§ 3 p.m.
§ Baroness Gardner of Parkesasked Her Majesty's Government:
What are the latest figures for the number of patients treated as HIV/AIDS in-patients and out-patients in each major London treatment centre and what is the amount of central funding for each of these centres.
§ The Minister of State, Department of Health (Baroness Jay of Paddington)My Lords, the Department of Health allocates funds for AIDS treatment and care to health authorities and not to treatment centres. In the main, information on numbers treated is also collected by the health authority. The latest information from the National Survey of Diagnosed Prevalent HIV infections shows that 8,158 individuals with AIDS or HIV infection were treated in the centres situated within the seven inner-London health authorities.
Data taken from these authorities show that the number of in-patient and day-case episodes for the seven health authorities was 19,345. I am afraid that the comparable data on out-patients are not collected. The funds for AIDS treatment and care are allocated to health authorities on the basis of AIDS case reports made to the Public Health Laboratory Service. The total amount allocated to the seven inner-London health authorities in 1997–98 for AIDS treatment and care is £132 million. As it will take some minutes to repeat the detailed information on each of the seven health authorities, I have already written to the noble Baroness with the information for each of those authorities in inner London. A copy of that letter will be placed in the Library.
§ Baroness Gardner of ParkesMy Lords, I thank the Minister for her reply and for the detailed report she sent me. Unfortunately, it is not current because the figures are a little behind time. Even the report that the noble Baroness has sent shows a great discrepancy between the funding and the number of patients treated within each district health authority.
I declare an interest as a trust chairman. Has the Minister seen the recent report entitled Meeting the Cost of Combination Therapy, which makes clear that the cost per patient of combination therapy varies widely, ranging from £7,000 per patient to £5,500 per patient between major treatment centres in London? In view of the fact that HIV/AIDS patients can choose to be treated 627 at any centre, the actual numbers and cost can only be known after the treatment. Therefore, will the noble Baroness confirm to me the commitment of the previous government to review retrospectively the distribution of treatment and care funding for HIV/AIDS patients in order to see that the two are directly related?
§ Baroness Jay of PaddingtonMy Lords, I thank the noble Baroness for her detailed and helpful commentary on the way this money is distributed. She will be aware that, although the figures I gave were for 1995–96—unfortunately, the current figures are not yet available—there was a rise of 7 per cent. in payments to all inner-London health authorities for combination therapy for 1997–98. There appear to be discrepancies in these costs between the different authorities. I believe that those questions relate to different clinical practices, but they are being looked at by both the health authorities concerned and by the London health regions. We shall consider whether patients should have their charges based on their district of residence rather than where they accept treatment. That will raise questions about confidentiality and open access to the service, which is one of the reasons why our AIDS services have been so successful.
Earl Baldwin of BewdleyMy Lords, given the noble Baroness's Answer to my Question on 19th June to the effect that HIV/AIDS patients are believed to be doing very well on complementary medicine, can she say what funding has been made available in this area?
§ Baroness Jay of PaddingtonMy Lords, no specific funding is made available for complementary medicine. I hope I reassured the noble Earl on the earlier Question that he asked that several of the health authorities are making complementary medicine available to their patients who have HIV and AIDS. In addition, there are a number of voluntary organisations—for example, the London Lighthouse— which offer complementary therapies to the people who come to them and which are funded under Section 64 grants from the Department of Health.
§ Baroness Gardner of ParkesMy Lords, I refer to the reply which the noble Earl received on 19th June. I believe that on that occasion the noble Baroness said that complementary medicine combined with other combination therapies was the practice that she supported on that day. I do not believe that it was 100 per cent. complementary medicine only. Can she confirm that and also my point about looking retrospectively at the balance of money in relation to patients treated while retaining their anonymity?
§ Baroness Jay of PaddingtonMy Lords, I can confirm that I still support the position that I took in response the Question from the noble Earl. I believe that on that occasion the noble Baroness and I were at one in believing that a combination of complementary therapies and what may be described as more 628 conventional drug therapies seemed to produced the best results for people with HIV. As regards the retrospective look at patients and their place of residence and where they are treated, that would be difficult because, as I said before, there is the question of anonymity. However, I shall check with those in the department who may have been working on this matter before. I shall see what the situation is and let the noble Baroness know.
The Earl of ClanwilliamMy Lords, will the Minister accept that there may be some controversy over the relationship between HIV and AIDS? Will she tell the House whether the HIV virus has been isolated and, if so, what is the report of the Medical Research Council to which we can refer to find that information? No doubt the noble Baroness will write to me if she does not have the information to hand.
§ Baroness Jay of PaddingtonMy Lords, I am not a micro-biologist or scientifically qualified in this field. My understanding is that the HIV virus was isolated some 12 to 15 years ago. Personally, I have never accepted the theory that the HIV virus was not connected with HIV infection and AIDS, but, as I say, I speak as a non-scientist.
§ Baroness Miller of HendonMy Lords, will the Minister consider reviewing the allocation of HIV/AIDS funds so that they better match the distribution of the patients at the various centres?
§ Baroness Jay of PaddingtonMy Lords, that is certainly something worth looking at. But, as I said in response to the noble Baroness, Lady Gardner of Parkes, money is not directly given to particular centres. However, we hope that funding allocated to particular inner-London health authorities will be picked up by those centres which are clustered in those inner-London authorities.