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Child Abuse
Mr. Hinchliffe: To ask the Secretary of State for Health if his Department will request local authorities to provide statistics on the abuse of disabled children as a subset of the annual figures collected regarding the total number of children registered for abuse. [11413]
Jacqui Smith: We already collect statistical information about the abuse of disabled children. Information on the numbers of disabled children in need known to local authority social services departments, and the reason for their being in need (including abuse/ neglect), was collected by the Department as part of the first children in need survey in February 2000. The report is published on the Department's Home Page of the Internet at www.doh.gov.uk/cinresults.htm. A copy of the report is also available in the Library. The survey is being repeated in late 2001, and the results are likely to be available in mid 2002.
Child Protection Register (Disabled Children)
Mr. Hinchliffe: To ask the Secretary of State for Health how many local authorities (a) have fulfilled their obligations to provide a register of disabled children and (b) are able to provide information on the numbers of disabled children on the child protection register. [11410]
Jacqui Smith: We do not keep a list of authorities which have a disabled children's register. However, this years' national overview report on the 2001–02 "quality protects" management action plans, reports that most councils currently have up-to-date registers of disabled children.
All local authorities should be able to provide information on the numbers of children on the child protection register although we do not hold it centrally. However, local authority returns from the children in need census, currently taking place, will mean this information will become available.
Drinking Water
Ms Walley: To ask the Secretary of State for Health what priority he gives to multi-barrier approaches to protect drinking water quality; and if he will make a statement in respect of hazard assessment critical control points. [11381]
Ms Blears: There is a regulatory requirement for all public water supplies in England and Wales to be treated before entering supply. If the raw water comes from a surface water derived source, the treatment has to be appropriate to the classification of the raw water as specified by the European Community Directive on the quality required of surface water intended for the abstraction of drinking water (75/440/EEC). This could involve a multi-barrier approach.
There are separate regulations relating to Cryptosporidium oocysts in drinking water, which require water companies to carry out risk assessments at all treatment works site. Companies may either install treatment capable of continuously removing particles greater than one micron in diameter or install continuous sampling for Cryptosporidium oocysts at sites considered to be at significant risk.
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These regulations are enforced by the Drinking Water Inspectorate on behalf of my right hon. Friend the Secretary of State for Environment, Food and Rural Affairs and for the National Assembly for Wales.
Zyban
Mr. Nicholas Winterton: To ask the Secretary of State for Health (1) what guidelines have been given to health authorities for the prescribing of the anti-smoking drug Zyban; and which health authorities allow GPs to prescribe this drug; [11100]
- (2) if he will calculate the number of people who have been prescribed the anti-smoking drug Zyban since its release on prescription basis; and how many deaths have been attributed to the use of Zyban; [11101]
(3) what changes have been made to the recommended dosage of Zyban by the manufacturers GlaxoSmithKline during the last 12 months; and for what reasons these alterations were made; [11102]
(4) what assessment he has made of the effectiveness and safety of Zyban in the treatment of people addicted to smoking; and if he will make a statement. [11103]
Ms Blears: Since Zyban (bupropion) was marketed in the United Kingdom in June 2000, at least 440,900 prescriptions of Zyban have been dispensed, based on the prescription cost analysis (PCA) data for England.
To date, there have been 53 reports to the Committee on Safety of Medicines (CSM)/Medicines Control Agency (MCA) of suspected adverse reactions in relation to Zyban with a fatal outcome. The contribution of Zyban to these fatal cases is unproven and in the majority of cases the individual's underlying condition may provide an alternative explanation. In 14 of these reports the individual was not taking Zyban at the time of death. Smoking itself is the single greatest cause of premature deaths in the UK and is responsible for 120,000 deaths per year, which is equivalent to more than 13 people an hour.
Zyban has been authorised in 14 European member states via the mutual recognition procedure. At the time of licensing our independent expert scientific advisory body, the CSM, advised that Zyban met appropriate standards of quality, safety and efficacy to justify its licence for use as an aid to smoking cessation in combination with motivational support in nicotine- dependent patients.
Since marketing, the safety of Zyban has been closely monitored by the MCA/CSM, particularly the accumulating evidence from spontaneous reports of suspected adverse drug reactions received in association with its use. The CSM has advised that the balance between the effectiveness of Zyban in helping people to stop smoking, and the health benefits that this brings, with the risk of adverse effects remains favourable.
