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Incontinence: Medical Equipment

Bob Spink: To ask the Secretary of State for Health what his Department’s policy is on maintenance and improvement of the (a) supply systems and (b) quality of stoma and incontinence products for elderly people in (i) residential care homes and (ii) their own homes; and if he will make a statement. [176652]

Dawn Primarolo: In primary care, users of stoma and incontinence appliances listed in part IX of the Drug Tariff are prescribed these appliances whether they live in their own home or a care home. The Department’s policy on maintenance and improvement is set out as follows:

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Supply systems

In primary care, stoma and incontinence appliances which have been prescribed on a FP10 are dispensed by a dispensing pharmacist, dispensing appliance contractor or dispensing doctor. As a related service, patients may also receive home delivery.

However, the Department has consulted on new arrangements for the provision of those appliances and related services in primary care in England. A key objective is that patients should receive the same standard of care no matter where they live. Consequently, one of the proposals is that dispensing appliance contractors and dispensing pharmacists shall, in the normal course of their business, provide a home or care home delivery service in respect of these appliances if the patient desires it.

Quality of stoma and incontinence products

Manufacturers apply directly to the prescription pricing division (PPD) of the NHS Business Services Authority Manufacturers to have these products approved for listing on part IX of the Drugs Tariff.

In assessing whether the product is appropriate for prescribing in primary care, the PPD may require applicants to provide clinical data to demonstrate that the product delivers clinical benefits, and any products required to carry a CE marking must do so. Providing these conditions are met, the PPD also requires that products are safe and of good quality and that they are cost-effective.

In relatively rare cases, the PPD may seek independent advice bearing on these issues although responsibility for the eventual decision will remain with the PPD and the evidence required will depend on the individual application. The need for evidence is likely to be greater if similar products have not been listed before. The PPD may require applicants to provide clinical data to demonstrate that the product delivers clinical benefits.

Lambert Hospital

Miss McIntosh: To ask the Secretary of State for Health when he next plans to visit the Lambert Hospital in Thirsk. [177102]

Ann Keen: The Secretary of State (Alan Johnson) makes regular visits to national health service facilities across the country. Invitations are considered on a case-by-case basis and will depend upon diary pressures and parliamentary business. Therefore, if the hon. Member wishes to, she may send a formal request to Ministers regarding a visit to the Thirsk area.

Macular Degeneration: North Yorkshire

Miss McIntosh: To ask the Secretary of State for Health (1) when he expects more rapid treatment to be available to those living in North Yorkshire for age-related macular degeneration; [175246]

(2) what provision there is for treatment for wet macular degeneration in North Yorkshire. [175376]

Ann Keen: The Yorkshire and Humber Strategic Health Authority reports that the National Institute for Health and Clinical Excellence (NICE) has already recommended the use of photodynamic therapy for
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treating wet age-related macular degeneration (ARMD) in some patients. North Yorkshire and York Primary Care Trust (PCT) is funding this treatment in accordance with the guidelines set out in the latest North Derbyshire, South Yorkshire and Bassetlaw Commissioning Consortium Policy document with which the PCT adheres.

Three new drugs have been identified as possible treatment options for wet ARMD. These drugs are Macugen (Pegaptinib), Lucentis (Ranibizumab) and Avastin (Bevacizumab). NICE is currently carrying out an appraisal of Lucentis and Macugen and expects to publish final guidance in the new year. NICE published draft guidance on 14 December 2007, which is now subject to consultation with stakeholders. Avastin is not included in the appraisal, as it is not licensed.

Where NICE has not issued guidance, PCTs are expected to make their own decisions on the funding of specific treatments based on an assessment of the available evidence.

Medical Equipment: Procurement

Mr. Spellar: To ask the Secretary of State for Health if he will take steps to ensure that the 34 million disposable respirators and 350 million surgical face masks he is purchasing are bought from companies in the UK. [170200]

Mr. Bradshaw: The tender for the procurement of the 34 million disposable respirators and 350 million surgical face masks has not commenced at this stage.

