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27 Jan 2004 : Column 316W—continued
Building Maintenance
Mr. Rosindell: To ask the Secretary of State for Health what percentage of the NHS budget for the current financial year has been allocated to the maintenance of buildings. [150362]
Mr. Hutton: Most significant maintenance that improves the condition of national health service buildings is capital-funded.
The allocation of capital resources to the NHS for the three-year period, 2003–04 to 2005–06, was announced on 8 January 2003. None of the resources allocated were identified specifically for the maintenance of buildings.
Operational capital is allocated directly to NHS trusts and primary care trusts (PCTs) and is used primarily for maintaining their asset bases and funding other minor investments. For 2003–04, £844 million has been allocated as operational capital, or 29 per cent, of the total public capital budget. It is, however, for local NHS
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trusts and PCTs to decide how much of this is used to fund building maintenance and how much is allocated to other local priorities.
By funding the replacement of major assets, the strategic health authorities' strategic capital programmes, totalling £684 million in 2003–04 and private finance initiative programme also make a contribution to meeting the NHS's maintenance requirement.
Cancer
Mr. Baron: To ask the Secretary of State for Health what action the Government are taking on the prevention of cancer; and what targets have been set for cancer prevention. [150234]
Miss Melanie Johnson [holding answer 26 January 2004]: The Government funds an extensive health improvement and prevention programme aimed at preventing cancer and coronary heart disease, which are the two main causes of mortality. This includes work on tobacco control and smoking cessation, improving nutrition and diet and increasing levels of physical activity, all of which have an effect on cancer prevention.
Health improvement and prevention work is also undertaken directly by primary care trusts (PCTs). Since April 2003, 75 per cent., of the national health service budget has been devolved directly to PCTs, allowing them to control the resources to deliver on both national and local priorities, including cancer.
All the targets we have established for cancer, including those for treatment and reducing smoking rates, will contribute towards prevention.
Cannabis
Dr. Tonge: To ask the Secretary of State for Health what research he has undertaken into links between taking cannabis and schizophrenia. [149821]
Miss Melanie Johnson: The Department commissioned the following research projects as part of the Drug Misuse Policy Research Initiative, which funded £2.4 million research between 2000 and 2003.
- Long term heavy cannabis use: patterns and problems. Mr. Niall Coggans, Strathclyde Institute for Biomedical Sciences
- A national epidemiological study of dually diagnosed substance misuse and psychiatric disorders between 1993–1998, using the General Practice Research Database. Dr. Martin Frischer, Keele University.
- Co-morbidity in the National Psychiatric Morbidity Surveys. Dr. Michael Farrell, Dr. Colin Taylor, Institute of Psychiatry.
- Co-morbidity of substance misuse and mental health problems: a study of the prevalence and patterns of co-morbidity and the need for services amongst treatment populations. Mr. Tim Weaver, Imperial College School of Medicine.
- Dual Diagnosis in a Primary Care Group (PCG), (100,000 population locality): a step by step epidemiological needs assessment and design of a training and service response model. Dr. Geraldine Strathdee, Oxleas National Health Service Trust.
The Department also monitors research in this area and has a range of expert advisers to inform policy.
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Colonoscopies
Mr. Baron: To ask the Secretary of State for Health what proportion of colonoscopies were unsuccessful in each of the last five years. [151254]
Mr. Hutton: Information about the proportion of unsuccessful colonoscopies is not held centrally.
Coronary Disease
Mr. Burstow: To ask the Secretary of State for Health what clinical audit data hospitals and primary care trusts in England have collated that is more than 12 months old covering the information in Milestone 3 on heart failure set out in the National Service Framework on Coronary Heart Disease. [149855]
Miss Melanie Johnson: This data is not held centrally, as the delivery of the national service framework (NSF) is managed locally. The Department's assessment is that the national health service has made good progress on this issue, as seen in the decline in emergency admissions for heart failure. As the new general medical services contract takes effect and heart failure assumes a higher priority in the central phase of delivery of the NSF, we expect to see further rapid progress on this important group of patients. To support the publication of the National Institute for Clinical Excellence's clinical guidelines that set out recommendations for NHS care of people with chronic heart failure, the Department has published a booklet, "Developing services for heart failure".
Dentistry
Sarah Teather: To ask the Secretary of State for Health how many dentists' surgeries there are in Brent East constituency. [149904]
Mr. Hutton: Figures collected by the Department are by primary care trust (PCT) and not by constituency.
