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14 May 2007 : Column 622W—continued

The imbalance between the number of prescription messages issued and the number dispensed is due to a number of factors. Most general practitioner (GP) system suppliers have achieved technical compliance with the electronic prescription service earlier than the pharmacy system suppliers, resulting in more GP practices having used the service for a longer period of time than pharmacies. In addition, the geographical distribution of bar-coded prescriptions available to pharmacies has been relatively limited. This is now changing and over 1,070 GP practices have achieved the technical capacity to issue bar-coded prescriptions within the last four weeks. As the volume of bar-coded prescriptions spreads geographically, there will be a related increase in the number of prescription dispensed using the electronic prescription service.

Information is not held centrally in a format that would make it possible to make a reliable estimate of
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the percentage of prescription items dispensed in the community that were conducted via the electronic prescription service over the same period.

Primary Health Care

Mr. Lansley: To ask the Secretary of State for Health when the National Director for Primary Care was first asked to produce his report “Keeping it Personal: clinical case for change”, published on 5 February. [123135]

Andy Burnham: The National Director for Primary Care’s report “Keeping it Personal: clinical case for change” was commissioned on 6 December 2006.

Psychiatry: Drugs

Mr. Hands: To ask the Secretary of State for Health what studies she has evaluated on the long-term efficacy of psychiatric drugs used on children; what plans she has for further such investigations; and if she will make a statement. [133863]

Caroline Flint: Only Fluoxetine is authorised for paediatric use. The Medicine and Healthcare product Regulatory Agency (MHRA) has evaluated studies of up to 12 months duration with the product Prozac (Fluoxetine) in paediatric patients and considered that efficacy was demonstrated and the risk/benefit was positive. The MHRA is not aware of other studies for the evaluation of long-term efficacy of psychiatric drugs in children.


Mrs. May: To ask the Secretary of State for Health how much the NHS spent on methylphenidate drugs in each year between 1997 and 2006. [132833]

Caroline Flint: The information requested is shown in the table.

£ million
Net ingredient cost of prescriptions for methylphenidate hydrochloride dispensed in primary care Estimated cost of methylphenidate hydrochloride dispensed in hospitals



Not held



Not held



Not held



Not held


















Not yet available

1. Net ingredient cost is the basic cost of a drug. It does not take account of discounts, dispensing costs, fees or prescription charges income.
2. The estimated cost of the medicines at NHS list price and not necessarily the price the hospital paid.
Prescription Cost Analysis (PCA) system

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Ritalin: Labelling

Mrs. May: To ask the Secretary of State for Health when the labelling of Methylphenidate-based medication was last updated in accordance with regulatory requirements; if she will review the adequacy of the regulations relating to such labelling; and if she will make a statement. [134182]

Caroline Flint: Methylphenidate (trade names Ritalin, Concerta XL and Equasym XL) is a stimulant drug licensed for children over six years of age as part of a comprehensive treatment programme for attention deficit hyperactivity disorder (ADHD). Such treatment should be under the supervision of a specialist in childhood behavioural disorders. Methylphenidate’s safety in routine clinical practice is closely monitored by the Medicines and Healthcare products Regulatory Agency (MHRA) in conjunction with other European regulatory authorities.

Since methylphenidate was first authorised in the United Kingdom, a number of changes have been made to the product information for prescribers and patients to better reflect its emerging safety profile. The last revision, in November 2006, was to the product information for Concerta, to advise about serious cardiovascular adverse effects and to recommend that methylphenidate should not be used in children or adolescents with known serious structural cardiac abnormalities. Steps are being taken to ensure consistency of information for all methylphenidate products.

The longer term safety of the use of methylphenidate is kept under careful review within Europe. The UK, on behalf of Europe, is in discussions with the pharmaceutical companies who manufacture methylphenidate products in order to develop risk management plans, which include the conduct of new research to better characterise and further investigate the safety profile of methylphenidate. As new data emerge they will be carefully evaluated by the MHRA and where necessary current prescribing advice will be updated to reflect the new evidence.

The marketing authorisation holder of any medicine is legally obliged to keep their product information up to date with all current developments, and respond to requests from regulatory agencies. European regulations governing medicinal products were amended in November 2005 and included provisions for improved monitoring of drug safety and quality of information for patients.

School Fruit and Vegetable Scheme

Mr. Milburn: To ask the Secretary of State for Health how many pupils in Darlington schools and nurseries receive free fruit. [135014]

Caroline Flint: There are 4,275 pupils attending 28 schools in the Darlington area that are currently participating in the school fruit and vegetable scheme.

Sight Impaired

Mr. Pelling: To ask the Secretary of State for Health what steps the Government are taking to improve the availability of recreational reading material for people with visual impairments. [133829]

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Mr. Lammy: I have been asked to reply.

