Mr. Jamie Reed: To ask the Secretary of State for Health (1) what estimate his Department has made of the value of unused prescription drugs prescribed throughout the national health economy in the last year for which figures are available; 
(4) what estimate his Department has made of the value of unused, wasted or returned prescription drugs in the Cumbrian health economy in the most recent period for which figures are available; what assessment he has made of how these costs may be reduced; what assessment he has made of alternative uses for returned medication; and what guidance is given to medical practitioners on these matters. 
Dawn Primarolo: The Department does not have an estimate of the current annual value of unused prescription drugs or wasted and returned prescription drugs. We are in the process of commissioning research to establish the scale, costs and causes of waste medicines in England. The research will provide the basis for further action to reduce the cost of wasted medicines.
We support a range of initiatives including repeat dispensing and medicines use reviews, through the contractual framework for community pharmacy, where pharmacists help patients get the most from their medicines, while at the same time minimising the wastage of medicines by optimising their use.
More than 1,200 prescribing advisors are employed at various levels in the national health service work with general practitioners to encourage and secure rational and cost-effective prescribing. We are concerned about wastage from unused medicines. However, it is not appropriate to promote the reuse of medicines returned from patients. Recycling medicines returned by patients is both unethical and unsafe.
A number of primary care trusts (PCTs) in the north-west have participated in a regional medicines waste campaign. However, Cumbria PCT is developing its own campaign on waste, working with local stakeholders and media.
Dawn Primarolo: The prices of national health service branded prescription medicines and the profits that companies can make on these sales are controlled by the 2005 Pharmaceutical Price Regulation Scheme (PPRS) which is a voluntary agreement, negotiated with the Association of the British Pharmaceutical Industry. On 1 January 2005 the prices of medicines covered by the PPRS were reduced by 7 per cent. with the aim of effecting a corresponding reduction in the NHS expenditure on branded medicines while securing the provision of safe and effective medicines for the NHS at reasonable prices. The PPRS is currently being renegotiated with the pharmaceutical industry.
The major control over the expenditure on NHS generic medicines is effected by the Category M system which adjusts reimbursement prices in line with market prices each quarter and taking into account of the findings of the medicines margins survey, which monitors the amount of margin pharmacies earn on the medicines they dispense. These arrangements were agreed as part of the community pharmacy contractual framework and have the objectives of ensuring that safe and effective generic medicines are available to patients while securing value for money for the NHS.
Mr. Bradshaw: Linking patient-level information to costing presents an important opportunity to make a step change in the quality of cost data. Patient level costing and information systems are therefore being adopted by some national health service organisations with the support and encouragement of the Department.
Mr. Lansley: To ask the Secretary of State for Health what proportion of primary care trust revenue allocations were covered by payment by results in each financial year since the system was initiated; what proportion of primary care trust revenue allocations he expects to be covered by payment by results in each year until 2010-11; and if he will make a statement. 
|Percentage of PCT revenue allocation covered by PbR
|(1) Based on 2005-06 outturn activity
(2) Based on 2006-07 outturn activity
(3) Based on forecast activity growth in 2007-08 and 2008-09
Mr. Lansley: To ask the Secretary of State for Health which specific concerns about the performance of the secondary uses service were raised by respondents to his Department's consultation on the Options for the Future of Payment by Results, as stated on pages 18-19 of the Summary of Responses to the consultation, published on 24 January 2008. 
levels of support and training;
the observation that SUS is not yet fully operational;
perceived problems from 2005-06, relating to lead in times, support, and guidance;
the flexibility of SUS to allow local arrangements to be taken into account;
the length of time allowed for 2007-08 SUS data to be submitted;
the clarity of rules on SUS that apply to all providers; and
SUS's ability to enable frequent uploads.
Mr. Hoban: To ask the Secretary of State for Health what the staffing costs for (a) doctors, (b) nursing staff and (c) all NHS staff were in the most recent year for which figures are available. 
£6,330,231,000 for doctors;
£11,114,727,000 for nurses, midwives and health visitors; and
£29,908,033,000 for all national health service staff.
