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Acrylamide
Mr. Gibb: To ask the Secretary of State for Health what recent guidance the Chief Medical Officer has issued
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to the public regarding the incidence of acrylamide in baked and fried food; and if he will make a statement. [66835]
Ms Blears: The Food Standards Agency (FSA) is responsible for providing advice on this issue. It advised consumers on 24 April 2002 that there was no need to change their diet as a result of research published that day by the Swedish National Food Authority, which had found previously unexpected levels of acrylamide in a range of cooked and heat-processed foods. Further information on the levels of acrylamide in food and their significance to public health has since been published by FSA and others. The FSA has reiterated, in statements on 17 May and 27 June, that on the basis of current evidence people should eat a balanced diet including a variety of fruit and vegetables, and that as part of a balanced diet people should moderate their consumption of fried and fatty foods. The FSA has not advised people to stop eating any of the foods tested. The same advice has been issued by an expert consultation convened by the World Health Organisation and United Nations Food and Agriculture Organisation, and has been endorsed by the European Commission's Scientific Committee on Food. The FSA will publish further information on acrylamide in food as it becomes available, and will keep its public advice under review.
Encephalitis
Mrs. Calton: To ask the Secretary of State for Health how many cases of encephalitis tick-borne infection were diagnosed in the UK in each year since 1997. [70345]
Ms Blears: No clinical cases of UK diagnosed tick-borne encephalitis have been reported to the public health laboratory service communicable disease surveillance centre between January 1997 and the end of June 2002.
Devolution
Angus Robertson: To ask the Secretary of State for Health when the EU Committee on the approximation of the laws, regulation and administrative provisions of the Member States concerning the manufacture, presentation and sale of tobacco products is next due to meet; whether representatives of the Scottish Executive (a) have been and (b) are members of it; and if he will make a statement. [70602]
Ms Blears: Under European Union Directive 2001/37/EC on the manufacture, presentation and sale of tobacco products, provision is made for a committee to be set up to assist the European Commission in developing and updating the provisions of the Directive. The committee is currently in the process of being set up and its first meeting is anticipated to take place before the end of this year. The United Kingdom will be represented by one independent expert, who is not an official of either the UK Government or the Scottish Executive.
Angus Robertson: To ask the Secretary of State for Health when the EU Committee on the Community action programme on injury prevention is next due to meet; whether representatives of the Scottish Executive (a) have been and (b) are members of it; and if he will make a statement. [70598]
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Ms Blears: This Committee last met on 18 December 2001, when it was formally disbanded, there are no plans for this committee to meet again.
The Department has lead responsibility for representing the United Kingdom at meetings of this committee. They consult the Devolved Administrations to ensure points made represent all parts of the United Kingdom including the Scottish Executive.
Following the successful outcome of the recent conciliation exercise, a new European Union public health programme will start in January 2003. This programme will build on the work of the current committee which will cease to function under the new programme.
Angus Robertson: To ask the Secretary of State for Health when the EU Committee for the implementation of the Decision to set up a network for the epidemiological surveillance and control of communicable diseases is next due to meet; whether representatives of the Scottish Executive (a) have been and (b) are members of it; and if he will make a statement. [70596]
Ms Blears: The next meeting is due to be held on 7/8 October. The director of the Scottish Centre for Infection and Environmental Health (SCIEH) attended for the UK surveillance unit on one occasion.
The Scottish Executive is represented by the Department.
Angus Robertson: To ask the Secretary of State for Health when the EU Committee for the implementation of the Community action programme on health monitoring in the framework of the action plan for public health is next due to meet; whether representatives of the Scottish Executive (a) have been and (b) are members of it; and if he will make a statement. [70600]
Ms Blears: There are no plans for this committee to meet again.
The Department and the Office for National Statistics have had lead responsibility for representing the United Kingdom at meetings of this committee. They consult the devolved authorities to ensure points made represent all parts of the United Kingdom including the Scottish Executive.
Following the successful outcome of the recent conciliation exercise, a new European Union public health programme will start in January 2003. This programme will build on the work of the current committee which will cease to function under the new programme.
Angus Robertson: To ask the Secretary of State for Health when the EU Committee for the implementation of the Community action programme on health promotion, information, education and training is next due to meet; whether representatives of the Scottish Executive (a) have been and (b) are members of it; and if he will make a statement. [70599]
Ms Blears: We understand there are no plans for this Committee to meet again. The Department has had lead responsibility for representing the United Kingdom at meetings of this Committee. The Devolved Administrations have been consulted to ensure points made represent all parts of the United Kingdom including the Scottish Executive.
