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HEALTH
Spectacles (Children)
Mr. Sayeed: To ask the Secretary of State for Health what action the Government are taking to publicise free availability of spectacles for children. [79050]
Mr. Denham: Under the National Health Service optical voucher scheme children under the age of 16 and young people aged 16 to 18, who are in full time education, are entitled to an optical voucher which they may use to buy spectacles from a basic range or, if they choose, put towards the cost of more expensive spectacles or contact lenses. These arrangements are publicised in the following leaflets which the Department distributes to a wide range of public premises including optical practices, doctors' surgeries, pharmacies, post offices and social security offices:
HC11 "Are you entitled to help with health costs".
HC12 "NHS charges and optical voucher values".
HIV
Mr. Stunell: To ask the Secretary of State for Health what steps he has taken (a) to implement the Stocktake Group report on support for HIV services and (b) to require health authorities to take timely decisions on funding HIV related services in financial year 1999-2000; and if he will make a statement. [79704]
Ms Jowell:
I am currently considering the recommendations of the Stocktake Group on the long- term future funding of HIV/AIDS treatment and care. Notification of the HIV/AIDS treatment and care and HIV prevention budgets for 1999-2000 was made to health authorities on 15 April, and a copy of the Allocations Working Paper (AWP (99-00) HA36) showing initial
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allocations to each health authority has been placed in the House of Commons Library. Guidance to health authorities on the use of these funds will be issued shortly.
Mr. Sayeed:
To ask the Secretary of State for Health what representations he has received from mid- Bedfordshire general practitioners with regard to the review of Biggleswade and Steppingley hospitals. [80460]
Mr. Denham:
I refer the hon. Member to the reply I gave him on 14 April 1999, Official Report, column 269.
Mr. Sayeed:
To ask the Secretary of State for Health if he will make a statement on Government policy on the development of regional and sub-regional centres of clinical and medical excellence and the role of (a) local hospitals and (b) health resource centres in the context of the move towards regional and sub-regional concentration. [80455]
Mr. Denham:
We are committed to the development of clinical excellence at all levels within the National Health Service, as set out in "A First Class Service: Quality in the NHS". National Service Frameworks and guidance issued nationally by the Government support health authorities and trusts in the development of clinical excellence locally.
However, it is for health authorities, primary care groups and NHS trusts to determine the most appropriate range and configurations of health services to meet local needs.
Mr. Ian Stewart:
To ask the Secretary of State for Health when research projects (a) started and (b) concluded at Porton Down into the development of an acellular DTP vaccine; how much the research programme cost; and when and for what reasons the Government decided to purchase such vaccines in the United States rather than continue development in the UK. [80646]
Ms Jowell:
Work on acellular pertussis vaccine commenced at the Centre for Applied Microbiology and Research (CAMR) (as the then named Microbiological Research Establishment under the Ministry of Defence) in 1974 and continued until 1993-94. Costs for the period 1974 to 1979 when the centre was under the Ministry of Defence are not available. Costs to the Public Health Laboratory Service (PHLS) and the Department from 1979 to 1993-94 (when the PHLS managed CAMR) were some £2.7 million, although some additional costs would have been incurred by PHLS and the Medical Research Council for clinical trials and by Porton Speywood for vaccine manufacture and trials.
The acellular pertussis vaccine development at CAMR was discontinued when the CAMR vaccine was not selected by international researchers for inclusion in trials comparing candidate pertussis vaccines. However, the agglutinogen components, the novel feature of the CAMR vaccine, were subsequently incorporated into a Canadian
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manufactured vaccine, along with other components not in the CAMR vaccine. This Canadian vaccine has been shown in studies to be the only acellular vaccine to provide protection comparable to that from the presently used UK whole cell pertussis vaccine. The studies have also shown that there is little difference in the level of local reactions and fever seen after use of the United Kingdom whole cell pertussis vaccine when compared to acellular pertussis vaccines under the immunisation schedule used in the UK.
The United States of America manufactured acellular vaccine purchased for UK use was chosen since it was the only single antigen, that is pertussis only, vaccine available.
Mrs. Brinton:
To ask the Secretary of State for Health what is his estimate of (a) the annual number of early deaths and hospital admissions currently attributable to particle pollution, (b) the reduction in early deaths and hospital admissions by 2005, if the whole of the UK were to meet its current national air quality objective for particles and (c) the reduction in early deaths and hospital admissions by 2005, if the whole of the UK were to meet the proposed EC Air Quality Daughter Directive Stage 1 limit value for particles. [80782]
Ms Jowell:
The Department has quantified the impact on health from current and future levels of airborne particle (PM 1 0 ) concentrations in the United Kingdom as follows.