These staffing cost figures do not include NHS foundation trusts as the Department does not hold such information. NHS foundation trusts staffing costs may be obtained by writing to the chairmen of those trusts.
Helen Southworth: To ask the Secretary of State for Health what funding has been allocated to North Cheshire Hospital NHS Trust in each year since its inception; and for what purposes the funding has been allocated. 
Ann Keen: Revenue allocations are made directly to primary care trusts (PCTs), not national health service trusts or individual hospitals. NHS trusts receive most of their income through the commissioning arrangements they have with PCTs.
Mr. Lansley: To ask the Secretary of State for Health pursuant to the answer of 21 January 2008, Official Report, column 1698W, on obesity, how many staff worked in his Department's obesity, nutrition and physical activity teams in each of the last five financial years for which figures are available, broken down by payband. 
Mr. Lansley: To ask the Secretary of State for Health what estimate his Department has made of the number of people referred to weight management clinics who did not attend such clinics in each of the past five financial years for which figures are available; and what percentage of the number of people referred this represented in each year. 
Mr. Stephen O'Brien: To ask the Secretary of State for Health what Government expenditure on palliative care was in each year since 2004-05; and what it is forecast to be in each year to 2010-11. 
Mr. Ivan Lewis:
We do not collect information centrally on expenditure on palliative/end of life care and there are no central revenue allocations specifically for end of life care. Primary care trusts (PCTs) remain
responsible within the national health service for commissioning and funding services for their resident population, including end of life care. It is for PCTs to determine how to use the funding allocated to them to commission services to meet the healthcare needs of their local populations.
Mr. Heath: To ask the Secretary of State for Health how many children's bodies had to be moved (a) to the adjoining coroner's district and (b) further afield for post mortem examinations by paediatric pathologists in each of the last five years. 
The statistical information is neither held centrally nor by individual coroners. However, we are aware that there are shortages of paediatric pathologists in some areas of the country, and coroners may have to move bodies beyond their adjoining districts to access the appropriate scientific expertise. The draft Coroners Bill, published in June 2006, sets out the Government's plans for reform of the system. It removes the current restrictions regarding the movement of bodies, giving coroners the power to order that a body be moved to any suitable place for a post-mortem examination. The Bill will be introduced as soon as parliamentary time allows.
Bob Russell: To ask the Secretary of State for Health when public consultation on prescription charges in England will commence; when its findings will be published; and if he will make a statement. 
Dawn Primarolo: The Government will be inviting views shortly on possible options for changes to prescription charges that are cost neutral to the national health service. A summary of the responses to the consultation will be published in due course.
Mark Simmonds: To ask the Secretary of State for Health (1) how many prescriptions incurred a prescription charge in each of the last three financial years; and how many are projected to incur a prescription charge in each of the next three financial years; 
(2) what estimate he has made of the number of people who (a) paid for their prescriptions in each of the last three financial years and (b) will pay for their prescriptions in each of the next three financial years. 
Dawn Primarolo: There are no data available on the numbers of people who pay the prescription charge. The total number of chargeable prescription items dispensed in the community, in England, for the last three financial years is provided in the following table. This is taken from prescription exemption category estimates. Projections for the next three financial years are not available.
|Number of chargeable prescription items
|Number of prescription items paid by pre payment prescriptions
|Total number of chargeable prescription items
| Source: Prescription Cost Analysis system.
Dr. Alasdair McDonnell: To ask the Secretary of State for Health what assessment he has made of the effect on clinical outcomes in primary care of the new GP contract in the last three years. 
Mr. Bradshaw: Practices have responded positively, to the Quality and Outcomes Framework (QOF), with almost universal participation covering 99.8 per cent. of registered patients in England. There is evidence from independent research that shows achieving the quality targets in the QOF can achieve significant health gains. There is also emerging evidence that care is now improving more rapidly for asthma and diabetes than before the QOF was introduced. For coronary heart disease, where there have already been major improvements in quality for a number of years, the improvement has continued at the same rate.
As part of a review of the new general practitioner contractual arrangements the Department has commissioned a long-term research project to assess the impact of the QOF by improving the quality of care to patients.