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27 Oct 2008 : Column 650W—continued
Once an NHS body has signed a PR or LIFT contract, the financial terms of the loan raised by the private sector consortium counterparty are set and fixed. The overall cost of the project to the NHS will not change (unless the NHS wants to make a change to its own requirements). PFI contracts deal comprehensively with the possibility of early termination due to contractor default, including through insolvency, in order to protect the public interest.
The Government's policy continues to be that PFI, LIFT and other public-private partnerships should be used to deliver public services when this offers value for money. This is assessed on a case by case basis at the appropriate approval point for each scheme.
Dietary Supplements: EC Law
Mr. Austin Mitchell: To ask the Secretary of State for Health (1) what support is being provided by the Food Standards Agency and the Medicines and Healthcare products Regulatory Agency to help the Governments of the Crown Dependencies bring forward measures to meet obligations to comply with European legislation on food supplements and herbal remedies; [228576]
(2) when Ministers in his Department last discussed with the Governments of the Channel Islands concerns about the import to the United Kingdom of food supplements and herbal remedies marketed using claims which would be illegal where the products to have been placed directly on the United Kingdom market; and what the outcome was of those discussions; [228577]
(3) how many adjudications have been made by the Advertising Standards Authority in relation to complaints about the making of illegal claims in the marketing of food supplements and herbal remedies from the Channel Islands; what assessment he has made of the such adjudications; and if he will make a statement. [228578]
Dawn Primarolo: A meeting was held on 11 April 2008 between officials from the Food Standards Agency, the Medicines and Healthcare products Regulatory Agency (MHRA), the Ministry of Justice and representatives of the Crown Dependencies, at which the UK offered support to the Crown Dependencies to assist with the implementation of relevant European legislation on food supplements.
Separately, the MHRA has provided considerable support to the Government of Guernsey by reviewing Guernsey's proposed medicines law to identify those areas which require additional legislation to implement Directive 2001/83/EC on medicinal products and by providing advice as necessary. The MHRA expects to provide the same review and advice assistance to the other Crown Dependencies as they bring forward their measures to implement the Medicines Directive.
Health Ministers have not raised these matters directly with Governments of the Channel Islands. The Ministry of Justice provides the official channel of communication between the UK and the Crown Dependencies and in late 2007 and early 2008 separate meetings took place between the Chief Executives of the three Crown Dependencies and the Minister of State for Justice during which these matters were discussed.
The Advertising Standards Authority (ASA) is an independent body set up by the advertising industry to police the rules laid down in two advertising codes. These codes are the responsibility of two industry Committees of Advertising Practice—CAP (Broadcast) and CAP (Non-broadcast) and are independently administered by the ASA. As such, the information could only be obtained from the ASA.
Drugs: Rehabilitation
Dr. Gibson: To ask the Secretary of State for Health what assessment his Department has made of the effects of the use of suboxone instead of methadone or subutex in prisons. [229880]
Phil Hope: Suboxone, methadone and subutex are available on the national health service. The decision to use any drug is a clinical one, taken in the community or in prison following consultation with the patient about their clinical needs and priorities.
In January 2007 the National Institute for Health and Clinical Excellence (NICE) published the Technology Appraisal “Methadone and buprenorphine for managing opioid dependence”, which recommended the use of both methadone and buprenorphine for the treatment of opioid dependence. Such treatments must be funded and provided within the NHS in line with NICE recommendations. However, this appraisal did not consider suboxone which combines buprenorphine and naloxone and subutex which is buprenorphine only, as newer products.
Advice on prescribing of suboxone is contained in “Drug Misuse and Dependence: UK Guidelines on Clinical Management”, which was published jointly by the Department of Health and the National Treatment Agency for Substance Misuse in September 2007. This has already been placed in the Library and can be found at:
Dr. Gibson: To ask the Secretary of State for Health what assessment he has made of whether suboxone has advantages in terms of reduced potential for diversion and reduced chance of overdose compared with other anti-opiate therapies. [229881]
Dawn Primarolo: Suboxone takes the form of a tablet to be placed under the tongue. It is a combination of buprenorphine hydrochloride and naloxone hydrochloride, used in the treatment of opioid dependence.
Buprenorphine stimulates the effects of opioids, such as heroin, and naloxone blocks the effects of opioids.
Suboxone has been designed to limit the potential for its misuse. When it is taken as prescribed, under the tongue, the naloxone has no effect, but if it is misused and injected the naloxone becomes activated and causes withdrawal symptoms, which makes the drug unattractive for misuse.
The decision to use suboxone is a clinical one and is taken following consultation with the patient about their clinical needs and priorities. This principle applies in prisons and the community alike. In prisons all prescribed doses of controlled drugs such as buprenorphine-based drugs and of methadone are administered under closely supervised conditions.
