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15 May 2006 : Column 756Wcontinued
Dr. Cable: To ask the Secretary of State for Health what arrangements are in place for patients who are unable to pay for prescriptions but are not eligible for free prescriptions. [50449]
Andy Burnham: Those that do have to pay prescription charges may be entitled to help under the NHS Low Income Scheme. They can apply by completing an HC1 form. These are available from Jobcentre Plus offices or by phoning on 0845 850 1166.
Alternatively, people can purchase a four-month prescription pre-payment certificate which will save them money if they anticipate requiring more than five prescription items during the four months. A 12-month certificate is also cost-effective if the patient requires14 items or more in a year.
Steve Webb: To ask the Secretary of State for Health if the UK Government will encourage the European Commission to support changes in regulations to enable pharmaceutical companies to provide information directly to patients about prescription medicines; and if she will make a statement. [67953]
Andy Burnham: Clear and relevant information is vital if patients are to use medicines safely and effectively. The provision of information about medicines is a key to increasing appropriate access to, uptake of and safe use of medicines. It is also vital to support people in making informed choices about prescribed medicines with their health professional, which in turn improves patient compliance and health outcomes.
Under current United Kingdom (UK) and European law, pharmaceutical companies may already provide non-promotional information directly to patients and the public about prescription medicines. We do not consider that any changes to regulations are needed to facilitate this in the UK but are working with European colleagues to ensure there is a common understanding and application of European Union law.
Tim Loughton: To ask the Secretary of State for Health what research her Department has (a) commissioned and (b) evaluated into side effects of the drug Strattera; and if she will make a statement. [69394]
Andy Burnham: Clinical trials data submitted by the marketing authorisation holder (MAH) for Strattera (atomoxetine) was evaluated at the time of licensing to ensure that it met appropriate standards of safety, quality and efficacy to support its use in the treatment of attention deficit hyperactivity disorder (ADHD).
Since the marketing of Strattera, the Independent Scientific Advisory Committee, the Commission on Human Medicines (CHM), and the Medicines and Healthcare products Regulatory Agency (MHRA) have kept its safety under close review. As new data have emerged, product information for prescribers and patients has been updated and advice has been issued.
In February 2006, the MHRA led a European review of the risks and benefits of Strattera and sought advice from the CHM and an expert working group whose membership included those with expertise in child and
adolescent psychiatry and lay representation. Doctors and patients were informed of the following conclusions of this review:
overall the balance of risks and benefits of Strattera in the treatment of ADHD in children and adolescents remains positive;
prescribers should be reminded that Strattera should be initiated only by and under the supervision of a specialist;
warnings on the risk of seizures and electrocardiogram QT prolongation (abnormal heart rhythm) should be included in the product information; and
the current warnings in the product information about the risk of liver disorders and suicidal thoughts and behaviour accurately reflect the available data.
Full guidance on prescribing and the use of Strattera, including possible side effects, is provided in the product information for prescribers (the Summary of Product Characteristics) and patients (Patient Information Leaflet).
The National Institute for Health and Clinical Excellence (NICE) has recently published a technology appraisal on methylphenidate, atomoxetine and dexamfetamine for the treatment of ADHD. During the development of this appraisal NICE was fully informed about the European review and the available data on the safety and efficacy of atomoxetine in the treatment of ADHD.
The MAH was also requested to put in place a risk management plan for Strattera, which includes the conduct of new research to better characterise and further investigate its safety profile.
A copy of the report on the risks and benefits of Strattera has been placed in the Library.
Mr. Bone: To ask the Secretary of State for Health from what point in an individual's treatment her Department calculates the waiting time for an NHS in-patient operation. [70897]
Andy Burnham: The waiting time for a national health service in-patient operation is taken from the point at which a consultant decides that the patient needs to be admitted for treatment, to the date upon which the patient is actually admitted to hospital.
Mr. Bone: To ask the Secretary of State for Health on what date she expects the Government to meet their target for nobody to wait more than six months for an in-patient operation in the NHS. [70933]
Andy Burnham: The national health service does now have an operating standard of six months for in-patient admission. Data collected by the Department show that there have been very few breaches of this standard since it was introduced in December 2005. Therefore, it is considered that the Government's in-patient target has been and continues to be achieved.
However, any breaches of the waiting time standards are unacceptable and the Department will continue to work closely to support the small number of NHS organisations where patients are waiting over six months.
