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Lord McColl of Dulwich asked Her Majesty's Government:
- What information has been made publicly available on how health authorities are monitoring the quality of the wheelchair services, specifically in accordance with Section 27 of Health Service Guidelines, HSG(96)34.[HL2746]
Baroness Jay of Paddington: Health Service Guidelines HSG(96)34 described the arrangements for the scheme for the funding and supply of powered indoor/outdoor wheelchairs, introduced in 1996. Section 27 of the guidelines stated that health authorities would be expected to monitor the quality of the service available to their residents. No information has been made publicly available on how health authorities are monitoring the quality of the supply of powered indoor/outdoor powered wheelchairs. A review of this scheme, and of the wheelchair voucher scheme, is being conducted over the next few months. These reviews are expected to be concluded, and the results made publicly available, during the current financial year.
Duckett's Cheese
The Countess of Mar asked Her Majesty's Government:
- Further to the Written Answer by the Baroness Jay of Paddington on 6 July (WA 108), in what form the initial request by the Department of Health's Food Incident Control Team to the department's lawyers for a draft of the Emergency Control Order was made; and, if the request was in writing, whether they will place a copy of the minute or written request in the Library of the House, together with a copy of the notes of the meetings of the Food Incident Control Team held on 15 and 19 May.[HL2651]
Baroness Jay of Paddington: Our request to lawyers was verbal. It is not our normal practice to publish notes of internal meetings.
E.coli 0157 and Duckett's Cheese
The Countess of Mar asked Her Majesty's Government:
- Upon what basis the opinion was formed that the single case of E.coli 0157 infection which occurred on 19 April, traced to a batch of cheese made on 4, 5 or 6 April, constituted an "emergency", involving a serious risk to public health, under the Food Safety Act 1990, by 19 May, when no other cases had been reported as a result of consumption of cheese from the same batches and no evidence of contamination by E.coli 0157 was found in any other samples of cheese made by Mr. Duckett.[HL2655]
Baroness Jay of Paddington: In view of the severity of illness caused by Escherichia coli 0157, the possibility of its presence in Duckett's cheese constituted an imminent risk of injury to health. It was found in 10 samples from a number of different production dates.
"Emergency": Definition
The Countess of Mar asked Her Majesty's Government:
- Whether they will define an "emergency" in terms of the Food Safety Act 1990.[HL2654]
Baroness Jay of Paddington: An emergency is not defined in the Act. There is provision for an emergency control order to be issued if it appears to the Minister that the carrying out of commercial operations in respect of food involves, or may involve, imminent risk of injury to health.
Donepezil Hydrochloride (Aricept) and Alzheimer's Disease
Lord Morris of Manchester asked Her Majesty's Government:
- Whether they have sought advice regarding the prescription of donepezil hydrochloride (Aricept); if so, from whom and whether the advice has been acted upon; and[HL2730]
What representations they have received from the Alzheimer's Disease Society and others regarding the prescription of donepezil hydrochloride (Aricept).[HL2731]
Baroness Jay of Paddington: Advice on the prescription of donepezil hydrochloride (Aricept) for Alzheimer's disease was obtained from the Royal College of Psychiatrists. This was the basis of the advice prepared by the Standing Medical Advisory Committee referred to in my reply to the noble Lord today.
Ministers have met Mr. Harry Cayton, Chief Executive of the Alzheimer's Disease Society to discuss the availability of donepezil hydrochloride on the National Health Service. Representations have also been received from Members of Parliament and members of the public about this issue.
Lord Morris of Manchester asked Her Majesty's Government:
- Whether, in pursuance of their policy as stated in the White Paper The New NHS aimed at creating a genuinely national NHS based on need rather than ability to pay, they will ensure that equality will be introduced in the prescription of new treatments such as the Alzheimer's disease drug, donepezil hydrochloride (Aricept), currently denied to patients in over half the health authority areas in the United Kingdom; and when guidelines for the prescription of Aricept will be published.[HL2668]
Baroness Jay of Paddington: Guidance on the prescription of donepezil hydrochloride (Aricept) has been prepared by the Standing Medical Advisory Committee and was issued on 30 April 1998 to Health Authority Directors of Public Health and National Health Service Trust Medical Directors in England. The guidance has been circulated widely within the NHS.
