Accident and Emergency Departments

Alex Cunningham: To ask the Secretary of State for Health what the (a) mean and (b) median duration to assessment, duration to treatment and duration to departure was in (i) type 1 and (ii) all accident and emergency departments in each month in each of the last five years. [202302]

Jane Ellison: The information has been placed in the Library.

Ambulance Services

Mr Spencer: To ask the Secretary of State for Health if he will estimate the Government spend per head of population on ambulance services in (a) Nottinghamshire, (b) the east midlands and (c) England in each of the last three years. [201780]

Jane Ellison: No estimate of the Government spend per head of population on ambulance services in Nottinghamshire, the east midlands and England in each of the last three years will be made.

Commissioning of urgent and emergency care, and therefore the amount of funding allocated, is the responsibility of clinical commissioning groups—this includes ambulance service provision for their local populations.

Nationally, the ambulance service is performing well—arriving on scene in under eight minutes in more than 75% of the most life-threatening cases, but there are still some areas where improvements can be made.

30 Jun 2014 : Column 479W

Latest monthly figures for April 2014 show the ambulance service did not meet the Red 2 response time standard:

Category A8 Red 1 performance was 75.2% (above the 75% standard)

Category A8 Red 2 performance was 73.6% (below the 75% standard)

Category A19 performance was 95.8% (above the 95% standard)

Full year figures (April 2013 to March 2014) show the ambulance service nationally achieved two of the response time standards:

Category A8 Red 1 performance was 75.6% (above the 75% standard)

Category A8 Red 2 performance was 74.8% (below the 75% standard)

Category A19 performance was 96.1% (above the 95% standard)

The Urgent and Emergency Care Review, led by Sir Bruce Keogh, is currently considering whole system change to the delivery of urgent and emergency care, including new models of delivery of care for ambulance services.

The first phase of the review was published last November. We expect NHS England to be publishing further reports later this year.

Arthritis

Luciana Berger: To ask the Secretary of State for Health what estimate he has made of how much arthritis has cost the UK economy in each year since 2010. [202216]

Norman Lamb: No estimate has been made of the annual cost of arthritis to the United Kingdom in each year since 2010.

Autism

Mrs Gillan: To ask the Secretary of State for Health (1) how many local authorities have a named autism lead; [202154]

(2) when he expects his Department's statutory guidance for autism to be published for consultation. [202155]

Norman Lamb: The Department commissions Public Health England to carry out an annual national autism self-assessment exercise. As part of the latest exercise, which reported on progress by the end of September 2013, across all 152 local authority areas in England, 151 areas said that they have a named joint commissioner/senior manager responsible for services for adults with autism. This exercise will next be carried out towards the end of 2014.

The Department intends to publish draft statutory guidance for consultation to support ‘Think Autism’, the update to the 2010 Adult Autism Strategy for England, in August.

Mrs Gillan: To ask the Secretary of State for Health (1) what steps he is taking to ensure that regulations and guidance under the Care Act 2014 are compatible with the Autism Act 2009 and existing autism strategies and autism statutory guidance; [202156]

(2) what steps his Department is taking to ensure that the Care Act 2014 part I regulations are compatible with the revised Adult Autism Strategy (a) in general and (b) in relation to autism training for community care assessors. [202157]

30 Jun 2014 : Column 480W

Norman Lamb: The core principles of the Care Act 2014 and the regulations and statutory guidance which support its implementation are to maintain the well-being of people who have care and support needs; support them in living independent lives; and ensure there is a vibrant market to offer choice on how their needs might be met. These enhance the areas of action set out in the 2010 Autism Strategy and reaffirmed recently in Think Autism.

The Act will require local authorities to ensure all assessors are appropriately trained to carry out assessments. This builds on the statutory guidance Implementing Fulfilling and Rewarding Lives which followed the 2010 Adult Autism Strategy for England, and which required autism awareness training to be available to all staff working in health and social care and specialist training for those in key roles that have a direct impact on access to services for adults with autism.

Due to the complexities of assessing people who are deafblind, regulations under the Act will require their assessments to be carried out by a specialist assessor. One of the questions in the consultation document is whether specialist assessors should be required to carry out the assessment of people with other conditions, such as autism, and to explain why this should be the case. Based on the evidence we receive through the consultation we will consider if this requirement should be extended to other conditions.

The draft regulations and guidance were co-produced with stakeholders, and this included engaging with the National Autistic Society. The public consultation runs until 15 August 2014.

Mrs Gillan: To ask the Secretary of State for Health how many services for adults with autism are commissioned under the payments by results framework. [202158]

Norman Lamb: National tariff prices are published primarily for acute care, and relate to procedure undertaken, not the diagnosis of the patient receiving the treatment. Information is not collected on the number of services within the scope of the national tariff that have been provided to adults with autism.

Robert Flello: To ask the Secretary of State for Health (1) what assessment his Department has made of the effect of the proposed changes to the social care system in the Care Act 2014 part 1 regulations on adults with autism; [202340]

(2) how many adults with autism in England receive support under the current social care system; and how many such adults will receive support under the system proposed in the Care Act 2014 part 1 regulations. [202344]

Norman Lamb: The Care Act 2014 will reform the care and support system for everyone, including adults with autism. The core principles of the Care Act 2014 and the regulations and statutory guidance which support its implementation are to maintain the well-being of people who have care and support needs and support them in living independent lives.

The draft regulations and guidance were co-produced with stakeholders, and this included engaging with the National Autistic Society. The Department is currently consulting on the regulations and statutory guidance

30 Jun 2014 : Column 481W

that will support the implementation of the Care Act 2014. The public consultation started on 6 June and runs until 15 August 2014.

The Health and Social Care Information Centre does not collect any data on the number of adults with autism receiving support under the current, or proposed, social care systems and therefore is unable to provide a response. The national eligibility criteria being introduced under the Care Act 2014 will allow local authorities to maintain levels of access for service users when they move from the current framework to the new care and support system in April 2015.

Barrett’s Oesophagus

Mike Thornton: To ask the Secretary of State for Health what steps his Department is taking to provide early diagnosis and treatment for patients with Barrett's oesophagus. [201805]

Jane Ellison: Our Be Clear on Cancer campaigns aim to raise awareness of the possible symptoms of cancer and to prompt people with the relevant symptoms to present to their general practitioner (GP). Following a local pilot which ran from April to July 2012, we ran a regional Be Clear on Cancer pilot campaign in February and March 2014, raising awareness of the signs and symptoms of oesophago-gastric cancer in the north east and north Cumbria. This early diagnosis campaign also aimed to identify patients with Barrett’s oesophagus, a precursor to oesophageal cancer.

The campaign included television, radio, press and outdoor advertising. The findings of this pilot will be evaluated by Public Health England (PHE), which works closely with the Department and NHS England to ensure that health care professionals are targeted with campaign information to encourage earlier diagnoses and referrals, before a decision is taken on whether to roll out the campaign nationally.

