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4 Mar 2002 : Column 131W
Report, column 1242W, on medicines control, if he will list the (a) dates and (b) issues of the articles relating to inappropriate use and overuse of medication in the publication "Current Problems in Pharmacovigilance"; and what articles have been produced in respect of overuse and inappropriate use of antipsychotic medication in care settings. 
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Yvette Cooper: The Medicines Control Agency (MCA) and its advisory committee, the Committee on Safety of Medicines (CSM) have published the following articles in the MCA's bulletin "Current Problems in Pharmacovigilance" alerting health professionals to the inappropriate use of medication. These articles include the following:
|Accidental overdose with Alfacalcidol (one-alpha drops)||February 2001 Vol. 27|
|Reminder: Methotrexate safe prescribing and dispensing||September 2000 Vol. 26|
|Medication error: Potential for confusing Humalog and Humalog Mix 25||May 2000 Vol. 26|
|Reminder: Naloxone in opioid overdose||May 1997 Vol. 23|
|Potential for confusion between Lamictal and Lamisil||December 1997 Vol. 23|
|Reminder: Paracetamol toxicity in overdose||November 1995 Vol. 21|
The MCA and CSM have not produced any articles specifically relating to the overuse and inappropriate use of antipsychotic medication in care settings. However the following articles in relation to antipsychotics have been published in "Current Problems in Pharmacovigilance" and encourage dose titration of the antipsychotics to help prevent adverse drug reactions:
|QT interval prolongation with antipsychotics||February 2001 Vol. 27|
|Drug-induced prolongation of the QT interval||March 1996 Vol. 22|
|Cardiac arrhythmias with pimozide (Orap)||February 1995 Vol. 21|
|Neuroleptic sensitivity in patients with dementia||May 1994 Vol. 20|
|Drug-induced extrapyramidal reactions||November 1994 Vol. 20|
|Convulsions may occur in patients receiving clozapine||June 1991 No. 31 Vol. 17|
|Cardiotoxic effects of pimozide||August 1990 No. 29 Vol. 16|
Mr. Burstow: To ask the Secretary of State for Health how many application packs for social workers training packs were sent out following the launch of the social worker recruitment campaign. 
Jacqui Smith: One of the aims of the social work recruitment campaign is to increase the number of people applying for social work training by 5,000 by 2004. As part of the campaign, the Department, has made available two publications, including "Careers in Social Work", which outlines the role of the social worker including the training required. 12,172 have been sent out by the helpline.
Yvette Cooper: Anecdotal and research evidence during the past 10 years has shown that maternity service liaison committees have proved very effective in influencing and shaping maternity service provision. In future primary care trusts will be the local health organisations responsible for working with maternity service liaison committees.
Yvette Cooper: The Hospital Episode Statistics (HES) system does not have definitive cause codes for accidents resulting from air rifles and pistols separately. The table shows the number of admissions with accidental firearm-related cause codes for the year 200001.
|W32 Handgun discharge||48|
|W33 Rifle shotgun and larger firearm discharge||67|
|W34 Discharge from other and unspecified firearms||737|
|Y22 Handgun discharge undetermined intent||6|
|Y23 Rifle shotgun and larger firearm discharge undetermined intent||13|
|Y24 Other and unspecified firearm discharge undetermined intent||44|
1. The cause code is a supplementary ICD10 code, which indicates the nature of the condition.
2. Data are for 200001 and is not yet adjusted for shortfalls.
Hospital Episode Statistics (HES), Department of Health
4 Mar 2002 : Column 133W
E9179: Striking against or struck accidentally by objects or persons
E9554: Suicide and self-inflicted injury
E9854: Other accidental or deliberate injury
Office for National Statistics
Yvette Cooper: The Hospital Episode Statistics (HES) system does not have definitive cause codes for accidents resulting from air rifles and pistols separately. It is also not possible to accurately determine the extent of physical impairment from injuries of this sort.
Gillian Merron: To ask the Secretary of State for Health since the publication of the national standards for GP exercise referral schemes in April 2001, how many exercise referral programmes have been offered by (a) GPs, (b) primary care nurses and (c) registered fitness professionals in each health authority in the UK. 
Yvette Cooper: The National Quality Assurance Framework published last year aims to improve the quality of existing schemes and help the development of new ones. The Department does not keep a national register of practices which offer these schemes. However, details of existing schemes are held locally by health authorities or local authorities.
The National Service Framework for Coronary Heart Disease requires that all NHS bodies will have agreed and be contributing to the delivery of a local programme of effective policies on increasing physical activity by April 2002. Exercise referral schemes can form an element in the delivery of these programmes. These schemes also contribute to the achievement of milestones relating to the prevention and treatment of coronary heart disease within primary care, and cardiac rehabilitation.
Mr. Paterson: To ask the Secretary of State for Health how many operations were cancelled in 2001 in the (a) Royal Shrewsbury, (b) Princess Royal, (c) Robert Jones and (d) Agnes Hunt Orthopaedic hospitals. 
|Royal Shrewsbury Hospital||423|
|Princess Royal Hospital||80|
|Robert Jones and Agnes Hunt Orthopaedic and District Hospital(51)||67|
(51) Robert Jones and Agnes Hunt Orthopaedic Hospital National Health Service Trust is one hospital.
4 Mar 2002 : Column 134W
Malcolm Bruce: To ask the Secretary of State for Health what systems the National Radiological Protection Board has in place to update their radiation risk models; when the risk models were last reviewed; and when the risk models were last updated. 
Yvette Cooper: The National Radiological Protection Board (NRPB) conducts a rolling programme of research and scientific review in order to update advice on the health effects of ionising radiation and the appropriate risk models for assessing these effects. NRPB has issued formal advice in the documents of the NRPB (Vol. 4(4), 1993; Vol 6(1), 1995). The NRPB's advisory group on ionising radiation will report shortly on the risks of leukaemia.
Scientific reviews and reports on risk models are also undertaken by NRPB staff in the context of a United Kingdom input to the work of the International Commission on Radiological Protection, the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), and a committee of the National Academy of Sciences of the USA. The UNSCEAR 2000 report on radiation effects and risk models included input from NRPB staff acting as consultants. This report represents the current international scientific consensus on the health effects of ionising radiation.
Malcolm Bruce: To ask the Secretary of State for Health what the National Radiological Protection Board's policy is on the radiation risk from (a) external and (b) internal low level radiation; when this policy was developed; and when it is next subject to review. 
Yvette Cooper: The policy of the National Radiological Protection Board is to provide advice on the health effects of exposure to external and internal radiations which is based on the totality of relevant scientific information. These sources of information include assessment of doses to critical tissues in the body, epidemiological (human health) investigations and knowledge of the fundamental biology of radiation action on cells and tissues. In circumstances where direct epidemiological information is lacking, judgments are developed using knowledge of doses to different tissues, the biological effectiveness of different radiations and the relative radiation sensitivity of different tissues.
Risk modelling procedures used by NRPB have been developed over many years often in conjunction with international bodies such as the International Commission on Radiological Protection (ICRP) and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR).
Current risk modelling procedures are based essentially on the 1990 Recommendations of ICRP and subsequent advice published by NRPB (Documents of the NRPB, Vol 4(4), 1993 and Vol 6(1), 1995). Scientific review of the data and procedures for assessing the health effects of external and internal radiations is an on-going process. The general policy of NRPB is to review and revise these procedures in the light of accruing scientific knowledge and therefore no specific date for revision may be given.
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