The consultation document A First Class Service, published on 1 July, copies of which are available in the Library, sets out a modernisation programme to deliver more consistent and higher quality care for patients. The new National Institute for Clinical Excellence (NICE) will produce clear guidance for clinicians about which treatments work best for which patients, based on an assessment of their clinical and cost effectiveness.
Lord Morris of Manchester asked Her Majesty's Government:
- How many people across the United Kingdom are currently being prescribed donepezil hydrochloride (Aricept) through the NHS; and what is the cost to the NHS.[HL2669]
Baroness Jay of Paddington: Information on the number of people who are being prescribed donepezil hydrochloride is not available. However, the number of prescription items dispensed in the community in England for the last three quarters of 1997 was 7,200.
Lord Morris of Manchester asked Her Majesty's Government:
- Which health authorities in the United Kingdom are currently allowing the prescription of donepezil hydrochloride (Aricept) for the treatment of Alzheimer's disease.[HL2670]
Baroness Jay of Paddington: This information is not collected centrally. However, data for the period January to March 1998 show that Aricept was dispensed against general practitioner prescription in most health authorities.
Prescribing of Medicines: Age Discrimination
Lord Morris of Manchester asked Her Majesty's Government:
- Whether they are satisfied that there is no discrimination between treatments for conditions which affect predominantly those under 65, and those which affect predominantly those over 65, within health authority guidelines in the prescription of medicines; and whether they would take action on this issue if examples of discrimination were brought to their attention.[HL2671]
Baroness Jay of Paddington: We have no evidence that such discrimination exists.
NHS Prescribing Costs
Lord Morris of Manchester asked Her Majesty's Government:
- What is the cost to the NHS of prescription of drug treatments for the following conditions: cancer, schizophrenia, Alzheimer's disease and depression.[HL2672]
Baroness Jay of Paddington: The available information is shown in the table. The information does not include drugs prescribed and dispensed in hospitals, so does not represent the overall cost to the National Health Service of these drugs. It is not possible to identify the indication for which drugs are prescribed, so some drugs included in the cost may have been used to treat other conditions.
| England | £ thousands |
| Cancer(1) | 85,946.2 |
| Schizophrenia(2) | 39,987.0 |
| Alzheimer's disease(3) | 656.8 |
| Depression(4) | 239,120.5 |
Notes:
(1)1. Drugs used for the treatment of cancer are those described in the British National Formulary (BNF) section 8.1 "Cytotoxic drugs", 8.2.4 "Interferons", 8.2.5 "aldesleukin" and 8.3 "Sex hormones and hormone antagonists in malignant disease". Other drugs will also be used to treat cancer patients. It is not possible to separate these for those used for the treatment of cancer only.
(2)2. Drugs used for the treatment of schizophrenia are those indicated for the treatment of schizophrenia in British National Formulary section 4.2, "Drugs used in psychoses and related disorders". Some of these drugs may be used for other conditions.
(3)3. Drugs used for the treatment of Alzheimer's disease are those described in the British National Formulary section 4.11, "Drugs for dementia". Such drugs were only dispensed from April 1997.
(4)4. Drugs used for the treatment of depression are those described in the British National Formulary section 4.3, "Antidepressant drugs".
5. The data covers all prescriptions dispensed by community pharmacists and appliance contractors, dispensing doctors, and prescriptions submitted by prescribing doctors for items personally administered.
6. The net ingredient cost refers to the cost of the drug before discounts and does not include any dispensing costs or fees. It does not include any adjustment for income obtained where a prescription charge is paid at the time the prescription is dispensed or where the patient has purchased a pre-payment certificate.
7. Based on BNF Number 32, September 1998.
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