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Diesel Engine Emissions

Mr. Dalyell: To ask the Secretary of State for Health what assessment he has made of the impact on health of a reduction in the use of diesel engines in urban areas. [71110]

Ms Jowell: Diesel engines are a major source of particles, particularly in urban areas and especially when air quality is poor. Particles have serious effects on health. The Report on the "Quantification of Health Effects of Air Pollution in the United Kingdom" published in 1998 by the Committee on the Medical Effects of Air Pollutants (COMEAP) estimated that up to 8,100 people who are already very ill have their deaths brought forward each year in urban Great Britain as a result of exposure to particles and that they are also responsible for up to 10,500 admissions to hospital for respiratory conditions. A proportion of these will be the result of exposure to particles from motor vehicles and from diesel. The measures set out in the review of the United Kingdom National Air Quality Strategy published last month, including the agreement in Europe for tighter limits on vehicle emissions and improved fuel quality under the Auto Oil programme, will lead to reductions in levels of particles in the UK.

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The relative merits of petrol-driven cars and light vehicles over diesel equivalents in urban areas was discussed at a meeting of COMEAP on 19 February and a full statement on this subject will be issued by the Committee shortly. In arriving at a conclusion, the Committee was unable to take account of the indirect effects of vehicle-generated air pollutants on health, such as climate change; it is also based on current knowledge and recognises that future technological improvements may mean the position will need to be reassessed at some future date. Nevertheless, it concluded that because of the damage to health from particles, at the present time petrol vehicles would be preferred to diesel where the majority of a vehicles' journeys take place in urban areas.

Internet Connections

Dr. Harris: To ask the Secretary of State for Health (1) if he will estimate the costs to (a) the Government, (b) hospitals and GPs' surgeries and (c) local authorities, of connections to the Internet for hospitals and GPs' surgeries to date; [71987]

Ms Jowell: Direct connection to the Internet by hospitals and general practitioners' surgeries is a matter for individual agreement between the National Health Service user and the Internet service provider. No information is collected or held centrally on the number of capital and running costs of such links.

A secure route to the Internet is available for hospitals and GPs' surgeries through the NHS's own intranet, NHSnet, and the additional cost of this service is between £340 and £400 a year for each NHS organisation. The costs of these connections are met by the individual NHS user organisations.

Dr. Harris: To ask the Secretary of State for Health (1) how many times he has met representatives of BT to discuss Internet connections to hospitals and GPs' surgeries; [71988]

Ms Jowell: My right hon. Friend the Secretary of State has not met representatives of British Telecom to discuss Internet connections to hospitals and general practitioners'

24 Feb 1999 : Column: 352

surgeries, nor has he received representations from BT, other service providers, hospitals and GPs' surgeries or local authorities on Internet connections.

Mental Health Services

Helen Jones: To ask the Secretary of State for Health if he will (a) list the (i) number of working groups currently considering a national framework for mental health services and (ii) the names of those serving on each group and (b) state how many members of the (1) Black and (2) other ethnic minority communities are on each group. [72283]

Mr. Hutton: There were eight sub-groups contributing to the development of the National Service Framework for Mental Health. A list of the individuals is in the table. Individual members were not asked about their ethnic or cultural background, but they reflect a wide range of interests, experience and expertise, including those from a black and minority ethnic group perspective.










































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    Sub-group 5


    Dr. Paul Lelliott


    Ms Judi Clements


    Ms Margaret Pedler


    Mr. Tom Sandford


    Ms Ethna Kilduff


    Roberta Graley


    Ms Karen Campbell


    Professor Peter Huxley


    Dr. Sonia Johnson


    Professor Peter Tyrerl


    Mrs. Susan Knight


    Sub-group 6


    Mr. Don Brand


    Ms Cath Cunningham


    Ms Jeni Bremner


    Ms Jane MacKay


    Professor Martin Knapp


    Professor Geoff Shepherd


    Professor Louis Appleby


    Professor Tom Burns


    Sub-group 7


    Mr. Chris Heginbotham


    Ms Julia Essex


    Mr. Martin Barkley


    Mr. David Joaniddes


    Dr. Edward Peck


    Mr. Charles Waddicor


    Ms Veronica Dewan


    Ms Fiona Wise


    Dr. Simon Baugh


    Dr. Julie Hollyman


    Sub-group 8


    Dr. Matt Muijen


    Ms Jenny Bernard


    Ms Judy Croton


    Mr. David Burchell


    Ms Kay Beaumont


    Professor Kevin Gourney


    Dr. Robert Kendell


    Ms Mary Nettle


    Ms Marjorie Wallace


    Ms Premila Trivedi.

Helen Jones: To ask the Secretary of State for Health how many members of the group currently considering a review of the Mental Health Act are members of (a) Black and (b) other ethnic minority communities. [72284]

Mr. Hutton: The twelve members of the expert group undertaking the first phase of the review of the Mental Health Act 1983 were appointed on the basis of their expertise in key areas rather than because they represent particular organisations. However, one expert group member is African.

Showa Denko

Mr. Maclean: To ask the Secretary of State for Health if the NHS purchases drugs from Showa Denko. [72695]

Ms Jowell: We are not aware of the National Health Service purchasing any drugs from Showa Denko.

24 Feb 1999 : Column: 354

Eosinophilia Myalgia Syndrome

Mr. Maclean: To ask the Secretary of State for Health (1) what assessment his Department has made of the alleged linkage of L-tryptophan to Eosinophilia Myalgia Syndrome; [72702]

Ms Jowell: There is no system of mandatory notification in the United Kingdom of cases of Eosinophilia Myalgia Syndrome (EMS) and no central register. Cases of EMS are thought to occur only in association with exposure to L-tryptophan. There were 11 possible cases reported to the Committee on Safety of Medicines by 1991, and there have been 7 possible cases subsequent to the reintroduction of Optimax in 1994, although a causal relationship for these cases has not been established. Several of the cases do not meet the internationally agreed definition of Eosinophilia Myalgia Syndrome. It is not known how many of these patients continue to have symptoms: several of the patients recovered completely after stopping their medicine.

EMS was first recognised as a condition in late-1989. There was extensive investigation into the association between EMS and L-tryptophan by the Medicines Control Agency at that time and the issue was considered in detail by the Committee on Safety of Medicines. It is considered likely that the reported cases of EMS were caused by an impurity or contaminant in L-tryptophan made by a single manufacturer in Japan.

The assessment then and subsequently included review of the worldwide published literature, examination of data submitted by the manufacturers of L-tryptophan and involved liaison with other regulatory authorities in Europe and the USA. In addition, there has been continuing evaluation of individual cases of adverse reactions reported in the United Kingdom under the Yellow Card scheme and via a monitoring scheme operated by the Marketing Authorisation Holder.

L-tryptophan is a simple chemical which cannot be modified genetically. As for all medicines made using biotechnology methods, all the steps taken in the manufacturing process are carefully controlled and have to comply with the specifications stipulated in the marketing authorisation (licence) for the product. All the relevant information is made available by the manufacturers and assessed by the Medicines Control Agency at the time of submission of an application for marketing authorisation and may be subject to ongoing site inspections.

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