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Lord Clement-Jones asked Her Majesty's Government:
- In the light of the fact that many other governments in Europe have either banned or removed fresh frozen plasma and methylene blue-treated plasma from their markets, whether they believe that all transfusion plasma products available in England and Wales should be evaluated by the National Institute for Clinical Excellence (NICE); and[HL5700]
Given that the licence for methylene blue-treated fresh frozen plasma was not renewed by the Paul Ehrlich Institute in Germany due to safety concerns, and that it has also been banned or removed from the market in a number of other European countries, why methylene blue-treated fresh frozen plasma is advocated for use in children and others by the National Blood Service.[HL5701]
Lord Hunt of Kings Heath: We have no plans to refer the use of transfusion plasma to the National Institute of Clinical Excellence for evaluation. This issue falls within the remit of the United Kingdom expert advisory committee on the Microbiological Safety of Blood and Tissues for Transplantation (MSBT). MSBT seeks specialist advice where necessary or includes the relevant specialists among its members.
The methylene blue photoinactivation system for fresh frozen plasma is a registered medical device under the Medical Devices Directive and has a European safety (CE) marking. Methylene blue has been administered in medical practice since 1900, and in much larger doses (many thousand-fold) than the National Blood Service (NBS) will be using. The NBS will be removing more than 90 per cent of the methylene blue before the fresh frozen plasma is issued to National Health Service hospitals.
National Blood Authority
Lord Clement-Jones asked Her Majesty's Government:
- How much financial support they have provided to the National Blood Authority over the past three years; and whether they will ensure that the full consolidated accounts of the National Blood Authority are published in the future.[HL5702]
Lord Hunt of Kings Heath: The Government have provided central funding to the National Blood Authority (NBA) as follows:
| Revenue (£ million) | Capital (£ million) | |
| 1999–2000 | 17,127 | 18,715 |
| 2000–2001 | 17,257 | 11,500 |
| 2001–2002 | 46,550 | 16,149 |
The published annual reports of the NBA contain financial statements in summary form. Each report states that a full set of accounts can be provided by NBA on request.
A full set of NBA Accounts for 2000–01 will be placed in the Library.
Lord Marlesford asked Her Majesty's Government:
Lord Hunt of Kings Heath : The main agency through which the Government support medical and clinical research is the Medical Research Council (MRC) which receives its grant-in-aid from the Department of Trade and Industry via the Office of Science and Technology. The MRC's funding decisions are set largely by scientific considerations, that is the quality of the scientific opportunity and the likelihood of significant development. But health needs are also important in terms of, for example, the burden of disease and the potential for health gain.
The MRC does not, as a rule, earmark funds for particular topics. Research proposals in all areas compete for the funding available. When appropriate,
The same considerations are used by other government providers of support for medical research, which include the other research councils and the devolved administrations as well as the Department of Health. The Department is committed to increasing its expenditure on directly commissioned research into prostate cancer to £4.2 million a year by 2003–04. In addition, an unquantifiable proportion of government expenditure on cancer research is spent on research that is relevant to many types of cancer, including prostate.
Baroness Byford asked Her Majesty's Government:
Lord Hunt of Kings Heath : We are not aware that the facilities available for prion testing in the Republic of Ireland are more advanced than those available in the United Kingdom.
Lord Hunt of Wirral asked Her Majesty's Government:
What is their response to the view of the manager of the Mental Health Act Commission team that the new security directions at Broadmoor are omnipresent and demoralise both staff and patients.[HL5762]
Lord Hunt of Kings Heath: Government policy with regard to the provision of high security psychiatric services is to secure the safety of the public, staff and patients, and to ensure that the best possible services are offered to patients who need to receive their care and treatment in a high security setting. The three high security hospitals must achieve an appropriate balance between therapy and security.