Alongside supporting PHE to increase symptom awareness among the general population, NHS England are also working to increase cancer symptom awareness among health care professionals, and to provide support to GPs in early diagnosis of cancer and pre-cancerous conditions. In 2013-14, NHS England made £2.3 million available to support improved symptom awareness and early diagnosis.

Cannabis

Zac Goldsmith: To ask the Secretary of State for Health how many applications have been made to the (a) National Institute for Health Research and (b) Medical Research Council for funding to research medicinal cannabis products since 2010; and how many such applications have been accepted. [201653]

Dr Poulter: Cannabis is naturally occurring plant and a Class B controlled drug; one of the main active chemicals in cannabis is tetrahydrocannabinol (THC). Cannabis is not a medicinal product and is not licensed as a medicine in the United Kingdom and the Government have no plans to legalise raw cannabis for medicinal purposes, as cannabis has a number of acute and chronic health effects, such the possibility of developing mental health problems or harming the lungs when smoked.

30 Jun 2014 : Column 482W

Since 2010 two applications for research funding into medicinal cannabis have been made to National Institute for Health Research (NIHR) research programmes. Of these one, within the Research for Patient Benefit (RfPB) programme, has been accepted.

The NIHR also provides support and facilities for research by funding a range of infrastructure facilities. Since 2010 seven projects related to medicinal cannabis have been supported through the NIHR infrastructure; however, it is not possible to ascertain the number of applications received as the Department, and our managing agent, does not record this information.

Between April 2010 and March 2014 the Medical Research Council received four applications for funding for research that related to the medicinal cannabis products. Of these four applications, two were successful.

Clinical Commissioning Groups

Charlotte Leslie: To ask the Secretary of State for Health (1) what mechanisms are in place to ensure that those clinical commissioning groups providing financial support to a neighbouring clinical commissioning group does not suffer a reduction in its own provision of services as a result; [202462]

(2) how many clinical commissioning groups are running financial deficits requiring financial support from neighbouring clinical commissioning groups; [202339]

(3) what (a) interest rate and (b) repayment plans a clinical commissioning group is allowed to set when providing financial support to a neighbouring clinical commissioning group. [202452]

Dr Poulter: NHS England has responsibility for clinical commissioning group (CCG) funding.

We are informed by NHS England that there is no provision for financial support between CCGs, and therefore no regime for repayment and/or interest.

CCGs are expected to live within the resources allocated to them, but in rare cases where this is not possible, and subject to detailed assurance by NHS England area teams, a deficit plan is agreed and centrally funded. CCGs are expected to repay such funding over an agreed time scale in accordance with an approved recovery plan. The same applies if a CCG with a planned surplus records a deficit in year.

In some cases, neighbouring CCGs have opted to enter into risk sharing or investment pooling arrangements, for example, in the context of shared commissioning arrangements or to facilitate wider health economy transformation programmes. The precise arrangements for such risk sharing are a matter for local determination by the governing bodies concerned, and they would be expected to ensure that these agreements were transparently documented and did not impact adversely on patient services.

Compulsorily Detained Mental Patients

Jonathan Ashworth: To ask the Secretary of State for Health what steps he is taking to prevent the detention of patients with mental health illnesses who have not received a full medical assessment. [201802]

30 Jun 2014 : Column 483W

Norman Lamb: The Mental Health Act 1983 sets out strict criteria which have to be satisfied before a person can be detained for assessment (under section 2) or treatment (under section 3) for mental disorder. Hospital managers can only detain a person under section 2 or section 3 of that Act if an application by an approved mental health professional (AMHP) is supported by two medical recommendations. One of those recommendations must come from a doctor who is approved under section 12 of the Act as having special experience in the diagnosis or treatment of mental disorder.

The doctors must confirm that they have examined the patient when they make their recommendation. The AMHP has to confirm that they have seen the patient within the 14-day period ending with the date of the application.

Deprivation of liberty safeguards apply when people with either physical or mental health conditions lack the capacity specifically to consent to treatment or care either in a hospital or care home. To legally authorise a deprivation of liberty in a hospital or care home, there have to be six assessments including a mental capacity assessment, a mental health assessment and a best interests assessment.

Family Practitioner Services

Sir Nicholas Soames: To ask the Secretary of State for Health what proportion and how much of the NHS budget has been spent on general practice in each of the last 15 years for which figures are available. [201960]

Dr Poulter: The Health and Social Care Information Centre (HSCIC) collects data on the total expenditure on general practice, both including and excluding the cost of dispensed drugs. The latest available data are from 2012-13, and the earliest available data are from 2003-04.

General practice spend as a proportion of the national health service budget is taken using the total departmental expenditure limits from the Department of Health Annual Report 2012-13. The latest available data are from 2012-13, and the earliest available data are from 2007-08. Substantial changes in methodology for calculating total NHS expenditure before 2007-08 mean directly comparable figures cannot be provided beyond this year to allow for like-for-like comparisons of the proportion of NHS budget spent on general practice.

Total spend on general practice, 2003-04 to 2012-13 (£ million)
 Total spendTotal net of dispensing

2003-04

5,811

5,006

2004-05

6,914

6,061

2005-06

7,747

6,864

2006-07

7,757

6,943

2007-08

7,867

7,053

2008-09

7,961

7,145

2009-10

8,321

7,514

2010-11

8,350

7,543

2011-12

8,397

7,607

30 Jun 2014 : Column 484W

2012-13

8,459

7,690

Source: HSCIC ‘Investment in General Practice’ (2008-09 to 2012-13) and HSCIC ‘Investment in General Practice’ (2003-04 to 2009-10)
General practice spend as proportion of NHS budget, 2007-08 to 2012-13 (percentage)
 General practice spend as proportion of NHS Budget

2007-08

9.31

2008-09

8.74

2009-10

8.45

2010-11

8.32

2011-12

8.16

2012-13

8.04

Source: HSCIC ‘Investment in General Practice’ (2008-09 to 2012-13), HSCIC ‘Investment in General Practice’ (2003-04 to 2009-10) and Department of Health ‘Annual Report and Accounts’ (2012-13).

Sir Nicholas Soames: To ask the Secretary of State for Health how many general practitioner surgeries are open seven days a week; and if he will make a statement. [201966]

Dr Poulter: Data are not held centrally on how many general practices are open seven days a week.

However, the Government recognise the importance of timely access to general practice. This is why the Prime Minister’s Challenge Fund has allocated £50 million to support 20 pilots to test innovative ways of improving access to general practitioner services and patient experience in their local areas. The pilots will benefit over 7.5 million patients across more than 1,110 practices, from rural areas to inner cities.