The Committee on the Medical Effects of Air Pollutants' report 'Quantification of the Effects of Air Pollution on Health in the United Kingdom' concluded that (PM 1 0 ) concentrations in 1996 were likely to have brought forward the deaths of around 8,100 people in the UK. It also concluded that PM 1 0 concentrations in 1996 contributed to about 10,500 respiratory hospital admissions, which may have been brought forward or additional. In both cases the people most at risk are likely to be the elderly suffering from chronic heart and lung diseases.
The Government recently published their proposals for review of the National Air Quality Strategy, and, in particular, their proposals for revised and additional objectives for the pollutants. During the review process, as a result of a better understanding of the sources and types of particles in the UK provided by the work of the Airborne Particles Expert Group, it became apparent that the current PM 1 0 objective would not be achievable in a number of local authority areas with any measures that are currently practicable. The Expert Group's work also revealed the importance of non-UK sources and the limit to which local authority and central Government action alone could control levels of PM 1 0 . The Government are consulting on a proposal to replace the current PM 1 0 objective with the Stage 1 limit values in the European Community Air Quality Daughter Directive, while retaining the current objective as an indicative level. Although sufficient information was not available to estimate the benefits of meeting the current objective across the whole of the UK, further work is planned to estimate the benefits of reducing levels of PM 1 0 below the limit values as part of the next review of the Strategy.
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The Government will reconsider the indicative level for particles once clear evidence is available on the significance of PM2.5 for health with a view, potentially, to setting an objective based on concentration of this finer fraction. Discussions are also in progress with the UK's EC partners to explore ways of reducing the transboundary particle problem.
There is expected to be a cumulative reduction of about 5,000 early deaths and about 4,000 respiratory hospital admissions over the period 1996 to 2005 as a result of agreed measures to reduce PM 1 0 1 . (Calculations for the year 2005 alone would give about 900 fewer early deaths and about 750 fewer respiratory hospital admissions than in 1996). In a typical year, the predicted concentrations of PM 1 0 in 2005 would meet the proposed EC Stage 1 limit value at all urban background locations. There are however likely to be exceedences at busy roadsides in some large urban areas and possibly in the vicinity of some industrial plants.
Mr. Alan Simpson:
To ask the Secretary of State for Health if he will list details of reported cases, over the last five years, of allergic reactions to (a) homeopathic medicines, (b) herbal medicines and (c) vitamin and mineral supplements. [81064]
Ms Jowell:
Suspected adverse drug reactions reported to the Committee on Safety of Medicines are recorded according to the active drug substance and reports for homeopathic medicines are not specifically identified as such. It is therefore not possible to provide a list of reported allergic reactions to homeopathic medicines.
The total number of suspected adverse drug reaction reports for any medicine containing a herbal ingredient, for the period 1 January 1994 to 31 December 1998, was 174. Suspected allergic reactions associated with medicines containing at least one herbal constituent, reported to the Committee on Safety of Medicines for the period 1 January 1994 until 31 December 1998, are given in the table.
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| Patient sex | Suspect drug | Reaction | Outcome of Reaction |
|---|---|---|---|
| F | Pripsen | Allergic reaction | Recovered after drug withdrawal |
| F | Colpermin | Allergic reaction | Not known |
| F | Ledermix dental kit | Anaphylactic reaction | Recovered after treatment |
| F | Anusol cream | Allergic reaction | Recovering after treatment |
| F | Arnica extract | Allergic reaction | Not recovered |
| M | Quiet Life | Allergic rash | Recovering |
| F | Colpermin | Allergic reaction | Not known |
| M | Regulan | Allergic rash | Recovered after drug withdrawal |
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The Yellow Card Scheme for reporting adverse drug reactions was extended to include unlicensed herbal medicines in October 1996.The total number of suspected adverse drug reaction reports for any medicine containing one or more of the drug substances: ascorbic acid, retinol, riboflavine, thiamine, pyridoxine, nicotinamide, cyanocobalamin, tocopherol, folic acid, iron, calcium,
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zinc, magnesium, phosphorus, sodium fluoride,
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| Patient sex | Suspect drug(s) | Reaction(s) | Outcome of Reaction |
|---|---|---|---|
| F | Redoxon, Calpol | Allergic reaction, face oedema, pyrexia, eye inflammation | Not known |
| F | Folic acid, Ferrous gluconate, Ascorbic acid | Anaphylactic reaction | Recovered after treatment |
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