one case of BSE reported in the US and considers this to be a negligible risk to the safety of the blood supply. This case is not in itself a reason to alter current arrangements but we will continue to monitor the situation closely.

It is standard in both the UK and the US that, in addition to screening donors for the major blood borne viruses of HIV, Hepatitis B and C, all blood products are heat treated or chemically treated to remove any viral contamination that may have escaped the screening process.

In the UK, expert advice is that if vCJD is transmissible through blood, the infection is most likely to be contained in the white cells and plasma. As a precautionary measure, we instituted universal leucodepletion (removal of the white cells) of all blood for transfusion from 31 October 1999.

Jane Griffiths: To ask the Secretary of State for Health what guidance his Department gives to the National Blood Service on the questions which may be asked of potential blood donors; and if he will make a statement. [144861]

Miss Melanie Johnson: The National Blood Authority (NBA) undertakes a rigorous selection of blood donors as the first step in ensuring the safety of the blood supply. The questionnaire and accompanying interview of potential blood donors have been developed to elicit appropriate information relevant to donation. There are two important aims, which are to ensure as far as possible that the donated blood is safe for transfusion to patients and that blood donation is not detrimental to the donor's health.

7 Jan 2004 : Column 390W

Donors are accepted or deferred on the basis of the information they give the NBA using the United Kingdom donor selection guidelines developed by the Joint UK Blood Transfusion Services and National Institute of Biological Standards and Control which are used throughout the UK. All donors are asked to read a blood safety leaflet, which outlines key lifestyle risk factors.

The donor selection procedures and questions used in the UK are in line with the recommendations of the Council of Europe and will be in line with the proposed European Union Directive 2002/98/EC (Article 29) on setting standards of quality and safety for the collection, testing, processing, storage and distribution of human blood and blood components.

Tim Loughton: To ask the Secretary of State for Health (1) how many pints of (a) blood and (b) plasma were used by the NHS in each of the last five years; [145938]

(2) how much donated blood was used in (a) cancer operations and (b) transfusions in each of the last five years. [145940]

Miss Melanie Johnson [holding answer 5 January 2004]: Information on the number of units of blood and plasma used by the national health service in the last five years is not collected centrally.

Tim Loughton: To ask the Secretary of State for Health what the main uses are to which donated blood is put; and what proportion of donated blood was discarded in each of the last five years. [145939]

Miss Melanie Johnson [holding answer 5 January 2004]: Approximately half of red cell transfusions are used for medicinal purposes including anaemia, haematology and gastro-intestinal bleeding. The remaining half is used mainly in surgery, but also in obstetrics and gynaecology.

Figures provided by the National Blood Authority (NBA) show the proportion of red blood cells that the NBA has discarded over the last three years.

Percentage

	Time expired	Collection discards	Testing related discards	Breakages and leaks discard	Processing discards	Total
2000–01	0.1	2.8	1.3	0.6	1.2	6.0
2001–02	0.2	2.6	1.2	0.5	1.4	5.9
2002–03	0.5	2.6	1.3	0.6	1.1	6.1

The NBA does not have data for previous years.

The NBA strives to hold enough stocks of blood to meet extra or excess demand for blood in the event of any emergencies or major incidents.

Tim Loughton: To ask the Secretary of State for Health how many pints of blood have been donated in each of the last five years. [145941]

Miss Melanie Johnson [holding answer 5 January 2004]: Figures in the table supplied by the National Blood Authority show number of units of blood donated in each of the last five years.

7 Jan 2004 : Column 391W

	Number of units donated
1998–99	2,389,622
1999–2000	2,427,052
2000–01	2,357,568
2001–02	2,379,784
2002–03	2,332,371

---