A wide variety of approaches to improving access are being tested: extended opening hours on weekdays and weekends; better use of telecare and health apps; more innovative ways to access services by Skype, e-mail or phone; and more integrated services with a single point of contact to co-ordinate patients services across health and social care.

Learning and best practice from the pilots will be shared with the wider NHS during the course of the pilot programme.

General Practitioners

Sir Nicholas Soames: To ask the Secretary of State for Health what the average annual salary of a general practitioner was in each of the last 15 years for which figures are available. [201957]

Dr Poulter: The requested information is contained in the following table. When interpreting the figures, it is important to note that the nature of general practitioner (GP) contracts and their work has changed over time. Since the start of the new General Medical Services contract in 2004-05, there have been some major changes to income, workstreams and investment in general practice.

The table is presented in cash terms of income before tax of contractor GPs across all contract types. This excludes expenses. Taxable income before pension contributions are deducted, made up of gross earnings less total expenses, also known as net income.

30 Jun 2014 : Column 485W

30 Jun 2014 : Column 486W

Contractor GPs: mean average income before tax in cash terms
Income by contract type (£)
 General Medical ServicesPersonal Medical ServicesGPMS (combined GMS and PMS)

1997-981,2

51,623

1998-993

51,455

1999-2000

57,620

2000-01

64,040

2001-02

66,114

2002-03

69,771

2003-04 GB

77,597

2003-04 UK

77,152

2004-054,5,6

96,322

110,164

100,170

2005-06

106,312

120,272

110,004

2006-077

103,530

118,499

107,667

2007-08

100,324

116,059

106,072

2008-098

99,200

116,300

105,300

2009-10

100,400

115,300

105,700

2010-11

99,000

113,400

104,100

2011-12

98,300

111,600

103,000

1 There was no inquiry in 1997, due to the change to self-assessment of tax liability. Income tax for the self-employed changed from assessment on prior year earnings to current year earnings. Estimates of earnings and expenses were therefore taken together in 1995-96 and 1996-97. 2 The Inland Revenue changed the treatment of capital allowances in calculating tax liability for 1996-97 as part of the move from tax assessment based on prior year earnings to current year earnings. Figures relating to years between 1995-96 and 1997-98 have been adjusted to put them on a comparable basis with previous years. 3 Figures from 1998-99 onwards are not adjusted in respect of the changed treatment of capital allowances in calculating tax liability in 1996-97. Therefore they are not on a comparable basis with previous years. 4 From 2004-05 onwards, results are at UK (England, Scotland Wales, Northern Ireland) level. Prior to this, they were published at GB (England, Scotland, Wales) level. 2003-04 results are given at both GB and UK level to illustrate the small effect of this transition on the figures in that year. 5 The first wave of PMS pilots started in April 1998 beginning a downward trend in the numbers of GMS GPs, and corresponding upward trend in PMS GPs. 6 Data from 2004-05 onwards exclude an estimate of employer’s superannuation contributions for the tax year, to make the figures comparable with previous years. 7 Due to a data quality issue regarding the GMS/PMS markers in 2006-07 comparisons of income and expenses between contracts in this year should be made with a degree of caution. 8 Figures from 2008-09 onwards are rounded to the nearest £100 9 Data are for Contractor GPs only. Notes: 1. Information from the Health and Social Care Information Centre GP Earnings and Expenses Report 2011-12 tables 36, 37 and 38 which also include real term equivalent amounts, expenses and gross earnings. 2. Definitions: General Medical Services (GMS): A GMS practice is one that has a standard, nationally negotiated contract. Within this, there is some local flexibility for GPs to ‘opt out' of certain services or ‘opt in' to the provision of other services. Personal Medical Services (PMS): The PMS contract was introduced in 1998 in England and Scotland (as in the Section 17c agreement) as a local alternative to the national GMS contract. PMS contracts are voluntary, locally negotiated contracts between PCOs and the PMS Provider, enabling, for example, flexible provision of services in accordance with specific local circumstances. New GMS contract (nGMS): The new General Medical Service contract was designed to improve the way that Primary Medical Care services (GMS, PMS, APMS and PCTMS) were funded and to allow practices greater flexibility to determine the range of services they wish to provide, including through opting out of additional services and out-of-hours care. The nGMS contract was fully in place in 2004-05. 3. GPMS: GPMS results are those of GMS and PMS GPs put together. 4. Income before tax: Taxable income before pension contributions are deducted, made up of gross earnings less total expenses, also known as net income.

Sir Nicholas Soames: To ask the Secretary of State for Health what the average age of a general practitioner was in each of the last 15 years for which figures are available. [201958]

Dr Poulter: The requested information is contained in the following table.

 Total general practitioner (GPs) (excluding retainers and registrars)Average age of GPs (excluding retainers and registrars)

1999

28,467

45.1

2000

28,593

45.5

2001

28,802

45.7

2002

29,202

45.8

2003

30,358

45.9

2004

31,523

46.0

2005

32,738

46.2

2006

33,091

46.3

2007

33,364

46.4

2008

34,010

46.7

2009

35,917

46.5

20101

35,120

46.6

20111

35,415

46.7

20121

35,527

46.7

20131

35,561

46.6

1 The new headcount methodology is not fully comparable with data for years prior to 2010, due to improvements that make it a more stringent count of absolute staff numbers. Headcount totals are unlikely to equal the sum of components. Further information on the headcount methodology is available in the Census publication. Note: GP data as at 30 September for each year except in 1999 when GP figures as at 1 October.

Sir Nicholas Soames: To ask the Secretary of State for Health what the number of general practitioners per 1,000 head of population was in each of the last 15 years for which figures are available. [201959]

Dr Poulter: The requested information is contained in the following table.

General practitioners (GPs) per head of population in England 1999-2013
 All GPs-hadcount1Per 1,000 head of population-headcountAll GPs-full time equivalent1Per 1,000 head of population-full time equivalent

1999

30,959

0.634

28,354

0.581

30 Jun 2014 : Column 487W

2000

31,369

0.640

28,544

0.582

2001

31,835

0.647

28,854

0.586

2002

32,292

0.653

29,155

0.590

2003

33,564

0.676

30,084

0.606

2004

34,855

0.698

31,021

0.621

2005

35,944

0.716

31,901

0.636

2006

36,008

0.712

33,384

0.660

2007

36,420

0.715

33,731

0.662

2008

37,720

0.734

34,043

0.663

2009

40,269

0.777

36,085

0.696

20102

39,409

0.755

35,243

0.675

20112

39,780

0.756

35,319

0.671

20122

40,265

0.758

35,871

0.675

20132

40,236

0.752

36,294

0.678

1 All GPs includes GP providers, salaried/other GPs, GP Registrars (trainers) and GP retainers. 2 The new headcount methodology is not fully comparable with data for years prior to 2010, due to improvements that make it a more stringent count of absolute staff numbers. Headcount totals are unlikely to equal the sum of components. Further information on the headcount methodology is available in the Census publication. Notes: 1. GP data as at 30 September for each year except in 1999 when GP figures as at 1 October. 2. Office for National Statistics mid-year population estimates used are the latest available at the time of the relevant GP Census, and are always a year behind the GP figures. So 2013 GP figures use mid-year 2012 population estimates, 2012 GP figures use mid-year 2011 population estimates etc. Sources: The Health and Social Care Information Centre General and Personal Medical Services Statistics Office for National Statistics: Mid-Year Population Estimates

Sir Nicholas Soames: To ask the Secretary of State for Health what the average weekly hours worked by each full-time general practitioner was in each of the last 15 years for which figures are available. [201961]

Dr Poulter: The requested information is not collected centrally.

