Letter from Melaine Johnson MP, Parliamentary
Under Secretary of State for Public Health, Department of Health
(SH 1A)
During the evidence session on 10 February,
undertaken as part of the Committee's inquiry into sexual health
and HIV, I agreed to write to you on a number of points and provide
further information.
You spoke about your conversation with the Director
of Yorkshire Mesmac, where he had expressed concern about the
48 hour waiting time target for GUM services (Q153). In particular
it was alleged that at least one clinic in West Yorkshire achieved
the target by not answering the telephone once all the following
two days' appointments were full.
Naturally, this is a cause for concern. I can
assure you, however, that the procedures in place to monitor GUM
waiting times, are designed to preclude any attempts to manipulate
performance data. The survey data collected from patients attending
GUM specifically asks when the first attempt was made to contact
the clinic, including where the patient called but the clinic
was closed, or the telephone was busy. Clinics will therefore,
not be able to give the impression that they are meeting the target,
when they are actually providing what is effectively a reduced
service. I have asked my officials to share the relevant extract
from the transcript of the evidence session with the sexual health
lead of the Primary Care Trust in question, so that they are aware
of this issue and can follow-up as appropriate.
On the question of when we received the data
arising from the first phase of the GUM services review, currently
being undertaken by MedFASH on behalf of the Department, I agreed
to let you know when it was received(Q170). I understand that
it was first received by officials in the Department in late December.
As was stated at the evidence session, however, neither myself
nor Geoff Dessent had sight of the document until early February,
when you wrote and asked for it to be made available to the Committee.
Regarding payment by results for GPs providing
contraception, and concerns that this could act as a disincentive
to prescribing longer acting methods of contraception (Q200),
a key element of the Government's strategy in respect of contraception
is to improve access to a wider range of methods. As you may be
aware the National Institute for Clinical Excellence (NICE) is
developing a clinical guideline on long acting methods of contraception.
The guideline will provide recommendations for good practice that
are based on the best available evidence of clinical and cost
effectiveness. This guideline together with the results of the
national audit, backed by the £40 million additional investment
from the public health White Paper `Choosing Health', will help
ensure that these issues are addressed.
I thought it might also be helpful to take this
opportunity to clarify my comments about the new "easement
clause" in the hospital charging regulations. Some of my
remarks could, I think, have been taken as implying that it is
a matter for clinicians to decide whether the easement clause
should apply in any particular case. In fact the arrangements
automatically apply where the required conditions are met. Thus,
any overseas visitor who begins any course of hospital treatment
free of charge must continue to receive that treatment free until
it is completed, even if, for whatever reason, it is later established
that they are no longer, or perhaps never were, eligible for free
treatment. What is a matter for clinicians, of course, is when
a particular course of treatment is complete. For HIV in many
case this will mean treatment will continue free of charge for
a very long time.
28 February 2005
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