Mr. Bone: To ask the Secretary of State for Health what estimate she has made of the number of people who are waiting for an NHS in-patient operation and who have been informed they will have to wait more than six months. [70990]
Andy Burnham: The national health service now has a maximum waiting time of six months for in-patient admission. Any breaches of this waiting time standard are unacceptable and the Department will continue to work closely to support each NHS organisation where this is an issue. No estimate has been made of whether the very small number of patients who may at risk of having to wait longer than the standard have been informed.
Mr. Wills: To ask the Secretary of State for Health how many people waited more than six months for a hospital appointment in (a) 1997 and (b) 2006 in(i) Swindon and (ii) England. [69043]
Andy Burnham: In March 1997, 283,866 patients were waiting more than six months for hospital admission in England and 4,671 patients were waiting more than six months for hospital admission in the area covered by Wiltshire Health Authority.
In March 2006, 199 patients were waiting more than six months for hospital admission nationally and no patients were waiting more than six months for hospital admission in the area covered by Swindon Primary Care Trust.
Mr. Letwin: To ask the Secretary of State for Health what the average length of time was for which patients in (a) England and (b) Dorset waited for dialysis during 2005. [68307]
Ms Rosie Winterton: There was no average length of time in England for which patients requiring dialysis waited for treatment in 2005. The national service framework for renal services notes that because the progression of chronic kidney disease is frequently slow clinicians can often predict the point when the person will need to start renal replacement therapy (RRT), which consists of haemodialysis, peritoneal dialysis or transplantation.
Professional consensus is that the optimal time required to prepare a patient and their carers for RRT is around one year. This is why good practice suggests that those with established renal failure requiring dialysis have timely and appropriate surgery for vascular or peritoneal dialysis access to improve outcomes, minimise complications and maximise longevity of the access site. However, research shows that a third of people present less than a month before requiring RRT, and the outcomes for this group are less good than for those who present earlier.
If someone presents as an emergency or it is not possible to establish mature access before dialysis is required an intravenous catheter can be inserted for dialysis at extremely short notice, usually into a vein deep in the patients neck.
Mr. Letwin: To ask the Secretary of State for Health how many patients in England requiring a form of dialysis were not able to obtain that form of dialysis during 2005. [68309]
Ms Rosie Winterton: The national service framework for renal services notes that the total number of people receiving renal replacement therapy (RRT) has been taken as a proxy measure for the prevalence of established renal failure (ERF). However it is generally agreed that in addition there will be people in the general population with ERF which has not been diagnosed and whose need for RRT has not been recognised. People who have been identified as requiring dialysis receive it, on an emergency basis if necessary. Research shows that a third of people present less than a month before requiring RRT.
RRT includes transplantation, haemodialysis and peritoneal dialysis. Data on the numbers of people requiring dialysis are not collected or held centrally. Data from the most recent national survey of renal units, commissioned by the Department from the renal registry of the Renal Association, show that in December 2002, 11,789 patients in England were receiving haemodialysis; 4,605 peritoneal dialysis, and 14,104 people had a transplant in the year ending December 2002.
For some patients with established renal failure, who are suffering from other, terminal, conditions, haemodialysis may not be an appropriate treatment, as it can add to the distress of these patients without extending life. These patients should be presented with the option of a properly managed palliative care plan.
Mr. Letwin: To ask the Secretary of State for Health what assessment she has made of the effects on kidney patients of being unable to obtain dialysis within a short time after this treatment is recommended by a consultant. [68310]
Ms Rosie Winterton: The national service framework for renal services notes that because the progression of chronic kidney disease is frequently slow clinicians can often predict the point when the person will need to start renal replacement therapy (RRT). Professional consensus is that the optimal time required to prepare a patient and their carers for RRT is around one year. This is why good practice suggests that those with established renal failure requiring dialysis have timely and appropriate surgery for vascular or peritoneal dialysis access to improve outcomes, minimise complications and maximise longevity of the access.
Research shows that a third of people present less than a month before requiring RRT, and the outcomes for this group are less good than for those who present earlier. If someone presents as an emergency an intravenous catheter can be inserted for dialysis, usually into a vein deep in the patient's neck.
