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Age-Related Macular Degeneration
Earl Howe asked Her Majesty's Government:
- Whether they will ensure that National Health Service patients suffering from "wet" age-related macular degeneration (AMD) have ready access to licensed treatments, including photodynamic therapy with Visudyne, pending the final appraisal determination on such treatments by NICE (National Institute for Clinical Excellence).[HL3969]
Lord Hunt of Kings Heath: The Department of Health issued a circular in August 1999 asking National Health Service bodies to continue with local arrangements for the managed introduction of new technologies where guidance from the National Institute for Clinical Excellence is not available at the time the technology first became available. These arrangements should involve an assessment of all the available evidence.
NICE has published for consultation the initial thoughts of the independent appraisal committee. The consultation concludes on 30 April 2002 and we are expecting guidance to be issued to the NHS in July 2002, provided there are no appeals.
Healthcare Resource Groups
Baroness Noakes asked Her Majesty's Government:
- What proportion of National Health Service (a) acute activity and (b) non-acute activity is covered by health resource groups. [HL3981]
Lord Hunt of Kings Heath: Healthcare resource groups (HRGs) are one of a series of activity measures used as the basis of reference costs. In the 2000–01 financial year, reference costs covered £21 billion of National Health Service expenditure, accounting for approximately 83 per cent. of hospital and community health services expenditure.
HRGs are used primarily for inpatient and day case activity, a limited range of outpatient activity and accident and emergency services. HRGs are also available for some specialised services, for example radiotherapy, but with the development of specialist commissioning some of the HRGs have been superseded to reflect changes in clinical practice, for example bone marrow transplantation. Where these refinements have been introduced, the aim is better to reflect the differences in cost due to casemix.
Overall, 53 per cent. of hospital and community health services and 64 per cent. of reference costs were covered by HRGs and these refinements in 2001–02.
Although HRGs have not been introduced for a range of non-acute services, some non-HRG refinements are planned better to reflect differences in caseload and casemix (for example nursing services for children in 2003).
As with any initiative, the level of coverage is iterative and reference costs are expected to cover 100 per cent. of all hospital and community health services by 2004, although some elements will not be fully casemix adjusted by this date.
Intermediate Care Capacity
Baroness Noakes asked Her Majesty's Government:
- How intermediate care capacity is measured; who is responsible for the creation of such capacity; and how much such capacity exists at present.[HL3982]
Lord Hunt of Kings Heath: Intermediate care capacity is measured in terms of numbers of beds, non-residential places and people receiving services in line with the targets set out in the NHS Plan. Local National Health Service and social services organisations commission intermediate care services, which are provided in a range of settings.
A survey of NHS intermediate care in England conducted last summer indicated the following levels of provision:
| 1999–2000 | 2001–02 | Additional | |
| No of beds | 4,579 | 6,974 | +2,395 |
| No of non-residential places | 8,343 | 14,580 | +6,237 |
| People receiving services | 136,032 | 262,206 | +126,174 |
The full results of the survey, giving data by region and by health authority, are available in the Library.
The Countess of Mar asked Her Majesty's Government:
When they expect the Medical Research Council to be in a position to call for research proposals based upon the recommendations of the independent working group's report to the Chief Medical Officer on chronic fatigue syndrome/myalgic encephalomyelitis. [HL4021]
Lord Hunt of Kings Heath: The Department of Health has asked the Medical Research Council (MRC) to develop a broad strategy for advancing biomedical and health services research on chronic fatigue syndrome (CFS)/ME. The MRC is currently setting up an Independent Scientific Advisory Group to develop that strategy. The terms of reference and timetable will be published on the MRC's website as soon as the group has agreed them. The MRC takes its responsibility in this matter very seriously and will ensure that progress is made as quickly as possible without jeopardising the integrity of the process.
It would be inappropriate at this stage to give a timescale for a call for research proposals or to anticipate any other possible recommendations of the independent advisory group.
However, 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. When appropriate, high quality research in the areas 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.
Lord Donoughue asked Her Majesty's Government:
When they will publish the terms of reference and timetable for the Medical Research Council to produce its broad strategy for advancing biomedical and health services research on chronic fatigue syndrome/myalgic encephalomyelitis following the Government's statement on 11 January; and [HL4020]
Why, in paragraph 4.10 of the Department for Culture, Media and Sport's report A Safe Bet for Success, there is a proposal to allow amusement-with-prizes (AWP) gaming machines generally in unlicensed and unsupervised premises; and whether this is consistent with (a) paragraph 23.12 of the Budd Report (Cm 5207) and (b) market research which suggests that machines in unlicensed premises are opposed by the public.[HL3959]
2 May 2002 : Column WA149
The Minister of State, Department for Culture, Media and Sport (Baroness Blackstone): A Safe Bet for Success (Cm 5397) draws a clear distinction between gaming machines and amusement machines which can offer a small prize. The Government plan that the maximum stakes and prizes in such amusement machines will be 10p and £5.
Gaming machines will be allowed only in on-licensed premises, registered clubs and specific gambling premises. Amusement machines will be allowed, with local authority permission, in other types of premises also. Paragraphs 7.10 to 7.12 of Cm 5397 explain our reasoning.
The report of the Gambling Review Body, chaired by Sir Alan Budd, noted that the research which it had commissioned indicated that most of those questioned did not think that there should be no fruit machines in venues such as cafes, take-away food shops and minicab offices.
Lord Donoughue asked Her Majesty's Government:
- Whether there is any official or reliable information on how many gaming machines operate in the United Kingdom; how much is spent on gaming machines; how many scratch cards are sold; and whether there is any central list of the physical location of operating gambling outlets, or gaming machines, or lottery terminals; and, if not, how
they propose to collate and publish such statistical information, as is required by law in other gambling countries, prior to legislation on gambling.[HL3960]
Baroness Blackstone: A Safe Bet for Success (Cm 5397), which sets out the Government's plans for reforming the controls on the gambling industry in Great Britain, estimates the number of gaming machines in Great Britain at 250,000 and the money retained from them each year by suppliers and site owners at £1.5 billion, gross of tax.
In 2000–01, 546 million National Lottery scratchcards were sold. Information is not readily available about the number of scratchcards sold through society lotteries.
The Gaming Board for Great Britain holds a list of operating bingo clubs and casinos. The locations of betting shops, racetracks and gaming machine arcades are known to their respective licensing authorities but there is no central list of these premises. There is no central list of the location of gaming machines.
The National Lottery operator maintains a list of retailers with its terminals.
A Safe Bet for Success does not propose the publication of a central list of the location of gambling facilities.
Lord Donoughue asked Her Majesty's Government:
- Whether the chairman of the Gaming Board stated on 11 April that amusement-with-prizes (AWP) gaming machines should not be allowed generally in unlicensed and unsupervised premises. [HL4006]
Baroness Blackstone: In his speech to the Gambling Industry Forum on 11 April, the chairman of the Gaming Board said that the board had suggested that AWP machines should be removed from outlets such as cafes and fish and chip shops. Partly because experience showed that such machines were often sited without a permit or were of a type not allowed; and that the problem would remain and enforcment would in practice be difficult.
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