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Hospitals: Transport

Mike Penning: To ask the Secretary of State for Health what guidance he issues on the responsibility of primary care and NHS trusts to consult (a) the public and (b) voluntary organisations on possible changes in patient transport services arising from the reconfiguration of hospitals and other services. [210138]

Ann Keen: This is a matter for the local NHS.

On 9 May 2008,the Department of Health published “Changing for the Better: guidance when undertaking major change in the NHS”. This recommends that,
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alongside proposals for service change, the local national health service publishes a business case setting out the clinical and patient benefits and that such options should also include a detailed analysis of the impact on travelling times and distances, identifying the impact on pedestrians and public and private transport users as well as the ambulance service.

Copies of this guidance have been placed in the Library and are also available on the Department’s website at:

Magnetic Resonance Imagers

Mr. Cameron: To ask the Secretary of State for Health how many magnetic resonance imaging scanners were purchased from (a) UK and (b) non-UK companies by the NHS in (i) 2004, (ii) 2005, (iii) 2006 and (iv) 2007. [202930]

Mr. Bradshaw: The Department does not collect data on the purchase of magnetic resonance imaging scanners centrally.

There are four main suppliers of scanners in the United Kingdom market and are all subsidiaries of multi-national organisations:

Medical Records

Mr. Stephen O'Brien: To ask the Secretary of State for Health for what reasons his Department will not publish the legal guidance provided to the Department relating to the report of the ministerial working party into the summary care record chaired by Lord Warner. [212237]

Mr. Bradshaw: The legal advice in question relates to the substance of our proposals for the creation of the summary care record rather than to the report of the working party. It is covered by legal professional privilege, which provides grounds, recognised in an exemption under section 42 of the Freedom of Information Act, for not disclosing communications between a public authority and its legal advisers where this would not be in the public interest.

Legal privilege is an essential feature of the solicitor/client relationship in that it allows frank and fully-informed analysis of risk to be made prior to undertaking a particular course of action. We have taken the view that there is a very strong public interest in maintaining that principle in this case.

Medical Records: Data Protection

Mr. Stephen O'Brien: To ask the Secretary of State for Health what consideration he has given to bringing forward legislative proposals to prevent information recorded on the secondary users database being used in ways which may be detrimental to the person to whom the information relates. [212178]

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Mr. Bradshaw: Legislative proposals are unnecessary since information managed within the Secondary Uses Service (SUS) will be no more likely to be used in ways detrimental to the patient to whom it relates than that held elsewhere in the NHS Care Records Service, or that which was previously held in the pre-existing secondary uses services provided at local, regional and national level in the national health service.

Information held on SUS will be anonymised or pseudonymised to remove information that could be used to identify individuals but still allow cases to be tracked and linked, for example for research.

The terms and conditions on the uses of SUS data will include limitations on the disclosure of the data to third parties and the copying of data, and termination and liability clauses in the event of unauthorised disclosure of personally-identifiable information. There will also be a right of audit to verify adherence to the terms and conditions, which will be the key condition determining permission to access for those wishing to use the service.

These measures will safeguard the confidentiality of information about patients, while supporting and facilitating the use of information for the purposes for which SUS exists.

Mr. Stephen O'Brien: To ask the Secretary of State for Health whether clinicians will have an obligation to maintain a record of their dealings with patients on (a) any component of the national care records database or (b) a record which will be copied to a component of the database. [212180]

Mr. Bradshaw: There is an obligation on doctors from their professional bodies to keep clear, accurate, legible and contemporaneous patient records. We have not put any specific obligation on clinicians to maintain records on the patient’s summary care record (SCR) but have encouraged them to include those components relating to current medications, and any allergies or adverse reactions to medications. However, patients can request that all or some of that information is not uploaded to the SCR.

It is possible that individual national health service organisations may require employed clinicians to use the system provided by the organisation for clinical record keeping, which could be part of the National Care Records System, since it may not be possible to provide some forms of care without information, for example digital images, which will be captured solely on the new systems.

Mr. Stephen O'Brien: To ask the Secretary of State for Health (1) which NHS staff other than those based at the surgery at which the record was created will be able to access information in detailed care records directly; [212183]

(2) whether each patient's medical records will be recorded by the national care records service within a single detailed care record; and whether such detailed care records will be accessible by anyone in healthcare establishments other than those within which they were recorded. [212188]

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Mr. Bradshaw: Detailed care record systems are being deployed under the local direction of health communities to suit the needs of those communities. While it is possible that a patient will have a single detailed care record this may not always be the case. Patients with complex conditions or who receive care in different locations are likely to have a number of detailed care records.

Individuals from outside the general practitioner’s practice or national health service trust where a patient’s detailed care record was created will only be able to access the record where they are working within a local health community where patient records are managed through a shared detailed record system and where they have a smartcard and role profile that enables access to patient records. Staff must also have a legitimate relationship with the patient, for example because they are providing healthcare or treatment in a different setting, or they have express consent from the patient for other reasons, for example clinical research, or there is a statutory basis or court order supporting disclosure.