Sir Nicholas Soames: To ask the Secretary of State for Health whether he plans to introduce charges for general practitioner appointments; and if he will make a statement. [201962]

Dr Poulter: The Government believe that the national health service should be free at the point of use and there are no plans to introduce charges for general practitioner appointments.

Sir Nicholas Soames: To ask the Secretary of State for Health what steps he plans to take to improve the service provided by general practitioners; and if he will make a statement. [201964]

Dr Poulter: The Department has recently set out its ambitions for primary care in publishing Transforming Primary Care. A copy has been placed in the Library. The changes to the general practitioner (GP) contract for this year will help ensure that patients aged over 75 and those with the most complex needs receive more personalised and proactive care.

The Government has also invested £50 million, through the Prime Minister’s Challenge Fund, to develop new ways of improving access to GP services.

30 Jun 2014 : Column 488W

The Department has recognised the need to increase the GP work force and between September 2010 and September 2013, the number of full-time equivalent GPs has risen by 1,051. Additionally, the Department has included in the Health Education England (HEE) mandate a requirement that

“HEE will ensure that 50% of trainees completing foundation level training enter GP training programmes by 2016”.

Sir Nicholas Soames: To ask the Secretary of State for Health what the average number of daily patient consultations per general practitioner was in each of the last 15 years for which figures are available. [201967]

Dr Poulter: Data are not held centrally on the average number of daily patient consultations per general practitioner (GP) for each of the last 15 years.

However, some information about trends in consultation rates in general practice was published in 2009 (‘Trends in Consultations Rates in General Practice—1995-2009’). More recent data than these are not available.

The data include consultations by nurses and other clinicians, as well as GPs.

Estimated numbers of consultations for a typical practice in England, 1995-96 to 2008-09
Financial yearCrude estimated number of consultations for a typical practice in EnglandMedian practice estimatesLower quartileUpper quartile

1995-96

21,300

22,000

17,900

25,700

1996-97

21,600

22,600

17,800

25,900

1997-98

22,600

23,300

18,800

27,400

1998-99

22,600

23,300

18,400

27,600

1999-2000

22,900

23,500

18,800

27,800

2000-01

24,500

25,100

20,200

29,900

2001-02

25,400

25,900

21,200

30,600

2002-03

26,500

26,900

22,700

31,500

2003-04

28,200

28,400

23,900

32,900

2004-05

30,400

30,000

26,100

35,000

2005-06

32,200

31,900

27,500

37,100

2006-07

33,000

32,700

28,400

38,200

2007-08

33,400

32,900

28,400

38,300

2008-09

34,600

34,100

29,600

39,300

Source: Table 8, Trends in Consultation Rates in General Practice—1995-2009, QResearch and Health and Social Care Information Centre (HSCIC)
Estimated proportion of patients seen by GPs, nurses and by other clinicians, 1995-96 to 2008-09
Percentage
Financial yearGPsNursesOther clinicians

1995-96

75

21

3

1996-97

74

22

4

1997-98

72

23

4

1998-99

71

24

5

1999-2000

70

26

5

2000-01

68

27

5

2001-02

67

29

5

2002-03

66

30

4

2003-04

65

31

4

2004-05

63

33

4

2005-06

62

34

4

2006-07

62

34

4

30 Jun 2014 : Column 489W

2007-08

62

34

4

2008-09

62

34

4

Source: Table 4, Trends in Consultation Rates in General Practice—1995-2009, QResearch and Health and Social Care Information Centre

Mr Andrew Turner: To ask the Secretary of State for Health what information his Department gathers on the number of people who move to another GP practice. [202345]

Dr Poulter: The Health and Social Care Information Centre has advised that data on the number of people changing general practitioner practice each year are not collected centrally.

Mr Andrew Turner: To ask the Secretary of State for Health how many people are on GP practice lists in (a) England and (b) each county; and how many people have been removed involuntarily from such lists in (i) England and (ii) each county in each of the last 12 months. [202531]

Dr Poulter: The following table shows the number of people on general practitioner (GP) practice lists and in each NHS England Area Team in England as at 30 September 2013. We do not hold this information by each county in England.

We do not hold the information centrally on how many people have been removed involuntarily from GP practice lists.

Under the terms of their contracts, GP practices must have reasonable grounds to remove a patient from their practice list which do not relate to the patient’s race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.

GP Registered Patients
  Number

England

 

56,007,348

Q49

Cumbria, Northumberland, Tyne and Wear

1,989,458

Q45

Durham, Darlington and Tees

1,224,872

Q50

North Yorkshire and Humber

1,689,042

Q47

Lancashire

1,521,721

Q52

West Yorkshire

2,435,786

Q48

Merseyside

1,257,011

Q46

Greater Manchester

2,880,262

Q44

Cheshire, Warrington and Wirral

1,279,416

Q51

South Yorkshire and Bassetlaw

1,506,383

Q55

Derbyshire and Nottinghamshire

2,049,773

Q59

Leicestershire and Lincolnshire

1,822,274

Q60

Shropshire and Staffordshire

1,591,314

Q54

Birmingham and the Black Country

2,615,060

Q53

Arden, Herefordshire and Worcestershire

1,693,801

Q58

Hertfordshire and the South Midlands

2,831,463

Q56

East Anglia

2,511,745

Q57

Essex

1,801,428

Q71

London

8,978,299

Q69

Thames Valley

2,160,146

Q64

Bath, Gloucestershire, Swindon and Wiltshire

1,520,942

Q65

Bristol, North Somerset, Somerset & South Gloucs

1,507,605

Q66

Devon, Cornwall and Isles of Scilly

1,745,638

30 Jun 2014 : Column 490W

Q70

Wessex

2,789,815

Q68

Surrey and Sussex

2,813,739

Q67

Kent and Medway

1,790,355

Notes: 1. Data as at 30 September 2013. 2. Figures show numbers of patient registrations at GP practices in England. Owing to multiple registrations and other issues the numbers of registered patients in England are higher each year than ONS resident population estimates, and as such these figures may not represent the actual number of people registered to access GP services in a given area. 3. General and Personal Medical Services statistics are only available by NHS organisations and do not map precisely into English county regions. 4. GP Registered Patient figures by Area Team are based on the location of the GP practice to which the patients are registered. 5. Data on numbers of people who have been removed involuntarily from GP lists is not published within the Health and Social Care Information Centre General and Personal Medical Services Statistics. Data Quality: The Health and Social Care Information Centre seeks to minimise inaccuracies and the effect of missing and invalid data but responsibility for data accuracy lies with the organisations providing the data. Methods are continually being updated to improve data quality where changes impact on figures already published. This is assessed but unless it is significant at national level figures are not changed. Impact at detailed or local level is footnoted in relevant analyses. Source: The Health and Social Care Information Centre General and Personal Medical Services Statistics

