§ Mr. Meadowcroftasked the Secretary of State for Social Services if he will make a statement on the relative costs per patient needing oxygen treatment of treatment by (a) cylinder and (b) concentrator.
§ Mr. Kenneth ClarkeThe absolute and relative costs of providing oxygen treatment by cylinder or concentrator vary according to the average daily volume of oxygen consumed and the period of time over which the treatment is continued.
Generally, cylinders are shown to be more cost-effective for low-volume consumption and/or short periods of treatment and concentrators for high volume consumption and/or prolonged periods of treatment.
A detailed financial analysis is contained in the North-Western regional health authority's report on the pilot study, a copy of which is in the Library.
§ Mr. Meadowcroftasked the Secretary of State for Social Services if he will estimate the annual cost to the National Health Service of (a) his Department's contracts with the British Oxygen Company for the supply of oxygen cylinders, (b) fees for pharmacists for handling 62W British Oxygen Company cylinders and delivering them to patients and (c) the total cost of both these items since (i) 1968, (ii) 1976 and (iii) 1980.
§ Mr. Kenneth ClarkeThere is no contract between the Department and the British Oxygen Company for the supply of cylinders for the domiciliary oxygen therapy service. Pharmacists make their own arrangements for the purchase, not necessarily from British Oxygen Company, of the oxygen gas required for the domiciliary oxygen service. It is not possible to identify separately the cost of oxygen gas supplied in BOC cylinders from the total cost of oxygen gas, nor is it possible separately to identify the cost of fees paid to pharmacists for delivering BOC oxygen cylinders to patients, without disproportionate cost.
§ Mr. Meadowcroftasked the Secretary of State for Social Services if he will make a statement on the possible use of oxygen concentrators rather than cylinders.
§ Mr. Kenneth ClarkeI refer the hon. Member to my reply to my hon. Friend the Member for Darlington (Mr. Fallon) on 14 February at column157. The financial consultants have now been appointed and their advice is expected shortly.
§ Mr. Meadowcroftasked the Secretary of State for Social Services if he will seek to establish a second source for the supply of oxygen to the National Health Service; and if he will make a statement.
§ Mr. Kenneth ClarkeThere are already at least two suppliers of oxygen to the National Health Service apart from the British Oxygen Company and it is open to any manufacturer or supplier of oxygen to compete for NHS business. I am expecting to receive the results of a review of arrangements for the supply of domiciliary oxygen under the NHS by Arthur Andersen, the accountants, very shortly. A Health Service supply council study group are examining arrangements in the hospital service.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will make a statement on the findings of (a) "Clinical Experience with Oxygen Concentrators", published in the British Medical Journal, volume 287, a copy of which has been sent to him, (b) the supply division report on medical gases in the National Health Service, and (c) the North-Western regional health authority report No. 4/9/176 on domiciliary oxygen concentrators.
§ Mr. Kenneth ClarkeThese findings concerning the use of concentrators for patients who have a need for very high volumes of oxygen are a useful addition to the other information which will be taken into account when the arrangements for the supply of oxygen are considered following the completion of the financial consultancy study on the domiciliary service.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services what are the latest figures available to him about the relative costs of oxygen cylinders and oxygen 63W concentrators in the provision of long-term domiciliary oxygen therapy; if he will give his estimate of the number of patients who could be given such treatment for the same sum of money as spent at present for (a) oxygen cylinders and (b) oxygen concentrators; and if he will make a statement.
§ Mr. Kenneth ClarkeThe latest available figures on relative costs are those contained in the North-Western regional health authority's report on the pilot study of oxygen concentrators. The number of patients who could be treated within a given sum of money would depend on the level of oxygen consumption of each patient and cannot be estimated.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services why his Department has recently appointed a consultant to work out the cost-saving benefits of oxygen concentrators; if his Department has rejected previous reports into cost savings by the use of oxygen concentrators; and if he will make a statement.
§ Mr. Kenneth ClarkeWe have appointed Arthur Andersen and Co., to advise Ministers on the cost-effectiveness of the present arrangements and any possible alternatives for the supply of domiciliary oxygen. We need its advice before deciding on the soundest economic method of providing oxygen therapy taking into account the cost-saving benefits which could accrue from introducing concentrators.
Numbers of deaths from hypothermia and respiratory disease at ages 65 and over, December and March quarters 1978 to 1983 Cause Year and quarter 1978 1979 1980 1981 1982 1983 December March December March December March December March December March December Hypothermia (all mentions) 121 492 91 276 127 290 198 354 112 250 *89 All respiratory diseases 16,766 26,951 17,301 23,204 18,535 24,458 18,996 26,922 18,387 27,647 † Chronic bronchitis 3,854 6,100 3,626 5,017 3,573 4,507 3,403 4,641 2,980 4,202 † Pneumonia 11,059 18,044 11,773 15,302 12,545 16,441 12,861 18,004 12,282 18,325 † Infuenza 99 507 49 146 113 437 74 391 94 631 † All other respiratory diseases‡ 1,754 2,807 1,818 2,739 2,304 3,073 2,658 3,886 3,031 4,489 † * Provisional † Not yet available ‡Includes acute bronchitis