In purchasing goods and services for the national health service, the Department is subject to all European Union public procurement regulations. The rules compel the Department to advertise and award any proposed contract in accordance with the legal procedure set out in the regulations. This ensures that the process is fair, transparent and non-discriminatory. It would be a breach of this legislation to ensure the products were only supplied by companies in the United Kingdom.

Mr. Jim Cunningham: To ask the Secretary of State for Health how much the Government has spent on updating hospital equipment since 1997. [175594]

Mr. Bradshaw [holding answer 7 January 2008]: The Department does not collect information on hospital equipment spend centrally. A decision on the procurement of hospital equipment is made at a local level.

Medical Records: Data Protection

Mr. Stephen O'Brien: To ask the Secretary of State for Health if he will publish all documents of (a) his Department and (b) Connecting for Health on the review into the possibility of NHS patient data being processed overseas by approved organisations. [172905]

Mr. Bradshaw: A reference to a ‘review’ was made in an unrestricted operational guidance document made widely available to the NHS by NHS Connecting for Health in March 2006. This was subsequently wrongly described in media reports as a leaked document. However, no such formal review has taken place and
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the reference was in respect of a general question asked by some suppliers as to whether patient data in respect of the National Programme for IT (NPfIT) could be held abroad. It was subsequently confirmed to all suppliers that there was no change to the policy that NPfIT patient data should not be held or processed overseas. The guidance document concerned has been reissued with the reference removed but there is no ‘review’ documentation to publish.

Medical Records: Databases

James Brokenshire: To ask the Secretary of State for Health how many people he expects to have access to the entire content of the NHS Medical Records Database. [167986]

Mr. Bradshaw: The security measures controlling access to national health service care records service clinical records are set at the Cabinet Office standard e-Government Interoperability Framework level 3, with access restricted to only those with a legitimate relationship with the patient, and further role-based access restrictions to specific information. It follows, therefore, that no one will have access to the entire content of the database.

In exceptional circumstances, when required by law, specialist staff may, for example, be authorised to access records without there being a clinical relationship with the patient or patients concerned. Theoretically these staff could be authorised to access any individual record within the database, but all such access is for specific purposes and in tightly controlled circumstances.

Jeremy Wright: To ask the Secretary of State for Health whether the provisions of section 10 of the Data Protection Act 1998 can be applied to the processing of data on any component of the national care records database; and whether this could include a patient requirement not to record clinical information on a database that can be accessed by users who are not directly involved in their care. [168954]

Mr. Bradshaw: Requests made by patients under the provisions of section 10 of the Data Protection Act 1998 must be considered on a case by case basis. For section 10 to apply, the data in question must be personal identifiable data and processing must not be subject to a legal requirement or other exception set out in the Act. Patient contact details held as part of the National Health Service Care Records Service (NHS CRS) are subject to legal requirements so are exempt from the section 10 provisions. Clinical information held nationally is not exempt from the section 10 provisions, but this information can only be accessed by NHS CRS users directly involved in the patient’s care.

Information is added to the national system in a number of different ways, some by deliberate clinical decision and some by automated processes. In some cases local organisations able and willing to accede to a request under section 10 may be able to withhold information from record systems. In other cases the record is created as a consequence of the treatment or action that takes place, for example the creation of an x-ray image in the new digital picture recording
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systems, and a section 10 request could only be considered after the event. In the case of the summary care record, which is fed by both clinical decision and automated processes, patients may elect not to have a summary care record or to impose access controls upon it so that information is only shared either with their consent, when anonymised, or where required by law.

Medical Treatments Abroad

Mr. Lansley: To ask the Secretary of State for Health how much of the £526,700,000 in claims made against the UK in respect of European Economic Area (EEA) claims for medical treatment was claimed by each EEA member state in the year 2006-07. [178056]

Dawn Primarolo: The following table shows the claims for medical treatment made against the United Kingdom by other European Economic Area member states by country of claim.

EEA Healthcare Cost Claims
Member states claims against UK £000



























Note: Totals are rounded to nearest 10,000.