Genito-urinary Medicine

Luciana Berger: To ask the Secretary of State for Health what his Department is doing to improve access to sexual health services. [202213]

Jane Ellison: Local authorities are mandated to commission comprehensive, open access sexually transmitted infection testing and treatment services, and contraception advice and provision that meet the needs of their local population. The Government’s ambitions for sexual health are set out in A Framework for Sexual Health Improvement in England (March 2013); a copy of which has already been placed in the Library.

Health Education: Sex

Luciana Berger: To ask the Secretary of State for Health what his Department is doing to support FPA Sexual Health Week 2014; and if he will make a statement. [202214]

Jane Ellison: The Department does not directly support the Family Planning Association's (FPA) Sexual Health Week. However, the Department holds a three-year contract with the FPA which runs to 31 March 2015 totalling £1.130 million for a sexual health information service. This provides information to the public and health care professionals on all aspects of contraception and sexually transmitted infections.

Luciana Berger: To ask the Secretary of State for Health what steps his Department is taking to (a) promote best practice for sexual health amongst local authorities and (b) disseminate good practice shown by local authorities on sexual health. [202466]

Jane Ellison: The Government’s ambitions for sexual health are set out in A Framework for Sexual Health Improvement in England (March 2013), a copy of which has already been placed in the Library. The first annual review of progress towards the ambitions in the framework

30 Jun 2014 : Column 491W

is in development and will include case studies of good and promising local practice. The Department, in partnership with other organisations including Public Health England, the Local Government Association and the Association of Directors of Public Health, has also produced a number of documents to assist local authorities to fulfil their new role in relation to sexual health commissioning.

Infant Foods

Luciana Berger: To ask the Secretary of State for Health (1) what steps he is taking to ensure that (a) the Infant Formula and Follow-on Formula Regulations are enforced, (b) guidance is provided to interested parties and the Advertising Standards Authority in line with his Department's Guidance Notes on the Infant Formula and Follow-on Formula Regulations 2007 and (c) necessary court action is taken to stop violations or settle questions of interpretation; [202465]

(2) what steps his Department has taken since October 2010 to ensure that local authorities and other interested parties are applying and interpreting the Infant Formula and Follow-on Formula Regulations in accordance with his Department's Guidance Notes on the Infant Formula and Follow-on Formula Regulations 2007. [202464]

Jane Ellison: The Department has made the Guidance Notes on the Infant Formula and Follow-on Formula Regulations 2007 available on the Department’s website and has regularly met with local authorities; the Advertising Standards Authority; the Food Standards Agency; the industry trade association and individual businesses to ensure that the Department’s advice is communicated to businesses and enforcers. Enforcement action, which could potentially result in court action, is carried out by local authorities.

Influenza: Vaccination

Mr Simon Burns: To ask the Secretary of State for Health what proportion of (a) NHS staff, (b) pregnant women and (c) pensioners took up influenza vaccinations in each of the last four years for which figures are available. [202301]

Jane Ellison: Data for England on the number of seasonal influenza vaccinations administered by primary care and national health service trusts to target groups have been derived from the Annual Influenza Vaccine Uptake Reports published by Public Health England (PHE).

Annual influenza vaccine uptake for health care workers (HCWs) (England) is reported in the following table. Influenza vaccination is offered to front-line health care or social care professionals directly involved in patient care.

Influenza vaccine uptake for front-line HCWs with direct patient care
 Number of HCWs with direct patient careNumber of vaccines administeredVaccine uptake (%)

2010-11

1,035,219

359,080

34.7

2011-12

1,023,679

456,542

44.6

2012-13

1,023,763

466,601

45.6

2013-14

974,632

534,090

54.8

30 Jun 2014 : Column 492W

Annual influenza vaccine uptake for pregnant women (England) are presented in the following table. Influenza vaccination has been offered to all pregnant women (includes those not in a clinical at-risk group and those in a clinical at-risk group) since the 2010-11 flu season.

Influenza vaccine uptake for pregnant women
 Number of patients registeredNumber of vaccines administeredVaccine uptake (%)

2010-11

318,562

121,164

38.0

2011-12

710,554

195,031

27.4

2012-13

713,740

287,561

40.3

2013-14

659,223

262,081

39.8

Annual influenza vaccine uptake for people aged 65 and over (England) are presented in the following table. Influenza vaccination is offered to this group.

Influenza vaccine uptake in those aged 65 years and over
 Number of patients registeredNumber of vaccines administeredVaccine uptake (%)

2010-11

8,631,137

6,287,011

72.8

2011-12

9,138,632

6,764,364

74.0

2012-13

9,377,661

6,881,636

73.4

2013-14

9,646,433

7,062,210

73.2

Source: PHE Influenza Immunisation Vaccine Uptake Monitoring Programme.

Mr Simon Burns: To ask the Secretary of State for Health what the total cost to the NHS was of providing free flu vaccinations in each of the last four years for which figures are available. [202341]

Jane Ellison: NHS England spent a total of £251 million on immunisation programmes in 2013-14. Of this, £89 million is identifiable as relating to the purchase of flu vaccines for adults and the administration of flu vaccines for both adults and children.

Vaccines for the national childhood immunisation programme, including for childhood flu immunisation from 2013-14, are purchased and managed by Public Health England on behalf of the Department and are not a cost for the national health service. The cost of the vaccine and its storage and distribution are commercially confidential.

Data for NHS spend for the years prior to 2013-14 are not held centrally.

Learning Disability

Liz Kendall: To ask the Secretary of State for Health (1) how many people with a learning disability placed in assessment and treatment units (ATUs) had their placements reviewed between December 2012 and June 2013; how many such people were found to have been placed there inappropriately; and how many of those found to have been inappropriately placed in ATUs have since been moved into the community; [202217]

(2) with reference to the oral statement of 10 December 2012 made by the Minister of State, Department of Health, Official Report, column 49, on Winterbourne View, how many meetings the Minister has had with (a) officials in his Department, (b) NHS England and (c) Ministers in the Department for Communities and Local Government to discuss progress on the commitments made in that statement. [202279]

30 Jun 2014 : Column 493W

Norman Lamb: NHS England’s paper “Implementing the Recommendations of the Government’s Response to the Francis Report and its Winterbourne Review Report” confirms that during the period 12 December 2012 to June 2013 for clinical commissioning groups there were 1,279 reviews completed and 38 were outstanding. These have all now been completed. By October 2013, NHS England identified a further 1,360 people in specialised services commissioned by NHS England. 1,303 of these people had their care reviewed by the end of 2013 and 57 people were identified as no longer requiring a review. Using these data, NHS England calculates that 35% of people who were in hospital on 1 April 2013 have now been transferred to another setting.

