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Autism: Costs to Community
Lord Clement-Jones asked Her Majesty's Government:
- What research they have undertaken or commissioned on the total costs to the community of autism.[HL1448]
Lord Hunt of Kings Heath: The Government have not commissioned research into the costs to the community of autism. The only published study in this area is The Economic Impact of Autism in Britain by Jarbrink and Knapp, sponsored by the Mental Health Foundation and the Shirley Foundation. Their paper suggests that the average additional cost per person with autism over a lifetime might be £2.4 million—the bulk of this being for living support and day activities. Statutory support for adults with autism comes predominantly from mental health and learning disability services. The total cost of these services in 1999-2000 was approximately £4,250 million and £3,000 million respectively. The proportion of each attributable to autism is not separately identified.
Adverse Drug Reactions: Autism
Lord Clement-Jones asked Her Majesty's Government:
Whether degeneration into autism is now recorded by the Medicines Control Agency as a potential adverse event after vaccination.[HL1449]
Lord Hunt of Kings Heath: The United Kingdom's spontaneous adverse drug reaction (ADR) reporting scheme (the Yellow Card Scheme), operated by the Medicines Control Agency (MCA) and Committee of Safety of Medicines, receives reports of suspected ADRs directly from doctors, dentists, coroners, pharmacists and indirectly via pharmaceutical companies. Any reported cases of autism suspected by the reporter to be associated with medicine or vaccine are routinely recorded on the MCA's ADROIT (Adverse Drug Reaction Online Information Tracking) database.
Lord Clement-Jones asked Her Majesty's Government:
- What guidance the Department of Health has given to general practitioners and other health professions on filing Yellow Card reports to the Medicines Control Agency on degeneration into autism after vaccination, including slow degeneration after months or years.[HL1450]
Lord Hunt of Kings Heath: Health professionals are requested to report all suspected adverse drug reactions (ADRs) associated with the newer Xblack triangle" medicines and all serious suspected ADRs to established medicines regardless of any uncertainty they may have about a casual relationship. They are also strongly encouraged to report all suspected ADRs which occur in children, regardless of whether the drug is Xblack triangle" or established. This includes any suspected ADRs associated with childhood vaccines. The guidance specifically mentions delayed effects to medicines that may manifest months or years after exposure and asks that any suspicion of such an association be reported. Guidance is included in the British National Formulary distributed to health professionals twice yearly and in the United Kingdom Health Department's memorandum Immunisation
against Infectious Disease which is supplied to health professionals involved in immunisation. Guidance is also given on the Medicines Control Agency website at www.mca.gov.uk. No specific guidance has been given on reporting suspected cases of autism associated with vaccines and it is the responsibility of individual reporters to use their clinical judgement in reporting if they suspect there is an association between an adverse event and any medicine given.Sexual Health and HIV Services
Baroness Gould of Potternewton asked Her Majesty's Government:
- How they are intending to resource the new National Strategy for Sexual Health and HIV beyond the first two years of its 10-year lifetime to enable commissions to plan and develop long-term services around local needs and trends.[HL1459]
Lord Hunt of Kings Heath: We have already committed £47.5 million to support initiatives in the strategy and future spending on specific activities will be set by the 2002 spending review. Securing investment at local level from main National Health Service allocations for sexual health and HIV services will be key to successful implementation of the strategy. Consultation responses are informing the development of an implementation action plan which, alongside the setting of new national targets, will facilitate this.
Long-term Care Residents
Baroness Greengross asked Her Majesty's Government:
- What the level of the weekly personal expenses allowance for people living in a long-term care setting will be from April 2002; and what is the method by which the allowance will be increased annually from April 2002. [HL1468]
Lord Hunt of Kings Heath: Decisions on the level of the personal expenses allowance for people in residential care for April 2002 have yet to be made.
Baroness Greengross asked Her Majesty's Government:
- What conditions have to be met before a person in long-term care is eligible to receive National Health Service-provided continuing care; and how these differ from the conditions which have to be met to receive the highest band of free nursing care implemented on 1 October. [HL1471]
Lord Hunt of Kings Heath: The responsibility for setting eligibility criteria for continuing National Health Service healthcare rests with local health authorites, working closely with their local councils. Health service local authority circulars HSC 2001/015: LAC (2001)18 on continuing care, issued in June 2001, copies of which are available in the Library, listed the
key issues that health authorities should pay attention to when establishing continuing NHS healthcare criteria. A need for continuing NHS healthcare may be indicated where the nature, complexity, intensity or unpredictability of the individual's healthcare needs (and any combination of these needs) requires regular supervision by a consultant, palliative care, therapy or other NHS member of the team.The local conditions or criteria for continuing NHS healthcare may differ from the highest band of free nursing care because they may include services other than nursing care, whereas the highest band of free nursing care only covers nursing needs that the registered nurse contribution tool picks up following the assessment process.
Residential and Nursing Care: Funding
Baroness Greengross asked Her Majesty's Government:
- How many people aged over state retirement age live in (a) residential care homes and (b) nursing homes, quantified by number and proportion for (i) self-funders (ii) those funded by income support and (iii) those funded by the National Health Service.[HL1469]
Lord Hunt of Kings Heath: At 31 March 2000, there were 263, 200 residential places for people aged 65 and over 1 in residential care homes and 149,600 registered nursing beds for them in nursing homes 2 in England. The number of people who are resident in residential care homes and paying for their own care is not available centrally. A survey conducted in June 2001 estimated that around 42,700 residents in general and mental nursing homes were paying wholly for their own care, but no information is collected by age.
Information collected by health and social care consultants Laing & Buisson on the number of people in residential and nursing homes who are funded by the National Health Service is available in the company's publication, Care of Elderly People Market Survey 2001, published in July 2001.
The numbers of income support claimants aged over state pension age and who are in residential care and nursing homes is available from the Department for Work and Pensions and shown in the table.
- 1 Client group of older people and older people who are mentally infirm.
- 2 General and mental nursing homes, private hospitals and clinics.
| Great Britain | Thousands |
| Number of cases | |
| All cases | 205.5 |
| Preserved Rights Residential Care | 20.6 |
| Preserved Rights Nursing Homes | 12.9 |
| Residential Allowance | 172.0 |
Source:
Income Support Quarterly Statistical Enquiry August 2001, DWP.
Notes:
1. Pension age claimants are defined as male over 64, female over 59.
2. Figures are based on a 5 per cent sample and are therefore subject to a degree of sampling error.
3. Caseload figures have been rounded to the nearest hundred and are expressed in thousands.
- What estimate they have made of the number of people who were forced to sell their main home to pay for long-term care fees in 2000–01.[HL1470]
Lord Hunt of Kings Heath: These data are not collected centrally. Through policies announced in the NHS Plan, and implemented in 2001, the Government have made changes to the system for residential care charges that mean that people may not have to sell their homes on admission to residential care.
Intermediate Care
Baroness Greengross asked Her Majesty's Government:
- How much money was allocated to intermediate care in 2000–02; how it has been distributed; and what amount and proportion will be or has been spent by social services departments on social care.[HL1569]
Lord Hunt of Kings Heath: Details of the funding of intermediate care and community equipment services were set out in a joint Health Service and Local Authority Circular (HSC 2001/001—LAC (2001)1) Intermediate Care, issued on 19 January 2001. A copy is available in the Library.
Deployment of resources made available to councils through the standard spending assessment remains a decision for councils to make in the light of local circumstances.
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