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Mr. Wiggin: To ask the Secretary of State for Health what plans he has to bring forward country of origin food labelling. 
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Ms Blears: Rules on origin labelling of food are set at European Union level. The Food Standards Agency has taken the lead in pressing for changes to improve the clarity and amount of information available to consumers particularly in relation to country of origin. In the meantime, the Agency has published advice to help enforcement authorities tackle misleading labelling.
Brian Cotter: To ask the Secretary of State for Health what plans he has to ensure that in areas where there is a shortage of general practitioners that extra funding will be provided to aid the recruitment process. 
Mr. Hutton: Funding to aid general practitioner recruitment is targeted at primary care trusts classified as being in under doctored areas, on the basis of the number of general practitioner principals, or equivalents, per weighted head of the population. The list will be reviewed and updated periodically.
Tim Loughton: To ask the Secretary of State for Health (1) what progress has been made with setting up assertive outreach and crisis intervention/home treatment teams for mental health services in West Sussex; 
Ms Blears: The earmarked funding included in the allocation for 200203 for investment in mental health was #1.112 million. In addition to mandatory cost pressures, over #800,000 of this allocation has been used for the provision of specific mental health services across West Sussex. There has also been additional commissioning of services not provided locally, such as high secure placements, amounting to #0.5 million. Monitoring is undertaken by the strategic health authority through the annual delivery agreement it has with the primary care trusts.
West Sussex Health and Social Care National Health Service Trust is developing plans for outreach, crisis intervention and home treatment teams as part of its adult mental health services strategy. Work is also progressing on the development of a crisis resolution service in Adur, Arun and Worthing with a view to the services becoming operational in April 2003.
Mr. Key: To ask the Secretary of State for Health how many health inspectors are available to check imports through the ports of (a) Southampton, (b) Bristol, (c) Portsmouth, (d) Poole, (e) Weymouth, (f) Bournemouth Airport and (g) Southampton Airport; and if he will make a statement. 
Ms Blears [ holding answer 15 October 2002]: I am advised by the Food Standards Agency that responsibility for employing environmental health
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officers at airports and seaports rests with the local authorities which have responsibilities for port health work. The number of enforcement officers employed is determined by the local authorities. The numbers of such officers are not held centrally.
Mr. Hoban: To ask the Secretary of State for Health if he will make a statement on the allocation of responsibility between a primary care trust and a hospital trust in the event that the latter incurs a financial deficit. 
Mr. Hutton: National health service trusts should ensure they do not incur a financial deficit. However, the underlying cause of a financial problem and the identification of any remedial action necessary needs to be handled jointly between primary care trusts and NHS trusts and managed overall by the strategic health authority.
Mr. Andrew Mitchell: To ask the Secretary of State for Health if he will make a statement on progress towards a reduction in hospital acquired infections. 
Ms Blears: A number of actions are already under way to help reduce infections, and analysis of infection control returns shows improved performance over the last two years. However, further work is needed, and we are working with key stakeholders to develop a targeted action plan for health care associated infection as part of our strategy to combat infectious diseases.
Mr. Gray: To ask the Secretary of State for Health, what the level is of indebtedness of the North Wiltshire and Kennett PCT. 
Ms Blears: Kennett and North Wiltshire Primary Care Trust started the current financial year with a range of financial pressures. These included the distribution of the liabilities of the former Wiltshire Health Authority, the share of underlying recurring deficits in providers within the strategic health authority area and a range of other cost pressures including primary care prescribing. As part of the assistance received from the NHS Bank, following the application by the Avon, Gloucestershire and Wiltshire Strategic Health Authority, the trust was allocated the second highest share of any organisation in the health authority area. The health authority will work with the trust in developing a three year recovery plan to address the underlying shortfall.
Roger Casale: To ask the Secretary of State for Health, what further steps he intends to take to promote the integration of health and social services. 
Jacqui Smith: The Government intend to continue to support the integration of health services, with not only social services but all health-related functions of councils.
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This month the Department of Health, working with the Office of the Deputy Prime Minister, will launch a new network to further support and promote joint working.
We have also recently announced our intention to pilot Children's Trusts. We expect as a minimum that these will bring together services from health, education and social care to deliver better co-ordinated services for children and their parents.
