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DTP Boosters
Mr. Peter Bottomley: To ask the Secretary of State for Health if he will make a statement on the production and availability of DTP boosters. [107510]
Yvette Cooper: Diphtheria, tetanus (DT) vaccine rather than diphtheria, tetanus, pertussis vaccine is used as a booster in the United Kingdom immunisation programme. DT has been in short supply due to the inability of Medeva, one of the two UK licensed sources, to supply contracted vaccine. A third manufacturer, Behring, has now obtained a product licence for its DT vaccine to be used in the UK and the first batches are due for release at the end of February 2000. This should give the UK enough stock to allow GPs and clinics to catch up on any deferred appointments for immunisation.
Fluoride
Sir Richard Body:
To ask the Secretary of State for Health what assessment he has made of the advice given by the World Health Organisation on the addition of fluoride to the water supply. [107728]
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Yvette Cooper:
Recommendation 7 on page 35 of the World Health Organisation Technical Report Series 846 "Fluorides and Oral Health: Report of a WHO Expert Committee on Oral Health Status and Fluoride Use" (1994) is that:
Sir Richard Body:
To ask the Secretary of State for Health what assessment he has made of the proportion of ingested fluoride that is retained in the body of a healthy adult. [107612]
Yvette Cooper:
The Department has not undertaken any such assessment. One recent review (United States National Research Council "Health effects of ingested fluoride" 1993) noted that
"Community water fluoridation is safe and cost-effective and should be introduced and maintained wherever it is socially acceptable and feasible. The optimum water fluoride concentration will normally be within the range 0.5-1.0 mg/l."
We will have regard to the World Health Organisation's views in developing policy in this area following the results of the review of fluoridation being undertaken by the University of York.
Sir Richard Body:
To ask the Secretary of State for Health what evidence he has received on the relationship between incidence of Down's syndrome and the fluoridation of water. [107611]
"Approximately 75-90 per cent. of the fluoride ingested each day is absorbed from the alimentary tract. Of the fluoride absorbed by the young or middle-aged adult each day, approximately 50 per cent. will be associated with calcified tissues within 24 hours and the remainder will be excreted in urine".
Yvette Cooper: The independent expert advisory Committee on Mutagenicity of Chemicals in Food, Consumer Products and the Environment considered fluoride in 1987, 1990 and 1995 and advised that
"there is sufficient evidence from the available data to conclude that the consumption of fluoridated water would not constitute a mutagenic hazard to man through the induction of heritable abnormalities in the germ cells." This implies that there is no biological basis for suspecting any relationship between fluoridation and the incidence of Down's syndrome. Epidemiological studies by Rapaport in the 1950s claimed to have shown an association, but were flawed and not supported by later epidemiological studies by others. An evaluation of the epidemiological studies will form part of the expert scientific review of fluoride and health in progress at the National Health Service Centre for Reviews and Dissemination at the University of York.
Selenium
Mr. Hammond: To ask the Secretary of State for Health what plans his Department has for publicising the value of selenium in the diet in reducing incidence of cancer. [107662]
Yvette Cooper: Selenium is an essential trace element which is particularly important in protecting the body against oxidative damage of the cells. Such damage is linked to diseases such as cancer and heart disease. It is therefore hypothesised that increasing selenium in the diet may decrease the risk of cancer.
The influence of diet and nutrition on the incidence of cancer was considered by the Committee on Medical Aspects of Food and Nutrition Policy in its 1998 report
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entitled "Nutritional Aspects of the Development of Cancer" 1 which stated that there was not enough evidence to reach conclusions for any specific links between selenium in the diet and cancer. We are funding research into the role of antioxidants, including selenium, in health and disease.
We have made reduction in death rates from cancer one of our four headline targets in our health strategy "Saving Lives: Our Healthier Nation". Action towards this target includes promoting a healthy and balanced diet, that is one which is varied and rich in cereals, fruit and vegetables.
Mr. Austin:
To ask the Secretary of State for Health what obligation he has placed on primary care trusts which wish to change their governance arrangements in a manner that departs from the guidance recently issued by his Department to consult with (a) users and (b) staff likely to be employed by the such trusts and their representatives. [107668]
Mr. Denham
[holding answer 31 January 2000]: The membership structure of each primary care trust is set out in its establishment order and must be in accordance with the Primary Care Trust (Membership, Procedure and Administration Arrangements) Regulations 2000. The Primary Care Trusts (Consultation on Establishment, Dissolution and Transfer of Staff) Regulations 1999 provide that before an establishment order is amended so as to alter the membership of the trust then the health authority must consult the trust concerned. There is however no obligation under the regulations to consult users or staff. This mirrors the existing situation for NHS trusts.
None the less, the Primary Care Trusts (Consultation on Establishment, Dissolution and Transfer of Staff) Regulations 1999 set out the consultation requirements which must be complied with before an order establishing a PCT is made. The regulations state that the health authority within whose area the primary care trust is to be established must consult, among others, the local community health council, bodies that represent health care professionals, any voluntary organisations that represent patients or their private carers, and any other persons considered appropriate. Also Health Service Circular 1999/167, "PCTs: the Application Process", stated that those to be consulted on proposals for PCTs should include, among others, trade unions, and other staff or professional representative groups.
Mr. Field:
To ask the Secretary of State for Health how many children under the age of 16 years were admitted to hospital as a result of severe unintentional injury resulting in a stay longer than three days for (a) 1997-98 and (b) 1998-99, (i) in absolute terms and (ii) expressed as a rate per thousand people. [108347]
Yvette Cooper:
The Hospital Episode Statistics database indicates that, in 1997-98, 10,457 children under the age of 16 were admitted to hospital as a result of an
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unintentional injury that resulted in a stay longer than three days. This translates into a rate per thousand people of 1.04. Figures for 1998-99 are not yet available.
Mrs. Spelman:
To ask the Secretary of State for Health if he will investigate the advantages and disadvantages of fiscal measures to encourage or discourage the purchase of certain foods, with particular reference to those containing a high proportion of saturated fatty acids. [109101]
Yvette Cooper:
The White Paper "Our Healthier Nation" recognised that unhealthy diets are a risk factor for coronary heart disease, stroke and for some cancers. Therefore, everyone can reduce the risk by reducing their intakes of fat and saturated fatty acids, increasing carbohydrate intakes and increasing consumption of fruit and vegetables.
The theory that selected fiscal measures would have a significant effect on saturated fatty acid intakes of particular population groups is still unproven. It depends on basic assumptions about the strength of relationships between prices and purchases which would require much further testing before their validity could be accepted and further investigations justified.
Mr. Letwin:
To ask the Secretary of State for Health if he will investigate the advantages of general screening of men over a certain age for prostate cancer; and if he will make a statement. [109120]
Yvette Cooper
[holding answer 8 February 2000]: The National Screening Committee, which advises the United Kingdom Health Departments about changes to screening policy, advised Ministers in 1997 that screening for prostate cancer, with current techniques for diagnosis and treatment, showed no evidence of benefit and could cause considerable harm. A report from the International Network of Agencies for Health Technology Assessment, published in January 1999, stated that mass screening for prostate cancer does not fulfil the ethical requirements and principles to avoid harm and do good. We have asked the Programme Director for the National Screening Committee, the National Cancer Director and the Director of Research and Development to keep this under active review.
1 Department of Health. "Nutritional Aspects of the Development of Cancer". London: The Station Office, 1998. (Report on Health and Social Subjects, No. 48).
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