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14 Mar 2003 : Column 464W—continued
Obesity
Tim Loughton: To ask the Secretary of State for Health what plans he has to introduce a National Standards Framework to tackle obesity. [100546]
Ms Blears: The Government are not considering a national standards framework (NSF) for obesity. However, action to address obesity is being taken forward through the NSF for coronary heart disease and older people. Action to reduce obesity will be necessary to meet Standard 1 of the NSF for diabetes .
Following publication of the Government's strategy for sustainable farming and food, the Department of Health is leading on developing a food and health action plan. This will pull together all of the issues on diet and nutrition, which is of direct relevance to the prevention and management of obesity, and promote action at national, regional and local levels.
Current guidance available to contribute to tackling obesity includes guidance issued by the National Institute for Clinical Excellence on the anti-obesity drugs orlistat and sibutramine, and surgery and a national quality assurance framework for exercise referral systems to promote physical activity. The evidenced-based Five-a-day handbook will support staff in primary care trusts and other organisations to establish community-wide initiatives to increase fruit and vegetable consumption, and the Health Development Agency is providing a report setting out the evidence base for the prevention and treatment of overweight people and obesity, and the maintenance of weight loss. Evidence from the local exercise action pilots will also provide guidance for increasing physical activity levels.
Older People (Drug Treatment)
Mr. Burstow: To ask the Secretary of State for Health what assessment he has made of the change from traditional to atypical antipsychotics drugs to treat older people in (a) care homes and (b) hospitals; what assessment he has made of possible over-medication of people using antipsychotic drugs; and if he will make a statement. [99380]
Jacqui Smith: Information about the prescribing of antipsychotic drugs is only available in relation to prescriptions dispensed in the community. It is estimated that, in 2001, just under 40 per cent, of antipsychotics dispensed to older people were atypicals, while in April-September 2002 this proportion is estimated to have increased to just over a half. There are likely to be a number of reasons for the move to
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atypicals. One is that clinicians believe they are better tolerated by patients than traditional antipsychotices. The Government is aware of concern about the possible overuse of antipsychotic drugs for older people A number of steps should help ensure their appropriate use—in particular, implementation of the medicines management supplement of the older people's national service framework and the requirements in the care homes national minimum standards.
Parliamentary Questions
Tim Loughton: To ask the Secretary of State for Health when the hon. Member for East Worthing and Shoreham will receive answers to his questions refs (a) 89928, (b) 92551 and (c) 92538. [100502]
Jacqui Smith: I refer the hon. Member to the replies that my right hon. Friend the Minister of State gave on 26 February 2003, Official Report, column 636W and on 28 February 2003, Official Report, column 779W. I also refer the hon. Member to the reply I gave him on 12 March 2003, Official Report, column 338–39W.
Patient Choice
Dr. Fox: To ask the Secretary of State for Health who will determine whether a patient in Greater Manchester waiting six months for (a) orthopaedic treatment, (b) ENT treatment or (c) general surgery is eligible to choose an alternative hospital. [99107]
Mr. Hutton: Approval has recently been given by the Department of Health to the establishment of a national health service based "CHOICE" pilot scheme. In Greater Manchester, this is to be based around the Greater Manchester Surgical Centre at Trafford General Hospital. When fully up and running in October 2003, the pilot proposes that any patient registered with a general practitioner in Greater Manchester who has been waiting over six months in the specialties of general surgery, ear, nose and throat and orthopaedics for set of procedures will be eligible to choose an alternative treatment centre.
Practice Lists (Child Removal)
Mr. Norman: To ask the Secretary of State for Health what measures he has taken to prevent GP practices removing children not immunised against MMR from their practice list. [99179]
Mr. Hutton: General practitioners should not remove patients from their lists in these circumstances. The General Medical Council has issued guidance—"Duties of a Doctor— Good Medical Practice", which makes it clear that patients should not be removed because of the financial impact of their care or treatment on the practice.
The Department fully supports that advice. The proposed new general medical services contract which was announced on 21 February is intended not only to provide for a consistently high quality service to patients but also to avoid perverse incentives such as any which might encourage removal of patients from practice lists other than for good reason.
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Smoking
Chris Ruane: To ask the Secretary of State for Health what recent research his Department has undertaken into the major health effects of passive smoking in (a) adults, with particular reference to pregnant women and (b) children, with particular reference to babies aged between eight and 12 weeks. [97575]
Ms Blears: The independent Scientific Committee on Tobacco and Health concluded in its 1998 Report that:
- Exposure to environmental tobacco smoke is a cause of lung cancer and, in those with long-term exposure, the increased risk is in the order of 20–30 per cent.
Exposure to environmental tobacco smoke is a cause of ischaemic heart diseases and if current published estimates of magnitude of relative risk are validated, such exposures represents a substantial public hazard.
