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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
the percentage of prescription items dispensed in the community that were conducted via the electronic prescription service over the same period.
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. 
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. 
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.
|Net ingredient cost of prescriptions for methylphenidate hydrochloride dispensed in primary care||Estimated cost of methylphenidate hydrochloride dispensed in hospitals|
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
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. 
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. Methylphenidates 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.
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:
the feasibility of using electronic files from publishers to reduce production costs and enable an increase in books produced;
the feasibility of making accessible books available through mainstream booksellers;
Braille, large print and daisy audio products;
Business models for a sustainable growth in accessible products.
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 DPMs can prevent screen readers providing a synthetic voice option to consumers.
The Department for Culture, Media and Sport (DCMS) has supported the Revealweb projectan 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. 
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.
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. 
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. 
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.
|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)|
|(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.|
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.
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.