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26 Mar 2004 : Column 1132W—continued

Coronary Angiograms

Mr. Moss: To ask the Secretary of State for Health what the cost of a coronary angiogram was in each NHS hospital trust in England in the latest period for which figures are available. [150731]

Miss Melanie Johnson: The information requested has been placed in the Library.

Free Health Care

Mr. Heathcoat-Amory: To ask the Secretary of State for Health what checks are carried out by (a) general practitioners and (b) hospitals to establish that patients from abroad are entitled to health care free at the point of delivery. [155796]

Mr. Hutton: General practices need to check details of an individual's residence or previous registration before deciding whether to accept the person as a registered patient, either on a permanent or temporary basis. This is set out in regulations and guidance. For hospital services, regulations require the national health service trust providing treatment to make

"such enquiries as it is satisfied are reasonable in all the circumstances, including the state of health of the overseas visitor"

to determine a patient's chargeable status. Guidance makes clear that all patients should be asked a baseline residency question, but it is for individual trusts to decide how far it is reasonable to go in following up on the response.

General Practitioners

Simon Hughes: To ask the Secretary of State for Health how many (a) nurses and (b) general practitioners are in training in (i) each London borough, (ii) Greater London and (iii) England; and what the figures were in 1997. [162366]

Mr. Hutton: The available information on the number of general practitioner registrars and student nursing populations is shown in the table. Student nursing population information by strategic health authority is only available for 2001–02 and from 1998–99 for the Greater London area.

26 Mar 2004 : Column 1133W

GP registrars and nursing course student populations by strategic health authority (SHA) and primary care trust (PCT) for London and England

		Headcount		Whole-time equivalents
		GP Registrars(3)		Student nurse population(4)
		1997	2003	1998–99	2001–02
England		1,343	2,235	45,668	51,713
Of which:
London		208	348	9,081	12,200
Of which:
Q04	North West London SHA	45	58	n/a	2,672
5AT	Hillingdon PCT	n/a	8	n/a	n/a
5H1	Hammersmith and Fulham PCT	n/a	2	n/a	n/a
5HX	Ealing PCT	n/a	8	n/a	n/a
5HY	Hounslow PCT	n/a	4	n/a	n/a
5K5	Brent PCT	n/a	17	n/a	n/a
5K6	5K6 Harrow PCT	n/a	8		n/a
5LA	Kensington and Chelsea PCT	n/a	10	n/a	n/a
5LC	Westminster PCT	n/a	1	n/a	n/a
QO5	North Central London SHA	44	74	n/a	2,803
5A9	Barnet PCT	n/a	15	n/a	n/a
5C1	Enfield PCT	n/a	6	n/a	n/a
5C9	Haringey PCT	n/a	14	n/a	n/a
5K7	Camden PCT	n/a	30	n/a	n/a
5K8	Islington PCT	n/a	9	n/a	n/a
QO6	North East London SHA	39	71	n/a	3,015
5A4	Havering PCT	n/a	12	n/a	n/a
5C2	Barking and Dagenham PCT	n/a	5	n/a	n/a
5C3	City and Hackney PCT	n/a	17	n/a	n/a
5C4	Tower Hamlets PCT	n/a	16	n/a	n/a
5C5	Newham PCT	n/a	8	n/a	n/a
5NC	Waltham Forest PCT	n/a	13	n/a	n/a
QO7	South East London SHA	35	51	n/a	2,424
5A7	Bromley PCT	n/a	13	n/a	n/a
5A8	Greenwich PCT	n/a	8	n/a	n/a
5AX	Bexley PCT	n/a	5	n/a	n/a
5LD	Lambeth PCT	n/a	11	n/a	n/a
5LE	Southwark PCT	n/a	6	n/a	n/a
5LF	Lewisham PCT	n/a	8	n/a	n/a
Q08	South West London SHA	45	94	n/a	1,286
5A5	Kingston PCT	n/a	16	n/a	n/a
5K9	Croydon PCT	n/a	24	n/a	n/a
5LG	Wandsworth PCT	n/a	15	n/a	n/a
5M6	Richmond and Twickenham PCT	n/a	19	n/a	n/a
5M7	Sutton and Merton PCT	n/a	20	n/a	n/a

n/a = Not applicable.