Advice on prescribing of suboxone is contained in “Drug Misuse and Dependence: UK Guidelines on Clinical Management”, which was published jointly by the Department and the National Treatment Agency for Substance Misuse in September 2007. A copy has been placed in the Library and can also be found at:
Eculizumab
Andrew Stunell: To ask the Secretary of State for Health (1) if he will assist primary care trusts with the funding of eculizumab; and if he will make a statement; [228829]
(2) how many primary care trusts in England and Wales are funding the use of eculizumab in the treatment of paroxysmal nocturnal haemoglobinuria; [228830]
(3) which primary care trusts in England and Wales have refused to fund the use of eculizumab in the treatment of paroxysmal nocturnal haemoglobinuria on the grounds of cost-effectiveness. [228831]
Phil Hope: My right hon. Friend the Minister for Public Health made a written ministerial statement on 8 October 2008, Official Report, columns 16-17WS, setting out the current position for the NHS commissioning of patients with paroxysmal nocturnal haemoglobinuria (PNH). The National Specialised Commissioning team are making good progress with arrangements to ensure that all patients who require the drug eculizumab before the national commissioning starts on 1 April 2009 will receive it.
The National Assembly for Wales will look at the position for PNH patients in Wales.
General Practitioners
Mr. Lansley: To ask the Secretary of State for Health pursuant to the Answer of 6 October 2008, Official Report, column 411WA, on general practitioners, how many examples his Department received from members of the public; and to which primary care trusts these examples related. [228249]
Mr. Bradshaw: A standard search of departmental records has identified three letters and a further 12 items of electronic correspondence that mention examples of ‘gentlemen’s agreements’.
There may be further examples that allude to this issue but do not use the term ‘gentlemen’s agreement’. Identifying any such cases would be disproportionately expensive.
The address of the correspondents cannot be identified on all the electronic correspondence. However, we can identify the address of the correspondent in 14 cases. These addresses were in the area of the following primary care trusts (PCTs).
Barnet PCT
Buckinghamshire PCT
Devon PCT
East Riding of Yorkshire PCT
East Sussex Downs and Weald PCT
Leicester and Rutland PCT
Lincolnshire PCT (2)
South Essex PCT
Surrey PCT
Western Cheshire PCT
Warwickshire PCT (2)
Trafford PCT
Health Centres
Mr. Lansley: To ask the Secretary of State for Health what data returns his Department plans to collect from (a) strategic health authorities and (b) primary care trusts to assess levels of implementation of the programme for a new GP-led health centre in each area. [229964]
Mr. Bradshaw: Primary care trusts (PCTs) are asked to provide a monthly update on progress against national procurement milestones, confirmation of compliance with departmental core criteria, the expected date of service commencement, and where known, the postcode of the service location. This information is provided by PCTs, and signed off by strategic health authorities (SHAs).
In addition, we have ad hoc discussions with SHAs on any issues arising.
Health Services: Per Capita Costs
Mr. Stewart Jackson: To ask the Secretary of State for Health how much was spent per head on health services in (a) Peterborough, (b) Cambridgeshire and (c) England in the latest period for which figures are available. [229452]
Mr. Bradshaw: Expenditure per unweighted head of population in 2007-08 was: (a) Peterborough £1,130.62, (b) Cambridgeshire £1,274.48, and (c) England £1,539.88
Spend in Peterborough and Cambridgeshire is based on the net operating cost reported by Peterborough Primary Care Trust (PCT) and Cambridgeshire PCT respectively. This does not include all expenditure as the majority of pharmaceutical services expenditure is accounted for by the NHS Business Services Authority rather than by PCTs.
The England figure is the total net operating costs of all PCTs and all strategic health authorities plus the national spend on pharmaceutical services. It is not directly comparable with the spend per head at the individual PCT level.
Spend figures are from the audited financial monitoring and accounts forms for the relevant NHS bodies.
Population figures are ONS 2007 estimates.
Mr. Burns: To ask the Secretary of State for Health how much was spent per head on health services in (a) the Mid Essex Hospital Trust area, (b) the North Essex Partnership NHS Foundation Trust area and (c) England in the latest period for which figures are available. [229884]
Mr. Bradshaw: Expenditure per head of population cannot be calculated for national health service trusts as they do not cover specific areas and may receive income from commissioners throughout England.
In 2007-08, the spend per unweighted head on health services in England was £1,539.88.
The England expenditure figure includes the total net operating costs of all primary care trusts and all strategic health authorities plus the national spend on pharmaceutical services.
Population figures are Office for National Statistics 2007 estimates.
Health Services: South West
Mr. Liddell-Grainger: To ask the Secretary of State for Health what the overall measurable NHS spending is per local resident in (a) England and (b) each primary care trust within the South West Strategic Health Authority in each financial year from 1997 to 2007. [230978]
Mr. Bradshaw: The national health service spend per unweighted head of population in England since 1997 is shown in table 1.
| Table 1: All England spend per head | |
| £ | |
NHS spend per unweighted head of population in primary care trusts (PCTs) in the South West Strategic Health Authority is shown in table 2 for years 2001-02 to 2005-06 and in table 3 for 2006-07 and 2007-08. Accounts figures by individual NHS body are not available prior to 2001-02.
| Table 2: Spend per head in primary care trusts 2001-02 to 2005-06 | |||||
| £ | |||||
| PCT name | 2001-02 | 2002-03 | 2003-04 | 2004-05 | 2005-06 |
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