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MMR Vaccination
Miss Kirkbride: To ask the Secretary of State for Health what plans he has to study the incidence of autism in (a) children immunised with MMR and (b) children who have not been given MMR jabs. [24277]
Yvette Cooper: I apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.
The cause of autism is not yet known and many factors may play a role. The recently completed Medical Research Council (MRC) review of the epidemiology and causes of autism concludes that the strongest evidence to date is for a major genetic component. It says that methodological differences between studies, changes in diagnostic practice, and increased public and professional awareness are likely causes of apparent increases in prevalence but notes that it is not yet clear whether these factors account for it all.
A number of studies, including one commissioned by the Medicines Control Agency have examined the postulated link between measles, mumps and rubella (MMR) and autism and have found no association. Two of these studies (Fombonne et al, Paediatrics, 2001 and Hiejbel and Gillberg, Autism, 1998) have specifically looked at rates of autism in populations who have had MMR and populations who have not had MMR using consistent definitions of autism. These studies did not find an increased reported rate of autism in MMR immunised children when compared with children who had not had MMR. Taylor et al, Lancet 1999, looked at the rate of MMR immunisation in autistic children in north Thames and found no significant difference when compared with the rate of MMR immunisation among all children in north Thames. A follow-up study (Vaccine 2001) showed no temporal association between MMR and onset of autism at any time. In February 2002, the Public Health Laboratory Service published a further study investigating MMR, regressive autism and bowel symptoms. This study compared the proportion of autistic children with bowel
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or developmental regression over a 20-year period from 1979, a period when MMR vaccine was introduced in the United Kingdom. They showed that there was no change in the proportion of children with regression or bowel symptoms during this time, irrespective of whether they had had MMR or not (Taylor et al, BMJ 2002, 324; 393–6).
In addition to the above, an ongoing study funded by the MRC and led by Professor Andrew Hall, is investigating possible causes of autism. This study will examine whether autistic children have a history of other conditions or medical problems, for example, problems during birth. This study, which examines a representative sample of health records drawn from over two million people registered with 300 general practices across the UK, will also look at autism and the MMR vaccine.
Miss Kirkbride: To ask the Secretary of State for Health if he will make a statement on what guidance he gives to GPs seeking to expel patients from their list because of a refusal to accept the MMR vaccination. [35424]
Yvette Cooper: I apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.
The registration/de-registration of patients with a general practitioner is governed by the Doctor's Terms of Service. We strongly endorse the General Medical Council guidance "Duties of A Doctor" which says that it is unacceptable to discriminate against patients on grounds of lifestyle, culture, beliefs, race, colour, sex, sexuality, age, social status or perceived economic worth. Refusal to accept the measles, mumps and rubella vaccination should not therefore be regarded by a general practitioner as a reason for removing somebody from his or her patient list.
Contingency Fund
Mr. Lansley: To ask the Secretary of State for Health (1) what criteria relating to bed availability are used to assess eligibility for funding from the Department's contingency fund; [27016]
Ms Blears [holding answer 10 January 2002]: I apologise to the hon. Member for the delay in responding to this question. I refer the hon. Member to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.
Officials within the Department have control over a small fund to deal with particular pressures on local health services. Money is allocated in discussion with regional offices based on well established procedures for monitoring local health services. This monitoring includes information on bed availability.
NHS Professionals
Dr. Evan Harris: To ask the Secretary of State for Health (1) what measures are in place to monitor the performance of NHS professionals; [30768]
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- (2) if he will list the performance targets that have been set for NHS professionals; [30770]
Mr. Heald: To ask the Secretary of State for Health (1) by what means he intends to (a) monitor and (b) improve the efficiency of NHS professionals; [37374]
- (2) whether the Commission for Health Improvement will be able to inspect and report on the work of NHS professionals. [37373]
Mr. Hutton: I apologise to the hon. Members for the delay in responding to these questions. I refer the hon. Members to the reply that my right hon. Friend the Secretary of State gave my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.
A national project board with representatives from the NHS and Department of Health is responsible for the extension and development of NHS professionals, including national monitoring and performance of NHS professionals providers. Regional project boards closely manage the development across regions. Also each site has its own project structure to manage and monitor implementation.
A Code of Practice is being developed to provide a framework for the management of temporary staff to the NHS, including NHS professionals.
The functions of the Commission for Health Improvement will cover NHS professionals.
Dr. Evan Harris: To ask the Secretary of State for Health what protections are contained within NHS Professionals to ensure nurses do not exceed the 48 hour work week. [30766]
Mr. Hutton: I apologise to the hon. Member for the delay in responding to this question. I refer him to the reply that my right hon. Friend the Secretary of State gave to my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, column 192W.
Health service circular 2001–002 and the guidance NHS Professionals—"A co-ordinated, NHS-led approach to temporary staffing" sets out national standards for good employment practice in the management of temporary staffing. This includes using the best of modern information technology and call centre technology within agreed national frameworks for terms and conditions of service, delivering high quality patient care through clinical governance.
NHS Professionals uses software that automatically flags up any shift in which an individual could exceed a 48-hour working week, and this is then raised with the individual.
Details of any current existing working arrangements are discussed during recruitment and the individual has a responsibility to inform NHS Professionals of any changes to these working hours.
Also, nurses working periods between rest periods are monitored to ensure that they are getting enough rest between shifts and that their total hours worked are satisfactory. These measures safeguard both the staff and their patients.
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Dr. Evan Harris: To ask the Secretary of State for Health how many nurses working through NHS Professionals in the week ending 19 January were in receipt of premium payments. [30773]
Mr. Hutton: I apologise to the hon. Member for the delay in responding to this question. I refer him to the reply that my right hon. Friend the Secretary of State gave to my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W).
The information requested is not held centrally.
Mr. Heald: To ask the Secretary of State for Health what steps he is taking to ensure that the costs of (a) timesheet processing and (b) payroll functions of NHS Professionals are identified and reported. [41728]
Mr. Hutton: I apologise to the hon. Member for the delay in responding to this question. I refer him to the reply that my right hon. Friend the Secretary of State gave to my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) on 5 March 2002, Official Report, column 192W.
HSC 2001–002 and guidance NHS Professionals—"A co-ordinated, NHS-led approach to temporary staffing" sets out national NHS Professionals standards for good employment practice, including provision for weekly payment upon submission of completed and authorised timesheets.
Local, regional and national project boards are in place to monitor the implementation of NHS Professionals to meet the required standards.
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