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7 May 2003 : Column 761W—continued

Drug Misuse and Dependence

Mr. Paul Marsden: To ask the Secretary of State for Health pursuant to his Answer of 1 April 2003, Official Report, column 691W, if he will place a copy of Drug Misuse and Dependence-Guidelines of Clinical Management (1999); in the Library. [110036]

Ms Blears: Copies of 'Drug Misuse and Dependence—Guidelines on Clinical Management' are available in the Library. The document is also available on the Department's website at http://www.doh.qov.uk/drugdep.htm.

Epilepsy

Mr. Paterson: To ask the Secretary of State for Health how many sudden unexpected deaths from epilepsy there were in (a) Shropshire, (b) the West Midlands, (c) England and (d) the UK in each of the last five years for which figures are available. [111667]

Ruth Kelly: I have been asked to reply.

The information requested falls within the responsibility of the National Statistician. I have asked him to reply.

Letter from Len Cook to Owen Paterson, dated 7 May 2003:

As National Statistician, I have been asked to reply to your recent question concerning how many sudden unexpected deaths from epilepsy there were in (a) Shropshire, (b) the West Midlands, (c) England and (d) the UK in each of the last five years for which figures are available (111667).

7 May 2003 : Column 762W

The figures requested are given in the following table. The total number of deaths with an underlying cause of epilepsy are also provided as context for the number that are "sudden unexpected deaths".

Number of deaths with an underlying cause of epilepsy⁽²⁵⁾ and among those, those where "sudden unexpected death in epilepsy"⁽²⁶⁾ was mentioned on the death certificate, England, West Midlands Government Office Region and Shropshire,⁽²⁷⁾ 1997 to 2001⁽²⁸⁾Number of deaths

	England			West Midlands			Shropshire
Year	All	Sudden unexpected	All	Sudden unexpected	All	Sudden unexpected
1997	769	54	77	*	*	—
1998	789	55	76	*	7	—
1999	819	87	97	5	8	—
2000	804	97	90	*	11	—
2001	984	149	118	25	9	*

— Zero deaths

*Fewer than five deaths

⁽²⁵⁾ Cause of death selected using the International Classification of Diseases, Ninth Revision (ICD-9) code 345 for the years 1997 to 2000, and, for the year 2001, the International Classification of Diseases, Tenth Revision (ICD-10) codes G40 and G41.

⁽²⁶⁾ Deaths where "sudden unexpected death in epilepsy" or similar wording (e.g. "sudden unexplained death in epilepsy") was written on the death certificate.

⁽²⁷⁾ Figures relate deaths of usual residents of these areas. Figures for Shropshire are for the former county as they include deaths in Telford and Wrekin which became a unitary authority in 1998. Figures for the United Kingdom are not available.

⁽²⁸⁾ Figures are for deaths which occurred in these years.

EU Cancer Plan

Mr. Bercow: To ask the Secretary of State for Health if he will list (a) the names, titles and grades of the officials who sit on the EU committee for the implementation of the Community action plan to combat cancer, (b) the number of times, and the dates, on which it has met since January 2002, (c) the agenda items it has considered since January 2002, (d) the decisions it has made since January 2002 and (e) the means used to communicate the decisions to the House. [110280]

Ms Blears: No officials now sit on this committee which existed for the purpose of the Europe Against Cancer programme. The Europe Against Cancer programme was completed in December 2002.

Fertility Treatment

Mr. Dhanda: To ask the Secretary of State for Health (1) what action he is taking to ensure that infertility treatment and assisted conception techniques are available on the NHS throughout England and Wales; [110829]

(2) if he will make a statement on the National Institute for Clinical Excellence's review of infertility services; [110833]

(3) what representations he has received from West Gloucestershire primary care trust regarding provision of infertility services. [110832]

Ms Blears [holding answer 1 May 2003]: The West Gloucestershire primary care trust (PCT) has made no representations to my right hon. Friend the Secretary of State for Health about the provision of infertility

7 May 2003 : Column 763W

services. Along with other PCTs, it is awaiting the outcome of the review of infertility services by the National Institute for Clinical Excellence (NICE).

In NICE we have a means of bringing order to what has, until now, often been an unfair way for patients to access treatment and care. NICE guidelines will provide recommendations for good practice based on the best available evidence of clinical and cost effectiveness. The guidelines emerging from NICE will reflect the three stages of infertility services, which are primary care, where couples first contact their general practitioner, secondary care for more advanced exploration and treatments, and tertiary centres that provide the high tech treatments such as in-vitro fertilisation.

Overall, however, we are seeking to achieve integrated guidance so that when couples have to be referred on to a further stage in the investigation and treatment of their infertility they can be offered a seamless service.

We expect the guidance produced by NICE to be implemented consistently across the national health service and the uptake of this guidance will be monitored locally and by the Commission for Healthcare Audit and Inspection. Clinicians have to make an independent clinical judgement taking due account of NICE's advice and the strength of evidence which lies behind it.

NICE is expected to deliver the guidelines in November 2003.

Methadone Overdose Deaths

Ms Atherton: To ask the Secretary of State for Health what research his Department has (a) commissioned into the number of methadone overdose deaths in the UK in the last 12 months for which figures are available and (b) evaluated on the role of methadone supervision in reducing overdose deaths. [110598]

Ms Blears: The Office for National Statistics maintains a database that contains information on deaths from drug-related poisonings for each year since 1993.

In 2001, the last year for which figures are available, there were 207 deaths where methadone was mentioned on the death certificate. It should be noted that where more than one drug is mentioned on the death certificate, it is not always possible to tell which of them was primarily responsible for the death.

Comprehensive reviews of the effectiveness of methadone have been provided by several authors (Hall et al., 1998, Farrell et al., 1994, Bertschy 1995, Marsch, 1998). Most of those studies demonstrating the effectiveness of methadone are of on-going maintenance treatment but the evidence generally becomes weaker as the duration of treatment shortens, with little systematic evidence to support short-term detoxification. Specific studies include Fontain & Ansseau, 1995, Glass, 1993 and Gossop, M. et al., 2001. High quality medical and psychosocial services, a clear orientation towards social rehabilitation, treatment longevity and slow detoxification of well-stabilised patients have all been identified as giving the best outcomes, including reducing overdose deaths.

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Prostate Cancer

Jon Trickett: To ask the Secretary of State for Health what plans he has to encourage applications for research funding for projects relating to prostate cancer. [109919]

Ms Blears: The Department, jointly with other members of the National Cancer Research Institute (NCRI), has established the NCRI prostate cancer collaboratives, and is funding half of the total cost of £7.4 million over five years. The collaboratives regularly issue calls for proposals for pilot projects to support innovative research ideas.

The Department is currently directly funding a large-scale randomised controlled trial (called ProtecT) evaluating the effectiveness of treatments for clinically localised prostate cancer. The trial, at a total cost of about £14 million, is being undertaken in nine centres. It will involve over 100,000 men between the ages of 50 and 69 years, and will compare three treatments: active monitoring; radical prostactectomy, and radical radiotherapy. The Department is also funding several other important projects into other aspects of prostate cancer that have been identified as priorities, and by 2003–04 will be directly funding £4.2 million of research a year into prostate cancer, subject to quality proposals being received.

Jon Trickett: To ask the Secretary of State for Health what plans he has to extend the model of the Prostate Cancer Advisory Group to other disease groups. [109912]

Ms Blears: The Department will continue to encourage, build on and improve partnership working between the National Health Service, the voluntary sector and professional organisations. The prostate cancer advisory group is one model that can be considered as this work develops.

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