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NHS Dentistry

Ms Walley: To ask the Secretary of State for Health what plans he has to review dental services in England. [53708]

Ms Blears: During 2001 the Chief Dental Officer led a working group to look at options for change to modernise national health service dentistry building on the Government's strategy document "Modernising NHS dentistry: Implementing the NHS Plan" published in September 2000.

This group has completed its deliberations and the Government announced on 25 April that we intend to move forward plans to reform NHS dentistry developed by the "Options for Change" group. The ideas behind "Options for Change" need practical testing and demonstration sites will be set up across the country, with the assistance of the NHS Modernisation Agency. The sites will explore a variety of new methods for providing NHS dentistry, such as allowing primary care trusts to commission all NHS dental services and allowing dentists to choose to work in different ways at different times in their careers.

Mr. Evans: To ask the Secretary of State for Health how much money has been spent on NHS dental treatment in each of the past five years in each of the health authorities of the north-west of England. [55110]

Jacqui Smith [holding answer 9 May 2002]: Fee expenditure in the general dental service is shown in the table, both gross and also net of patient charges. Figures are given by health authority in the north-west region for the years 1996–97 to 2000–01.

Fee expenditure covers dentists' claims for treating patients and patient registrations payments. It excludes some other payments to dentists where a breakdown by health authority is not collected centrally, for example reimbursement of practice rates.

Expenditure by other national health service dental services is not collected centrally.

General dental service: gross and net fees by health authority in the north-west region, 1996–97 to 2000–01
£ million

1996–97 1997–98 1998–99 1999–2000 2000–01
Health authorityGrossNetGrossNetGrossNetGrossNetGrossNet
Bury and Rochdale10.87.710.87.711.68.211.88.412.18.5
East Lancashire12.99.113.39.413.99.714.310.013.99.8
Liverpool14.511.714.611.815.112.215.312.215.512.4
Manchester14.811.614.811.615.612.216.312.717.013.1
Morecambe Bay7.85.07.95.18.25.28.55.38.85.4
North Cheshire7.95.58.15.68.45.88.86.19.26.3
North-west Lancashire13.69.314.19.715.010.315.811.015.910.9
Salford and Trafford14.510.414.410.315.110.815.411.116.011.4
Sefton8.65.98.96.19.36.39.26.19.05.8
South Cheshire17.611.518.312.119.012.518.512.219.512.8
South Lancashire6.74.77.04.97.65.17.95.48.65.9
St. Helens and Knowsley9.17.09.67.39.97.510.07.59.97.4
Stockport8.85.68.95.69.45.99.66.010.26.4
West Pennine14.310.414.610.515.110.715.911.416.211.4
Wigan and Bolton16.711.617.412.118.412.718.512.918.813.1
Wirral9.56.710.07.010.97.511.37.711.78.1
North-west region total188.1133.8192.6136.8202.5142.7207.2145.9212.1148.6


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Methicillin Resistant Staphylococcus Aureus

Paul Flynn: To ask the Secretary of State for Health what were the percentage changes in the incidence of Methicillin Resistant Staphylococcus Aureus in (a) the NHS and (b) the private sector in each of the past five years. [54015]

Yvette Cooper: The mandatory reporting of Methicillin Resistant Staphylococcus Aureus (MRSA) bacteraemias by national health service acute trusts began in April 2001. The system does not cover private hospitals. The data are published quarterly in the CDR Weekly. The data collected so far can be used as baselines only and do not indicate trends.

15 May 2002 : Column 726W

Microbiology laboratories in England and Wales have been voluntarily reporting MRSA bacteraemias to the Public Health Laboratory Service (PHLS) for many years. Provisional quarterly data are published in the CDR Weekly. Corrected annual data have been published recently in the 1999–2000 Review of Communicable Disease.

Some private microbiology laboratories report some infections to the PHLS, but these are a very small proportion of reports received.

Data from a voluntary system are shown as follows:

Laboratory reports of staphylococcus aureus isolated from blood and their susceptibility to methicillin: England and Wales, annual totals 1997–2001

Total reportsSusceptibility not reportedSensitive to methicillinResistant to methicillin (MRSA)Total susceptibility reportedPercentage (MRSA)
1997(16)9,3281,7195,3122,2977,60930.2
1998(16)9,3741,7465,0202,6087,62834.2
1999(16)10,8131,8485,6243,3418,96537.2
2000(16)11,6351,6675,7924,1769,96842.0
2001(17)12,6311,2386,6264,76711,39241.8

(16) Corrected data (PHLS Communicable Disease Surveillance Centre 1999–2000 Review of Communicable Diseases)

(17) Provisional data (CDR Weekly)


Smallpox Vaccine

Mr. Kevan Jones: To ask the Secretary of State for Health for what reason it was decided to establish a national stockpile of smallpox vaccine; who took the decision; and on what date. [53930]

Mr. Hutton: The United Kingdom has held a substantial stockpile of smallpox vaccine for contingency purposes since smallpox vaccination ceased in the 1970s. The existing stock of vaccine is nearly 30-years-old. Although the vaccine has retained its potency, the technology underpinning these stocks is now also 30-years-old. In the aftermath of the events of September 11, we reviewed our ability to deal with terrorist attacks involving biological weapons. We have decided that the sensible course of action is to up-date our existing smallpox vaccine supplies with new supplies of cell based vaccines to reflect advances in vaccine development and safety standards.