Medical Treatments: Finance

Dr. Gibson: To ask the Secretary of State for Health (1) if he will take steps to require primary care trusts (PCTs) to establish formal mechanisms to receive and consider applications from patients and clinicians for treatments not usually funded by the PCT; [204526]

(2) if he will issue guidance to primary care trusts (PCTs) on exceptional case processes setting out best practice on (a) appeals, (b) liaison with patient advice and liaison services and (c) training for exceptional case committee members; if he will direct PCTs to publish data on the processing of exceptional cases; and if he will make a statement; [204527]

(3) whether he plans to issue national guidance on the obligations on primary care trusts in relation to the process of allowing applications from patients and clinicians for treatments that are not routinely funded by a primary care trust; [204833]

(4) what his policy is on whether all primary care trusts (PCTs) should use the same criteria to determine whether funding should be granted for treatments that a PCT does not usually fund; [204835]

(5) what his policy is on whether primary care trusts should have a formalised process for considering applications by patients and clinicians for treatments which are not usually funded by the primary care trust; and if he will make a statement; [205292]

(6) whether he plans to issue national guidance on the obligations on primary care trusts in relation to the processes for applications from patients and clinicians for treatments that are not routinely funded by a primary care trust; [205293]

(7) if he will (a) ensure that all primary care trusts (PCTs) publish their exceptional case process, including their appeals process, on their websites and through local Patient Advice and Liaison Services offices, (b) support PCTs in the provision of training to all members of exceptional case committees and (c) collect data on the number of exceptional cases heard, approved or declined and for which therapy in each case. [205294]

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Mr. Bradshaw: It is for primary care trusts (PCTs) to commission services on behalf of their populations and to make decisions locally on which treatments to fund, taking into account all relevant circumstances and their statutory responsibilities and the principles of administrative law set out by the courts, particularly in relation to funding policies and whether to fund treatment in exceptional circumstances. The Government expect PCTs to have in place appropriate processes for reaching decisions on applications for treatments that are not normally funded, and to ensure that information on these processes is available to patients and clinicians, but the details and operation of such processes are for local determination.


Dr. Kumar: To ask the Secretary of State for Health how much his Department has spent on research into the treatment of migraine in each of the last 10 years; and if he will make a statement. [212168]

Dawn Primarolo: Over the last 10 years, the main part of the Department’s total expenditure on health research has been devolved to and managed by national health service organisations. Details of individual NHS supported research projects undertaken during that time, including a number concerned with migraine, are available on the archived national research register at:

Implementation of the Department’s research strategy “Best Research for Best Health” (copies of this publication are available in the Library) and the establishment of the National Institute for Health Research (NIHR) has resulted in an expansion of our research programmes and in significant new funding opportunities. The NIHR funded University College London Hospitals Biomedical Research Centre is for example undertaking research on headache and pain. A five-year budget of £3.7 million has been allocated to this work.

The Medical Research Council (MRC) is one of the main agencies through which the Government support medical and clinical research. The MRC, an independent body, receives its grant-in-aid from the Department for Innovation, Universities and Skills.

Since 1998 the MRC has funded three research projects relevant to migraine, at a total cost of £1.7 million.

NHS: Drugs

Tim Farron: To ask the Secretary of State for Health (1) what the cost to the NHS of prescribing the drug Vioxx was in the latest period for which figures are available; [213160]

(2) if the Government will review the use of drugs produced by Merck Sharpe & Dohme Ltd; [213173]

(3) what estimate he has made of the annual cost to the NHS of treating those with health impairments resulting from the use of Vioxx; [213174]

(4) whether alternative suppliers or a suitable alternative exist for each of the drugs, or a suitable alternative supplied to the NHS by Merck, Sharpe & Dohme; [213175]

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(5) how much the NHS spent on drugs supplied by Merck, Sharpe & Dohme in each of the last five years. [213176]

Dawn Primarolo: In 2007, the net ingredient cost of Vioxx (rofecoxib) prescription items dispensed in England was £357.00(1).

Of a total of 39 chemical products listed on the Prescription Cost Analysis system (PCA) as manufactured by Merck, Sharpe and Dohme and dispensed in the community, 15 had no alternative manufacturer.

The net ingredient cost of prescription items dispensed in the community and in hospitals in England, which are listed as manufactured by Merck, Sharpe and Dohme are shown in the table.

Net ingredient cost of products manufactured by Merck, Sharpe and Dohme
£ million
Dispensed in community Dispensed in hospitals Total





















IMS Health: Hospital Pharmacy Audit

The Medicines and Healthcare products Regulatory Agency continuously monitors the safety of all medicines in the United Kingdom. The Department has no plans to take additional measures to review separately the use of medicines manufactured by the company. Nor has it made any estimate of the cost to the national health service of treating people whose health has been adversely affected as a result of being prescribed Vioxx.

NHS: Finance

Mr. Davey: To ask the Secretary of State for Health what the (a) budget control targets and (b) outturns were for each primary care trust in London for 2007-08. [212341]

Mr. Bradshaw: Based on national health service projections, the Department agreed financial performance ranges with each of the strategic health authorities (SHAs). It did not agree individual control totals with organisations below the SHA tier.

The draft, unaudited accounts for the primary care trusts within London strategic health economy are given in the following table:

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Organisation name 2007-08 draft accounts surplus/(deficit) £000

Havering PCT


Kingston PCT


Bromley PCT


Greenwich Teaching PCT


Barnet PCT


Hillingdon PCT


Enfield PCT


Barking and Dagenham PCT


City and Hackney Teaching PCT


Tower Hamlets PCT


Newham PCT


Haringey Teaching PCT


Hammersmith and Fulham PCT


Ealing PCT


Hounslow PCT


Brent Teaching PCT


Harrow PCT


Camden PCT


Islington PCT


Croydon PCT


Kensington and Chelsea PCT


Westminster PCT


Lambeth PCT


Southwark PCT


Lewisham PCT


Wandsworth PCT


Richmond and Twickenham PCT


Sutton and Merton PCT


Waltham Forest PCT


Redbridge PCT


Bexley Care PCT


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