NHS England is identifying all people with learning disabilities in in-patient settings to ensure that they receive safe, appropriate, high quality care. NHS England is now collecting data quarterly for this purpose. It has recently published data as of March 2014. These data show that 2,615 people were identified as being in in-patient services, with 2,334 of these people having had their care reviewed within the last 26 weeks. These data do not specifically identify people in in-patient settings within the specific period (December 2012 to June 2013) as a separate cohort.

NHS England’s data do not identify people as being in ‘assessment and treatment units’ but use other categories of in-patient beds, settings and units drawn from categorisation developed by the Royal College of Psychiatrists and also used in the learning disability census. The data identify those people who are expected to transfer, as well as those who have no transfer date. The reviews of people’s care identify those individuals for whom it is appropriate to move to alternative settings.

I have had several meetings with Department officials and NHS England to discuss progress on the commitments made in my oral statement of 10 December 2012, Official Report, column 49, in the House of Commons, but have had no meetings with Ministers in the Department for Communities and Local Government about these commitments.

Liver Diseases

Luciana Berger: To ask the Secretary of State for Health when he plans to publish the strategy for combating liver disease referred to in the Prime Minister's message of support for World Hepatitis Day, published on the 10 Downing Street website on 28 July 2011. [202468]

Jane Ellison: Responsibility for determining the overall national approach to improving clinical outcomes from health care services, including services for people with liver disease, lies with NHS England.

NHS England advises that it is adopting a broad strategy for delivering improvements in relation to premature mortality. It is working with commissioners and Public Health England to support clinical commissioning groups to understand where local challenges lie and to identify the evidence in relation to the priorities for reducing mortality at a national level. NHS England is generally not working within a condition-specific framework and has no plans to produce a liver-specific strategy.

30 Jun 2014 : Column 494W

Meningitis: Vaccination

Ms Ritchie: To ask the Secretary of State for Health when his Department plans to begin negotiations with Novartis on the procurement of the vaccine for meningitis B as part of the primary infant immunisation schedule. [202342]

Jane Ellison: The Government are taking the necessary steps to ensure this procurement is properly conducted.

We are committed to introducing this vaccine in line with the Joint Committee on Vaccination and Immunisation’s recommendation, subject to the vaccine being available at a cost-effective price.

Mental Health

Mr Godsiff: To ask the Secretary of State for Health what assessment he has made of the recommendations in Take action for better mental health, published by the charity Mind. [201919]

Norman Lamb: This Government have made their commitment to mental health explicit in the Health and Social Care Act 2012. Our priorities for the next 15 months, set out in Closing the Gap, our mental health action plan, anticipate many of the key actions set out in Take action for better mental health, Mind's manifesto for better mental health for the 2015 general election.

We are committed to stamping out discrimination and have already made a financial commitment of up to £16 million to the Time to Change campaign.

We have already committed more than £450 million to improve access to National Institute for Health and Care Excellence-approved psychological therapies, including £54 million for the children and young people's improving access to psychological therapies project which will transform child and adolescent mental health services. We are actively incentivising clinical commissioning groups to increase access to psychological therapies through the quality premium scheme, which provides additional funding to those that meet key goals.

The mental health crisis care concordat, signed by more than 20 national organisations, is a commitment for agencies involved in supporting someone in a crisis to work together to improve the system of care and support so people in crisis are kept safe and helped to find the support they need. All the signatories have committed to working together and the expectation is that, in every locality in England, local partnerships of health, criminal justice and local authority agencies will agree and commit to local mental health crisis declarations.

We are supporting employers to help more people with mental health problems to remain in or move into work. We are also developing new approaches to help people with mental health problems who are unemployed to move into work, and to support them when they are unable to work.

Public Health England (PHE) will be launching an action plan for well-being and mental health in the autumn. This is one part of PHE's commitment to embedding well-being and mental health in its work and working towards achieving parity of esteem between mental and physical health.

30 Jun 2014 : Column 495W

Mental Health: Research

Luciana Berger: To ask the Secretary of State for Health how much his Department has spent on mental health research in each year since 2010. [202212]

Norman Lamb: Spend on research funded directly by the Department’s National Institute for Health Research (NIHR) from 2010-11 to 2012-13 in mental health is shown in the following table. The complete information on NIHR spend in 2013-14 is not currently available. These figures do not take account of NIHR expenditure on research infrastructure and systems where spend cannot be attributed to health categories.

£
Health category2010-112011-122012-13

Mental Health

49,848,487

53,217,726

69,978,468

In addition, the Department commissions research through the Policy Research Programme (PRP) which funds research to inform policy development and implementation across the full range of the Department’s responsibilities. Spend on research funded directly by the PRP from 2010-11 to 2013-14 in mental health is shown as follows:

£
Health category2010-112011-122012-132013-14

Mental Health

452,086

1,318,356

564,604

700,712

Midwives

Mr Andrew Smith: To ask the Secretary of State for Health how many student midwives were in receipt of a bursary in each of the last three years for which figures are available; what the average bursary paid to a student midwife was in each of those years; and what the total cost of those bursaries was to his Department in each of those years. [201615]

Dr Poulter: The number of midwifery students who were in receipt of a bursary, the average bursary paid to those students and the total cost of all bursaries paid to student midwives in each of the last three academic years can be found in the following table:

 Number of bursary holders1Average amount paid per bursary holder2 (£)Total amount paid 2 (£)

2010-11

5,218

5,722

29,854,947

2011-12

5,345

5,867

31,358,058

30 Jun 2014 : Column 496W

2012-13

5,448

6,121

33,344,511

1 Includes nil award holders (European Union fee-only students and students whose living allowance element of the bursary has been reduced to nil after income assessment) 2 Includes the basic award and all supplementary allowances and one-off payments. Note: All figures are rounded to the nearest pound. Source: NHS Business Services Authority

Mr Andrew Smith: To ask the Secretary of State for Health what the total number of student midwives has been in each of the last three years for which figures are available. [201616]

Dr Poulter: The following table provides the annual population of student midwives from 2011-12 to 2013-14. The table includes students enrolled on the degree and 18 month diploma courses.

