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7 Feb 2002 : Column 1147W
Ms Blears: The annual returns received from national health service trusts stating their position in relation to Firecode compliance are not submitted in a form to allow the number of hospital beds to be identified in wards which do not comply with fire safety statutory requirements.
Ms Walley: To ask the Secretary of State for Health if the Committee on the Medical Effects of Air Pollutants is considering the possible effects on (a) animal health and (b) human health of the use of methyl tertiary butyl ether in petrol; and if he will make a statement. 
Yvette Cooper: The Committee on the Medical Effects of Air Pollutants (COMEAP) advises the Chief Medical Officer on the possible effects of air pollutants on human health. No advice is provided on animal health.
COMEAP has considered the possible effects on human health that might occur as a result of exposure to concentrations of methyl tertiary butyl ether (MTBE) that may be produced as a result of the addition of MTBE to petrol as an octane enhancer. The concentrations likely to be produced are low and no significant effects on public health are expected. The COMEAP statement on this topic has been placed in the Library.
Early indications are that the implementation of the strategy is yielding positive results towards the two main goals of halving the rate of under-18 conceptions by 2010 and increasing the participation of teenage parents in education, training and employment. The under-18 conception rate has been on a downward trend for the last eight quarters for which data are available, and fell by 4 per cent. during the first year of implementation. The proportion of teenage mothers aged 16 to 19-years in education or work increased from 16 per cent. in 1997 to 31 per cent. in 2000.
Dr. Fox: To ask the Secretary of State for Health what proportion of haemophiliacs (a) over 16 years and (b) in (i) England, (ii) Wales, (iii) Scotland and (iv) Northern Ireland receive recombinant Factor 8. 
Yvette Cooper: The latest information from the United Kingdom Haemophilia Centre Doctors Organisation shows that in England patients aged 20 or younger (approximately 43 per cent. of all patients) are eligible to receive recombinant clotting factors. These patients may not currently be receiving recombinant clotting factors due to the recent world wide shortage but supplies are returning to normal and they will be put back onto
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recombinant clotting factors as soon as possible. Questions relating to Wales, Scotland and Northern Ireland are matters for the devolved Administrations.
Mr. Willis: To ask the Secretary of State for Health what research the Government have recently commissioned (a) on the risks of contracting human BSE from surgical instruments and (b) on how the NHS should deal with patients exposed to such risk through medical treatment; and when the results will be published. 
Yvette Cooper: The Department published a report entitled "Risk assessment for the transmission of vCJD via surgical instruments" on 16 March. This is available on the Department's website at www.doh.gov.uk/cjd/ riskassessmentsi.htm.
On 10 October 2001 the Creutzfeldt-Jakob Disease Incidents Panel published for consultation a framework document setting out proposals on the management of incidents involving possible exposure to CJD via surgery or donated blood, organs or tissues. The document is available on the Department's website at http://www.doh.gov.uk/ cjd/consultation.
Since 1998 the Department has allocated nearly £4 million to research on risk and decontamination of surgical instruments, and hopes to commission further contracts worth over £2 million in 2002. This work is carried out in major Transmissible Spongiform Encephalopathy research centres such as the Medical Research Council's prion unit in London and the National Creutzfeldt-Jakob Diseases surveillance unit in Edinburgh. Scientists at the Universities of Cambridge, London and Southampton are also involved, as well as those at Government research centres such as the Centre for Applied Microbiology and Research and the Institute for Animal Health.
Harry Cohen: To ask the Secretary of State for Health if he will call for a report from the Chief Medical Officer about vulnerability to heart disease from (a) high cholesterol, (b) cholesterol levels normally deemed safe but which are sensitive at this lower level for particular individuals and ethnic groups, (c) insulin-resistant metabolic syndrome and (d) non-cholesterol related causes; whether there are targeted remedies other than quitting smoking and excessive alcohol intake and improving diet and exercise; and if he will make a statement. 
