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23 Mar 2006 : Column 579W—continued


John Bercow: To ask the Secretary of State for Health what is the policy of (a) her Department and (b) the NHS regarding the sourcing of goods from Burma. [52217]

Jane Kennedy: The Department's policy on the procurement of goods and services is based on value for money, having due regard to propriety and regularity and ensuring full compliance with the European Union public procurement directive and other regulatory requirements. The directive promotes equal treatment, transparency and competitive procurement as well as prohibiting discrimination on grounds of nationality.

Counterfeit Medicines

Mr. Stephen O'Brien: To ask the Secretary of State for Health what assessment she has made of the (a) prevalence and (b) effects on health care of (i) counterfeit Lipitor and (ii) other counterfeit medicines. [57516]

Jane Kennedy: There have been three reported incidents of counterfeit medicines having reached patients through the United Kingdom pharmaceutical supply chain via prescription since 1994. Over 650 million prescriptions are written annually in the UK. Therefore the risk of receiving a counterfeit medicine through the regulated pharmaceutical supply chain in the UK is low.

However, there is evidence of counterfeit medicines being obtained by customers in the UK via the internet, by mail order or on a personal basis. The vast majority of these instances are from websites or organisations based in other countries and are mainly lifestyle products used to treat erectile dysfunction, obesity and hair-loss. Products purchased in this way cannot be guaranteed for their safety, quality and efficacy. The Medicines and Healthcare products Regulatory Agency (MHRA) investigates such websites or related persons/organisations based in the UK and refers details of overseas equivalents to respective international counterparts.

Following the detection of counterfeit Lipitor tablets (20milligram Lot 004405K1) in the legitimate UK pharmaceutical supply chain in July 2005, the
23 Mar 2006 : Column 580W
counterfeit tablets were analysed by the manufacturer (Pfizer) and the MHRA laboratory. The analysed tablets contained Lovastatin which is a different active ingredient to Lipitor's Atorvastatin but has similar actions in vivo. The medical risks and benefits were reviewed by physicians in the MHRA and Pfizer who both independently agreed that a class two recall was appropriate because there was assessed to be no immediate danger to patients. The MHRA issued the recall for this medicine on 28 July 2005 which covered both counterfeit material and genuine material which shared a common batch number.

Counterfeit medicines which are discovered in the legitimate UK pharmaceutical supply chain are analysed to establish the identity and amount of any active ingredients present. A medical evaluation of the risks to patients is undertaken which determines the level of recall to be conducted for the medicine. The absence of active ingredient, reduced potency, hyperpotency and/or incorrect active ingredient in suspected and determined counterfeits as well as an analysis of the length and type of treatment contribute to this risk assessment process.


David Taylor: To ask the Secretary of State for Health whether dentists who do not sign the general dental services contract will be able to provide free dental treatment for school-age NHS patients. [58988]

Ms Rosie Winterton [holding answer 16 March 2006]: From 1 April 2006, a general dental practitioner who has not signed a new general dental services contract or new personal dental services agreement will not be able to provide national health service treatment.

Mr. Steen: To ask the Secretary of State for Health what (a) assumptions, (b) estimates and (c) trends were used in forecasting an average annual income for a dentist under the new personal dental services contract of (i) £80,000 fees and (ii) £80,000 expenses; and what steps she took to validate this forecast. [59671]

Mr. Byrne [holding answer 20 March 2006]: Most dentists who provide national health service primary dental care services are not paid on a salaried basis, but through a system of NHS fees and other payments that go towards the costs of running a dental practice as well as the dentist's net income.

These estimates of average net income and expenses for a committed NHS dentist are based on data for dentists in the general dental services (GDS). The historical estimates of average earnings and expenses for GDS dentists are calculated by the NHS Health and Social Care Information Centre, based on data on gross fees and payments from the Dental Practice Board (DPB) and data from HM Revenue and Customs on expenses.

DPB payment data show that on average, a dentist with a reasonable NHS commitment in 2004–05 in the GDS received gross GDS income of about £154,350. Dentists with a reasonable commitment are defined as those with gross fee earnings of £59,100 or more. These averages covered some 7,640 GDS principal dentists who worked throughout the year 2004–05.
23 Mar 2006 : Column 581W

HM Revenue and Customs information from dentists' tax returns show that the average ratio of expenses to gross earnings for a highly committed NHS dentist is around 52 per cent. (2003–04 tax year). The same source gives average net income of a highly committed NHS dentist from all sources as £78,600 in the tax year 2003–04. Average expenses were about £85,200. This information is taken from the tax returns of 392 GDS principal dentists who were in non-associate business arrangements for whom the tax year ended between January and March 2004.

