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Mr. David Anderson: To ask the Secretary of State for Health what assessment his Department has made of the resources needed to implement the forthcoming National Service Framework for chronic obstructive pulmonary disease; and whether there will be ring-fenced funding from his Department for this purpose. 
Ann Keen: The Department is currently developing a detailed Impact Assessment for the National Strategy for chronic obstructive pulmonary disease and any financial implications of implementing the programme will be published alongside the strategy.
Mr. Binley: To ask the Secretary of State for Health what assessment his Department has made of (a) the side-effects of (i) Vioxx, (ii) SSRI antidepressants and (iii) Salmeterol and (b) the use of complementary and alternative medicines to treat the conditions such drugs were developed to address. 
Dawn Primarolo: The safety and efficacy of medicinal products is formally assessed from clinical trials submitted at the time of marketing authorisation. These data are carefully evaluated by the independent scientific advisory committee, the Commission on Human Medicines (CHM), and the Medicines Healthcare products Regulatory Agency (MHRA) prior to authorisation for evidence that the products work and are acceptably safe. The longer term safety of the use of medicines in routine clinical practice is closely monitored by the MHRA, including reports of suspected adverse drug reactions (ADRs) submitted by health professionals and patients through the Yellow Card scheme, to ensure that benefit risk balance continues to be favourable.
The safety of Vioxx (rofecoxib), the Selective Serotonin Reuptake Inhibitor antidepressants (SSRIs) and salmeterol has been under continuous review by the MHRA since these medicinal products were first authorised. Any new data or possible safety issue to emerge have been carefully evaluated and, as necessary, appropriate action taken to update the product information for prescribers and patients to reflect the emerging safety profile and where necessary revised prescribing advice has been issued.
Vioxx (rofecoxib) was a selective COX-2 inhibitor, a type of non-selective anti-inflammatory drug, licensed for the treatment of osteoarthritis, rheumatoid arthritis and acute pain conditions. In 2000, comparative clinical trial data raised concerns over the risk of heart attacks and other thrombotic cardiovascular events in association with use of rofecoxib. The Committee on Safety of Medicines (CSM, the predecessor to the CHM) reviewed the safety of rofecoxib on several occasions between 2000 and 2003. This led to updates to product information and prescribing advice on the risk of thrombotic cardiovascular events. In 2004, the manufacturers of rofecoxib withdrew the product after clinical trial data comparing rofecoxib with placebo (a dummy pill) provided the first definitive evidence of an increased risk of heart
attack and stroke, evident after 18 months of treatment. The safety of other selective COX-2 inhibitors and non-steroidal anti-inflammatory drugs (NSAIDs) was fully reviewed between 2004 and 2006 and the conclusion was that the benefits of the authorised NSAIDs continue to outweigh the risks in the licensed indications.
SSRI antidepressants are used to treat depression and anxiety disorders. Ongoing concerns about the safety of the SSRIs in early 2003 prompted a review by an Expert Working Group of the CSM of the risk of suicidal behaviour and withdrawal reactions associated with the SSRIs. The Expert Working Group conducted a comprehensive review of the safety of this entire class of drugs, examining all available evidence and reviewing all the regulatory advice issued. The MHRA published key findings and updated advice to healthcare professionals and patients as the review progressed.
Salmeterol is a long-acting adrenoceptor beta agonist (LABA) used in the management of asthma and chronic obstructive pulmonary disease. The CSM and CHM have reviewed the safety of salmeterol on a number of occasions, leading to updates to product information and communications to remind healthcare professionals of the appropriate use of LABA in the treatment of asthma. The balance of risks and benefits of LABA was recently reviewed at the request of CHM, and was considered positive in the treatment of asthma in adults and adolescents, provided LABA are used with inhaled corticosteroids. The outcome of the review was published in the MHRA bulletin Drug Safety Update, which is available on the MHRA website.
