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4 Sep 2006 : Column 2158W—continued


Danny Alexander: To ask the Secretary of State for Health at which locations her Department funds research into (a) understanding and (b) treatment of osteoarthritis; and if she will make a statement on the Government's strategy for researching osteoarthritis. [88632]

Andy Burnham: Over 75 per cent. of the Department's total expenditure on health research is currently devolved to and managed by national health service organisations. Details of individual projects including a large number concerned with osteoarthritis are available on the national research register (NRR) at NRR entries include the address of the hospital or other location at which the principal researcher is based.

The Department funds research to support policy and to provide the evidence needed to underpin quality improvement and service development in the NHS. Information about osteoarthritis research commissioned by Department's national research programmes can similarly be found on the NRR.

The Government also support medical and clinical research by funding the Medical Research Council (MRC). The MRC is an independent body funded by the Department of Trade and Industry via the Office of Science and Innovation.

The MRC spent £6.8 million on arthritis and rheumatism research in 2003-04, and is about to issue a highlight notice encouraging researchers to submit innovative proposals aimed at identifying factors involved in the maintenance of musculoskeletal health, especially where such research could underpin the development of new diagnostic approaches.

The approaches to the research are also important and the MRC wishes particularly to support longer- term collaborative research from new partnerships working at the interface of basic and clinical research. To this end, the MRC will consider collaborative funding with other research councils, charities and industry.


Mr. Drew: To ask the Secretary of State for Health (1) why the decision was made not to include measures to diagnose and treat osteoporosis within the Quality and Outcomes Frameworks; [83245]

(2) what consideration her Department has given to the inclusion of osteoporosis in the Quality and Outcomes Framework of the General Medical Services contract. [85581]

Andy Burnham: As part of the negotiations for the new general medical services contract for April 2006 an expert panel was engaged by NHS Employers to receive and review submissions on clinical areas for possible inclusion in the quality and outcomes framework (QOF). The number of submissions to the panel for the inclusion of osteoporosis totalled seven out of 514. All submissions were considered and the expert panel produced reports which have been published on the University of Birmingham website at: Copies have been placed in the Library.

During the negotiations many clinical conditions were considered. The key criteria for inclusion in QOF were:

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Due to technical problems with the proposed indicators and the degree of priority attached to other changes to the QOF, the proposals for osteoporosis were not taken forward for the 2006 contract changes. As part of the continuing development of the framework, indicators will be reviewed in the light of emerging evidence.

Out-of-hours Care

Steve Webb: To ask the Secretary of State for Health (1) what the average hourly rate of pay was for GPs providing out-of-hours care in 2005-06; [89110]

(2) if she will conduct an evaluation of standards of out-of-hours care following the introduction of the general medical service contract in 2004; and if she will make a statement. [89111]

Caroline Flint: Information on general practitioner pay for out-of-hours services is not collected centrally.

The National Audit Office published a report on “The Provision of Out-of-hours Care in England” on 5 May 2006. A copy has been placed in the Library.

The report highlights that patient experiences of out-of-hours services are generally positive.

Eight out of 10 patients are satisfied with the service, while six out of 10 rate the service as excellent or good.


Mr. Gauke: To ask the Secretary of State for Health what administrative functions for which her Department is responsible are outsourced overseas; and what assessment she has made of the merits of outsourcing further such functions overseas. [81554]

Caroline Flint: None of the Department’s administrative functions are outsourced overseas. However, in April 2005, the Department entered into a 50/50 joint venture partnership with Xansa to provide shared services to the national health service, called NHS Shared Business Services. NHS Shared Business Services now has over 100 clients on board for finance and accounting services and it is expanding into other areas such as payroll and e-procurement.

To date, NHS Shared Business Services has offshored some activities to India:

Overseas Doctors

Mr. Hurd: To ask the Secretary of State for Health what rules and regulations govern overseas doctors who work in the national health service; who assesses the competence of overseas doctors; and whether that assessment is carried out by a (a) national and (b) local scheme. [89099]

Ms Rosie Winterton: Overseas doctors who work in the national health service are subject to the same terms and conditions of employment as their United
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Kingdom (UK) counterparts. Like all doctors, before they can practise medicine in the UK they must be registered with the General Medical Council (GMC) and are subject to the GMC's standards of fitness to practise.

At present, for international medical graduates from outside the European economic area the first step is to gain limited registration. This will enable them to practise in the NHS in supervised employment. Before they can be granted limited registration they must provide the GMC with evidence of their medical knowledge and skills-passes at part one and part two of the PLAB test.

Parallel-traded Medicines

Mr. Stephen O'Brien: To ask the Secretary of State for Health (1) what the value was of parallel-traded prescription medicines in the UK in 2005-06; [88880]

(2) what estimate she has made of the effect of parallel imports on the NHS pharmaceutical budget in 2005-06; [88881]

(3) what the additional earnings were of pharmacists from the purchase of parallel traded medicines in 2005-06; [88882]

(4) what assessment she has made of the effect of the reimbursement mechanism for pharmacists in England on (a) parallel imports and (b) new branded medicines entering the market. [88884]

Andy Burnham: No estimates are available centrally.

