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26 Nov 2008 : Column 2076W—continued
Two other drugs are used in opioid dependence, lofexidine hydrochloride and naltrexone hydrochloride but these are not used as substitutes so figures for these have not been included.
The National Treatment Agency for Substance Misuse’s (NTA) National Drug Treatment Monitoring System (NDTMS) has collected data on people in drug treatment in England since 2004-05.
NDTMS records numbers of people receiving specialist prescribing for drug treatment rather than the type of drug which is prescribed. Most of those in treatment receive oral methadone, but buprenorphine or other substitute opioids may also be prescribed. Although heroin (prescribed as diamorphine) is an option for the treatment of opiate misuse, it is appropriate for only a very small proportion of opiate misusers.
The number of people in England reported as receiving treatment in a specialist drug treatment prescribing service for each of the years since 2004-05 is set out as follows:
| Number | |
| Note: These figures exclude non-drug specialist GPs who may also prescribe substitute opioids for drug misusers, but do not submit reports to the NDTMS. | |
Extending Professional Regulation Working Group
Anne Milton: To ask the Secretary of State for Health when he expects the Extending Professional Regulation Working Group to publish its final report. [238888]
Mr. Bradshaw: The Extending Professional Regulation Working Group will be finalising their report with a view to presenting findings to Ministers in December 2008. The final report will be published more widely thereafter.
Gastrointestinal System: Cancer
Andrew George: To ask the Secretary of State for Health pursuant to the Answer of 3 November 2008, Official Report, column 93W, on upper gastrointestinal cancer, on what basis he assesses the effectiveness of the Government’s national cancer policy on (a) clinical outcomes, (ii) comparable mortality and (iii) other measurable outcomes. [235599]
Ann Keen: There is a range of measures used to assess the effectiveness of the Government’s national cancer policy. These include cancer mortality rates. Cancer mortality in those aged under 75 fell by over 18 per cent. between 1996 and 2006.
They also include five-year survival rates. For example, the following table shows the information available in relation to five-year survival for cancer of the oesophagus, pancreas and stomach.
| Five year age-standardised relative survival (percentage) for adults in England diagnosed with cancer of the oesophagus, pancreas and stomach (upper gastro-intestinal cancer) during 1998-2001 and 1999-2003 by sex | ||||||
| Patients diagnosed 1998-2001 | Patients diagnosed 1999-2003 | |||||
| Cancer | Sex | Number of patients | Five year relative survival (percentage) | Number of patients | Five year relative survival (percentage) | Difference |
| Source: Office for National Statistics (ONS) | ||||||
Another source of relevant data is 30-day mortality rates. For example, in 1999-2000 the 30-day mortality percentage for all oesophageal cancer was 8.1 per cent. at specialist centres and 9.1 per cent. at non-specialist centres. By 2005-06 that had reduced to 4.3 per cent. for specialist centres and 5.9 per cent. in non specialist centres.
General Practitioners: Pharmacy
Mr. Ancram: To ask the Secretary of State for Health what proportion of prescriptions in England were dispensed by GP surgeries in the last 12 months. [239561]
Dawn Primarolo: For the calendar year 2007, dispensing doctors accounted for 7 per cent. of all prescription items dispensed in the community in England. In addition, 2.2 per cent. of items were personally administered by prescribing doctors and dispensing doctors in the community.
Mr. Ancram: To ask the Secretary of State for Health how many dispensing GP surgeries there are in England. [239562]
Phil Hope: As at March 2008 there were 5,664 dispensing doctors and 1,147 dispensing practices in England.
Health Authorities: Finance
Norman Lamb: To ask the Secretary of State for Health whether voluntary sector organisations will be eligible for the new Strategic Health Authority innovation funds. [239578]
Phil Hope: The new strategic health authority innovation funds are intended to be accessed by the broadest range of organisations, bodies and individuals possible, working either in the national health service or in partnership with the NHS. This will include voluntary sector organisations.
Health Professions: Training
Mr. Gordon Prentice: To ask the Secretary of State for Health what guidance is given to NHS hospital trusts by (a) his Department, (b) deaneries and (c) the NHS on the protocols to be followed when clinicians under training examine patients. [239937]
Dawn Primarolo: There is no specific guidance on this for postgraduate trainee doctors.
Health Services
Norman Lamb: To ask the Secretary of State for Health what assessment he has made of the effect of the roll-out of practice-based commissioning in (a) Norfolk, (b) the East of England and (c) England; and if he will make a statement. [233805]
Mr. Bradshaw: As identified in the NHS Next Stage Review “Our Vision for Primary and Community Care”, with some exceptions, practice-based commissioning (PBC) has not yet lived up to its full potential.
NHS Norfolk has plans in place for PBC services including the redesign and expansion of community continence clinics; community gynaecology clinics; an ambulatory ECG primary care service; and primary and intermediate aural care.
PBC in the east of England is bringing benefits to patients across the region. In every primary care trust in the region there are new or redesigned services in place as a result of PBC. For patients this means services are closer to home because practices now commission more services locally; gaps have been filled, for example therapy services are commissioned at practice level; and there is more choice, as alternative services are set up.