There are currently no complementary or alternative medicines with marketing authorisations for the treatment of major conditions such as osteoarthritis, depression or asthma therefore the MHRA does not hold any information on the usage of complementary and alternative medicines for these conditions.
Some years ago the MHRA considered a number of applications for marketing authorisations for products containing St. Johns Wort ( Hypericum perforatum L.) for mild to moderate depression. However, the applications were refused due to lack of adequate evidence of safety and efficacy.
Mr. Swire: To ask the Secretary of State for Health how many people were diagnosed with (a) Alzheimer's disease and (b) dementia in (i) East Devon constituency and (ii) Devon in each of the last five years. 
Phil Hope: The national Quality and Outcomes Framework (QOF) records the number of people recorded on practice disease registers with a diagnosis of dementia but this does not distinguish between Alzheimer's disease and other forms of dementia. The publication Revisions to the GMS Contract 2006/07, from NHS Employers, states that Alzheimer's disease accounts for 50-75 per cent. of cases of dementia. This register count is available for the two latest releases of QOF, covering 2006-07 and 2007-08.
We are unable to supply this information for parliamentary constituencies, as the data are only available for general practices (GPs) and can be aggregated to primary care trust (PCT) level. We have supplied figures for the smallest health area that covers Devon, namely Devon PCT.
|QOF datanumber of patients on the Dementia disease registers|
The data supplied in the table above are published on the website of the Information Centre for health and social care.
(a) For 2007-08 see the Quality and Outcomes Framework 2007/08 publication data tables at the following link (published 30 September 2008):
The table for PCT level QOF for 2007-08 can be found at the following link:
This publication has already been placed in the Library.
(b) For 2006-07 see Quality and Outcomes Framework 2006/07 publication data tables at this link (published 28 September 2007):
The table for PCT level QOF for 2006-07 can be found at this link:
This publication has already been placed in the Library.
1. QOF is the national Quality and Outcomes Framework, introduced as part of the new General Medical Services contract on 1 April 2004.
2. Participation by practices in the QOF is voluntary, though participation rates are very high, with most Personal Medical Services practices also taking part.
3. The published QOF information was derived from the Quality Management Analysis System (QMAS), a national system developed by NHS Connecting for Health.
4. QMAS uses data from general practices to calculate individual practices' QOF achievement. QMAS is a national information technology system developed by NHS Connecting for Health to support the QOF.
5. The system calculates practice achievement against national targets. It gives general practices, PCTs and strategic health authorities objective evidence and feedback on the quality of care delivered to patients.
6. QMAS captures the number of patients on the various disease registers for each practice. The number of patients on the clinical registers can be used to calculate measures of disease prevalence, expressing the number of patients on each register as a percentage of the number of patients on practices' lists.
7. Figures presented here are just the number of patients on the disease register for dementia.
Dementia is one of the most important issues we face as the population ages. Around 570,000 people already have the condition in England and this number is set to double in the next 30 years, with the costs of dementia tripling.
That is why the Department published the first National Dementia Strategy on 3 February 2009. It sets out how we can transform services, through a combination of better training, earlier intervention and real support for people with dementia and their families.
Miss McIntosh: To ask the Secretary of State for Health how many courses of treatment dentists carried out in (a) the North Yorkshire and York primary care trust area and (b) England in each year since 1997. 
The information is not available in the format requested. However, information is available on the numbers of courses of treatment (CoTs) in England
in the years ending 31 March, 1997 to 2006 in Table 3 of the NHS Dental Activity and Workforce Report, England: 31 March 2006 report.
This information is based on the old contractual arrangements which were in place up to and including 31 March 2006. This report has already been placed in the Library and is available on the NHS Information Centre website at:
The number of CoTs performed in England in 2006-07 and 2007-08 are available in Table A4 of Annex 3 of the NHS Dental Statistics for England: 2007/08 report. Information is provided by primary care trust and strategic health authority. This information is based on the new dental contractual arrangements, introduced on 1 April 2006. This report, has already been placed in the Library and is also available on the NHS Information Centre website at:
Miss McIntosh: To ask the Secretary of State for Health how many practising dentists there were in (a) the North Yorkshire and York primary care trust area and (b) England on 1 April in each year since 1997. 