Medical Treatments Abroad: France

Mr. Streeter: To ask the Secretary of State for Health if he will extend the E106s of British citizens currently living abroad in France, so they will not have to obtain private medical insurance to access healthcare following a change in French law. [177912]

Dawn Primarolo: Under European Union regulations if someone moves to another European Economic Area country to live they are entitled to health care paid for by the United Kingdom in the following circumstances only:

In addition the UK does under certain circumstances pay the health care costs for a limited period of those people who move abroad before they are in receipt of their pension. (An E106 will be issued by the UK). There are no plans to extend this entitlement.

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Members: Correspondence

Mr. Grieve: To ask the Secretary of State for Health when a reply will be sent to the hon. Member for Beaconsfield’s letter of 30 July 2007 to the Parliamentary Under-Secretary of State responsible for Care Services on the SIGN charity in Beaconsfield constituency. [178005]

Mr. Bradshaw: A reply was sent on 23 August 2007.

Musculoskeletal Disorders

Harry Cohen: To ask the Secretary of State for Health what support is available to employers to ensure patients with musculoskeletal disorders access early diagnosis and treatment to remain in work. [177048]

Ann Keen: We are not aware of any support available to employers to ensure patients with musculoskeletal disorders have access to early diagnosis and treatment to remain in work.

National Institute for Health and Clinical Excellence

Mr. Harper: To ask the Secretary of State for Health what assessment he has made of primary care trusts' compliance with (a) his Department's and (b) the National Institute for Health and Clinical Excellence's guidelines that three cycles of in vitro fertilisation should be provided to couples by the NHS. [177231]

Dawn Primarolo: In response to a survey carried out by the Department in autumn 2007, approximately one third of primary care trusts (PCTs) report that they are offering at least one fresh cycle of in vitro fertilisation to eligible patients, just over a third report one full cycle of fresh plus frozen embryos, and a third report two cycles or more. A very small number report a temporary suspension of the service. We are working with the patient support organisation Infertility Network UK to help PCTs share best practice in the provision of fertility services and move to the implementation of the National Institute for Health and Clinical Excellence recommendations. To build on the progress being made we are establishing an expert group to advise the project and consider how to help PCT commissioners.

NHS: Disclosure of Information

Mr. Stephen O'Brien: To ask the Secretary of State for Health what policies his Department has for making data collected by the NHS available to the pharmaceutical industry; what assessment he has made of the effectiveness of these policies; and if he will make a statement. [170073]

Mr. Bradshaw: Any requests for national health service data from the pharmaceutical industry are treated in the same way as other requests from outside the NHS.

NHS: Finance

Andrew George: To ask the Secretary of State for Health what progress has been made in reviewing the
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impact of the market forces factor on (a) the overall NHS funding formula and (b) overall budgets of NHS trusts. [176052]

Mr. Bradshaw: The Advisory Committee on Resource Allocation (ACRA) continually oversees the development of the weighted capitation formula. ACRA’s current work programme includes a review of the market forces factor (MFF). The review of the MFF will also inform the MFF adjustments made to providers of national health service services paid for through the national tariff.

Although ACRA has made good progress on some major aspects of its work programme, it has requested, and been granted, additional time to finalise the work that it is doing to review the formula. Given the importance of the weighted capitation formula it is crucial that ACRA has the time required to produce a robust and transparent formula.

Only when this work programme is completed will ACRA finalise its recommendations to Ministers on potential changes to the funding formula. Ministers will then look at all of ACRA’s recommendations and decide how to take these recommendations into account when making allocations to primary care trusts (PCTs) for 2009-10 and 2010-11.

We will inform providers and PCTs of the changes to the formula, and the revenue allocations as soon as is practically possible after the completion of ACRA’s work programme. The aim is to announce revenue allocations to PCTs for 2009-10 and 2010-11 by the summer 2008. The MFF indices applied to providers of NHS services paid for by the national tariff were published on the Department’s website on 13 December as part of the national tariff package for 2008-09, and are available at:

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