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Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health, pursuant to his reply to the hon. Member for Ynys Mo n on 29 November, if he will list those district health authorities in England from which he has received reports of vacancies for qualified pharmaceutical staff.
Mrs. Currie : Leicestershire health authority is currently consulting on proposals to close maternity services at Rutland memorial hospital. Since these proposals could come to Ministers for a decision if agreement cannot be reached locally, it would not be appropriate for me to comment on this at present.
Mr. Kenneth Clarke : We have now completed consideration of comments arising from consultation on the report of the working group on the monitoring and surveillance of HIV infection and AIDS (the Smith report). Assisted by these comments we have reached a decision on anonymous and named screening for HIV. We are grateful to the large number of organisations which have let us have their comments. Anonymous screening is the testing under conditions of total anonymity, for HIV infection of blood from patients who have voluntarily given it for other tests, but who have not specifically consented to an HIV test. Before any of the blood taken is tested for HIV identifying details are removed from the blood sample so as to render the test wholly anonymous. The balance of scientific opinion strongly favours such testing as the best way to obtain information about the overall prevalance of HIV infection by age and sex in the various parts of the country, and the rate at which it is spreading in the population at large. The Cox report, on short-term prediction of HIV infection and AIDS in England and Wales, which was published on 30 November, explicitly recommends anonymous testing.
The Government see no legal obstacle to such testing. From the layman's point of view, we also see no ethical objections to the testing for scientific purposes of blood samples taken property in the first place for another purpose from a patient no longer identifiable.
We are therefore inviting the Medical Research Council to bring forward proposals within three months for a programme of anonymous screening.
The Smith report recommended setting up large scale named antenatal studies, which the report believes should
Column 438play an important role in identifying how far the infection has spread beyond the at-risk groups. Two such studies have been already announced and have begun in Dundee and Edinburgh. These studies are extremely important because of the higher prevalence of HIV in drug abusers in Scotland. We accept in principle the case for a programme of named studies in England as recommended in the report but believe many important matters of detail as to scale and groups to be tested need to be determined. It is of course essential that the patients in these tests are volunteers who have been advised fully before the test and will if they wish to be told the results afterwards. We are therefore asking the MRC to let us have detailed proposals on such studies within three months. Further named studies will enable comparisons to be made of the results of surveys based on anonymous testing and on named testing.
The Smith report made a number of other useful recommendations concerning epidemiological studies of particular groups and improvements to the collection and collation of data. These recommendations were generally welcomed and we are asking the MRC, public health laboratory service and other bodies concerned to take them forward. £1.7 million has been made available to the MRC in 1989-90 for research into the spread of HIV infection and AIDS including such studies. The adequacy of this sum will be kept under review.
Mr. Strang : To ask the Secretary of State for Health what steps he will take to ensure that the reporting of positive HIV test results is covered by the confidentiality provisions of paragraph 3 of the schedule to the AIDS (Control) Act 1987 ; and when he expects the reports under the Act to be published.
Mr. Mellor : Under the AIDS (Control) (Contents of Reports) (No. 2) Order 1988, the reporting of positive HIV test results in the reports required under the AIDS (Control) Act 1987 are covered by the confidentiality provisions of paragraph 3 of the schedule of that Act. Under section 3 of the Act, the reports have to be published by the health authority or board by which they are made. All the reports for the period April 1987 to March 1988 are now available.
Mr. Bermingham : To ask the Secretary of State for Health (1) what is the current annual cost to the national blood transfusion service of the use of existing tests to identify antibodies of the HIV-2 virus ; and if he will make a statement ;
(2) what is (a) the number and (b) the proportion of total blood donors currently screened in respect of the HIV-2 virus ; and if he will make a statement ;
(3) what would be the cost to the national blood transfusion service of full-scale testing of blood from all donors in respect of the detection of HIV-2 virus ; and if he will make a statement.
Mr. Mellor : Potential blood donors are given preliminary screening by medical questionnaire. Donations from those who are accepted are routinely tested for HIV-1 and other diseases at the regional transfusion centres of the national blood transfusion service. Since June 1988 samples of donations from donors who have visited specified West African countries where HIV-2 is more common have been referred to the public health laboratory service for testing for antibodies to HIV-2.
Column 439Of the donations collected between June and November 1988 around 4,500 (0.4 per cent.) have been tested and all have been found negative. The cost of these tests is not readily identifiable. It is not possible to give the precise cost of testing all donations for HIV-2 because an evaluation programme to identify a suitable test for use by the NBTS has not yet been completed. However, it is estimated that testing all blood donations for antibodies to HIV-2 would cost the NBTS between £1 million and £2 million annually. The need for testing on a wider basis is kept under constant review.
(2) if his Department will make moneys available to regional health authorities in order that they may carry out locally based advertising campaigns alerting women to any rights they may have in regard to compensation for injuries caused by the Dalkon shield ; (3) how many British women have, to the knowledge of his Department, registered claims for compensation against the manufacturers of the Dalkon shield ;
(4) if he will list in the Official Report any publicity conducted by the manufacturers of the Dalkon shield in the United Kingdom.
Mrs. Currie : In the years following their voluntary withdrawal of the Dalkon shield from the United Kingdom market, the manufacturers A. H. Robins have written to doctors on a number of occasions and have placed advertisements in the women's press. In early 1986 the company conducted media publicity, in accordance with the directions of the United States bankruptcy court, to publicise the deadline of 30 April 1986 for filing claims. We understand that claims were subsequently received from over 3,000 British women.