Based on the data from these sources, the Department estimates that a highly committed GDS dentist earns an average NHS income of around £80,000 in 2005–06. We do not have equivalent data for personal dental services (PDS) dentists, but there are no reasons for supposing any significant difference in average earnings.

GDS dentists are being offered new contracts which guarantee their earnings in the reference period, October 2004 to September 2005, provided their activity
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as expressed in units of dental activity (UDAs) is 95 per cent. of its level during this reference period. PDS providers are entitled to new PDS agreements (or GDS contracts) based on their current contract values.

Mr. Evans: To ask the Secretary of State for Health how much was spent on NHS general dental services in Lancashire in (a) cash and (b) real terms in each of the last five years. [60798]

Ms Rosie Winterton: The main element of national health service dental services are the primary dental care services provided by dentists working within the general dental service (GDS), or personal dental service (PDS) pilots. The following tables display the readily available data on expenditure on these services for primary care trusts in the Lancashire area and for the Cumbria and Lancashire strategic health authority (SHA). The difference between gross and net expenditure is the contribution to costs from dental charges collected directly from patients. Note that data on PDS expenditure are only available for the financial year 2004–05.
Core GDS and PDS dental payments 1, 2, 3, 4

£ million, cash terms(52)
Blackburn with Darwen
Gross GDS payments4.3724.6374.9815.2894.915
Net GDS payments3.1283.3743.6444.0683.966
Gross GDS and PDS payments4.3724.6374.9815.2895.372
Net GDS and PDS payments3.1283.3743.6444.0684.378
Gross GDS payments5.5395.6765.6515.7454.340
Net GDS payments4.0264.0914.0304.1153.089
Gross GDS and PDS payments5.5395.6765.6515.7455.726
Net GDS and PDS payments4.0264.0914.0304.1154.297
Burnley, Pendle and Rossendale
Gross GDS payments6.8376.2446.1046.5944.784
Net GDS payments4.8274.4634.3114.5473.496
Gross GDS and PDS payments6.8376.2446.1046.5947.031
Net GDS and PDS payments4.8274.4634.3114.5475.434
Chorley and South Ribble
Gross GDS payments5.1425.6165.7955.9295.957
Net GDS payments3.4193.6953.7983.9364.034
Gross GDS and PDS payments5.1425.6165.7955.9296.748
Net GDS and PDS payments3.4193.6953.7983.9364.728
Gross GDS payments2.4092.4952.6282.6792.652
Net GDS payments1.4921.5471.6311.6421.703
Gross GDS and PDS payments2.4092.4952.6282.6793.360
Net GDS and PDS payments1.4921.5471.6311.6422.305
Hyndburn and Ribble Valley
Gross GDS payments2.9833.0853.2123.2522.244
Net GDS payments2.0762.1442.2312.2901.691
Gross GDS and PDS payments2.9833.0853.2123.2523.228
Net GDS and PDS payments2.0762.1442.2312.2902.544
Morecambe Bay
Gross GDS payments8.9839.6429.7679.7999.260
Net GDS payments5.6676.0816.1806.3316.140
Gross GDS and PDS payments8.9839.6429.7679.79910.824
Net GDS and PDS payments5.6676.0816.1806.3317.519
Gross GDS payments4.7254.6554.6235.0345.061
Net GDS payments3.4943.4323.3713.6483.762
Gross GDS and PDS payments4.7254.6554.6235.0345.275
Net GDS and PDS payments3.4943.4323.3713.6483.955
West Lancashire
Gross GDS payments3.6913.9224.1274.5833.844
Net GDS payments2.6542.8203.0033.3813.044
Gross GDS and PDS payments3.6913.9224.1274.5835.580
Net GDS and PDS payments2.6542.8203.0033.3814.511
Gross GDS payments3.6203.7843.9703.7832.813
Net GDS payments2.3192.4122.5192.4161.810
Gross GDS and PDS payments3.6203.7843.9703.7834.511
Net GDS and PDS payments2.3192.4122.5192.4163.250

