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HEALTH
Levonorgestrel
Mr. Amess: To ask the Secretary of State for Health (1) if he will publish the medical research and evidence on which the Committee for the Safety of Medicines based their recommendation that levonorgestrel 0.75 mg could be supplied as a pharmacy medication; [129410]
- (2) what trials have been conducted in the United Kingdom to test the safety and long-term health effects of levonorgestrel 0.75 mg. [129409]
Yvette Cooper: A product containing levonorgestrel 0.75 mg has been authorised in the United Kingdom as a prescription only medicine. This followed advice from the Committee on Safety of Medicines (CSM) who were satisfied as to the product's quality, safety and efficacy. The evidence considered included two World Health Organisation sponsored pivotal studies. One study involving approximately 3,000 women in 14 countries, including the UK, has been published in the Lancet (1998). The other, published in Human Reproduction (1993), involved 880 women. Copies are available in the Library. Other supporting data not in the public domain are confidential to the application.
Evidence of safety as stated was taken into account when the CSM considered the proposal for levonorgestrel 0.75 mg to be available without prescription. There is also evidence from a study of the effects of self-administering emergency contraception (New England Journal of Medicine, 1998). Levonorgestrel 0.75 mg has been available from pharmacies in France without a doctor's prescription since June 1999. The criteria for prescription control are defined in the legislation. The CSM considered each of these criteria and advised that they did not apply to levonorgestrel 0.75 mg for emergency contraception in women of 16 and over. They considered that all the steps required to supply emergency contraception safely could be successfully completed in a pharmacy.
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E.coli
Sir Teddy Taylor: To ask the Secretary of State for Health what priority is being given in the Health Service to emphasising (a) the health dangers of bacterium E.coli and (b) ensuring that the disease can be speedily identified. [131420]
Ms Stuart: The bacterium currently of most concern is vero cytotoxin producing E.coli, of which E.coli 0157 is the commonest. In may this year the Chief Medical Officer's Update, which is distributed to all medical practitioners, carried an article "VTEC Guidance" which drew attention to the seasonal increase in infection, the risks from farm visits and the susceptibility of children to developing Haemolytic Uraemic Syndrome following infection with E.coli 0157. A further CMO Update in August will alert medical practitioners to the potential increased release of toxin that can be caused by certain classes of antibiotic in patients with E.coli 0157. The CMO also issued a press release "Health advice issued for farm visits by children" in April alerting the public to the risks of infection associated with farm visits and advising on sensible precautions to be taken to avoid infection. This advice was sent to all directors of public health and consultants in communicable disease control. Information has been given to vulnerable groups such as pregnant women on how to avoid infection. The Pregnancy Book, given to all first time mothers, contains advice on safe eating and how to avoid infection and this advice is repeated in the leaflet "While you are pregnant: safe eating and how to avoid infection" given to all mothers. Guidance was issued by the CMO in July 1998 on the safe cooking of burger meat to prevent foodborne infection.
All Public Health Service Laboratories test all stool samples for E.coli 0157 in accordance with agreed Standard Operating Procedures. The PHLS published its "Guidelines for the control of infection with Vero cytotoxin producing Escherichia coli (VTEC)" dealing with sampling and identification procedures. E.coli 0157 infection that is foodborne, which is the majority, is
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notifiable as a 'foodborne disease', and all laboratories voluntarily notify all E.coli infections as part of an agreed reporting protocol.
Residential and Nursing Homes
Mr. Field: To ask the Secretary of State for Health what response he has made to the submission by Methodist Homes for the Aged to his consultation paper on Nationally Required Standards for Residential and Nursing Homes for Older People. [130781]
Mr. Hutton: I am aware that the supportive response from Methodist Homes to the consultation document raised a number of concerns including about the staffing and physical environment standards and the timescale for implementing the standards.
I refer my right hon. Friend to the reply I gave to my hon. Friend the Member for Warrington, North (Helen Jones) on 20 July 2000, Official Report, columns 287-88W. This set out the conclusions we have reached in relation to the physical standards in residential and nursing homes based on the responses to the consultation process on "Fit for the Future?".
Regarding staffing, we do not accept that fixed ratios are the best means of specifying the number and qualifications of staff to be employed in a nursing home. For qualified nurses, numbers should relate to the assessed needs of residents at any one time. We are considering what models of assessment should be recognised by the National Care Standards Commission for this purpose and how nursing needs are defined so that nurse staffing levels can be set accurately and realistically. For ancillary staff, levels should take account of the degree of efficiency and effectiveness demonstrated by providers in managing ancillary tasks.
The standards for nine out of the eleven topic areas that we consulted upon in "Fit for the Future?" received overwhelming support and these will form the basis for the full set of national minimum standards which we will publish later this year.
Meat Inspection
Mr. Gill: To ask the Secretary of State for Health how many veterinary surgeons were employed on duties associated with abattoirs in each of the past 18 months. [131101]
Ms Stuart: I am advised by the Food Standards Agency (FSA) that the number of veterinary surgeons employed by or on behalf of either the FSA (and previously the Joint Food Safety and Standards Group (JFSSG) of the Department of Health and the Ministry of Agriculture, Fisheries and Food) or its executive agency, the Meat Hygiene Service (MHS), on duties associated with abattoirs in Great Britain for each of the past 18 months is as follows:
(1) FSA since 1 April 2000
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MHS veterinary surgeons are employed throughout Great Britain on meat hygiene, inspection and animal welfare duties as well as the enforcement of specified risk materials (SRM) controls. The vast majority of these staff are employed on a contract basis. These contracts relate to individual plants and to a specific number of hours. The above figures therefore do not equate to full-time equivalent figures which are considerably less.
Veterinary Meat Hygiene Advisers have been employed by or on behalf of the Food Standards Agency since its established on 1 April 2000. Prior to this they formed part of the JFSSG. They play a major role in the audit of the MHS, the licensing of meat plants and other activities in England. In Scotland and Wales, these duties are carried out by staff of the State Veterinary Service (SVS).
SVS staff throughout Great Britain may also from time to time visit abattoirs on other official business. The above figures do not include veterinary surgeons employed by the SVS who undertake any of these other duties.
Food Supplements
Mr. Hancock: To ask the Secretary of State for Health what progress has been made on the international regulation of vitamins and minerals at the Codex Alimentarius Commission; and if he will make a statement. [131492]
Ms Stuart: A proposal for draft guidelines for vitamin and mineral supplements was discussed at the meeting of the Codex Committee on Nutrition and Foods for Special Dietary Uses on 19-23 June 2000. The Committee made some progress towards consensus on the text and will discuss it further at its next meeting.
Mr. Hancock: To ask the Secretary of State for Health (1) when (a) he and (b) his officials last attended European Ministerial Working Group meetings to discuss the Draft European Directive on Food Supplements; what assessment he has made of the extent to which the Directive provides for the continued access by consumers to safe dietary supplements on retail sale; what amendments are being proposed to that Directive by other member state Governments; and if he will make a statement; [131491]
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- (2) what his policy objectives are in relation to the proposed Food Supplements Directive; what the timetable is for further progress in discussions on the Directive; and if he will make a statement. [131493]
Ms Stuart: There have been no meetings at ministerial level to discuss this proposal. It was discussed by officials at a council expert working group held in July, and the Food Standards Agency has circulated details of the specific issues discussed to interested parties. The timetable for further discussions has not been announced but the next meeting of this group is due in September.
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