Guidance on prescribing and use of Zyban is provided in the authorised Summary of Product Characteristics for health professionals and Patient Information Leaflet. These documents provide information on use of Zyban, contraindications, warnings and possible adverse effects. Key prescribing information is also included in the British National Formulary which is sent by the Department to doctors and pharmacists.
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Zyban was made available on national health service prescription in June 2000 in all health authorities. Since then a number of communications have been issued to health professionals. In March 2001 the MCA and CSM reminded general practitioners and health professionals in smoking cessation clinics about the safety profile of bupropion and provided information on safe prescribing, in particular predisposing factors for seizures. This information was distributed to doctors and pharmacists in the MCA/CSM drug safety bulletin "Current Problems in Pharmacovigilance".
In May 2001, the CSM issued new guidance (strengthened warnings particularly about potential interactions with other medicines) and advised a slower increase in the dose of Zyban in order to minimise the risk of side effects especially seizures (the lower 150mg dose should be prescribed for the first six days, increasing to 150mg twice daily on day seven rather than day four). This new guidance was issued in order to allow more time for the drug levels to stabilise, to help minimise the risk of adverse reactions, particularly seizures.
The Department provided information to all doctors concerning the safety of Zyban, via an article in the Chief Medical Officer's Update 30 (May 2001), entitled "Safety of Zyban as an aid to smoking cessation". A copy of the CMO's Update 30 can be found in the Statistics Section, in the Library. Updated information on the safety profile of Zyban can also be found on the MCA website.
General Practitioners
Mr. Bercow: To ask the Secretary of State for Health if he will make a statement on the number of general practitioners in the national health service in England and Wales in each of the last four years. [11868]
Mr. Hutton: The number of general practitioners in the national health service in England in each of the last four years is shown in the table. Information relating to Wales is a matter for the devolved Administration.
| Headcount | ||||
|---|---|---|---|---|
| 1997 | 1998 | 1999 | 2000 | |
| All practitioners (excluding GP retainers)(25) | 29,389 | 29,697 | 29,987 | 30,252 |
| of which: | ||||
| Unrestricted principals and equivalents (UPEs)(26) | 27,099 | 27,392 | 27,591 | 27,704 |
(25) All practitioners (excluding GP retainers) includes UPEs, restricted principals, assistants, GP registrars, salaried doctors (para. 52 SFA) and PMS other. GP retainers were not collected until 1999. In 1999 there were 972 GP retainers; in 2000 there were 1,117.
(26) Unrestricted principals and equivalents (UPEs) includes GMS unrestricted principals, PMS contracted GPs and PMS salaried GPs.
Source:
Department of Health General and Personal Medical Services Statistics.
Dr. Fox: To ask the Secretary of State for Health if he will make a statement on the definition of excessive as applied to GP list sizes; what measures he plans to take to ensure that areas which experience sudden population growth have sufficient numbers of medical practitioners; and what measures he will encourage the National Clinical Assessment Authority to take against doctors with excessive list sizes. [12767]
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Mr. Hutton: From 2002 health authorities will be responsible for determining how many general practitioners are needed in their areas. List size and population change are among the factors they will consider. The National Clinical Assessment Authority's role is to assess the clinical performance of a GP if a health authority raises concern.
Dr. Fox: To ask the Secretary of State for Health if he will publish the number of general practitioner vacancies in each (a) health authority and (b) primary care trust in the last two years. [12775]
Mr. Hutton: The number of general practitioner vacancies reported by health authorities in the Department's annual general practitioner recruitment retention and vacancy surveys for 1999–2000 and 2000–01 are shown in the table. Information on vacancies in primary care trusts is not held centrally.
(27) This table reflects the health authorities as at April 2001.
(28) Not provided
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Dr. Fox: To ask the Secretary of State for Health what estimate he has made of the number of general practitioners due to retire in each of the next five years. [12774]
Mr. Hutton: The Department does not collect information about retirement intentions of general practitioners. All unrestricted principals and equivalents (UPEs) have to retire as a principal by the age of 70. Around 480 UPEs will reach 70 by 2006.
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