We are aware of no subsequent court directions on publicity but we understand that a trust established in the United States has set aside compensation funds for claims received before 31 December 1988 which are successful.
Decisions about funding local advertising campaigns are for individual health authorities.
Mrs. Currie : The latest available data for mortality by month of occurrence and age are shown in the table ; figures for 1988 are provisional, and the later months in particular are likely to be affected by late registration.
Number of deaths by month of occurrence, aged 75 and over, September 1987 to August 1988 England and Wales Month of occurrence |Males |Females |Persons ---------------------------------------------------------------------------------------------------- 1987 September |9,192 |13,353 |22,545 October |10,557 |15,613 |26,170 November |10,488 |15,337 |26,025 December |12,516 |18,314 |30,830 1988 January<1> |12,394 |18,275 |30,699 February |11,558 |16,889 |28,447 March |12,380 |18,998 |31,378 April |10,621 |16,057 |26,678 May |10,005 |14,891 |24,896 June |9,497 |14,054 |23,551 July |9,556 |13,869 |23,425 August |8,844 |13,181 |22,025 <1>Provisional.
Mr. Thurnham : To ask the Secretary of State for Health what progress is being made at the blood products laboratory at Elstree towards meeting the needs of haemophiliacs in England and Wales for factor VIII.
Mrs. Currie : The £60 million blood products laboratory is now producing factor VIII at record levels, but it is not yet possible to predict when we shall no longer need to import factor VIII. Yields so far are lower than expected though higher than the commercial producers', and a reappraisal of the buffer stock of plasma has shown it to be less than previously thought. Action is being taken by the central blood laboratories authority to increase yields and by the blood transfusion service to increase the collection of plasma which will lead to higher output over the next three years.
Mr. Ashley : To ask the Secretary of State for Health if his Department has any information on diagnostic tests for multiple sclerosis which involve applied kinesiology and which can identify foods or other factors to which sufferers are allergic.
Mrs. Currie [holding answer 1 December 1988] : Kinesiology is an alternative medical technique. There is no evidence of the value of applied kinesiology as a diagnostic test for multiple sclerosis. There are already effective diagnostic tests for this disease. There is no convincing evidence that diet has any role in precipitating or affecting the course of mutiple sclerosis. It is advisable for people with mutiple sclerosis to pay the same attention to diet and allergic reaction as other people.
Mr. Hoyle : To ask the Secretary of State for Health if he will list the money awarded for regrading to each district health authority in the Merseyside and north-west health region ; if he will publish a list showing how nurses were regraded in each district health authority in the Merseyside and north-west region and the criteria used ; and if he will specify (a) the amount of money allocated to Warrington health authority and the national average sum allocated to health authorities, (b) the grades awarded in the Warrington health authority and those awarded nationally, (c) the criteria for grading used by the Warrington health authority and those used nationally and (d) the national average pay rise for nurses resulting from regrading.
Column 441individual district health authorities, I refer the hon. Member to my reply to my hon. Friend the Member for Staffordshire, Moorlands (Mr. Knox) on 1 December. All health authorities have carried out the regrading process in accordance with the grading definitions agreed in the Nursing and Midwifery Staffs Negotiation Council and the national guidance subsequently issued by my Department.
The national average increase in the pay bill arising from the nurses' pay award is 17.9 per cent including London supplements. Outside London, the average increase is 16.8 per cent.
The total allocation for the cost of the nurses pay award in England was £731 million, of which £34.9 million was allocated to Mersey regional health authority. These figures were based on regions' own estimates of the extra cost of regrading. Allocation of funds to districts is a matter for regional health authorities, and we do not hold figures centrally. For further information the hon. Member should consult the chairman of Mersey regional health authority.
Mr. Meacher : To ask the Secretary of State for Energy how many oil rigs have ceased operation as a result of the flexible hose in blow-out prevention equipment being found not to be able to withstand pressures of up to 15,000 lb per sq in ; how many rigs in the North sea use this equipment ; and what new advice he is issuing about use of these hoses.
Mr. Peter Morrison : Two oil rigs have ceased operation. There are 23 oil rigs operating or currently available for use in controlled waters on the United Kingdom continental shelf and which are fitted with 15,000 pounds per square inch (psi) blowout prevention systems. The majority of these are engaged in operations where pressures above 10,000 psi will not be encountered.
Column 442My petroleum engineering division has advised oil companies using such equipment at higher pressures to define the maximum temperatures and pressures expected to occur in individual well operations and fully assess them against the flexible hose specifications. If a company is able to provide sufficient evidence to show that it is safe to continue or to resume operations I will consider giving the consent necessary under the terms and conditions of their licence. The division is also consulting interested parties with a view to issuing general guidance about the way in which this equipment should be used to ensure that it is safe at higher pressures.
Mr. Peter Morrison : The Secretary of State could require the removal of debris only in the context of an abandonment programme. As I explained to the House on 30 November Official Report, columns 757 ans 764, before approving an abandonment programme subject to conditions, the Secretary of State must give the persons who submitted the programme an opportunity to make written
representations about the proposed conditions (Petroleum Act 1987 section 4(3)). The conditions which the Secretary of State has proposed should be attached to his approval of the abandonment programme for Piper Alpha include : provisions that following survey, Occidental and its co-venturers shall if required by the Secretary of State move or remove from the sea bed such remains of the installations as he may direct. Given the character and size of the central debris pile and of the jacket members which it is proposed to topple, I do not think that total removal is likely to be practicable. The Secretary of State advised Occidental and its co-venturers on 1 December of the conditions that he proposed to attach to the approval of their abandonment programme.