⁽³⁾ Figures as at 30 September each year.

⁽⁴⁾ Figures for the financial year.

Source:

Department of Health General and Personal Medical Services Statistics.

Tim Loughton: To ask the Secretary of State for Health how many general practitioners he estimates over-prescribe (a) Seroxat and (b) other selective serotonin re-uptake inhibitors. [162564]

Ms Rosie Winterton: Information is not available in requested format.

It is not possible to estimate the numbers of general practitioners prescribing above the recommended doses.

Hormone Replacement Therapy

Sandra Gidley: To ask the Secretary of State for Health what assessment he has made of the link between hormone replacement therapy and an increased risk of (a) stroke and (b) heart disease; and if he will make a statement. [161927]

26 Mar 2004 : Column 1134W

Miss Melanie Johnson: The Committee on Safety of Medicines (CSM) and its expert working group on hormone replacement therapy (HRT) has kept the safety of HRT under constant review and provided targeted advice to women and health professionals in response to important new evidence as it has emerged.

Despite some weak observational evidence suggesting a possible benefit, HRT has never been licensed for the prevention of heart disease in the United Kingdom. In 2002, two large studies in the United States provided important new clinical trial information about the effect of combined oestrogen plus progestogen HRT on the risk of heart disease in women with and without a pre-existing heart condition. One of these studies further demonstrated an effect of HRT on the risk of stroke. Immediately upon publication of this study, the CSM informed health professionals and women that HRT had not been proven to be beneficial in preventing coronary heart disease and may in fact result in a small

26 Mar 2004 : Column 1135W

increase in the risk in the first year of use. The CSM also advised that this type of HRT causes a small increase in the risk of stroke.

Clear warnings about the risk of heart disease and stroke in association with combined HRT use have been agreed throughout Europe and are being included in the summary of product characteristics for health professionals and the patient information leaflet that accompanies each pack of medicine.

In addition, the Medicines and Healthcare products Regulatory Agency (MHRA) has placed a comprehensive review of the risks (including heart disease and stroke) associated with HRT use on its website. Detailed information has also been published in the safety bulletins issued by the MHRA and the Chief Medical Officer, which are available on their respective websites.

The CSM's expert working group on HRT has been informed that the oestrogen-only arm of the US Women's Health Initiative trial has now found that the risk of stroke in users of this HRT preparation is increased similarly to combined HRT. These findings have not yet been published, but will be urgently considered by the CSM and its expert working group on HRT as soon as they are available. When their review is complete, the current product information will be updated as necessary and women and health care professionals will be clearly informed of the new advice.

The CSM advises that for the alleviation of menopausal symptoms, health professionals should prescribe the lowest effective dose of HRT for the shortest possible time and perform regular health checks on HRT users, including a reassessment of the need to continue HRT on an annual basis. The CSM also advises that for the prevention of osteoporosis, HRT should only be used by women who are intolerant of, or contraindicated for, other medicines approved for this purpose.

IT

Mr. Burstow: To ask the Secretary of State for Health what consultation has been undertaken with healthcare professionals before the awarding of contracts under the National Programme for Information Technology; and if he will make a statement. [162186]

Mr. Hutton: Extensive consultation has taken place with clinical representative groups, including the professional Royal Colleges, the General Medical Council, and the British Medical Council, all of whom have provided valuable input. As well as the national professional bodies and groups, the national programme for information technology (NPfIT) team has engaged closely with expert primary care practitioners, including practising general practitioners, who are there to represent and feedback issues with their professional colleagues.

The National Clinical Advisory Board has ensured that the wide-ranging clinical needs and requirements are reflected in the design of the NPfIT solutions and integrated into the ongoing plans of the programme. There are currently 29 full members and 12 working groups covering a variety of care settings, from cancer care to out of hours care.

26 Mar 2004 : Column 1136W

The NPfIT to date has hosted around 400 local events, engaging managers, clinicians, allied health professionals and IT staff. Over 21,000 individuals have been involved. We are undertaking a concerted effort to ensure as many people as possible are now engaged on the local plans to prepare for phased roll out after April 2004.

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