Smoking in the presence of infants and children is a cause of serious respiratory illness and asthmatic attacks
Sudden infant death syndrome, the main cause of post-neonatal death in the first year of life, is associated with exposure to environmental tobacco smoke. The association is judged to be one of cause and effect.
Middle ear disease in children is linked with parental smoking and this association is likely to be causal.
- www.doh.gov.uk/scoth/index.htm
http://www.archive.official-documents.co.uk/document/doh/tobacco/report.htrn
Mr. Pollard: To ask the Secretary of State for Health what research he has commissioned on the effects of passive smoking in the workplace; and if he will make a statement. [98492]
Ms Blears: The independent Scientific Committee on Tobacco and Health concluded in its 1998 Report that:
- Exposure to environmental tobacco smoke is a cause of lung cancer and, in those with long term exposure, the increased risk is in the order of 20–30 per cent.
- Exposure to environmental tobacco smoke is a cause of ischaemic heart diseases and if current published estimates of magnitude of relative risk are validated, such exposures represents a substantial public hazard
The independent Scientific Committee on Tobacco and Health subsequently re-iterated this view in its 2001 Annual Report. The statement can be found on the following websites:
www.doh.qov.uk/scoth/index.htm
http://www.archive.official-documents.co.uk/document/doh/tobacco/report.htm
No further recent research has been commissioned by the Department into the health effects of passive smoking.
Mr. Chaytor: To ask the Secretary of State for Health what recent research his Department has carried out into the health implications of passive smoking. [98921]
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Ms Blears [holding answer 27 February 2003]: The independent Scientific Committee on Tobacco and Health concluded in its 1998 Report that:
- Exposure to environmental tobacco smoke is a cause of lung cancer and, in those with long-term exposure, the increased risk is in the order of 20–30 per cent.
Exposure to environmental tobacco smoke is a cause of ischaemic heart diseases and if current published estimates of magnitude of relative risk are validated, such exposures represents a substantial public hazard.
Smoking in the presence of infants and children is a cause of serious respiratory illness and asthmatic attacks.
Sudden infant death syndrome, the main cause of post-neonatal death in the first year of life, is associated with exposure to environmental tobacco smoke. The association is judged to be one of cause and effect.
Middle ear disease in children is linked with parental smoking and this association is likely to be causal.
- www.doh.gov.uk/scoth/index.htm
http://www.archive.official-documents.co.uk/document/doh/tobacco/report.htm
Chris Grayling: To ask the Secretary of State for Health what his policy is on (a) smoking in public places and (b) passive smoking. [98843]
Ms Blears: The White Paper, "Smoking Kills" committed the Government to working in partnership with industry to reduce the problem of exposure to passive smoke through voluntary action rather than legislation. It praised the example of the licensed hospitality industry, which agreed, with Government support, the Public Places Charter. The Charter commits signatories to increasing the provision of facilities for non-smokers, improving ventilation and giving customers better information about the level of smoke-free facilities in a given establishment.
We consider that if we are to ensure protection against passive smoking in public places, we need action nationally and locally both to raise awareness of the risks associated with passive smoking and to increase the prevalence of smoke free environments. The Department of Health will continue to encourage the development of smoke free policies, working with employers and communities.
At a national level the Department of Health has, since 1998, worked with the hospitality industry to reduce the problem of exposure to passive smoking through the development of a Public Places Charter. An independent evaluation of the Charter is being commissioned, and further work will be considered on the basis of the findings.Locally, the Department is funding tobacco control alliances across England to work in communities to raise awareness and to increase the number of smoke-free environments. Findings from these projects will inform future development of the Department's work in this area.
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The Department of Health will, in addition to action already under way, develop education and information resources to raise awareness and understanding of the risks associated with passive smoking.
Mr. Chaytor: To ask the Secretary of State for Health if he will make it his policy to support legislation against smoking in the workplace. [98922]
Ms Blears [holding answer 27 February 2003]: Although the Government do not support legislation to ban smoking in the workplace, existing health and safety legislation, the Health and Safety at Work Act 1974, places responsibility on employers to protect the health, safety and welfare of their employees.
The Government are giving careful consideration to the Health and Safety Commission's proposals for an Approved Code of Practice on Smoking in the Workplace (ACoP). While consideration of the ACoP continues, other action is being taken to encourage the provision of smoke free areas in public and workplaces.
We consider that if we are to ensure protection against passive smoking in public places and workplaces, we need action nationally and locally both to raise awareness of the risks associated with passive smoking and to increase the prevalence of smoke free environments. The Department will continue to encourage the development of smoke free policies, working with employers and communities.
Locally, the Department is funding tobacco control alliances across England to work in communities to raise awareness and to increase the number of smoke free environments. Findings from these projects will inform future development of the Department's work in this area.
The Department will, in addition to action already under way, develop education and information resources to raise awareness and understanding of the risks associated with passive smoking.
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