Mr. Heald: To ask the Secretary of State for Health (1) when he intends to publish the conclusions of the Medicines Control Agency's consultation, MLX286, on the herbal ingredient kava-kava in unlicensed medicines; 
(3) which herbal interest groups and organisations are participating in the voluntary agreement to withdraw products containing kava-kava from sale in the United Kingdom; how many have not agreed to the voluntary agreement; and if he will list the reasons his Department has received from such organisations for not participating; 
(4) what discussions he has held with (a) the Medicines Control Agency and (b) the Food Standards Agency with regards to the proposals to prohibit the sale of products containing kava-kava in the United Kingdom; 
(5) if he will make a statement on his position regarding the sale and use of the herbal ingredient kava-kava in herbal remedies and food products; 
(6) what representations he has received from herbal interest groups with regards to the (a) voluntary agreement to withdraw the ingredient kava-kava from unlicensed medicines and food products and (b) the proposals to prohibit the herbal ingredient kava-kava in unlicensed medicines and food products; 
(7) whether products containing the herbal ingredient kava-kava sold in the United Kingdom are comparable with such products sold in Germany. 
Ms Blears: Following initial advice from the Committee on Safety of Medicines in December 2001 as to public health risk associated with medicines containing Kava-kava, a voluntary agreement between the Medicines Control Agency (MCA) and the herbal sector to withdraw from sale medicinal products containing Kava-kava took effect at the beginning of 2002. In July the Committee on Safety of Medicines (CSM) gave further advice, that there was evidence that in rare cases Kava-kava was associated with hepatotoxicity, which may be serious in nature. The CSM made the provisional recommendation that use of the plant should be prohibited in unlicensed medicines. The Government considered that advice and asked the Medicines Control Agency to consult on proposals to prohibit the sale, supply or importation of unlicensed
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medicinal products consisting of, or containing, Kava-kava except those for external use only. The proposals were set out in consultation letter MIX 286.
The consultation period has now ended and the Government have requested further advice on this issue, taking account of the responses to consultation, from the independent advisory committee, the Committee on Safety of Medicines. In addition, in accordance with the statutory procedure under section 62 of the Medicines Act 1968, the consultation responses have been referred to the Medicines Commission, who will report their findings and conclusions to Ministers. The Government will make an announcement once it has considered this advice and the Commission's report.
During the consultation period around 50 responses were received, with a majority of those commenting supporting the proposal. A number of the responses from the herbal sector advocated alternative options, in particular the continued availability of Kava-kava with voluntary inclusion of warning information for the purchaser or the continued availability of Kava but subject to restrictions, for example as to strength.
Over 20 representative organisations in the herbal sector or individual companies have at various stages notified the MCA of their participation in the voluntary agreement. In the period preceding the CSM's further advice in July, the MCA was aware that one company had withdrawn from the agreement on the basis of its view that there was insufficient evidence of risk to the public from Kava-kava to justify the withdrawal of the product, although it subsequently resumed participation. The current position is that the MCA is not aware of any relevant representative groups or organisations that have advised their members not to participate in the agreement. However, the national association of health stores notified the MCA at the end of July of their position that it was a matter for individual shops to check with their insurance companies to establish whether cover would remain in force.
The MCA has received a wide range of oral or written representations and views from the herbal sector relating to the voluntary agreement. The main points made by various parties have included: support for the agreement pending a decision on the future regulatory status of Kava-kava; disagreement or doubt that the strength of evidence of risk justified the agreement or its continuation; requests for an early decision about any regulatory action in order to resolve the position; and concerns over whether all parties were implementing or abiding by the agreement.
As herbal remedies may be supplied under section 12 of the Medicines Act 1968 without a marketing authorisation or any other form of notification to the MCA, a comprehensive record of Kava-kava products on the United Kingdom's market is not available. The MCA therefore requested information from the herbal sector about unlicensed remedies containing Kava-kava which had been on the market prior to the voluntary agreement. The information provided was insufficiently comprehensive to enable a detailed comparison with products on the German market. However, products listed by the herbal sector included ones similar to those
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sold in Germany, such as standardised extracts providing a daily dose of between 120 and 210 mg of kavalactones.
In relation to the position on food, since December 2001 the Food Standards Agency (FSA) has been advising against consumption of foods containing Kava-kava and encouraging industry to voluntarily withdraw these products from the market. In July 2002, acting on the advice of the chairman of the committee on toxicity of chemicals in food, consumer products and the environment (COT), the FSA initiated a consultation on proposals which would prohibit the use and import of Kava-kava in foods. The consultation period has now ended and the FSA is considering the responses. Around 30 written responses have been received from a range of interested parties with roughly equal numbers supporting and opposing the proposals.
My right hon. Friend the Secretary of State for Health has had no discussions with the FSA on this matter. The FSA has no additional information to that outlined above on compliance with the voluntary withdrawal. The FSA does not hold information on the range of food products containing Kava-kava available on the German market.
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