Mr. Burns: To ask the Secretary of State for Health how many people in the Mid Essex Hospital Trust area missed their appointments in the last year for which figures are available; and what the estimated cost was to the Trust of these missed appointments. [69842]
Ms Rosie Winterton: The number of missed first outpatient appointments reported by Mid Essex Hospitals National Health Service Trust in 2004-05 was 5,590 and for the first three quarters of 2005-06, the trust reported 4,646.
Information is not held centrally as to the cost of missed appointments.
Source:
Primary care and activity analysis
Mr. Burns: To ask the Secretary of State for Health how many people in the Mid Essex Hospital Trust area had their appointments cancelled by the Trust (a) once, (b) twice, (c) three times and (d) more than three times in the last year for which figures are available. [69843]
Ms Rosie Winterton: The information requested is not held centrally.
Mr. Lansley: To ask the Secretary of State for Health when she plans to publish the principles and definitions which will underpin the delivery of the 18-week patient pathway. [69610]
Andy Burnham: The principles and definitions underpinning the delivery of the 18-week patient pathway were published on 10 May 2006 in the publication, Tackling Hospital Waiting: The 18-week Patient Pathway. An implementation framework is available in the Library and on the Department's website at:
www.dh.gov.uk/assetRoot/04/13/46/69/04134669.pdf
Keith Vaz: To ask the Chancellor of the Exchequer if he will list the companies which were paid consultancy fees by his Department in 2005-06; how much each was paid; and what each of the companies was used to accomplish. [69699]
John Healey: A table setting out the amounts paid in 2005-06 by the Treasury to companies and partnerships, recorded as consultancy spending, has been placed in the Library of the House. Information on what each supplier was used to accomplish could be provided only at disproportionate cost, and in some cases would be commercially prejudicial.
David Simpson: To ask the Chancellor of the Exchequer how much of the budget for his Department remained unspent in the 2005-06 financial year. [70550]
John Healey: The Public Expenditure Out-turn White Paper (PEOWP), due to be presented to Parliament before the summer recess in July, will provide provisional out-turn figures for 2005-06 public expenditure for all Departments, including underspends against departmental expenditure limits and administration costs limits. The Treasury's own resource accounts are also due to be presented to Parliament before the summer recess, and will show the audited out-turn against voted expenditure.
David Simpson: To ask the Chancellor of the Exchequer how many public consultations his Department undertook in the last 12 months; and what the cost was (a) in total and (b) of each consultation. [70551]
John Healey: A list of the public consultations undertaken by the Treasury since 2000 is available on the Department's website http://www.hm-treasury.gov.uk/consultations_ and_legislation/consult_fullindex.cfm. Seventeen consultations have been launched since 1 April 2005. The Treasury's accounting system does not record the cost of public consultations separately from other administration costs, so the cost of those consultations, either individually or in aggregate, could be provided only at disproportionate cost.
David Simpson: To ask the Chancellor of the Exchequer how many free air miles have been accrued by senior civil servants in his Department on official business in each of the last three years; and how they were used. [70557]
John Healey: I refer to the answer I gave the hon. Member for Lewes (Norman Baker) on 17 October 2005, Official Report, column 717W.
Chris Ruane: To ask the Chancellor of the Exchequer how many electors there were in each ward of (a) the Vale of Clwyd and (b) Denbighshire in each of the last 10 years. [70191]
John Healey: The information requested falls within the responsibility of the National Statistician who has been asked to reply.
Letter from Karen Dunnell, 15 May 2006:
As National Statistician, I have been asked to reply to your question regarding the number of electors in each ward in (a) the Vale of Clwyd and (b) Denbighshire in each of the last 10 years. (70191)
The latest available Welsh ward electorate counts are for December 2005, and the electorate counts for the last available10 years (1996 to 2005) are shown in the attached tables. Table 1 includes wards within the parliamentary constituency of the Vale of Clwyd. Table 2 for the local authority of Denbighshire, includes wards for the whole of the parliamentary constituency of the Vale of Clwyd (as included in Table 1) and also wards which are within part of the parliamentary constituencies of Clwyd South and Clwyd West.
The ward electorate counts are for parliamentary electors, including attainers. Local government electorate counts are not available at ward level. Thus the figures in Table 1 and Table 2 do not sum to the combined count of Parliamentary or local electors referred to as total electorate, for Vale of Clwyd and Denbighshire in reply to your previous parliamentary question Official Report No. 149, column 450 of 11 May 2006.
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