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Rheumatoid Arthritis

Lord Roberts of Conwy asked Her Majesty's Government:

Lord Hunt of Kings Heath: The National Institute for Clinical Excellence (NICE) carries out appraisals in accordance with its framework document. This document states that Xits task is to assess the evidence of all clinical and other health-related benefits of an intervention—taking this in a wide sense, to include impact on quality of life, relief of pain, or disability etc as well as any impact on likely length of life—to estimate the associated costs, and to reach a judgment on whether on balance this intervention can be recommended as a cost-effective use of NHS and PSS resources". The detailed application of these principles is a matter for NICE itself.

Lord Morris of Manchester asked Her Majesty's Government:

Lord Hunt of Kings Heath: The most recent edition of the British Medical Journal's publication, Clinical Evidence, estimates the ratio of women to men with rheumatoid arthritis in the United Kingdom to be 2.5:1. The Department of Health is seeking advice on the evidence that is available for possible explanations of the difference in prevalence of rheumatoid arthritis in women and men.

The Medical Research Council (MRC), the main government agency that funds research into treatment and causes of disease, spent approximately £4 million on arthritis and rheumatic disease in 2000–01. The MRC does not as a rule earmark funds for particular topics; research proposals in all areas will compete for

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the funding available. When appropriate, high quality research in the areas the MRC is promoting may be given priority in competition for funds, but research excellence and importance to health will continue to be the primary considerations in funding decisions. The MRC always welcomes high quality applications from the scientific community for support into any aspect of biomedical research and these are judged in open competition with other demands on funding.

The Department of Health funds research to support policy and the delivery of effective practice in the National Health Service. Research on the clinical effectiveness and cost-effectiveness of anakinra for rheumatoid arthritis was recently commissioned through the Health Technology Assessment Programme. This work is being undertaken on behalf of National Institute for Clinical Excellence.

Lord Roberts of Conwy asked Her Majesty's Government:

    Why the national service framework for coronary heart disease includes phase two diabetes but not rheumatoid arthritis, which is an equal contributor to coronary heart disease.[HL1779]

Lord Hunt of Kings Heath: The national service framework (NSF) was drawn up by an independent group of experts led by Professor Sir George Alberti, President of the Royal College of Physicians.

Diabetes is an important risk factor for coronary heart disease (CHD), and CHD is also the major cause of death for people with diabetes. Although rheumatoid arthritis can lead to serious heart disease, the underlying processes differ from those that commonly cause CHD, whereas the weight of clinical opinion is that diabetes is such an important risk factor that it merits specific inclusion in the NSF.

Digital Hearing Aids

Lord Clement-Jones asked Her Majesty's Government:

    Whether the statement about the National Health Service provision of digital hearing aids by John Hutton MP, Minister of State for Health, to Dr Evan Harris MP in a letter dated 3 May that Xwe will study the results of the project and will roll out the changes to the rest of the National Health Service in a planned and systematic way which will benefit everyone who uses the National Health Service hearing aid services" is consistent with the statement made by Jacqui Smith MP, Minister of State for Health, in HC Deb, 13 November, 685W that XPlanning and decisions on modernisation and associated funding and resources are being kept under review until further data can start to be taken into account".[HL1813]

Lord Hunt of Kings Heath: Yes. The Modernising Hearing Aid Services Project is being evaluated by the Institute of Hearing Research to provide information on the most effective hearing aids for National Health

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Service patients, the best ways to supply hearing aids and how a modern hearing aid service can best be delivered to NHS patients. The Department of Health has received interim reports based on data collected from a relatively small sample of patients. The evaluation is still ongoing and the final full evaluation report will be available next year. Decisions on how best to spread the modernised services throughout the NHS will be made as the results of the evaluation emerge. In the meantime, we have earmarked funds to begin roll-out of a modernised service and have said that up to £25 million will be invested by 2003–04.

Lords of Appeal in Ordinary

Lord Jopling asked Her Majesty's Government:

    On what dates since 1945 the maximum number of Lords of Appeal in Ordinary has been revised; to what figure on each occasion; and whether the number in office has ever been less than the maximum (save for short periods between appointments).[HL1680]

The Lord Chancellor (Lord Irvine of Lairg): The maximum number of Lords of Appeal in Ordinary has been increased from seven in 1945, to nine in 1947, to 11 in 1968 and to 12 since 1994.

