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18 Apr 2006 : Column 251W—continued

PFI Contracts

Lynne Featherstone: To ask the Secretary of State for Health what the estimated maximum cost is of liabilities indemnified by the NHS arising from private finance initiative contracts; and if she will make a statement. [54833]

Jane Kennedy: The need for indemnities to be given by the national health service to the private sector, or by the private sector to the NHS, normally arises in cases where it is not clear if a liability will ever arise, or, if it does, what the amount of that liability will be. An example would be where, at some point in the future, an NHS employee deliberately damages the contractor's property while on duty at work. It is impossible to predict this sort of event, but it is clear that this would be the NHS's responsibility if it ever occurred. It is better value for money for the NHS to give an indemnity than to make the contractor take the risk, because the contractor is likely to include an allowance in its price in case this should ever happen.

However, this means that it is impossible to provide a meaningful estimate of the maximum costs of liabilities covered by these indemnities. The liabilities are normally contingent and may never arise. The same applies to many of the indemnities given by the private sector to the NHS.

The Department is not aware of any examples of claims having been made under contractual indemnities in NHS private finance initiative projects.

Pharmaceutical Industry

Chris Grayling: To ask the Secretary of State for Health if she will place in the Library minutes of recent meetings she has had with the Association of the British Pharmaceutical Industry to discuss the conduct of the pharmaceutical industry. [61128]

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Jane Kennedy: The Department is the sponsor of United Kingdom pharmaceutical industry, and provides a channel for communication between the Government and the industry. Ministers and leaders in the pharmaceutical industry meet twice a year through the ministerial industry strategy group. The minutes of these meetings are placed on the Department's website at Ministers have held no meetings in the past 12 months to discuss the conduct of the pharmaceutical industry.


John Hemming: To ask the Secretary of State for Health (1) what estimate she has made of the funds received by pharmacies as a result of the difference between the price paid for drugs by (a) the Prescription Pricing Authority and (b) pharmacists in each financial year since 2000–01; and what estimate she has made of the funds received in (i)2005–06 and (ii) 2006–07; [58322]

(2) which 10 drugs contributed most to the total funding of pharmacies because of the difference between the price paid by the pharmacies and the price paid by the Prescription Pricing Authority (PPA) in each year since 2000–01; what estimate she has made of the total funding from that source in the next two financial years; and what the price paid was by (a) the pharmacy and (b) the PPA for each of those 10 drugs. [58323]

Jane Kennedy: There was a survey to measure the margin on drugs available to community pharmaceutical contractors (the discount inquiry) in October 2000. The discount inquiry asked a random sample of pharmacy contractors what prices they had paid for a sample of medicines including rebates from suppliers. As a result of this survey, the claw-back used to calculate reimbursement prices paid to pharmacists was increased by about 0.6 per cent., depending on size of pharmacy, from an average of about 10.6 per cent. to 11.2 per cent. Under the terms of its agreement between the Department and the pharmaceutical services negotiating committee, the data used in the discount inquiry remain confidential.

Although there have been no discount inquiries since 2000, the Department has monitored drug prices using market information from manufacturers and wholesalers. As a result of this, and following a public consultation paper, the Department reduced the reimbursement prices of four recently out of patent medicines on two occasions: the first with effect from December 2003 and the second with effect from September 2004. In total, this reduced the retained margins available to community pharmacy contractors by £300 million per annum.

When the current community pharmacy contractual framework was implemented in April 2005, the amount of retained margins in England was assessed as £500 million per year. This money is an integral part of the total of £1,766 million agreed during the contract negotiations, and will help to pay for services to patients. The Department is currently undertaking surveys of community pharmacy contractor invoices to determine the current amount of retained margin available to pharmacy contractors. If the current survey shows that total retained margins differ substantially from £500 million, the Department will make
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adjustments by varying reimbursement prices or the claw-back to bring it in line with the sum agreed as part of the contractual framework. The Department will continue to assess the level of retained margin but does not believe it is realistic to prepare forecasts as the actual sums retained will be determined by the market prices for generic medicines which can change significantly over time.

From a survey in October 2005, the 10 drug presentations that contributed most to the total funding of pharmacies due to the difference between the price paid by the pharmacies and the price paid by the Prescription Pricing Authority (PPA) were as in the following table.
Drug presentationPPA reimbursement price,
October 2005
Simvastatin tablets 40mg, pack size 284.14
Simvastatin tablets 20mg, pack size 281.79
Omeprazole capsules enteric coated 20mg, pack size 2810.59
Amlodipine tablets 5mg, pack size 285.48
Citalopram Hydrobromide tablets 20mg, pack size 282.59
Amlodipine tablets l0mg, pack size 287.96
Pravastatin Sodium tablets 40mg, pack size 283.33
Ramipril capsules l0mg, pack size 282.78
Gabapentin capsules 300mg, pack size 10053.26
Ramipril capsules 5mg, pack size 282.55

When assessing the prices paid by the PPA, it is important to note that there is a claw-back such that the reimbursement to pharmacies is reduced currently by 6 per cent. to 12.5 per cent., depending on the size of the pharmacy; this reduction is not allowed for in the table.

Disclosure of prices paid by pharmacy contractors for the purchase of these medicines might prejudice co-operation in future and make it impossible to undertake these surveys, and hence make the monitoring of total payments under the pharmacy contract very difficult.

Steve McCabe: To ask the Secretary of State for Health whether it is her policy that patients should continue to have access to pharmacists for advice and support following the enactment of the Health Bill. [61708]

Jane Kennedy: Patients will continue to have access to pharmacists for advice and support following enactment of the Health Bill. Provisions in the Bill will allow pharmacists greater flexibility in how they use their clinical skills to offer patients a wider range of pharmacy services.

Post-traumatic Stress Disorder

Peter Viggers: To ask the Secretary of State for Health what treatment is available for post-traumatic stress disorder (a) in England and (b) in the Gosport area; and what delays in the availability of treatment have occurred in the last 12 months. [60050]

Ms Rosie Winterton: Psychological and drug treatments for the treatment of post-traumatic stress disorder (PTSD) are available for people eligible for
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national health service treatment. NHS organisations were given guidance on the management of PTSD in primary and secondary care by the National Institute for Health and Clinical Excellence in March 2005. Local NHS organisations should review their existing clinical guidelines, care pathways and protocols in the treatment and management of PTSD in the light of this guidance, and revise them accordingly.

The Hampshire and Isle of Wight strategic health authority reported that there had been delays in accessing the psychological therapy service in Fareham and Gosport over the last year but that plans are in hand to address this.

Premature Babies

Lynne Featherstone: To ask the Secretary of State for Health how many babies were born under 25 weeks in each hospital in England in the last five years; and how many of these survived. [62503]

Mr. Byrne: This information is not collected centrally.

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