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Mr. Austin Mitchell: To ask the Secretary of State for Health (1) whether she has made an assessment of the extent to which the proposed future inclusion of some herbal ingredients within the provisions of the food supplements directive would change decisions on the part of the Medicines and Healthcare Products Regulatory Agency on (a) whether a product containing herbal ingredients required registration under the traditional herbal medicinal products directive and (b) licensing such a product as a medicine on the basis of its function; 
(2) how many recent meetings with industry have been held by officials of the Medicines and Healthcare Products Regulatory Agency to discuss product classification arising from the provisions of the traditional herbal medicinal products directive; what costs and other compliance burdens for industry have been identified through regulatory impact assessments and other means as arising from identifying with confidence which herbal ingredients (a) may be sold under food law and (b) require (i) medicinal product licences and (ii) traditional use registrations; and if she will make a statement; 
(3) on what date the provisions of the traditional herbal medicinal products directive come into force in the United Kingdom; if she will list herbal ingredients which manufacturers may continue to sell in supplement form under food law beyond that date; and if she will list those herbal ingredients that the Medicines and Healthcare Products Regulatory Agency consider likely to be classified as medicines requiring (i) registration and (ii) licensing by virtue of being medicinal by function. 
Jane Kennedy: The provisions of Directive 2004/24/EC on traditional herbal medicinal products came into force in the United Kingdom on 30 October 2005. Unlicensed herbal remedies which were legally on the market under Section 12(2) of the Medicines Act 1968 on 30 April 2004 are not required to comply with the directive until 30 April 2011. The decision as to whether a product (rather than an ingredient) falls within the definition of a medicinal product is made on a case by case basis using the definition of that term contained in Article 1 of Directive 2001/83/EC as amended. Accordingly, it is not possible to provide a definitive list of herbal ingredients which are always medicinal or never medicinal. Directive 2004/24/EC does not affect the classification process.
To assist manufacturers in determining the likely status of their products the Medicines and Healthcare products Regulatory Agency (MHRA) published a list
27 Feb 2006 : Column 446W
of herbal ingredients and their uses in March 2005. This can be found on the borderline products page of the MHRA's website at www.mhra.gov.uk. Advice and information on the status of a product is available without charge from the medicines borderline section of the MHRA and no costs to industry have been identified on issues relating to product classification. The MHRA has held no recent meetings with industry to discuss difficulties of product classification in relation to Directive 2004/24/EC. However, the MHRA has held around 60 meetings with individual companies to discuss their initial plans for registering products under the directive. In these meetings where companies have expressed any doubt as to the status of their products they have been advised to seek further specific advice from the MHRA borderline section.
We do not envisage that an extension to the food supplements directive would of itself affect whether products are classified as medicines since that decision is made on the basis of Article 1 of Directive 2001/83/EC.
Edward Miliband: To ask the Secretary of State for Health how much her Department has allocated for (a) hospital services, (b) general practitioner services and (c) dental services in the constituency of Doncaster, North in each year since 1997. 
Mr. Byrne: The information is not available in the format requested. Funding is allocated to primary care trusts (PCTs) on the basis of the relative needs of their populations. It is for PCTs to determine how to use the funding allocated to them to commission services to meet the healthcare needs of their local populations. Allocations made to the Doncaster PCTs from 200506 to 200708 are shown in the following table.
|Doncaster central PCT||Doncaster|
Lynne Jones: To ask the Secretary of State for Health what the average cost to the NHS was of (a) male to female and (b) female to male gender reassignment operations carried out in (i) 2004 and (ii) 2005; and how many of each type of operation were carried out in the most recent period for which figures are available. 
In 200405, there were 99 combined operations for transformation from male to female and zero combined operations for transformation from female to male. There is no cost data collected centrally for these procedures.
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Mr. Byrne: No estimate has been made on the optimal number of general practitioners per 100,000 weighted population. Primary care trusts are responsible for assessing and meeting the primary care needs of their local populations. In doing so they will take into account a variety of factors including the health needs of their communities and the mix and number of professional primary care staff needed to deliver services.
Mr. Byrne: Data on the number of single-handed contracted general practitioners by primary care trust (PCT) area have been placed in the Library. This information is not available by local authority areas unless that is coterminous with the PCT area.
Mr. Jenkin: To ask the Secretary of State for Health how many general practitioners are practising in Essex; what the ratio of GPs to patients is in (a) Essex and (b) England; and what the equivalent ratios were for each of the last five years. 
|All practitioners, excluding retainers and registrars||28,593||28,802||29,202||30,358||31,523|
|Average list size||1,795||1,780||1,764||1,736||1,666|
|All practitioners, excluding retainers and registrars||829||816||803||866||915|
|Average list size||1,989||2,011||2,051||1,952||1,830|
Jane Kennedy: Patients in the London borough of Hillingdon who need a general practitioner (GP) when their practice is closed are instructed to telephone their GP and listen carefully to recorded instructions and advice. If for any reasons a GP practice cannot help the patient and the patient cannot wait until the practice is open, the patient is advised to phone Harmony, a local co-operative of GPs covering out of hours services in Hillingdon on 0845 850 1568. For health information or advice, patients are advised to phone NHS Direct on 0845 4647 whose services are available 24 hours a day.
There is a statutory obligation to provide out of hours GP services. GPs do not have to do so as part of their national contract. So out of hours services are contracted by the national health service. Organisations contracted to provide these services are either commercial organisations or co-operatives.
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