Ministers took the decision to proceed to purchase smallpox vaccine on 11 March, and a contract was signed with PowderJect on 11 April.

Mr. Kevan Jones: To ask the Secretary of State for Health how many doses of smallpox vaccine have been procured; at what cost; and how was the number of doses determined. [54022]

Mr. Hutton: The Department is not putting information about the size of its smallpox vaccine stock or its deployment in the public domain as this is information that might be useful to terrorists. As smallpox has been eradicated since the 1970s, its re-introduction into the UK is only likely if there is a terrorist attack on the United Kingdom. This therefore raises issues of national security. The cost of the current procurement is £32 million.

Mr. Kevan Jones: To ask the Secretary of State for Health if the smallpox vaccine to be supplied by Powderject will be trialled. [53932]

Mr. Hutton: There are currently no plans to undertake clinical trials of the smallpox vaccine in the United Kingdom. Since smallpox does not currently exist in the population, trials of protective efficacy are not possible.

The European Union committee for proprietary medicinal products is currently considering the requirements for the development and manufacture of second generation smallpox vaccine, which will include guidance on the design of clinical trials.

Dr. Gibson: To ask the Secretary of State for Health which population of humans will be targeted in clinical testing of smallpox vaccines; and what tests will be used to determine immunity protections. [53902]

Mr. Hutton [holding answer 2 May 2002]: There are currently no plans to undertake clinical trials of the smallpox vaccine in the United Kingdom. Since smallpox does not currently exist in the population, trials of protective efficacy are not possible.

The European Union committee for proprietary medicinal products is currently considering the requirements for the development and manufacture of second generation smallpox vaccine, which will include guidance on the design of clinical trials.

Dr. Gibson: To ask the Secretary of State for Health, pursuant to the answer of 25 April 2002, Official Report, column 460W, on the smallpox vaccine, who the members of the specially convened sub-group of the Joint Committee on Vaccination and Immunisation are; what their institutional and commercial affiliations are; and how often the sub-group meets. [53897]

15 May 2002 : Column 727W

Mr. Hutton [holding answer 2 May 2002]: The expert sub-group, under the chairmanship of the chair of the joint committee on vaccination and immunisation (JCVI), was convened by the Department. The sub-group was comprised of those core members of the JCVI with experience relevant to smallpox vaccine issues, other experts with related expertise in virology, communicable disease control, smallpox eradication, intensive clinical care, smallpox research, and vaccine production and licensing. The Ministry of Defence and the Department were also fully represented at the meeting. In the interests of national security, the discussions were confidential as they related to the nation's preparedness to deal with a bioterrorist attack, and the experts gave their individual views on this basis. The names of the participants are therefore not being made public.

A declaration of interests and their academic affiliations is required of all members of the JCVI and a full list of members and their interests is shortly to be placed in the Library.

The expert sub-group has met five times since 11 September on an ad hoc basis to advise on medical countermeasures and outbreak control issues for smallpox and other biological agents. The sub-group was convened on an ad hoc basis and there is no timetable for regular meetings.

Dr. Gibson: To ask the Secretary of State for Health if he plans to issue information on smallpox vaccination quantities and deployment to (a) local authorities, (b) local hospitals and (c) the police. [53903]

Mr. Hutton [holding answer 2 May 2002]: As smallpox has not occurred naturally in the world since the 1970s, its re-introduction into the UK is likely to be as the result of a direct terrorist attack on our country. This raises issues of national security as well as public health. For this reason the Department is not making public details about the quantities of vaccine stocks or vaccine deployment, as this might be information that could be useful to terrorists. The Department issued guidance to all health authorities and regional directors of public health on the procedures to be followed in the event of a deliberate release of smallpox and other biological agents, on 17 October. At the same time, guidance for medical and laboratory staff was issued by the Public Health Laboratory Service (PHLS) concerning the precautions to be adopted in the event of an outbreak of smallpox. This advice is available on the PHLS website: http:// www.phls.co.uk/advice/smallpox—guidelines.pdf

In the event of an outbreak, more detailed information for patients and the public will be made available.

Dr. Gibson: To ask the Secretary of State for Health how long it will take Powderject to develop the plant and methodology to produce smallpox vaccine. [53901]

Mr. Hutton [holding answer 2 May 2002]: PowderJect's chosen UK partners, Bavarian Nordic, are already producing the smallpox vaccine to meet the UK contract.

Mr. Gerald Howarth: To ask the Secretary of State for Health what contact his officials have had with Impfstoffwerke Dessau Tornav in connection with the supply of smallpox vaccine. [54863]

15 May 2002 : Column 728W

Mr. Hutton: An official from the Department accompanied officials from the Ministry of Defence on a visit to Bavarian Nordic and Impfstoffwerke Dessau Tornav at the end of January on a fact-finding visit to discuss vaccine developments and manufacturing techniques and capacity for both types of smallpox vaccine being made by the company.

Mr. Gerald Howarth: To ask the Secretary of State for Health where the smallpox vaccine to be acquired under the contract with PowderJect Pharmaceuticals is to be manufactured; and which company will be responsible for its manufacture. [54864]

Mr. Hutton: Under the contract recently awarded to PowderJect, the smallpox vaccine will be manufactured in Germany under the responsibility of PowderJect and its collaborative partner Bavarian Nordic.


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