Mr. Stephen O'Brien: To ask the Secretary of State for Health how the Medicine and Healthcare products Regulatory Agency ensures that the procedures that the research and development based pharmaceutical industry has to follow to ensure quality and patient safety is followed by parallel import traders. [88883]

Andy Burnham: The United Kingdom (UK) parallel import licensing scheme, as required by the European treaty, allows medicinal products already authorised in other European Union (EU) member states to be marketed in the UK provided the imported products have no therapeutic difference from the equivalent UK products and do not appear in the light of scientific knowledge to differ as regards their safety and efficacy.

The Medicines and Healthcare products Regulatory Agency (MHRA) liaises closely with the relevant competent authorities in the EU to obtain the necessary information to ensure that only those products which fully comply with the stringent criteria for parallel import are granted a licence.

Quality and patient safety are further ensured by a thorough assessment of the proposed labelling and/or packaging and the patient information leaflet by assessors prior to the issuing of a licence. Repackaging of the imported product when it occurs is carried out by an approved company in possession of a manufacturer’s or assembler’s licence, issued by the MHRA. In addition, patient information leaflets
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and/or packaging are kept up to date by variations to the parallel import licences when relevant information becomes available via the MHRA’s pharmacovigilance activities.

Parallel import traders are also subject to routine inspections by staff of the MHRA’s inspection and standards division.

Mr. Stephen O'Brien: To ask the Secretary of State for Health whether parallel importers of pharmaceuticals are asked to guarantee continuous supplies to the NHS. [89171]

Andy Burnham: Neither parallel importers or pharmaceutical companies are asked to guarantee continuous supplies to the national health service. However, for those products tendered and contracted for by the NHS Purchasing and Supply Agency on behalf of NHS trusts, arrangements are in place to ensure that the supply chain is robust.

Parliamentary Questions

Mr. Burstow: To ask the Secretary of State for Health when she will reply to question 22980, tabled by the hon. Member for Sutton and Cheam on 25 October 2005, on NHS organisations' financial recovery plans. [88901]

Andy Burnham: A reply was sent to the hon. Member on 22 August 2006.

Patient Care Records

Anne Main: To ask the Secretary of State for Health what advice she has issued to doctors following the National Institute for Health and Clinical Excellence's recommendations on the advisability of patients being given a record of significant matters discussed during diagnosis and at key stages during their treatment; and if she will make a statement. [86718]

Ms Rosie Winterton: Cancer networks have developed action plans to ensure the National Institute for Health and Clinical Excellence's (NICE) supportive and palliative care guidance is implemented. This includes setting key milestones for delivery, including setting a date by which patients will be provided with a permanent record of important points relating to their consultation. Implementation of the NICE guidance will take place over a number of years and will be monitored by strategic health authorities. We have also commissioned work for the development of a tool to assess patient need at key stages throughout the cancer journey. This will report in spring 2007.

Practice-based Commissioning

Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 5 July 2006, Official Report, column 1228W, on practice-based commissioning, what the total level of expenditure on incentive payments for practices to take up practice-based commissioning was in each year since the incentive payments were first offered. [85831]

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Caroline Flint: A directed enhanced service (DES) had been negotiated under the new general medical services contract to offer all practices an incentive payment to take part in practice based commissioning. The DES is for 2006-07 and has two component parts, each of 95p per registered patient. The DES is available until the end of March 2007, therefore a total expenditure for this year is not currently available.


Dr. Cable: To ask the Secretary of State for Health (1) how many prescriptions were not used to collect medicines in each of the last five years for which records are available; [87772]

(2) what research she has undertaken to establish the principle reasons for prescriptions not being used by patients; [87773]

(3) what estimate she has made of the percentage of people earning less than £10,000 who are eligible for free prescriptions; [87774]

(4) what percentage of free prescriptions were provided under each type of exemption in each of the last three years; [87775]

(5) whether individual primary care trusts have any freedom to establish prescription charges on services that are provided free-of-charge nationally. [88279]

Andy Burnham: Information is not available about the number of prescriptions issued to patients but not subsequently dispensed and no research has been undertaken to establish the reasons for prescriptions not being used.

Anyone whose income (including earnings) is less than £15,050 per year and is receiving child tax credit, or working tax credit that includes a disability or severe disability element, is entitled to free prescriptions. No separate assessment has been made of the number with earnings under £10,000 who are eligible for free prescriptions.

Prescription charges may only be made in accordance with section 77 of the National Health Service Act 1977 and regulations made under that Act—the National Health Service (Charges for Drugs and Appliances) Regulations 2000 (as amended).

Information about the percentage of the total prescriptions provided free in respect of each type of exemption is in the table.

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2003 2004 2005

People aged 60 and over




Children under 16 and young people aged 16-18 in full time education




Maternity and medical exemption certificate held




Income based entitlement




Prescribed contraceptives




Items personally administered by a doctor




Other items including war pensioners and no specific declaration




Note: The figures do not total 100 per cent. due to rounding. Source: The information in the table has been taken from the Statistical Bulletin which is available at and which provides more detailed information.

Jeff Ennis: To ask the Secretary of State for Health how many people in (a) Barnsley and (b) Doncaster are eligible for free prescriptions. [88381]

Andy Burnham: Information is not collected about the individuals in Barnsley and Doncaster who are entitled to free prescriptions. The information available about the number of free prescriptions is shown in the table.

Prescriptions dispensed in 2005
Barnsley Doncaster

Total items dispensed (million)



Total free of charge items (million)



Percentage of total dispensed free of charge



Total chargeable items (million)



Percentage of total chargeable



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