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Following the successful outcome of the recent conciliation exercise, a new EU Public Health programme will start in January 2003. This programme will build on the work of the Committee which will cease to function under the new programme.
Angus Robertson: To ask the Secretary of State for Health when the EU Committee for the implementation of the Community action programme for the prevention of AIDS and certain other communicable diseases is next due to meet; whether representatives of the Scottish Executive (a) have been and (b) are members of it; and if he will make a statement. [70597]
Ms Blears: The date of the next meeting has not been set. There are no Scottish executive members. The Scottish Executive is represented by the Department.
Nuclear Emergency Plan
Mr. Swayne: To ask the Secretary of State for Health what recent research he has commissioned into the practicality of distributing iodine tablets as part of a national nuclear emergency plan. [71465]
Mr. Hutton: The Government has established detailed plans for responding to major incidents involving radiation. Cross-departmental contingency plans are in place and regular exercises test national and local responses to a radiation or nuclear incident. Careful consideration has been given to the practicalities of distributing potassium iodate tablets to the population and arrangements for distributing these tablets have been tested in recent exercises.
RU-486
Mr. McNamara: To ask the Secretary of State for Health (1) what studies his Department has undertaken during each of the last 10 years into the safety of the abortion drug RU-486; and if he will make a statement; [70114] (2) what the (a) contra-indications and (b) side effects are of the use of the abortion drug RU-486; and if he will make a statement. [70218]
Ms Blears: RU-486, now more commonly known as mifepristone (Mifegyne), is licensed for use in medical termination of pregnancy. Information on how to use mifepristone, as well as information on possible side effects, is provided in the product information for prescribers in the summary of product characteristics (SPC) and for patients in the patient information leaflet (PIL).
Warnings and contraindications for the use of mifepristone which are included in the SPC and PIL are as follows: allergy to mifepristone or any component of the product, suspected ectopic pregnancy, pregnancy not confirmed by ultrasound scan or biological tests, chronic adrenal failure, severe asthma not controlled by therapy and presence of a inter-uterine device in situ. In addition, special care should be given to patients with haemostatic disorders with hypocoagulability or with anaemia, and patients on long term therapy with corticosteroids since corticosteroid efficacy can be decreased by concomitant treatment with mifepristone. Mifepristone is not
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recommended for use in patients with hepatic or renal failure or in women over 35 years of age and who smoke more than ten cigarettes a day.
As with all medicines, mifepristone is not without side effects. Some of the side effects experienced by patients such as pain, uterine contractions or cramping and vaginal bleeding result from the termination of pregnancy. Side effects of the medication which may occur in some women include nausea, vomiting, stomach cramping, hypersensitivity reactions such as skin rashes and urticaria, headaches, malaise, hot flushes, dizziness, chills and fever.
The Medicines Control Agency, with advice from the independent scientific advisory Committee, the Committee on Safety of Medicines, is responsible for monitoring the safety of all marketed medicines.
The safety of a mifepristone was evaluated at the time of granting a marketing authorisation and continues to be monitored using information from clinical trials, post-marketing studies and from spontaneous adverse reaction reports. There have been a large number of studies and reviews of the safety of mifepristone published in the scientific literature in the last ten years.
Induced abortion is one of the most commonly performed gynaecological procedures in Great Britain. Abortion, both surgical and medical, is safer than carrying a pregnancy to term and complications are uncommon. All available evidence in terms of safety and efficacy of mifepristone was reviewed by the Royal College of Obstetricians and Gynaecologists when producing its evidence based clinical guideline "The Care of Women Seeking Induced Abortion (2000)" and is referenced. Medical abortion is one of the methods recommended in the guideline.
Mr. McNamara: To ask the Secretary of State for Health (1) what he estimates will be the savings during each of the next five years to the National Health Service of using the abortion drug RU-486 instead of surgical abortion; and if he will make a statement; [70115]
- (2) what was the total cost to the National Health Service in each of the last five years of providing the abortion drug RU-486. [70119]
Ms Blears: The information available relates to all medical abortions, of which about 95 per cent. are undertaken using RU-486.
The estimated cost to the National Health Service for NHS-funded medical abortions that took place on NHS premises is in the table below. This information is not available prior to 1998–99.
| Inpatient and day case activity | Outpatient attendances(82),(83) | |
|---|---|---|
| 1998–99 | £3.9m | Not available |
| 1999–2000 | £4.4m | Not available |
| 2000–01 | £5.2m | £1.8m |
(82)A medical abortion, using RU486, is a two-stage process. The first stage, which is the administering of the drug RU486, often takes place in an outpatient clinic.
