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Muscular Dystrophy

Kevin Brennan: To ask the Secretary of State for Health how much has been spent on research into a cure for Duschenne Muscular Dystrophy in the last five years; and if he will make a statement. [45787]

Jacqui Smith: The main Government agency for research into the causes of and treatments for disease is the Medical Research Council (MRC) which receives its funding via the Department of Trade and Industry. The MRC supports a major project on the molecular analysis

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of Duchenne Muscular Dystrophy at the MRC Functional Genetics Unit in Oxford and the expenditure on this is about £440,000 a year.

The MRC expenditure figure on all types of Muscular Dystrophy for the last five years is an estimated £3.7 million. It is not possible to extract Duchenne Muscular Dystrophy spending specifically from this total as so much of the work is basic in nature and could apply to all forms of the disease.

The Department provides support funding for research commissioned by charities and the research councils that take place in the NHS. Management of much of the research supported by NHS research and development funding is devolved and expenditure at project level is not held centrally by the Department.

Depleted Uranium

Mr. Swire: To ask the Secretary of State for Health what plans he has to instruct the National Radiological Protection Board to carry out research into illnesses caused by exposure to depleted uranium. [43654]

Yvette Cooper [holding answer 26 March 2002]: The Department has no plans to ask the National Radiological Protection Board (NRPB) to carry out research specifically into illnesses possibly caused by exposure to depleted uranium. However, NRPB does undertake research that is relevant to the assessment of the risks to health from such exposures. In particular NRPB has carried out extensive research into the distribution of uranium in body organs, its retention and excretion, following inhalation of a wide range of uranium compounds. It has also developed computer models that enable the concentration of uranium in the various organs and resulting radiation doses to be calculated. Depleted uranium is mildly radioactive, and NRPB's research programme on the effects of ionising radiation in general is therefore relevant to assessment of the radiological risks from exposure to depleted uranium.

Food Supplements

Mr. Spring: To ask the Secretary of State for Health what assessment the Government have made of the cost to British business of the Directive on food supplements. [45515]

Yvette Cooper [holding answer 26 March 2002]: The Food Standards Agency, which has been responsible for negotiating this Directive on the Government's behalf, has consulted widely on its likely impact. There would be labelling costs falling on manufacturers of all food supplements, but these would be substantially offset by a two-year transitional period. Any additional impact of future developments on lists of permitted nutrients and maximum limits cannot yet be assessed.

Blood Tests

Mr. Burstow: To ask the Secretary of State for Health how many blood tests in each of the last five years for which figures are available (a) were sent to laboratories for tests and (b) were misplaced before the patient received the results. [46576]

Yvette Cooper: The information requested is not collected centrally.

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Community Pharmacists

Mr. Burstow: To ask the Secretary of State for Health what estimate he has made of the number of community pharmacists (a) in post and (b) vacancies, broken down by (i) health authority and (ii) region in each of the last five years for which figures are available. [45641]

Ms Blears [holding answer 20 March 2002]: Information on the number of community pharmacists in post and vacancies is not held centrally.

University Hospital Coventry and

Warwickshire NHS Trust

Mr. Burns: To ask the Secretary of State for Health if he will make a statement on the reasons for which the Chief Executive of the University Hospital Coventry and Warwickshire NHS Trust remained in post after the publication of the CHI report and the zero rating of Walsgrave hospital. [46822]

Yvette Cooper [holding answer 10 April 2002]: All Trusts were assessed on their performance during 2000–01 against a set of key targets that are the most significant factors in determining their overall performance rating for the year. Those Trusts that indicated the poorest levels of performance against the key targets were awarded a rating of zero stars.

In September 2001, twelve NHS Trusts, including the University Hospitals Coventry and Warwickshire NHS Trust, were classed as 'zero stars' under the new performance ratings system. In line with national guidance on monitoring ongoing performance, as the Chief Executive had been in post for longer than 18 months, the Trust were given 3 months notice to improve the performance of the Trust to a satisfactory level.