 2011-122012-132013-14

Midwife population

5,955

6,315

6,413

Source: Multi professional education and training budget monitoring returns

Mr Andrew Smith: To ask the Secretary of State for Health how many training places for student midwives were commissioned in each of the last three years for which figures are available. [201617]

Dr Poulter: The following table provides the number of new midwifery training places for the period 2011-12 to 2013-14. The table includes students enrolled on the degree and 18-month diploma courses.

 Total midwife commissions

2011-12

2,484

2012-13

2,578

2013-14

2,540

Source: Multi professional education and training budget monitoring returns.

Mr Andrew Smith: To ask the Secretary of State for Health what the age profile of midwives working for the NHS was in each year since 2001. [201644]

Dr Poulter: The national health service annual work force census published by the Health and Social Care Information Centre shows the age profile of midwives working for the NHS in England as at 30 September each year. The age profile of midwives working in the NHS from 2001 to 2013 is shown in the following table. The data are headcount because equality data relate to individuals.

NHS hospital and community health services: Registered midwives in England by age band as at 30 September each specified year
Headcount
 Under 2525 to 2930 to 3435 to 3940 to 4445 to 4950 to 5455 to 5960 to 6465 and overUnknownAll staff

2001

563

1,483

2,896

4,972

4,442

3,093

2,409

1,334

306

8

-

21,506

2002

571

1,467

2,542

4,811

4,705

3,372

2,380

1,495

348

13

-

21,704

2003

682

1,586

2,405

4,524

4,990

3,584

2,466

1,592

404

25

-

22,258

2004

671

1,707

2,279

4,255

5,224

3,943

2,594

1,738

473

46

-

22,930

2005

648

1,949

2,238

3,798

5,224

4,225

2,752

1,716

532

63

-

23,145

2006

559

2,034

2,281

3,339

5,167

4,386

2,920

1,779

591

57

-

23,113

2007

549

2,102

2,366

3,142

5,098

4,623

3,139

1,750

689

70

-

23,528

2008

640

2,187

2,401

2,968

4,787

4,757

3,313

1,798

717

91

-

23,659

30 Jun 2014 : Column 497W

30 Jun 2014 : Column 498W

2009

710

2,175

2,641

2,900

4,490

5,014

3,591

1,890

770

132

-

24,313

             

20101

802

2,193

2,839

2,906

4,212

5,156

3,858

2,010

822

139

1

24,938

2011

924

2,283

2,973

2,978

3,844

5,163

4,094

2,100

835

122

-

25,316

2012

1,028

2,404

3,079

2,930

3,632

5,078

4,278

2,268

820

137

-

25,654

2013

1,163

2,641

3,175

2,945

3,358

4,851

4,467

2,345

809

156

-

25,910

‘-’= zero 1 The new headcount methodology from 2010 onwards is not fully comparable with previous years data due to improvements that make it a more stringent count of absolute staff numbers. Further information on the headcount methodology is available in the Census publication. Note: These statistics relate to the contracted positions within English NHS organisations and may include those where the person assigned to the position is temporarily absent, for example on maternity leave. Source: Health and Social Care Information Centre Non-Medical Workforce Census.

Nervous System

Derek Twigg: To ask the Secretary of State for Health how many NHS hospital trusts are not currently meeting the 18-week target in respect of spinal services. [202204]

Jane Ellison: The information requested is not held centrally. Consultant-led referral to treatment waiting times are collected separately for 18 high volume treatment functions (divisions of clinical work based on main specialty). These treatment functions are listed in the national health service data dictionary at:

www.datadictionary.nhs.uk/data_dictionary/data_field_notes/t/tr/treatment_function_code_(referral_to_treatment _period)_de.asp?shownav=1

Referral to treatment waiting times for all other treatment functions, including spinal surgery services and spinal injuries, are collected under a single other treatment function, and are not separately identifiable.

Nurses

Miss McIntosh: To ask the Secretary of State for Health how many specialist nurses are available for children suffering from (a) epilepsy and (b) mental health in (i) North Yorkshire and (ii) the UK. [201700]

Dr Poulter: The current numbers of specialist nurses for children suffering from epilepsy and mental health problems available in North Yorkshire and the United Kingdom are not collected centrally. The national health service annual work force census provides information on the number of nursing, midwifery and health visiting staff employed in the NHS in England but does not identify specialist nurses separately.

The Nursing and Midwifery Council (NMC) holds a register of nurses and midwives registered to practise in the UK. Nurses must be registered with the NMC to work as a nurse. To keep their registration up to date, nurses also need to renew their registration every three years. The register does not include details of nursing specialties.

More information is available at the NMC website at

www.nmc-uk.org/

The provision of health services in the UK is a devolved issue. The contacts for Northern Ireland, Scotland and Wales are available from the following links:

Northern Ireland:

www.dhsspsni.gov.uk/index.htm

Scotland:

www.scotland.gov.uk/Topics/Health

Wales:

www.wales.gov.uk/topics/health?lang=en

The Government have supported the development of a range of specialist roles within nursing. It is for local NHS organisations with their knowledge of the health care needs of their local population to invest in training for specialist skills and to deploy specialist nurses. In this context, the Government recognise that more could be done by some local health care organisations to prioritise preventative care and better support children’s needs. Specialist nurses can play an important role in this which can both save the NHS money and, more importantly, provide better care for patients.

Patient Choice Schemes

Liz Kendall: To ask the Secretary of State for Health what proportion of NHS outpatient appointments were made through Choose and Book in each quarter of 2013-14 and to date in the first quarter of 2014-15. [202220]

Dr Poulter: Quarterly Choose and Book utilisation data are available for each month and each quarter of the 2013-14 financial year and are set out in the following table.

When reviewing the table, it is important to note that utilisation is calculated as the percentage of referrals made to first consultant-led out-patient services using the Choose and Book system, compared to the total number of referrals made to first out-patient services, as reported by provider organisations.

Each month this represents around 500,000 referrals being made from general practitioner (GP) practices to first consultant-led out-patient services through Choose and Book. Use of Choose and Book is, however, significantly greater than this with an additional 200,000 or so referrals per month being booked to other out-patient services, which include allied health professionals and GPs with special interests diagnostic and assessment services. These are not currently included as part of the utilisation figures as the denominator data are not currently reported at a national level.

30 Jun 2014 : Column 499W

Utilisation breakdown—monthly and quarterly for 2013-14 financial year
 Percentage of NHS first out-patient appointments made through Choose and BookAverage quarterly (%)

2013

  

April

52

52

May

52

 

June

52

 
   

July

52

53

August

53

 

September

53

 
   

October

53

52

November

52

 

December

51

 
   

2014

  

January

54

Unavailable at present

February

52

 

March

Data not validated

 

Data for the first quarter of 2014-15 are currently being validated by the Health and Social Care Information Centre. It is expected that this information will be available in July 2014.