Yvette Cooper: There are no immediate plans to issue a specific report about the links between cholesterol levels and coronary heart disease. There is a requirement within the National Service Framework (NSF) for Coronary Heart Disease that all general practitioners and primary health care teams should identify all people with
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established cardiovascular disease, and those who are at significant risk of cardiovascular disease but who have not yet developed symptoms. They should offer them appropriate advice and treatment to reduce their risks. This includes specific dietary advice to lower serum cholesterol concentrations.
The NSF also sets out the policy for the prescribing of statins. The first priority is to ensure that people with established CHD are treated with statins to lower their cholesterol level. The next step is the treatment of those without diagnosed CHD but whose risk of a cardiac event is greater than 30 per cent. over 10 years.
Insulin-resistant metabolic syndrome is an underlying condition in many people with Type 2 diabetes. Diabetes is a major risk factor for coronary heart disease. Prevention of Type 2 diabetes, which is achievable mainly by lifestyle change, will be addressed in the forthcoming Diabetes National Service Framework.
In addition to smoking, poor diet, and physical inactivity, other modifiable risk factors for CHD include obesity and hypertension. The Department is taking action to address these risk factors through the NHS Plan, Cancer Plan and NSFs for Coronary Heart Disease, Older People and the forthcoming one on Diabetes.
Mr. Burstow: To ask the Secretary of State for Health what research his Department (a) has commissioned and (b) plans to commission in respect of polysaccharide vaccine; when it was commissioned; when it will report; which (i) persons and (ii) organisations are undertaking the research; and what the (A) remit and (B) aims of the research are. 
Yvette Cooper [holding answer 10 December 2001]: The Department has commissioned the Public Health Laboratory Service (PHLS) to undertake studies on the safety and immunogenicity of pneumococcal conjugate polysaccharide vaccines in infants and young children. The studies are under the direction of Dr. Elizabeth Miller, Head of Immunisation at PHLS. The studies were started in 2001 and results are expected in 2002 and 2003. Further studies in infants or the elderly will be considered in response to suitable applications.
Mr. Burstow: To ask the Secretary of State for Health (1) what estimate he has made of the cost of malnutrition per annum (a) to the NHS and (b) to public funds by (i) region and (ii) health authority in the last five years for which figures are available; 
Yvette Cooper [holding answer 19 December 2001]: Figures on the number of episodes of hospital in-patients with a primary diagnosis relating to malnutrition show that the incidence of malnutrition leading to hospitalisation is rare but increases with age. Information
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on costs is not centrally located. The total cost of malnutrition would be extremely difficult to calculate as it is often associated with another diseaseeither as a result of the disease or only diagnosed during the treatment for the disease.
There are a number of measures and strategies in place to specifically manage, monitor and screen patients for under-nutrition in hospitals, residential care and the wider community. This includes the Better Hospital Food programme and the introduction of ward housekeepers in hospital, as outlined in the NHS Plan. In addition, from April 2002 all care homes will be regulated in accordance with national minimum standards, including nutrition.
Mr. Burstow: To ask the Secretary of State for Health what screening methods are in place and on what frequency (a) in England and (b) by health authority to monitor nutritional levels in people aged (i) 015, (ii) 1659, (iii) 6075 and (iv) 75 years and over; and what his policy is on a standard national nutritional screening policy. 
Yvette Cooper [holding answer 19 December 2002]: There is no standard national policy on screening for malnutrition in hospitals. It is a matter for individual trusts. However, in February 2001, we released the essence of care toolkit to be used for local clinical governance activity, and in which best practice standards include the need for nutritional screening and assessment of all patients.
Nutritional screening is also recommended for the care of specific groups, such as those outlined in the National Service Framework for Older People. As highlighted in the response to previous inquiries to my right hon. Friend the Secretary of State in November 2001, a number of strategies are in place to manage, monitor and screen patients for under-nutrition in hospitals, residential care and the wider community. These were outlined previously.
Guidance on the single assessment process for older people was issued for consultation in August 2001. The assessment will identify the health and social care needs of people over 65 years, including difficulties with diet and nutrition.
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