It has been a commonplace occurrence to have fewer Lords of Appeal in Ordinary than the maximum figure allowed for in the legislation. For instance, there were never more than 10, and on occasion fewer, Lords of Appeal in Ordinary in post between 1968, when the maximum was increased to 11 by the Administration of Justice Act 1968, and March 1992, when the noble and learned Lord, Lord Slynn of Hadley, was appointed as (the eleventh) Lord of Appeal in Ordinary.

Electronic Conveyancing

Lord Gladwin of Clee asked Her Majesty's Government:

    When they intend to publish the analysis of the responses to the consultation paper Electronic Conveyancing: A draft order under section 8 of the Electronic Communications Act 2000 (CP:5/2001).[HL1964]

The Lord Chancellor: My department has today published an analysis of the responses under the title Electronic Conveyancing: Analysis of the responses to the consultation paper on a draft order under section 8 of the Electronic Communications Act 2000 (CP(R):05/2001). I have arranged for copies to be placed in the Libraries of both Houses.

Crown Leaseholders

Lord Brett asked Her Majesty's Government:

    What effect the Commonhold and Leasehold Reform Bill, if enacted, will have on the rights of Crown leaseholders to enfranchise and to acquire a new or extended lease.(HL1960)

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The Parliamentary Secretary, Lord Chancellor's Department (Baroness Scotland of Asthal): Following a statement made on 2 November 1992 by Sir George Young, the Crown authorities gave an undertaking that the Crown would, as landlord and subject to specified conditions, agree to the enfranchisement or extension of residential long leases under the same qualifications and terms which applied by virtue of the Leasehold Reform Act 1967 and the Leasehold Reform, Housing and Urban Development Act 1993 to lessees who hold from other landlords.

It was announced on 3 April 2001, Official Report, cols, WA 110–112 that the Crown authorities had confirmed that they would apply the undertaking to the provisions of the 1967 Act and the 1993 Act as amended by the Commonhold and Leasehold Reform Bill which was then before Parliament. As was announced by my noble and learned friend Lord Falconer of Thoroton during Third Reading of the Commonhold and Leasehold Reform Bill, which is before this Parliament, on 19 November 2001, (Official Report, col 927), the Crown authorities have now confirmed that this also applies to those Acts as amended by the current Bill. This undertaking accordingly supersedes the one given on 3 April 2001.

The full terms of the agreement made by the Crown are as follows: (1) the Crown as landlord will, subject to the conditions described below, agree to the enfranchisement or extension of residential long leases or the grant of new residential long leases, under the same qualifications and terms which will apply by virtue of the Leasehold Reform Act 1967 and the Leasehold Reform, Housing and Urban Development Act 1993 to lessees who hold from other landlords; (2) enfranchisement will be refused where property stands on land which is held inalienably; (3) enfranchisement will also be refused where certain circumstances, which only apply to the Crown, obtain. These are:


    (i) where there are particular security considerations (on the advice of the Royal and Diplomatic Protection Group of the Metropolitan Police or other security agencies);


    (ii) where properties are in, or intimately connected with, the curtilage of historic Royal Parks and Palaces;


    (iii) where properties, or the areas in which they are situated, have a long historic or particular association with the Crown. (4) the areas referred to in paragraph (3) (iii) include the Off Islands within the Isles of Scilly (St Agnes, Bryher, St Martins and Tresco), the Garrison on St Mary's, the village of Newton St Loe and parts of central Dartmoor. The properties referred to in that paragraph include old land revenue and reverter properties and grace and favour properties; (5) where enfranchisement is refused on the grounds set out in paragraphs (2) and (3) but the tenant would otherwise qualify for enfranchisement, lease extension

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    or the grant of a new lease by analogy with the statutes, the Crown will be prepared to negotiate new leases; (6) the Crown will follow the valuation bases set out in the Leasehold Reform Act 1967 and the Leasehold Reform, Housing and Urban Development Act 1993; (7) the Crown will agree to be bound by arbitration where there is dispute over valuation or other terms, except in cases under paragraphs (2) and (3). The Leasehold Valuation Tribunal will be empowered to act as the arbitration body, and will hear such disputes on voluntary reference; (8) the Crown will be entitled to apply to the Leasehold Valuation Tribunal for approval of a scheme of estate management in the same way as other landlords.


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