Patients

Sir Nicholas Soames: To ask the Secretary of State for Health how many patients were seen by (a) general practitioners and (b) accident and emergency staff in each of the last 15 years for which figures are available. [201963]

Jane Ellison: Information about numbers of patients seen by general practitioners (GPs) is available in Trends in Consultation Rates in General Practice 1995-2009. This report estimates the number of consultations by GPs, nurses and other primary care clinicians in England using statistical techniques based on a sample. Consultations include visits to surgery, telephone consultations, home visits and consultations at other locations. Information is not available for years after 2008.

Information about numbers of patients seen by accident and emergency (A and E) staff is available from weekly situation reports about A and E activity and waiting times.

Such information as is available for the last 15 years is shown in the following table:

Numbers of GP consultations and A&E attendances in England, 1999-2000 to 2013-141
Calendar yearGP consultations

1999

155,500,000

2000

155,100,000

2001

161,900,000

2002

162,100,000

2003

168,900,000

2004

170,900,000

2005

175,400,000

2006

181,400,000

2007

185,300,000

2008

189,000,000

30 Jun 2014 : Column 500W

Financial yearA&E attendances2, 3

1999-2000

14,629,025

2000-01

14,293,307

2001-02

14,044,018

2002-03

14,045,575

2003-04

16,516,845

2004-05

17,837,180

2005-06

18,759,164

2006-07

18,922,275

2007-08

19,076,831

2008-09

19,588,344

2009-10

20,511,908

2010-11

21,380,985

2011-12

21,481,402

2012-13

21,738,637

2013-14

21,778,946

1 Information on GP consultations is for calendar years. Information on A and E attendances is for financial years. It is not possible to show both datasets on a consistent calendar or financial year basis. 2 KH09 data are used from 1987-88 to 2001-02. Quarterly Monitoring of Accident and Emergency data are used from 2002-03 to 2010-11. Weekly situation reports are used from 2011-12 onwards. 3 Attendance data are for all A and E department types, including major A and Es departments, single speciality departments, and minor injury units. In 2002-03, attendance data were first collected split by type, but not from walk-in centres (WiCs). Data from WiCs were first collected in 2003-04. Hence, data prior to 2003-04 are not comparable. Sources: Trends in Consultation Rates in General Practice-1995-2009, Health and Social Care Information Centre Accident and emergency weekly situation reports, NHS England

Pharmaceutical Price Regulation Scheme

Mr Simon Burns: To ask the Secretary of State for Health pursuant to the answer of 23 June 2014, Official Report, columns 27-8W, on pharmaceutical price regulation scheme, what payments have been made to the devolved Administrations in the financial year 2014-15 to date; and what payments were made to the devolved Administrations in (a) 2013-14 and (b) 2014-15 financial years under the iteration of the Pharmaceutical Price Regulation Scheme which has applied from 1 January 2014. [202163]

Norman Lamb: To date, no payments have been made to the devolved Administrations in respect of the 2014 Pharmaceutical Price Regulation Scheme (PPRS) in financial year 2014-15. Constructive discussions have taken place with the Department and the devolved Administrations to identify a fair allocation of receipts received under the PPRS. Agreement on the allocations for financial year 2013-14 has been reached and the Department intends to make the payments for that financial year within the next month.

Prescription Drugs

Robert Halfon: To ask the Secretary of State for Health what progress he has made on replacing branded drug prescriptions with generic drug prescriptions; how much from the NHS drugs budget has been saved as a result; and if he will make a statement. [201693]

Norman Lamb: The Health and Social Care Information Centre (HSCIC) publication ‘Prescriptions Dispensed in the Community, Statistics for England—2002-12’, contains a series of statistical tables, one of which, table A5: ‘Generic prescribing and dispensing, percentage by

30 Jun 2014 : Column 501W

class, 2002–12’, provided an 11-year time series of data on generic prescribing. Information from this is provided in the table. The next edition of this publication, which will contain 2013 data, is due to be published by the

30 Jun 2014 : Column 502W

HSCIC on 9 July 2014. The Department has not made an estimate of the savings that have resulted from greater use of generics.

Generic prescribing and dispensing, percentage by class, 2002–12
 Percentage 
Prescription itemsPrescribed generically (class 1 and 2)Prescribed and dispensed generically (class 1)Prescribed generically, dispensed and reimbursed as proprietary (class 2)Total number (million)

2002

76.0

53.0

23.0

600.0

2003

77.8

55.4

22.4

631.8

2004

79.1

57.8

21.3

667.6

2005

80.1

59.3

20.8

700.7

2006

81.8

62.2

19.6

730.3

2007

82.6

64.1

18.5

773.2

2008

82.6

65.0

17.7

818.6

2009

82.8

66.1

16.7

861.0

2010

82.7

67.4

15.4

900.1

2011

83.0

68.9

14.1

933.2

2012

83.6

72.7

10.8

970.2

Net ingredient cost
 PercentagePercentagePercentageValue £ million

2002

68.0

19.9

48.1

6,509.4

2003

70.3

23.7

46.6

7,139.5

2004

71.1

26.3

44.7

7,677.6

2005

70.8

26.4

44.4

7,500.6

2006

71.9

29.5

42.4

7,724.0

2007

71.8

29.1

42.7

7,868.4

2008

70.3

26.2

44.1

7,790.7

2009

69.9

28.3

41.5

7,966.6

2010

69.3

29.6

39.7

8,232.0

2011

68.3

29.8

38.5

8,164.4

2012

66.3

34.7

31.7

7,840.4

Notes: 1. The share of prescription items written generically has risen to 83.6%, a slight increase on the previous year. The share of the associated net ingredient cost has continued to decrease, from 68.3% to 66.3%. This is the lowest value in the last 10 years. 2. The proportion of prescription items dispensed generically continues to increase, from 68.9% in 2011 to 72.7% in 2012. The increase in the share of the associated net ingredient cost rose from 29.8% to 34.7%. 3. The prescribing of drugs by approved (generic) name has been encouraged, largely because such prescriptions can be dispensed with a generic product if available. Generally generic medicines (where the patent has expired) are less expensive, although this is not always the case. The rate of generic prescribing may not rise much further if it has reached a clinically appropriate level for the drugs currently available. 4. The proportion of generically prescribed items which were dispensed generically has risen in each year, from 53.0% in 2002 to 72.7% in 2012. The proportion that was dispensed as proprietary items, when there was no generic version available, has fallen each year since 2002, to 10.8% in 2012. This may indicate that more generic products are available and that the number of proprietary-only products is falling. The proportion of net ingredient cost for items that were dispensed as proprietary items is the lowest it has been in the last 10 years, having fallen each year since 2008. 5. In 2012 the 72.7% of items prescribed and dispensed generically account for 34.7% of the net ingredient cost. The 10.8% of items which were written generically and dispensed as proprietary accounted for 31.7% of the net ingredient cost. Source: The Health and Social Care Information Centre