A number of Government Departments have undertaken specific initiatives to improve access to and the availability of recreational reading material for people with visual impairments:

The Department of Trade and Industry (DTI) is working with publishers, booksellers and other sector stakeholders with a view to improving the amount of book material available in accessible formats for blind and visually impaired people. The project has examined:

It is anticipated that the project will now proceed to a market test, funded by industry and RNIB.

In addition the Government are encouraging publishers to consider the needs of visually impaired people in the application of digital protection measures (DPM) to their e-book titles. Some DPM’s can prevent screen readers providing a synthetic voice option to consumers.

The Department for Culture, Media and Sport (DCMS) has supported the ‘Revealweb’ project—an on-line resource to enable visually impaired people and their helpers to easily locate available material in alternative formats. The Museums, Libraries and Archives Council (MLA) are working to link Revealweb to the public libraries’ interlibrary loans system to improve access to the public library network for visually impaired people.

The Government supported the Copyright (Visually Impaired Persons) Act 2002 which removes the need for organisations and individuals to request permission before they reproduce copies in accessible formats, and enables accessible versions of published works to be made under licence.

The Royal National Institute of the Blind (RNIB) receives an annual grant from the Department for Education and Science (DfES) of £200,000 to support the UK production of embossed literature and to make it available in the UK for the benefit of visually-impaired people.


Anne Milton: To ask the Secretary of State for Health how much has been allocated for advertising the implementation of the smoking ban in (a) Wales, (b) England and (c) Northern Ireland; and if she will make a statement. [131989]

Caroline Flint: In May, the Department will begin a national and regional advertising campaign in England, targeted at businesses and the general public, to communicate the key aspects of smokefree legislation that will be implemented on 1 July 2007. A budget of £4.8 million has been allocated to the campaign in this financial year.

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The implementation of smokefree legislation in Wales and Northern Ireland is a devolved matter.

Special Advisers

Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 20 March 2007, Official Report, column 872W, on special advisers, whether her special advisers have given any notice of any external employment in the last 12 months. [131949]

Mr. Ivan Lewis: There is nothing further to add to the answer given on 20 March 2007, Official Report, column 872W.

Taxi Contracts

Gordon Banks: To ask the Secretary of State for Health what the value of taxi contracts entered into by the NHS was in each year since 2000. [115290]

Andy Burnham: The information requested is not collected centrally.


Ian Stewart: To ask the Secretary of State for Health how many adverse reactions to vaccines were reported between 1982 and 1985; and whether there were any deaths attributed to vaccination in each year. [135183]

Caroline Flint: The table lists the numbers of reports of suspected adverse reactions (ADRs) to vaccines submitted to the Medicines Division of the Department of Health, the responsible authority prior to the Medicines Control Agency, and current Medicines and Healthcare products Regulatory Agency (MHRA), via the yellow card scheme between 1 January 1982 and 31 December 1985.

It is important to note that the report of a suspected ADR via the yellow card scheme and inclusion in this list does not necessarily mean that the event was caused by the vaccine. Suspected ADRs are suspicions that a vaccine may have caused an event and not proof of a causal association. For these events with a fatal outcome, causality with vaccination has not been proven.

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Vaccine Number of suspected ADRs reports where a vaccine was indicated as a suspected drug( 1) Number of suspected ADRs reports with a fatal outcome( 1)










Diphtheria, tetanus and pertussis (DTP)



Diphtheria and tetanus (DT)









Oral polio


















Hepatitis B






Yellow Fever



Tick Borne encephalitis



(1 )Reports in each column should not be added to derive a cumulative total as in many individual cases more than one vaccine may be co-suspect.


Mr. Laws: To ask the Secretary of State for Health how many UK-based websites breached medicines legislation in each of the last 10 years; and what enforcement action has been taken. [129893]

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Caroline Flint: In the United Kingdom, there are strict legal controls on the retail sale, supply and advertisement of medicinal products. These controls apply without distinction to medicines sold or supplied through internet transactions and mail order.

The Medicines and Healthcare products Regulatory Agency (MHRA) takes the view that internet and mail order sale and supply of medicines are acceptable provided these legal requirements are met. However, any website brought to their attention for breaching regulations will be investigated.

Records held by MHRA show that from 1 April 1997 to date, out of 294 cases opened involving internet activity, 227 of these were found to be in breach of medicines legislation.

MHRA will initially aim to achieve compliance with regulatory requirements, sites are contacted and given advice on UK statutory obligations. Although MHRA has no powers to force closure of websites, internet service providers are contacted concerning illegal activity and can close down offending sites. However, if compliance cannot be achieved, further action can be taken including a criminal prosecution brought through the criminal courts and civil proceedings.

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