23 Mar 2006 : Column 583W

Core GDS and PDS dental payments 1, 2, 3, 4

£ million, real terms(52)
Blackburn with Darwen
Gross GDS payments4.8465.01552225.4024.919
Net GDS payments3.4673.6503.8204.1553.966
Gross GDS and PDS payments4.8465.0155.2225.4025.372
Net GDS and PDS payments3.4673.6503.8204.1554.378
Gross GDS payments6.1396.1405.9245.8674.340
Net GDS payments4.4624.4254.2254.2033.089
Gross GDS and PDS payments6.1396.1405.9245.8675.726
Net GDS and PDS payments4.4624.4254.2254.2034.297
Burnley, Pendle and Rossendale
Gross GDS payments7.5786.7536.3996.7354.784
Net GDS payments5.3504.8274.5204.6443.496
Gross GDS and PDS payments7.5786.7536.3996.7357.031
Net GDS and PDS payments5.3504.8274.5204.6445.434
Chorley and South Ribble
Gross GDS payments5.6996.0746.0766.0555.957
Net GDS payments3.7893.9963.9824.0204.034
Gross GDS and PDS payments5.6996.0746.0766.0556.748
Net GDS and PDS payments3.7893.9963.9824.0204.728
Gross GDS payments2.6702.6992.7552.7362.652
Net GDS payments1.6541.6731.7101.6771.703
Gross GDS and PDS payments2.6702.6992.7552.7363.360
Net GDS and PDS payments1.6541.6731.7101.6772.305
Hyndburn and Ribble Valley
Gross GDS payments3.3063.3363.3673.3222.244
Net GDS payments2.3012.3192.3392.3391.691
Gross GDS and PDS payments3.3063.3363.3673.3223.228
Net GDS and PDS payments2.3012.3192.3392.3392.544
Morecambe Bay
Gross GDS payments9.95610.42910.23910.0089.2650
Net GDS payments6.2816.5786.4796.4666.140
Gross GDS and PDS payments9.95610.42910.23910.00810.824
Net GDS and PDS payments6.2816.5786.4796.4667.519
Gross GDS payments5.2375.0354.8465.1415.061
Net GDS payments3.8723.7123.5333.7263.762
Gross GDS and PDS payments5.2375.0354.8465.1415.275
Net GDS and PDS payments3.8723.7123.5333.7263.955
West Lancashire
Gross GDS payments4.0904.2424.3264.6813.844
Net GDS payments2.9413.0503.1483.4543.044
Gross GDS and PDS payments4.0904.2424.3264.6815.580
Net GDS and PDS payments2.9413.0503.1483.4544.511
Gross GDS payments4.0124.0934.1623.8642.813
Net GDS payments2.5702.6092.6412.4671.810
Gross GDS and PDS payments4.0124.0934.1623.8644.511
Net GDS and PDS payments2.5702.6092.6412.4673.250

23 Mar 2006 : Column 585W

Cumbria and Lancashire SHA data, Core GDS and PDS dental payments1, 2, 3, 4

£ million, cash terms(52)
Gross GDS payments56.83658.73859.80061.91554.585
Net GDS payments38.70740.00640.61042.48438.556
Gross GDS and PDS payments56.83658.73859.80061.91566.567
Net GDS and PDS payments38.70740.00640.61042.48448.939

Core GDS and PDS dental payments1, 2, 3, 4

£ million, real terms(52)
Gross GDS payments62.99563.53362.69063.23654.585
Net GDS payments42.90143.27142.57343.39038.556
Gross GDS and PDS payments62.99563.53362.69063.23666.597
Net GDS and PDS payments42.90143.27142.57343.39048.939

(48) Gross GDS payments include adult fees (including item of service and continuing care payments), child fees (including item of service and capitation payments), commitment payments and point of treatment check payment training (in 2001 only), seniority payments, maternity/paternity/adoptive leave payments, long-term sick leave payments, continuing professional development allowances including travel hours, reimbursement of business rates, vocational training grants and clinical audit payments. The following costs are excluded from this data: employer's superannuation costs, vocational trainee salaries and national insurance contribution costs, clinical audit convenors, clinical audit secretarial support costs and travel expenses, and costs associated with any salaried general dental practitioners and emergency dental services.
(49) PDS payment data are included for 2004–05 only and relates to baseline payments or the agreed regular monthly payments made to PDS practices. Reliable PDS data at practice level are not available prior to 2004–05. The data cannot identify the cost of any PDS services that are directly managed by local NHS trusts, such as certain dental access centres.
(50) Payments are assigned to areas on the basis of practice postcode data.
(51) Net payments represent the balance of payments due after taking account of NHS dental charge income collected from patients by dental practices.
5 Figures have been converted into 2004–05 prices using the December 2005 GDP deflator index.
Primary Care Statistics.

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