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Lord Beaumont of Whitley asked Her Majesty's Government:
- When the daily rates for independent advocates representing the Crown Prosecution Service in the London magistrates' courts and London youth courts were last reviewed; what the previous rates were; and whether they were higher or lower than those which are currently paid. [HL3555]
The Attorney-General: The rates paid to independent advocates appearing for the CPS to undertake sessional work in the magistrates' court and the youth court in London are negotiated centrally with the Bar, while the rates paid to solicitor advocates are agreed locally and can vary. Similar arrangements apply across the rest of England and Wales.
The rates paid to barristers under the central agreement were last revised in April 1992. The rate for a half-day session was increased from £109 to £112 and the rate for a full-day session increased from £172 to £175. An additional uplift of £25 payable for heavy courts (remand courts with either 25 or more cases or 40 or more defendants) remained unchanged.
The CPS is presently engaged in a review of the current rates, precipitated by a recent request from the Bar Council.
Familial Hyperlipidaemia
Earl Howe asked Her Majesty's Government:
- What research they have recently sponsored, or are aware of, into familial hyperlipidaemia. [HL3544]
The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): The main government agency for research into the causes of and treatments for disease is the Medical Research Council (MRC) which receives its funding via the Department of Trade and Industry. The MRC Clinical Sciences Centre currently has two groups whose research is directly relevant to familial hyperlipidaemias (inherited metabolic disorders). They are the Molecular Medicine Group, led by Professor James Scott, and the Lipoprotein Team, led by Drs A K Soutar and B L Knight. The MRC's relevant expenditure for 2000–01 is estmated at £871,000. This figure does not include other research that may be relevant to these disorders but not specifically looking at them.
In addition, the MRC always welcomes high quality applications for support into any aspect of human health. These are judged in open competition with other demands on funding. Awards are made according to their scientific quality and importance to human health.
The Department of Health funds research to support policy and the delivery of effective practice in health and social care. The department does not currently fund any research focusing specifically on familial hyperlipidaemia but it funds research projects that may have some relevance to this condition. Current research projects include two prospective cohort studies on risk factors for cardiovascular disease, both of which include blood lipid levels, and a systematic review of the long-term outcomes of the treatments for obesity and implications for health improvement and the economic consequences for the National Health Service.
Recently completed research projects include those on cost-effectiveness of screening for hypercholesterolaemia versus case finding for familial hypercholesterolaemia and cost-effectiveness of the statins.
In addition to specific projects, the Department of Health provides NHS support funding for research commissioned by the research councils and charities that take place in the NHS. Details of ongoing and recently completed research projects funded by, or of interest to, the NHS are available on the National Research Register (NRR at www.doh.gov.uk/research. The NRR currently shows five ongoing and eight completed projects relating to familial hyperlipidaemia.
NHS-funded Nursing Care
Baroness Greengross asked Her Majesty's Government:
- What plans they have to ensure that older people entitled to receive free nursing care in a nursing home actually receive the payment due to them. [HL3452]
Lord Hunt of Kings Heath: In implementing NHS-funded nursing care, the National Health Service is ensuring that people's needs are properly assessed and that nursing homes receive an appropriate level of funding for their care by registered nurses. As a result, most people are experiencing reduced fees. Where this has not been the case, the Minister for Community Care announced a number of measures on 11 March. These were the issue of a national core contract for use by the NHS and nursing homes to ensure clarity on funding issues; a proposed amendment to Regulation 5 of the Care Home Regulations 2001 to require care homes to provide a breakdown of fees; and the National Care Standards Commission to ensure that the national minimum standards regarding contracts are enforced. Similarly, in Wales, the National Assembly Government will seek to ensure that the fee structures in care homes and lines of funding accountability are clearly defined.