(83)The outpatient clinic component of the cost of medical abortions is not available prior to 2000–01.
Source:
National Schedule of Reference Costs.
The independent sector also undertakes some medical abortions, using RU486, under NHS contract. Costs to the NHS for these abortions are not collected centrally.
It is important that women should be offered a choice of recommended methods for relevant gestation bands, in accordance with the Royal College of Obstetricians and Gynaecologists' evidence-based guideline The Care of Women Requesting Induced Abortion (2000). The Government has not set targets or made projections for the future uptake and costs of medical abortion. There is no significant difference in the overall costs between surgical and medical abortion.
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Mr. McNamara: To ask the Secretary of State for Health what steps he is taking to ensure that the abortion drug RU-486 will be administered in accordance with the Abortion Act 1967, as amended by section 37 of the Human Fertilisation and Embryology Act 1990; and if he will make a statement. [70116]
Ms Blears: Under Section 2(2) of the Abortion Act 1967, as amended, registered medical practitioners must notify the Chief Medical Officer of every completed termination of pregnancy they perform. The notification form contains detailed information relating to the procedure including the doctors who certified there were grounds under the Act, gestation, method used and place of termination. Every form is checked and monitored by Departmental officials to ensure that the abortion was performed within the provisions of the Act.
Mr. McNamara: To ask the Secretary of State for Health (1) how many abortions were carried out in each of the last 10 years using the abortion drug RU-486; [70117] (2) what his proposed target levels in 2002–03 are for use of the abortion drug RU-486; and if he will make a statement. [70118]
Ms Blears: The number of abortions carried out in the last ten years using the abortion drug RU-486 for residents of England and Wales are shown in the table.
| Year | England | Wales | England and Wales |
|---|---|---|---|
| 1991 | 1022 | 42 | 1064 |
| 1992 | 1502 | 63 | 1565 |
| 1993 | 3719 | 224 | 3943 |
| 1994 | 5324 | 376 | 5700 |
| 1995 | 6983 | 685 | 7668 |
| 1996 | 8782 | 933 | 9715 |
| 1997 | 10345 | 956 | 11301 |
| 1998 | 12849 | 1064 | 13913 |
| 1999 | 14735 | 1284 | 16019 |
| 2000 | 17647 | 1844 | 19491 |
Source:
Statistics Division—Department of Health.
The Royal College of Obstetricians and Gynaecologists' evidence-based guideline The Care of Women Requesting Induced Abortion (2000) recommends that women should be offered a choice of recommended methods for relevant gestation bands. It is expected that as medical abortion becomes more widely available more women will choose this method. No targets have been set for the use of medical abortion.
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Mr. McNamara: To ask the Secretary of State for Health what the rate of incomplete abortions following the use of the abortion drug RU-486 is; and if he will make a statement. [70219]
Ms Blears: All methods of first trimester abortion carry a risk of failure to terminate the pregnancy, thus necessitating a further procedure. The evidence based clinical guideline The Care of Women Requesting Induced Abortion (2000) produced by the Royal College of Obstetricians and Gynaecologists states that the failure rate for medical abortions is around 6.0 per thousand.
Mr. McNamara: To ask the Secretary of State for Health what counselling is offered to a woman (a) contemplating, (b) during and (c) after an abortion using the abortion drug RU-486; and if he will make a statement. [70220]
Ms Blears: The Royal College of Obstetricians and Gynaecologists's evidence-based guideline "The Care of Women Requesting Induced Abortion" (2000), which applies to both medical and surgical abortions, recognises the importance of women seeking abortion receiving accurate impartial information. Verbal advice must be supported by printed information which every woman considering abortion can understand and may take away and read before the procedure.
Clinicians caring for women requesting abortion should try to identify those patients who require more support in decision making than can be provided in the routine clinic setting. Facilities for additional support, including access to social services, should be available. Appropriate information and support should be available for those who consider, but do not proceed to, abortion.
Professionals should be equipped to provide women with the information they need in order to give genuinely informed consent:
that abortion is safer than continuing a pregnancy to term and that complications are uncommon;
description of the abortion methods that are available;
immediate complications;
complications in the early weeks following abortion.
During the procedure, staff are on hand to give support to women.
The guideline also considers the mental health implications of termination and concluded: "Only a small minority of women experience any long term, adverse psychological sequelae after abortion. Early distress, although common, is usually a continuation of symptoms present before the abortion. Conversely, long-lasting, negative effects on both mothers and their children are reported where abortion has been denied."
Referral for further counselling should be available for the small minority of women who experience long term post abortion distress.
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