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Cancer

Mr. Streeter: To ask the Secretary of State for Health how much was spent by his Department on (a) publicity, (b) research and (c) treatment relating to cancer in the last year for which figures are available. [963]

Mr. Boateng: In 1995-96 (latest available figures), the Department allocated (a) approximately £200 thousand to publicity, and (b) £9 million to research relating to cancer.

Information about expenditure on treatment relating to cancer is not available centrally.

Mixed-sex Wards

Mr. Simon Hughes: To ask the Secretary of State for Health if he will place in the Library the statistics held by his Department on the extent of (a) mixed-sex wards, (b) mixed-sex bays and (c) mixed-sex bathing and toilet facilities in hospitals, by region. [777]

Mr. Hancock: To ask the Secretary of State for Health when he expects mixed-sex wards to be abolished in the Queen Alexandra and St. Mary's hospitals in Portsmouth; what action he proposes to assist this process; and if he will make a statement. [1216]

Alan Milburn: Information about health authorities target dates to meet the previous Government's three objectives for reducing the incidence of mixed-sex hospital accommodation will be available shortly. I shall arrange for copies to be sent to the hon. Members.

General Practitioner Fundholding

Mr. Bercow: To ask the Secretary of State for Health what is his policy on GP fundholding; and if he will make a statement. [850]

Alan Milburn: I refer the hon. Member to the reply my right hon. Friend the Secretary of State gave the hon. Member for Romsey (Mr. Colvin) on 20 May at columns 495-96.

Private Health Insurance

Mr. Llew Smith: To ask the Secretary of State for Health what discussions he has had with the Chancellor of the Exchequer on the implications of the removal of tax relief on private health insurance plans. [862]

Mr. Colvin: To ask the Secretary of State for Health what is his estimate of the extra cost to the NHS from having to care for elderly patients unable to continue subscribing to private patients insurance schemes, because of the loss of tax relief on their premiums. [1109]

Alan Milburn: Tax relief has not been removed from private health insurance premiums.

Measles, Mumps and Rubella Vaccine

Mr. Simon Hughes: To ask the Secretary of State for Health what assessment his Department has made of (a) the safety of the MMR vaccines and (b) the links the vaccines have with the development of autism in children; what representations he has received from abroad about the potential link with autism; what assessment he has made of the regulatory action which has been taken by other countries; and if he will make a statement. [1026]

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Ms Jowell: Before measles, mumps and rubella (MMR) vaccination was introduced into the United Kingdom's immunisation programme in 1988, there was extensive long-term experience of its use in many other industrialised countries. The United States had been using MMR vaccine routinely since the early 1970s and around 100 million doses have been administered. Prior to the introduction of MMR in the UK a study involving 10,000 children was conducted to look at the safety of the vaccine. By the time of the UK introduction of a two-dose programme in 1996, there was extensive experience of two-dose programmes in many other countries. A two-dose programme of MMR in place in Finland since 1982 has led to the elimination of these diseases from that country. The vaccine was reported to have an excellent safety record. All the relevant data were considered by the independent expert advisory group, the Joint Committee on Vaccination and Immunisation, which advises the UK Secretaries of State for health on vaccination matters, before it made its recommendations for the introduction of MMR and subsequently the introduction of the second dose of MMR.

The Department of Health and other international authorities are not aware of any scientific evidence supporting a link between MMR vaccine and autism. We have received no representations from abroad on this matter, although we are aware that the Danish authorities have looked at the possibility of a link in the past, but found no evidence to support it. Similarly, the Institute of Medicine in the US reviewed more than 7,000 abstracts and read over 2,000 books and articles on adverse reactions to vaccines and found no work which suggested a link between MMR vaccine and autism. We are not aware of any regulatory action taken by other countries on this issue.

A study conducted in Gothenburg, Sweden, looked at the incidence of autism over a ten-year period during which MMR vaccine was introduced into the childhood immunisation programme. The incidence of autism was unaffected by the introduction of MMR vaccine.

All reported adverse reactions to vaccines are carefully monitored both by the Committee on Safety of Medicines and the Joint Committee on Vaccination and Immunisation which advise the UK health departments. No vaccine is issued in the United Kingdom unless it passes the highest standards for quality, and parents should have confidence that the vaccines that are provided are both safe and efficacious. MMR immunisation remains the safest way for parents to protect their children against these diseases.

Mr. Smith: To ask the Secretary of State for Health if he will establish a review of (a) the effectiveness of and (b) side effects arising from the most recent national MMR vaccination campaign. [865]

Ms Jowell: The effectiveness of, and side effects arising from, the 1994 measles/rubella (MR) school-based immunisation campaign have been carefully reviewed. Copies of "One Year On", a review of the MR campaign published in November 1995, are available in the Library.

The campaign was very successful. Around 7 million children between the ages of 5 and sixteen were targeted and 92 per cent. were immunised. The predicted epidemic was averted. Since the campaign measles has become

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rare. The number of notified cases of measles fell from between 10,000 and 20,000 per year between 1990 and 1994 to 7,768 in 1995 and 5,878 in 1996. Notified cases have been tested to confirm whether they are true cases of measles using a salivary testing technique developed by the Public Health Laboratory Service (PHLS). In 1996, 3,274 of the 5,878 notified cases were tested and measles was confirmed in 63 (1.9 per cent.) of those tested. The number of confirmed notifications of measles in 1996 was the lowest recorded. (PHLS "Communicable Disease Report" (Vol. 7, No. 6, 7 February 1997)). There are good grounds to believe that a sizeable proportion of the few confirmed cases arise from importations. As a consequence of the MR campaign, indigenous measles is now close to elimination.

Suspected adverse reactions to the MR vaccine were reported by doctors to the Medicines Control Agency (MCA) under the voluntary 'yellow card' reporting system. Doctors were reminded on three separate occasions by the Chief Medical Officer to report all suspected adverse reactions to MR vaccine. The Committee on the Safety of Medicines carefully reviewed all the reports received and reports of serious adverse reactions following the MR campaign were very rare (0.007 per cent. of all those immunised). Full information on suspected adverse reactions reported as a consequence of the campaign were published in the MCA's "Current Problems in Pharmacovigilance" (Vol. 21, November 1995), copies of which are available in the Library.

Mr. Smith: To ask the Secretary of State for Health if he will commission a study to evaluate the possible links between the administration of MMR vaccines and the incidence of Crohn's disease in children. [964]

Ms Jowell: The United Kingdom health departments are advised on all matters concerning immunisation by the independent expert advisory committee, the Joint Committee on Vaccination and Immunisation (JCVI). The JCVI has already studied the putative association between Crohn's disease and measles on three recent occasions and members of the Committee have met the researchers who have suggested such an association. The Committee was of the view that work suggesting such an association was not convincing and increasing evidence was becoming available that there was not an association between exposure to measles virus or MMR vaccine and Crohn's disease. The World Health Organisation also has seen the published research and rejects the theory that there is a link.

This issue will be kept under review by the JCVI.

A list of references showing work done around the world not supporting the theory of a link between measles and Crohn's disease has been placed in the Library.

Long-term Care for the Elderly

Mr. Colvin: To ask the Secretary of State for Health when he last met the local government associations to discuss the provision of long-term care for the elderly; and if he will make a statement. [849]

Paul Boateng: I met the Local Government Association on 12 May to discuss a range of issues including the priority we will give to improving provision of long-term care for the elderly.

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