Brent PCT has 64 dental practices (latest data available as at January 2004).
These figures can be routinely obtained from the NHS UK web-site at www.nhs.uk.
Dermatology
Mr. Baron: To ask the Secretary of State for Health what steps the Government are taking to increase the number of general practitioners and nurses who undertake training in dermatology. [151252]
Mr. Hutton: The relevant statutory bodies are responsible for setting curricula for health professional training. We do share a commitment with those bodies that all health professionals are trained so that they have the skills and knowledge to deliver a high quality health service to all groups of the population with whom they deal. National health service trusts, primary care trusts and workforce development confederations are responsible for commissioning the training and development across their local health economies that their professionals need.
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Mr. Baron: To ask the Secretary of State for Health how many (a) general practitioners and (b) nurses have been trained in dermatology in each of the last five years; and what percentage of the total numbers of each this represents. [151253]
Mr. Hutton: This information is not collected centrally.
Erythropoietic Treatments
Mr. Lansley: To ask the Secretary of State for Health (1) how many recorded incidences of pure red cell aplasia there were in England and Wales between 1999 and 2002 following treatment using erythropoietic products; [149173]
- (2) if he will list the incidences of pure red cell aplasia occurring after treatment with (a) Epogen, (b) Aranesp, (c) Neorecormon and (d) Eprex since 1999; [149174]
(3) how many fatalities have been linked to the use of erythropoietic treatments for anaemia; [149175]
(4) if he will commission studies into the incidence of pure red cell aplasia after erythropoietic treatments for anaemia; and what studies he has assessed into the
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- potentially adverse effects of erythropoietic treatments for anaemia. [149176]
Miss Melanie Johnson: The Medicines and Healthcare products Regulatory Agency (MHRA) and the Committee on Safety of Medicines (CSM) receive reports of suspected adverse drug reactions (ADRs) submitted by doctors, nurses, dentists, pharmacists and coroners via the Yellow Card Scheme, and there is a legal requirement for companies to report suspected ADRs to their products.
The table shows the number of suspected ADR reports of red cell aplasia received annually by the MHRA/CSM between 1999 and 2003. These numbers do not necessarily represent all cases that may have occurred, because there is an unquantifiable degree of under-reporting associated with the Yellow Card Scheme, as with all voluntary reporting schemes. Figures are presented for epoetin alfa (Eprex), and epoetin beta (Neorecormon). The MHRA/CSM has received no ADR reports involving red cell aplasia in association with either Aranesp or Epogen during this interval. The product known as Epogen was not marketed in the United Kingdom during the interval in question.
| 1999 | 2000 | 2001 | 2002 | 2003 | |
|---|---|---|---|---|---|
| Epoetin alfa (Eprex) United Kingdom | 4 | 4 | 9 | 21 | 6 |
| England and Wales only | 4 | 3 | 8 | 19 | 6 |
| Epoetin beta (Neorecormon) United Kingdom | 4 | 2 | 0 | 7 | 1 |
| England and Wales only | 4 | 1 | 0 | 7 | 1 |
The total number of suspected ADR reports received from UK sources between the start of 1999 and the end of 2003 in association with epoetin alfa was 44; the number associated with epoetin beta was 14. Both epoetin alfa and epoetin beta were implicated in 10 reports; therefore the total number of reports of red cell aplasia received in association with all epoetins was 48.
The cause of death was recorded as red cell aplasia in one case. This patient showed evidence of parvovirus B19 infection, which is a well-established cause of red cell aplasia. Therefore, there are reasonable grounds to doubt a causal association between the epoetin administered and the red cell aplasia that occurred in this case.
Two large studies are currently under way to investigate the apparent association between epoetins and red cell aplasia, including the incidence of red cell aplasia in patients treated with epoetins.
The epoetins available in the UK were authorised on the basis of data, including clinical trial data, that have demonstrated evidence of safety and efficacy in all licensed indications. All studies were assessed for evidence of potential unwanted effects that might be attributable to treatment. The number of patients exposed to treatment prior to grant of a Marketing Authorisation would not normally be large enough to permit the detection of very rare unwanted effects, which would usually only come to light as a result of post-marketing surveillance following the exposure of much larger numbers of patients, as was the case with red cell aplasia in association with epoetins.
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