Select Committee on Health Minutes of Evidence

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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