Deep Vein Thrombosis

Mr. Burns: To ask the Secretary of State for Health if he will make a statement on the link between women taking the contraceptive pill or on hormone replacement therapy and their likelihood of suffering a deep vein thrombosis; and what measures are being taken to advise and make aware these vulnerable groups of the dangers of DVT and how to lower the risk of suffering from it. [46830]

Yvette Cooper [holding answer 10 April 2002]: A very small increase in the risk of developing deep vein thrombosis (DVT) for women who take oral contraceptives (OCs) or hormone replacement therapy (HRT) has been recognised for many years. Accordingly, OCs and HRT are contraindicated in women who have a personal or family history of DVT and who are therefore most at risk.

In 1995 several new studies suggested that a slightly increased risk of DVT was associated with newer OCs (the so-called third generation pills that contain desogestrel or gestodene as progestogen) compared to older ones (so-called second generation pills that contain levonorgestrel as progestogen). This issue was considered by the Committee on Safety of Medicines (CSM) in 1995, 1996 and 2001 and by the Medicines Commission in 1998 as more data became available. They have advised that

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for every 100,000 women who use OCs for a year, 10–20 more cases of DVT may be expected to occur relative to healthy non-users. This increase in risk is less than the risk of DVT associated with pregnancy (an extra 55 cases of DVT for every 100,000 pregnancies).

Warnings about the risk of DVT in women who take OCs have been in the Summary of Product Characteristics (SPCs) for health professionals and the patient information leaflet (PIL) for women for many years. These warnings were updated with respect to the increased risk of DVT in women who use third, as opposed to second, generation pills in early 1999 and were included in the BNF (British National Formulary). In 2001, product information for all combined oral contraceptives was further updated to inform women and their health professionals that their risk of DVT is greatest in the first year they ever use an OC. Comprehensive information about the risk of DVT with use of oral contraceptives was provided to health professionals and women in a Dear Doctor letter in 1995, in an article in the Medicine Control Agency's (MCA) safety bulletin "Current Problems in Pharmacovigilance" in 1999 and on the MCA's website in 2001.

With respect to HRT, evidence suggesting an increased risk for DVT was considered by CSM in 1996. They advised that an additional 10–20 women may experience a DVT out of every 100,000 women who use HRT compared with healthy non-HRT users of a similar age. The SPCs and PILs for HRT products and the BNF were updated in line with this advice in 1998. Health professionals were informed of the risk of DVT in association with use of HRT in an article in "Current Problems in Pharmacovigilance" which contained a pull-out sheet with information specifically for women.

In addition to targeted information, every pack of oral contraceptives and HRT contains a PIL for women. These clearly inform women that they should not use OCs or HRT if they have a personal or family history of DVT. They also inform women of their additional risk of DVT compared with non-users. PILs for the second and third generation OCs describe what DVT is and how it is caused, its potential severity and possible outcome. They also list the symptoms of DVT and advise women to stop taking their pills immediately and seek medical help in the event of their occurrence. In addition, they advise women to stop taking their pills prior to periods of prolonged immobilisation, especially surgery and to re-start only when fully re-mobilised. Any woman wishing to take OCs is encouraged to discuss the risks of DVT with her doctor and, provided she understands and accepts those risks, to jointly choose the treatment that is best suited to her in light of her individual medical history.

Mr. Burns: To ask the Secretary of State for Health how many people in England have been diagnosed with deep vein thrombosis in (a) each of the last six years and (b) 2002 to the latest available date. [46743]

Yvette Cooper [holding answer 10 April 2002]: The information shown in the table is the number of admissions to national health service hospitals in England where the patient's main diagnosis was Deep Vein Thrombosis.

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Year	Finished consultant episode
1995–96	19,598
1996–97	20,736
1997–98	22,551
1998–99	24,871
1999/2000	25155
2000/01	24,903

Notes:

Admissions are defined as the first period of patient care under one consultant within one health care provider. Admissions do not represent the number of patients, as a person may have more than one admission within the year.

Figures are only given for NHS hospital in-patient admissions; there are no figures available for patients diagnosed or treated elsewhere. The figures are the latest available.

The figures for 1995–96 to 1999–2000 are grossed for both coverage and invalid/unknown clinical data, but the figure for 2000–01 have not yet been adjusted for shortfalls in data (i.e. it is ungrossed).

Source:

Hospital Episode Statistics (HES), Department of Health.

The International Classification of Diseases (ICD-10) code used: 180.2.

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