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From 1 April 1999, we restored free sight tests under the National Health Service to those aged 60 and over. Previous to this date, records were only kept for the total number of sight tests for all patients. These figures are shown in Tables 1 and 2.
|Total sight tests for all patients (million)|
|Total sight tests for all patients (Thousand)|
Tables 3 and 4 show the number of National Health Service sight tests paid for in England for the year 19992000 to 200304 and for South Derbyshire (HA) for the years ending 31 March 2000 to 2003 and the five primary care trusts (PCTs) covering the old South Derbyshire HA for the year ending 31 March 2004.
|Number of sight tests for aged 60 and over (Million)|
|HA and PCT||Number of sight tests for aged 60 and over (Thousand)|
|19992000||South Derbyshire HA||37.9|
|200001||South Derbyshire HA||43.5|
|200102||South Derbyshire HA||47.9|
|200203||South Derbyshire HA||40.7|
|200304||Amber Valley PCT||6.9|
|Central Derby PCT||15.4|
|Derbyshire Dales And South Derbyshire PCT||3.8|
|Greater Derby PCT||7.0|
Sight tests can not be equated to the numbers of patients. Although most people do not come back for a sight test within the year, some patients suffering from medical conditions are advised to have re-examinations sooner.
Chris Grayling: To ask the Secretary of State for Health what the purpose is of the Food Standards Agency review led by Baroness Dean; what estimate he has made of the cost of the review; what account the review will take of the recent report of the National Audit Office and the Public Accounts Committee on the performance of the Agency; and whether the Dean Review will include an assessment of the performance of that Agency in its handling of negotiations on the Food Supplements Directive. 
Miss Melanie Johnson: The board of the Food Standards Agency (FSA) has commissioned an external, independent review to assess whether the FSA has delivered its published objectives and, in doing so, has operated in accordance with its key values; to assess the extent to which the FSA operates effectively as a United Kingdom-wide body in a devolved policy area; and to appraise how the FSA is viewed by its stakeholders. The terms of reference of the review allow my noble Friend, the Baroness Dean of Thornton-le-Fylde as the independent reviewer to investigate the performance of the FSA in any of its functions, and to draw on any relevant evidence in so doing. The anticipated cost of the review of the FSA is between £15,000 and £25,000.
|Patients of UPEs||309,365|
|Average list size of UPEs||1,778|
Miss Melanie Johnson:
Health champions will be people with experience and skills in developing new services across the public, voluntary and private sectors that improve health and narrow health inequalities and will not receive any fee for services to individual national health service patients.
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They will provide advice and consultancy to organisations to spread good practice. We expect that this support will usually be provided on a reciprocal basis between the agencies who employ the individuals concerned. However, there may be occasions when an organisation may wish to purchase the support of a health champion for a fee in the same way that it might purchase other consultancy services.
Jeremy Corbyn: To ask the Secretary of State for Health what the level of per capita public expenditure through the NHS was in Islington on (a) primary care, (b) hospital care and (c) mental health for each year since 199697. 
Expenditure per weighted head of the population in the North Central London Strategic Health Authority (SHA) area, which includes Islington, has increased from £623.57 in 199798 to £1,224.67 in 200304.
Mr. Flook: To ask the Secretary of State for Health whether it is his policy to support rights for patients (a) to refuse to accept medicines from pharmacies if they are packaged in a way that the patient believes is substandard and (b) to accept medicine only in the packaging intended by the manufacturer for the UK. 
Ms Rosie Winterton: The Department's policy is for medicines to be dispensed with sufficient information and advice to enable the patient to use them safely and effectively. Pharmacists should use their professional judgment and conform to the generally accepted standards of the profession to convey this information in a way, which the patient readily understands. Patients encountering any problems with National Health Service medicines supplied should discuss this further with their pharmacist or general practitioner. If a patient remains dissatisfied, he or she can lodge a formal complaint with the pharmacy or GP.
All medicines licensed for sale in the United Kingdom, including parallel imports, must comply with the UK medicines labelling regulations, which set out the information that must be provided, in English, on the product packaging. Following importation, the importer will re-label or repack the product and produce
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a patient information leaflet in English so that these regulations are complied with. Packaging and labelling are evaluated during the licensing process for parallel imports.
Ms Rosie Winterton: The Medicines and Healthcare products Regulatory Agency (MHRA) is in regular discussions with the parallel importer's trade association (British Association of European Pharmaceutical Distributors), United Kingdom marketing authorisation holders and individual parallel importers to discuss aspects of the packaging of imported medicines. This has generally been done on a case-by-case basis if issues are identified or when new requirements or guidance are introduced. The agency has not had any formal discussions with parallel trade associations regarding the possible risks to patient safety from re-packaged medicines from the parallel trade in pharmaceuticals.
To date, the Medicines and Healthcare products Regulatory Agency (MHRA) has not received any representation from, nor had any discussions with patient organisations regarding any substandard and poorly repackaged medicines from the parallel trade in pharmaceuticals, nor has had any discussions specifically dealing with parallel trade in medicines.
The MHRA has received some letters from individual patients, patient carers and health professionals on the packaging of parallel imports. In these cases, the product labelling and repackaging has been reviewed and, where appropriate, the parallel importer asked to address the concern raised.
The agency has also met with the National Patient Safety Agency (NPSA) to advise them of its requirements relating to parallel imports so that patients and their carers can have access to accurate information about these medicines.
The repackaging of licensed medicinal products, such as parallel imports, is controlled by the specification registered in the parallel import licence and may only be carried out by assembly sites licensed and inspected by the MHRA.
During the repackaging operation parallel importers are not permitted to change or interfere with the primary packaging of the productthat is the immediate packaging in contact with the product itself (for instance the blister packaging). However to comply with the ED labelling regulations as laid down in Title V of the Directive 2001/83/EC the importer is required to over label the immediate packaging with certain details in English and to over label or replace the outer packaging to provide additional information in English. Each product must also contain a patient information
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leaflet in English. These operations may be carried out by the importer if the company holds an assembly licence, issued by MHRA after the inspecting the site. Any repackaging and re-labelling proposed by a parallel importer is considered by MHRA before a parallel import licence is issued.
MHRA operates a Defective Medicines Report Centre (DMRC) which deals with reports of defects to all medicines, including parallel imports. All reports made to the DMRC are investigated and where necessary, appropriate action taken.
Mr. Flook: To ask the Secretary of State for Health how many applications for wholesale distribution licences have been declined following a criminal records inquiry by the Medicines and Healthcare Products Regulatory Agency in each year since 2000. 
Ms Rosie Winterton: Most wholesale dealer's licence applications are made in the name of a company rather than an individual. A criminal enquiry check cannot be made on a company. The Licensing Authority does not perform a criminal enquiry check on an individual.
Records held by the Medicines and Healthcare products Regulatory Authority show that two applications for a wholesale dealer's licence have been refused since 1 January 2000 because the proposed premises in their application were unsuitable for the distribution of medicinal products.
Mr. Flook: To ask the Secretary of State for Health how many parallel traders have (a) been prosecuted, (b) been reprimanded and (c) had their licences revoked by the Medicines and Healthcare Products Regulatory Agency in each year since 2000. 
Ms Rosie Winterton: Records held by the Medicines and Healthcare products Regulatory Agency have identified that, from the 1 January 2000, no licensed wholesale dealers, who are involved in the business of parallel import trading of medicinal products, have been prosecuted, or reprimanded, or have been issued a formal caution for a medicines legislation offence.
During the same period, four wholesale dealers that were involved in the business of parallel import trading of medicinal products have had their wholesale dealer's licence revoked as a result of breaching the conditions of their licence.
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