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Domiciliary Oxygen

Steve Webb: To ask the Secretary of State for Health if she will estimate the aggregate cost to the NHS of providing (a) routine and (b) emergency domiciliary oxygen supplies under the system based on provision by (i) pharmacists and (ii) central suppliers. [55011]

Jane Kennedy: It is not possible to aggregate and compare the cost to the national health service of providing routine and emergency supply of domiciliary oxygen by pharmacists and central suppliers because of differences in service provision and the basis for calculating costs. In the past, there was no explicit arrangement for pharmacists to provide oxygen to patients at home on an emergency basis. Pharmacists received payment for provision of an oxygen cylinder service, which included the cost of equipment listed in Part 10 of the drug tariff, together with locally negotiated fees for service delivery. The contract for the new service includes the provision of oxygen to patients on an emergency basis, with a delivery requirement of four hours. The cost of all oxygen services provided by new suppliers is on a per day basis. It takes into account the required flow rate for a patient and the hours per day a patient uses oxygen. The per diem rates include supply of oxygen, all associated equipment, delivery, collection and maintenance of equipment and the provision of training to patients and their families on its safe use.

Duchenne Muscular Dystrophy

Mr. Bone: To ask the Secretary of State for Health what plans the Government have to provide further funding for the MDEX consortium gene therapy clinical trials into Duchenne muscular dystrophy. [56766]

Jane Kennedy: I refer the hon. Member to the reply I gave my hon. Friend the Member for Coventry, South (Mr. Cunningham) on 30 January 2006, Official Report, column 167W.

Dysfluency

Mr. Clappison: To ask the Secretary of State for Health how many NHS speech therapists are employed in each (a) strategic health authority and (b) NHS trust. [52753]

Mr. Byrne: The number of qualified speech and language therapy staff in England by Government officeregion, strategic health authority area and by organisation as at 30 September 2004 has been placed in the Library.
 
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Expert Patients

John Bercow: To ask the Secretary of State for Health if she will support self-care by increasing the availability and uptake of expert patient programmes by (a) funding programme leaders and (b) increasing referrals from the NHS and partner organisations. [45397]

Ms Rosie Winterton: The Government will continue to support self-care and self-management. One of the ways it will do this is by expanding the expert patients programme (EPP). Using the investment pledged in the manifesto to increase the number of EPP course places from 12,000 a year to over 100,000 by 2012. It is likely that this will be taken forward through the establishment of a community interest company to deliver and market the EPP. Work is already under way with the British Medical Association and other organisations to encourage direct referrals to the EPP.

General Medical Services Contract (Obesity)

Stephen Williams: To ask the Secretary of State for Health whether the numbers of obese patients held on registers by general practitioners under the provisions of the new General Medical Services Contract will be collected centrally; and whether she intends to collect information on the numbers and percentages of such patients who are given advice, counselling, treatment or appropriate referrals by those practices. [56460]

Caroline Flint: The new quality and outcomes framework for 2006–07 has been finalised, and includes an indicator which rewards practices for maintaining an obesity register. The recording of body mass index for the register will take place in the practice as part of routine care and will be collected by quality management and analysis system as a percentage of patients. The framework does not currently provide incentives for weight management and advice, and as such no information can be collected on these activities

Stephen Williams: To ask the Secretary of State for Health what assessment she has made of the merits of rewarding practices covered by the General Medical Services contract for offering patients advice on weight loss and management. [56461]

Caroline Flint: The negotiation of the new general medical services contract for 2006–07 included a process for gathering and assessing evidence for changes to the quality and outcomes framework, via an expert panel engaged by NHS Employers. The provision of weight loss and management advice was considered by the expert panel, whose reports will by published by NHS Employers at the end of March.

The quality and outcomes framework will be subject to a process of change and improvement over times as part of the negotiation process.

Health White Paper

Mr. Lansley: To ask the Secretary of State for Health what the expected timetable is for introduction of the regulation of counsellors and therapists as proposed in paragraph 2.51 of the White Paper, Our Health, Our Care, Our Say, whether she plans for the regulation of counsellors and therapists to be overseen by the Health Professions Council; what representations she has
 
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received regarding the need for regulation of counsellors and therapists, and from whom; and if she will make a statement. [49528]

Jane Kennedy: The regulation of counsellors and therapists will be considered in the light of the recent review of non-medical professional regulation. A statement will be given in due course.

A number of representations have been received regarding the need for regulation of counsellors and psychotherapists from a variety of organisations including professional bodies and service users. A three-month public consultation exercise will take place before any move to statutory regulation of counsellors and therapists.

Hepatitis B

Mr. Denis Murphy: To ask the Secretary of State for Health (1) what estimate she has made of the number of people immunised against hepatitis B since 1988 who have subsequently suffered from (a) chronic fatigue syndrome, (b) multiple sclerosis and (c) rheumatoid arthritis; [56363]

(2) what estimate she has made of the number of people working in the NHS immunised against hepatitis B since 1988 in each of the categories recommended by the NHS who have subsequently suffered from (a) chronic fatigue syndrome, (b) multiple sclerosis and (c) rheumatoid arthritis. [56364]

Jane Kennedy: The safety of all medicines and vaccines, including hepatitis B vaccine, is continuously monitored by the Medicines and Healthcare products Regulatory Agency (MHRA), with expert advice from the commission on human medicines (CHM). The MHRA uses a variety of data sources for this purpose but an important source of information is spontaneous reports of suspected adverse reactions that are reported by health professionals, pharmaceutical companies and most recently by patients through the yellow card scheme.

Since 1988, the MHRA has received a total of 13 reports of chronic fatigue syndrome (CFS), 11 reports of rheumatoid arthritis and 16 reports of multiple sclerosis in people who have received hepatitis B vaccination. This is in the context of 16.2 million doses of hepatitis B vaccine sold in the United Kingdom. We are unable to state how many of these suspected adverse reactions (ADRs) occurred in national health service workers as this information is not captured on a yellow card.

Since the yellow card scheme is entirely voluntary for health professionals, these data cannot be used as a reliable indicator of the frequency of suspected ADRs to vaccines or medicines as not all cases may be reported. In addition, an association of a patient's illness with a particular medicine or vaccine may not always be made, particularly for conditions that take some time to manifest. It is important to note that the reporting of a suspected adverse reaction does not necessarily mean that it was caused by the drug or vaccine. Many factors have to be taken into account in assessing causal relationships including temporal association, the possible contribution of concomitant medication, a previously undiagnosed underlying illness or a coincidental newly occurring illness.
 
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As with all licensed medicines the MHRA will continue to carefully examine any important new evidence as it emerges, seeking the advice of independent experts as necessary, and will communicate new safety information to health professionals and the public.

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