Ann Keen: The numbers of national health service dentists, as at 31 March, 1997 to 2006 are available in annex E of the NHS Dental Activity and Workforce Report England: 31 March 2006. Information is available by strategic health authority (SHA) and by primary care trust (PCT).
This measure counted the number of NHS dentists recorded on PCT lists as at 31 March each year. This information is based on the old contractual arrangements, which were in place up to and including 31 March 2006. This report has already been placed in the Library and is also available on the NHS Information Centre website at:
The numbers of dentists with NHS activity during the years ending 31 March, 2007 and 2008 are available in table G1 of annex 3 of the NHS Dental Statistics for England: 2007/08 report. Information is provided by SHA and by PCT. This information is based on the new dental contractual arrangements, introduced on 1 April 2006. This report has already been placed in the Library and is also available on the NHS Information Centre website at:
This measure is based on a revised methodology and therefore supersedes previously published work force figures relating to the new dental contractual arrangements. It is not comparable to the information collected under the old contractual arrangements. This revised methodology counted the number of dental performers with NHS activity recorded via FP17 claim forms in each year ending 31 March.
Both sets of published figures relate to headcounts and do not differentiate between full-time and part-time dentists, nor do they account for the fact that some dentists may do more NHS work than others.
Ann Keen: Professor Jimmy Steele of Newcastle university is currently chairing an independent review of national health service dentistry in England. The review will consider how the Department can respond to the conclusions and recommendations the Health Select Committee (HSC) recently made, following their inquiry into dental services. The system of banded patient charges is one of the issues the HSC raised and that Professor Steele and his team will consider, taking views from a wide range of stakeholders. Professor Steele will publish his findings later in the spring, and the Department will then respond to his recommendations.
Miss McIntosh: To ask the Secretary of State for Health (1) how many prescription items were dispensed by dentists in (a) the North Yorkshire and York Primary Care Trust area and (b) England in each year since 1997; 
Ann Keen: Information on prescribing by dentists is available from the Prescription Cost Analysis (PCA) system. It is available only for England as a whole. It is available by calendar year from 2003.
|Calendar year||Number of items (thousand)||Net ingredient cost (£000)|
Prescription information is taken from the PCA system, supplied by the Prescription Services Division of the NHS Business Services Authority, and is based on a full analysis of all prescriptions dispensed in the community ie by community pharmacists and appliance contractors, dispensing doctors, and prescriptions submitted by prescribing doctors for items personally administered in England. Also included are prescriptions written in Wales, Scotland, Northern Ireland and the Isle of Man but dispensed in England. The data do not cover drugs dispensed in hospitals, including mental health trusts, or private prescriptions.
The vast majority of these prescriptions are written by general medical practitioners in England; however, prescriptions written by nurses, dentists, other non-medical prescribers and hospital doctors are also included provided they were dispensed in the community.
The figures are taken from separate tables relating to prescribing by dentists only.
Mr. Lansley: To ask the Secretary of State for Health (a) how many students were given NHS dental bursaries and (b) how much was paid out in NHS dental bursaries (i) in each of the last five years and (ii) in each primary care trust area in 2007-08. 
|Academic year||Number of dental students awarded an NHS bursary( 1)|
|(1) Includes students who received a nil award following means testing, English domiciled students studying in other parts of the UK, and EU fees only students.|
NHS BSA Student Bursaries Scheme database
|Academic year||Amount paid for maintenance support and other allowances( 1 ) (£)|
|(1) Excludes students who received a nil award following means testing and EU fees only students|
NHS BSA Student Bursaries Scheme database
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