Momentum is beginning to gather nationally as the latest PBC survey results show. The number of practices across the country commissioning or providing new services through PBC continues to increase quarter on quarter—from 36 per cent. in November 2007, to 41 per cent. in March 2008 and 46 per cent, in August 2008.
PBC is the key route for world class commissioners to develop the effective clinical engagement and leadership necessary to drive improvements in service quality. The Next Stage Review underlines the importance of PBC as a driving force for innovation and improvement. It also set out a range of measures to strengthen PBC, demonstrating our commitment to ensuring that its enormous potential is fully realised.
Health Services: Elderly
Mike Penning: To ask the Secretary of State for Health what assessment he has made of his Department’s effectiveness in promoting innovation since the publication of the Wanless report. [237555]
Mr. Bradshaw: In my noble Friend’s, the Parliamentary Under-Secretary of State’s report, High Quality Care for All, he made clear that innovation must be central to the national health service to ensure that new treatments, practices and services are readily available for patients. The Health Innovation Council was established, chaired by my noble Friend, and the Council advised on a number of initiatives which later became commitments to support and enable innovation.
In addition, work has been undertaken, and is still continuing, to promote the adoption of clinically and cost effective innovative medical technologies and medicines. The reports of the Health Care Industries Task Force (2004), Better health through partnership and of the Ministerial Industry Strategy Group’s Long Term Leadership Strategy for Medicines (2007) made proposals in this respect. Both reports have been placed in the Library.
In line with Wanless’ vision of integrated information and communication technologies (ICT) applications supporting and linking primary and secondary care and, in due course, also reaching into social care, the National Programme for IT has been a driver of NHS reform.
Health Services: Ex-servicemen
Mr. Stephen O'Brien: To ask the Secretary of State for Health what measures he is using to assess improvement in the access to health services by war veterans. [234361]
Mr. Bradshaw: The Department does not collect information specific to veterans’ access to the national health service or on how many receive priority treatment.
By the end of December 2008, NHS patients in England can expect to start their consultant-led treatment within a maximum of 18 weeks from referral unless they choose to wait longer or it is clinically appropriate that they do so. This applies to all NHS patients including veterans living in England.
In addition to extending the priority treatment to all military veterans whose treatment is required as a result of their military service, over this past year the Department has taken forward pilots aimed at helping better to identify and treat veterans with mental health problems and ensure continuity of care for those discharged from military service with prosthetic limbs. The Department is currently working with the MOD on improving information on how veterans’ health needs differ from those in the population more generally.
The current operating framework for the NHS makes clear the need to take account of the health needs of service families and veterans when commissioning services.
Health Services: Foreigners
Sandra Gidley: To ask the Secretary of State for Health when he plans to publish the results of the 2004 consultation on his Department’s proposals to exclude overseas visitors from eligibility to free NHS primary medical services; and if he will make a statement. [239176]
Dawn Primarolo: The Department will publish the responses it received to the consultation document “Proposals to Exclude Overseas Visitors from Eligibility to Free NHS Primary Medical Services”, a copy of which has been placed in the Library.
However, given that over four years have elapsed since the consultation exercise, the Department is contacting all those who replied to ensure that they still have no objections to their comments being published. We will then publish the responses.
Health Services: Schools
Mr. Sanders: To ask the Secretary of State for Health what national targets are in place for the use by young people of in-school health care services; and what performance primary care trusts in Devon have achieved against these targets in the latest period for which information is available. [238410]
Ann Keen: There are no national targets for the use of in-school health care but the National Healthy School Programme has a target that by December 2009, all schools will be participating and 75 per cent. achieving Healthy School status. As of today, 97 per cent. of schools are participating and 68 per cent. have achieved status. In working towards status schools are encouraged to provide support services for children and young people both on site and in the wider community.
Devon currently has all of its schools participating and 83 per cent. of its schools having achieved Healthy School status.
Herbal Medicine: EU Law
Dr. Ladyman: To ask the Secretary of State for Health (1) what assessment he has made of the effects of implementing the traditional herbal medicinal products directive; [237659]
(2) what discussions (a) have been held and (b) are planned between Ministers in his Department and representatives of the National Association of Health Stores to discuss the effect of the traditional herbal medicinal products directive; [237660]
(3) if he will seek a delay in the deadline for implementation of the traditional herbal medicinal products directive in light of the European Commission’s review of the implementation of the Directive; [237661]
(4) what assessment he has made of the outcomes of the review by the European Commission of the implementation of the traditional herbal medicinal products directive. [237662]
Dawn Primarolo: The effects of the implementation in the United Kingdom of the traditional herbal registration scheme, introduced following the European directive on traditional herbal medicinal products, remain broadly as anticipated in the regulatory impact assessment prepared by the Medicines and Healthcare products Regulatory Agency (MHRA). As expected, there is a steadily expanding take up of the scheme by a wide range of companies.
Ministers have not met representatives of the National Association of Health Stores to discuss implementation of the directive. However, officials at the MHRA meet regularly with the Herbal Forum, a body representing trade associations covering manufacturers operating in the traditional herbal medicines sector, to discuss issues arising from the implementation of the directive.
The directive was agreed in 2004 and allowed a transitional period, until April 2011, for compliance with that legislation where products were legally on the market at April 2004. We have no plans to press the European Commission to bring forward legislative proposals to extend this seven-year transitional period.
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