Birth Defects
Lord Alton of Liverpool asked Her Majesty's Government:
- What assessment they have made of the increase in the number of babies who are born with disabilities; and what factors have caused this. [HL3455]
Lord Hunt of Kings Heath: The Office for National Statistics National Congenital Anomaly System collects information on live born babies and stillbirths with congenital anomalies, primarily to detect changes in the frequency of reporting of congenital anomalies rather than to estimate exact prevalence at birth. Over the last 10 years there have been both increases and
decreases in the numbers and rates of selected conditions. Despite the success of introducing folic acid as a dietary supplement in pregnancy to reduce the incidence of Spina Bifida, our understanding of the causative agents for all these conditions is incomplete and efforts to further a better understanding will continue.
Lord Alton of Liverpool asked Her Majesty's Government:
- What data they have collected on the impact of the use of recreational drugs by young mothers and an increase in oestrogen-like substances in the diet as contributory factors in the rise in birth defects. [HL3456]
Lord Hunt of Kings Heath: The data requested are not collected centrally.
Haemophilia
Lord Clement-Jones asked Her Majesty's Government:
- When they expect to be able to respond to the Question for Written Answer tabled by Lord Morris of Manchester on 7 February (HL2781) following answers by Lord Hunt of Kings Heath on 6 February (HL Deb, cols. 629—630) concerning recombinant treatment for people with haemophilia. [HL3465]
Lord Hunt of Kings Heath: I replied to my noble friend's Question on 21 March at col. WA 175.
National Service Framework for Long-Term Conditions
Earl Howe asked Her Majesty's Government:
- Whether they will prepare national service frameworks for the treatment of long-term medical conditions, including the control of chronic pain. [HL3548]
Lord Hunt of Kings Heath: In February 2001 my right honourable friend the Secretary of State for Health announced a National Service Framework for Long-term Conditions, with a particular focus on the needs of people with neurological conditions. It will also draw out some of the commonalities in the experience of patients with long-term conditions in using health and social services. The department expects to announce more details about the scope of the NSF later this year.
NHS: Data Quality
Baroness Noakes asked Her Majesty's Government:
- Whether they propose to take any action in response to the Audit Commission's management paper Data Remember-improving quality of patient based information systems. [HL3565]
Lord Hunt of Kings Heath: The Department of Health welcomes the Audit Commission management paper, Data Remember, as it reflects joint work by the department, Audit Commission and Commission for Health Improvement to improve the quality of National Health Service performance data.
While the ultimate responsibility for data quality lies within the trusts themselves, we are already working with the Audit Commission, Commission for Health Improvement, the Modernisation Agency and the NHS Information Authority better to understand and build upon the results of the report. This includes identifying what can be learned from the findings of the report, improving national performance management of data quality, providing support and guidance to trusts and assuring data quality through accreditation and audit.
NHS Prescribing Budgets
Lord Smith of Leigh asked Her Majesty's Government:
- What is the extent of overspending on National Health Service prescribing budgets for 2001–02 by region; and what factors have caused this overspending. [HL3603]
Lord Hunt of Kings Heath: The following table sets out the prescribing budgets notified to the Prescription Payment Authority by each regional office. The forecasts are based on prescribing data up to and including January 2002 data.
| Region | 2001–02 Budget £ | 2001–02 Forecast Outturn £ | Estimated Overspend % |
| Eastern | 545,768,187 | 593,207,432 | 8.69 |
| London | 666,212,093 | 703,050,751 | 5.53 |
| North West | 781,108,913 | 858,061,781 | 9.85 |
| Northern & Yorks | 705,871,356 | 755,266,274 | 6.99 |
| South East | 860,125,542 | 929,845,669 | 8.10 |
| South West | 513,113,427 | 546,477,057 | 6.50 |
| Trent | 544,133,472 | 593,951,721 | 9.15 |
| West Midlands | 563,711,831 | 603,821,485 | 7.11 |
These forecasts are based on practice level prescribing budgets and as such do not necessarily reflect the total resource set aside locally for prescribing as primary care trusts, primary care groups and health authorities may hold contingency reserves. A range of factors, for example national service frameworks, newly licensed drugs and the National Institute for Clinical Excellence recommendations, affects growth in prescribing expenditure.
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