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HEALTH
Accident and Emergency Services
Mr. Hoban: To ask the Secretary of State for Health (1) what (a) geographic and (b) demographic factors he requires should be taken into account when reviewing the provision of accident and emergency services in (i) acute and (ii) community hospitals; [182521]
(2) how many accident treatment centres there are in England; and how many use tele-medicine; [182522]
(3) what assessment he has made of the optimal population size to be served by an accident treatment centre. [182523]
Ms Rosie Winterton [holding answer 6 July 2004]: The Department does not collect information on number of accident treatment centres in England, or how many use tele-medicine.
Accident and emergency departments, minor injury units and walk-in centres all vary in their sizes and in the populations they serve. It is the responsibility of the local national health service to develop services in response to local needs and to ensure that appropriate facilities are provided for the local population.
Guidance on service change, "Keeping the NHS Local—A New Direction of Travel" was published in February 2003. It sets out core principles for service change that the NHS must now follow. It challenges the view that biggest is best and sets out a range of strategies and options to help the NHS keep services local. This guidance also emphasises the important role community hospitals can play in providing partnership working with the whole health and social care system locally.
Anti-depressants
Mr. Burstow: To ask the Secretary of State for Health what representations he has received expressing dissatisfaction with the performance of the Medicines and Healthcare Products Regulatory Agency and the Committee on Safety of Medicines in communicating to users the risks of dependence on selective serotonin reuptake inhibitors and related drugs. [178442]
Ms Rosie Winterton:
Representations have been received from patients and from hon. and right hon. Members in respect of constituents about withdrawal
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reactions associated with selective serotonin reuptake inhibitors (SSRIs) and related drugs. In response, the Medicines and Healthcare products Regulatory Agency (MHRA) and the Committee on Safety of Medicines (CSM) has communicated with prescribers about the potential for withdrawal reactions via articles in the bulletin, "Current Problems in Pharmacovigilance". An information sheet for patients about use of SSRIs in the September 2003 edition of "Current Problems in Pharmacovigilance" highlighted the issue of withdrawal reactions. This was drafted with the input of patient representatives from the CSM's expert working group on the safety of SSRIs. This information is also reflected in the patient information leaflets for these products, which have been updated as new evidence has become available.
Tim Loughton: To ask the Secretary of State for Health what assessment he has made of the (a) quality and (b) outcome of the 1998 review of the risk of dependence on selective serotonin reuptake inhibitor and related anti-depressants, conducted by the sub-committee on pharmacovigilance; and what the relevant qualifications were of each member of the review panel. [178336]
Ms Rosie Winterton: The then Medicines Control Agency (MCA) conducted the review of withdrawal reactions associated with selective serotonin reuptake inhibitors (SSRIs) and related anti-depressants, which was considered by the sub-committee on pharmacovigilance on 24 February 1998 and the Committee on Safety of Medicines (CSM) on 26 March 1998. The CSM endorsed the conclusions of the sub-committee on pharmacovigilance, that all SSRIs were associated with withdrawal reactions and that no strong evidence from any source had been identified to suggest that the SSRIs and related anti-depressants cause features of dependence other than withdrawal symptoms.
A separate review of all available data was subsequently conducted by the European scientific advisory committee, the Committee for Proprietary Medicinal Products (CPMP) with France and Germany as lead member states. The conclusions of this review were consistent with those of the CSM and were published in a CPMP position paper in 2000.
The list of the members of the sub-committee on pharmacovigilance present at the 24 February 1998 meeting and their qualifications has been placed in the Library.
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Cancer Treatment
Mr. Paul Marsden: To ask the Secretary of State for Health if he will make a statement on the use of linear accelerators in treating cancer patients. [182647]
Miss Melanie Johnson: Radiotherapy is a principle tool in the fight against cancer, alongside chemotherapy and surgery. Linear accelerators use high-energy x-ray beams to treat deep tumours and electrons to treat skin cancer.
We are committed to giving patients equal access to this technology. We have committed £145 million between 2002 and 2006 to provide 28 additional and 82 replacement linear accelerators to the national health service. This is in addition to the 15 additional linear accelerators and 42 replacements provided from the new opportunities fund between 1999 and 2003.
Commercial Directorate
Mr. Oaten: To ask the Secretary of State for Health (1) which Minister within his Department has responsibility for the Commercial Directorate at the NHS; [180441]
(2) what the objectives are of the Commercial Directorate in the NHS. [180443]
Mr. Hutton [holding answer 28 June 2004]: My right hon. Friend the Secretary of State for Health has overall responsibility for all areas of the Department, including the Commercial Directorate. I have specific responsibility for the Commercial Directorate.
The Commercial Directorate was established in June 2003 in response to the recognition of a need for more focus and synergy by the Department and the national health service in its dealings with the independent sector and also a requirement for the adoption of sharper commercial management and good practice.
The objectives of the Commercial Directorate are to secure best value and best practice for the Department and the NHS from its relationship with private and voluntary organisations and to provide a professional and commercially trained interface with the independent sector.
Departmental Policy (Gloucester Constituency)
Mr. Dhanda: To ask the Secretary of State for Health if he will set out, with statistical evidence relating as closely as possible to the Gloucester constituency, the effects of changes to departmental policy since 1997 on the Gloucester constituency. [182328]
Ms Rosie Winterton [holding answer5 July 2004]: The Government have put in place a programme of National Health Service investment and reform since 1997 to improve service delivery in all parts of the United Kingdom. There is significant evidence that these policies have yielded considerable benefits for the Gloucester constituency.
At the end of March 2004, the number of people waiting more than nine months for inpatient treatment within West Gloucestershire Primary Care Trust (PCT) has fallen to 2, from 217 in June 2002.
At the end of March 2004, the number of patients waiting over 13 weeks for outpatient treatment within West Gloucestershire PCT has fallen to 75, from 1016 in June 2002.
In 2002, at Gloucestershire Hospitals NHS Trust, 87.1 per cent, of patients spent less than four hours in accident and emergency from arrival to admission, transfer or discharge. Figures for December 2003 show an improvement to 94.2 per cent.
Between September 2002 and September 2003, the number of consultants at Gloucestershire Hospitals NHS Trust has increased from 205 to 226. The number of nurses increased from 1,928 to 2,152.
Figures for April 2004 show that all patients within West Gloucestershire PCT are able to be offered an appointment with a primary care professional within one working day.
In the Gloucester local authority area, death rates from cancer per 100,000 population have fallen to 165.6 in 2002, from 176.7 in 1997.
In the Gloucester local authority area, death rates from coronary heart disease per 100,000 population have fallen to 149.8 in 2002, from 162.4 in 1997.
West Gloucestershire PCT's allocation has risen to 206.0 million for 2004–05, a cash increase of 9.4 per cent.
£30 million investment has been made in a private finance initiative redevelopment at Gloucestershire Royal Hospital to provide modern, state of the art health care facilities; anticipated to open in autumn 2004
£8.5 million has been invested in four new operating theatres and oral and maxillofacial laboratory and a medical engineering department at Gloucestershire Royal Hospital.
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