The safety and security directions were originally introduced as a result of the findings of the committee of inquiry into the Personality Disorder Unit, Ashworth Special Hospital (Fallon inquiry) that reported in 1999. They were amended in the light of recommendations arising from the review of security at the high security hospitals that was published in 2000. The directions were designed to address significant security shortcomings and inconsistencies identified across the three high security hospitals and
Following the Fallon inquiry, an additional £6.3 million was made available to increase staffing in the three hospitals. At Broadmoor Hospital this has allowed an additional 100 full-time equivalent nurses to be recruited and sufficient occupational therapists to achieve input to each clinical team. This has enhanced the range of therapeutic interventions available for patients.
Lord Chan asked Her Majesty's Government:
Lord Hunt of Kings Heath: Recent guidance following Shifting the Balance of Power indicates that the lead commissioning of specialist services is the collective responsibility of all primary care trusts (PCTs). PCTs are expected to collaborate with neighbouring PCTs to commission services and work as part of consortia.
Within the North West there are three PCT led specialist commissioning teams, one covering each of the three strategic health authority areas. Specialist children's services are included in the work of these teams.
Resources and plans for these services are included in the service and financial framework process, which begins when the planning and priorities guidance is issued in the autumn.
Baroness Finlay of Llandaff asked Her Majesty's Government:
Lord Hunt of Kings Heath: Strategic Health Authorities are responsible for performance managing Primary Care Trusts and National Health Service trusts in their area. Decisions about exact configurations of services are a local matter, in the context of national guidance. PCTs are responsible for commissioning services for their populations, and they are accountable to their StHA for discharging this function effectively. In our previous reply to the noble Baroness on 28 August (HL5685) we also emphasised the importance of a multi-disciplinary approach to mental healthcare and treatment. We know that
Baroness Gould of Potternewton asked Her Majesty's Government:
What plans they have to implement an action plan to address epilepsy-related death; and[HL5509]
What plans are in place to ensure that Primary Care Trusts will act following the National Institute for Clinical Excellence recommendation in its summary report of the national audit of epilepsy-related death that local National Health Service clinicians and organisations should establish or review policies of practices regarding the management of epilepsy.[HL5510]
Lord Hunt of Kings Heath: Following publication of the National Sentinel Audit of Epilepsy-Related Death in May we are now considering in full the recommendations of the audit including the issues raised by my noble friend. We expect to develop an action plan later this year to address the key issues, and will consult with interested parties as appropriate. It will need to take account of and feed into a range of other initiatives, including the National Service Framework for Long Term Conditions (NSF), which will have a focus on neurological conditions such as epilepsy.
The National Institute for Clinical Excellence (NICE) published a summary report of the audit. The publication draws the attention of local NHS clinicians and organisations to the need to establish or review policies and practices regarding the management of epilepsy related deaths.
The department is also undertaking a range of other initiatives to improve services for the care and management of people with epilepsy, including asking NICE to develop a clinical guideline (due in summer 2004) for the diagnosis, management and treatment of epilepsy to help address widespread variations in clinical practice and contribute to the improvement of services.
Who allocates government expenditure on different forms of medical research; and on what basis it was decided that the present annual expenditure of taxpayers' money into research on HIV/AIDS should be £21 million and that into prostate cancer £2 million.[HL5752]
Whether the Irish Food Standards Agency's prion testing facilities are more advanced than those available to the United Kingdom Food Standards Agency.[HL5152]
Whether the new security directions at Broadmoor have had an adverse effect on the attempts of the staff to inculcate pro-social attitudes in the patients.[HL5761]
What arrangements have been made to commission specialist services in children's hospitals in the North West of England, and when the commissioning scheme will be published.[HL5682]
How the availability of specialist physiotherapy and occupational therapy services to mental health patients is monitored through strategic health authorities.[HL5684]
Whether the Home office is being consulted on the action plan to address the finding of the national audit of epilepsy-related death that only 13 per cent of port-mortem investigations were adequate; and[HL5508]
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