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25 Jun 2003 : Column 831W—continued
Diabetes
Bob Russell: To ask the Secretary of State for Health how many vacancies there are for diabetes specialists; and when he expects all posts to be filled. [118877]
Mr. Hutton: The table shows the three month vacancy rate and three month vacancy number for consultants specialising in endocrinology and diabetes mellitus taken from the National Health Service vacancy
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survey. The vacancy rate of 2 per cent. is lower than the average vacancy rate across all specialties, which was 3.8 per cent. as at 31 March 2002.
The number of consultants in endocrinology and diabetes mellitus has increased by 59 per cent. between September 1997 and March 2002. By September 2004, we expect to see further increases in the number of trained specialists of around 160, over a 2000 baseline, as part of the substantial planned expansion of the consultants workforce.
| 3 month vacancy rate % | 3 month vacancy number | |
|---|---|---|
| England (excluding HA staff) | 2.0 | 9 |
3 month vacancy notes:
1. Three month vacancy information is as at 31 March 2002
2. Three month vacancies are vacancies which trusts are actively trying to fill, which had lasted for three months or more (whole time equivalents)
3. Three month Vacancy Rates are three month vacancies expressed as a percentage of three month vacancies plus staff in post
4. Percentages are rounded to one decimal place
Source:Department of Health Vacancies Survey, March 2002
The NHS vacancy survey has been conducted in March each year since 1999. The survey collects information on the number of posts, which trusts are actively trying to fill, which have been vacant for three months or more.
Drugs
Mark Tami: To ask the Secretary of State for Health how much needle exchange programmes have cost the NHS in each of the last three years. [113022]
Miss Melanie Johnson: Needle exchange schemes are one of a number of harm reduction activities carried out in support of the Drug Strategy. Spend on needle exchange schemes is not separately identifiable but a total of £27 million of Government funding was spent on harm reduction activities in 2001–02. We do not have figures for the previous two years. Other harm reduction activities include work to reduce the spread of blood-borne diseases, including HIV and Hepatitis B and C, and the Government's Action Plan to reduce drug related deaths.
Substantial funding is also made available for needle exchange schemes from National Health Service mainstream resources but we have no way of estimating the actual amount, as this is based on local decision-making by drug action teams and primary care trusts.
Drugs Policy (Brain Report)
John Mann: To ask the Secretary of State for the Home Department what assessment he has made of the relevance of the recommendations of the second Brain committee report to UK drugs policy. [119667]
Miss Melanie Johnson: The second Brain Committee Report dates back to 1965, when the nature of drug use, both in the numbers misusing drugs and the types of
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drugs being taken were very different from today. Since then a number of reports into drug misuse have been written, particularly the Home Affairs Select Committee Third Report on the Government's Drugs Policy "Is it Working". A large number of the recommendations in this report have be accepted and used to inform the development of the Government's current policy. Therefore, we do not believe that an assessment of the recommendations in the Brain Report would be appropriate.
Elderly Care (Cleethorpes)
Shona McIsaac: To ask the Secretary of State for Health if he will make a statement on funding for care for the elderly living in Cleethorpes constituency. [121536]
Dr. Ladyman: It is for the North East Lincolnshire Council to decide, in the light of its priorities, how much to spend on social care for elderly people in the Cleethorpes constituency and how to make available the necessary funds. North East Lincolnshire's personal social services formula spending share increased by 6.1 per cent. in cash terms, to £34.925 million in 2003–04. In addition, the social care grants which North East Lincolnshire has been allocated for 2003–04 have increased substantially. In particular, the council has been allocated £527,000 from the new access and systems capacity grant and £155,000 from the delayed discharges grant.
Food Supplements
Brian Cotter: To ask the Secretary of State for Health what steps he is taking to ensure that the maximum permitted levels for nutrients in food supplements as stated in Article 5 of the Food Supplements Directive are set on the basis of safety; and if he will make a statement. [120765]
Miss Melanie Johnson [holding answer 20 June 2003]: Article 5 of the Food Supplements Directive sets out principles for setting maximum permitted levels for vitamins and minerals in food supplements. The Government's view is that these should be based on consideration of safety rather than supposed need, so as to neither unnecessarily limit consumer choice nor unduly restrict trade.
The Food Standards Agency (FSA), which is responsible for negotiations on this issue, takes every opportunity to press this case bilaterally with other Member States. In May, the FSA wrote to other Member States to advise them of the conclusions of the United Kingdom Expert Group on Vitamins and Minerals (EVM) on safe intakes of vitamins and minerals. The EVM's advice will form the basis of the UK's position when substantive discussions at EU level take place in due course.
Healthy Start Initiative
Mrs. Calton: To ask the Secretary of State for Health if he will place in the Library a list of those focus groups consulted about the Healthy Start Initiative proposals, including (a) methods of recruitment, (b) reports of the meetings and (c) conclusions reached. [120261]
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Miss Melanie Johnson: Details of the focus groups are provided in Annex A of the report on the Healthy Start consultation exercise. A copy of the report, which summarises the outcome of the consultation, is available in the Library.
Copies of the 500 individual responses to the consultation, including feedback from the focus groups, can be obtained on request from the Department at healthvstart@doh.gov.uk or from Healthy Start Team, Room 702, Wellington House, 133–155 Waterloo Road, London, SE1 8UG.
Hormone Replacement Therapy
Dr. Kumar: To ask the Secretary of State for Health what recent research he has assessed on links between hormone replacement therapy and susceptibility to Alzheimer's; what research is being conducted into this in the UK; and what guidance has been issued to GPs and hospitals prescribing HRT about advising patients of the risks of dementia. [118239]
Miss Melanie Johnson: The main Government agency for research into the causes and treatments of disease is the Medical Research Council (MRC), which receives its funding from the Department of Trade and Industry via the Office for Science and Technology.
The MRC WISDOM (Women's International Study of Long Duration Oestrogen after Menopause) trial was to assess the balance of risks and benefits of long-term hormone replacement therapy (HRT) on conditions such as heart disease and dementia to allow women and their doctors to make informed choices about treatment. The decision was taken on 23 October 2002 to stop the trial for scientific and practical reasons.
The Committee on the Safety of Medicines (CSM) considered a pre-publication copy of the Women's Health Initiative (WHI) study (a USA study, published in the Journal of the American Medical Association in 2002, demonstrating that HRT doubled the risk of dementia in women over 65 years) and gave advice that the information confirmed the known risks of long-term HRT. The CSM had issued advice on the safety of HRT in 1997 and did so again in 2002. Product information, including patient information leaflets, gives clear advice on the indications and risks of HRT. In the light of the WHI study, the Department of Health issued an urgent communication to primary care trust chief executives, medical directors of trusts and directors of public health to cascade to general practitioners, alerting them to the study's findings and to deal with queries from women who were concerned about HRT following publicity about the study.
Hospices
Tim Loughton: To ask the Secretary of State for Health how many hospice beds have been taken out of service in the last year. [120371]
Miss Melanie Johnson: We do not hold this information centrally.
Industrial Disease
Dr. Kumar: To ask the Secretary of State for Health what evidence he has collated on possible links between
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industrial processes and installations and specific cancers, broken down by (a) cancer type and (b) geographic region; and if he will make a statement. [120630]
Miss Melanie Johnson: I have been asked to reply.
For people occupationally exposed to industrial processes, I am advised by the Health and Safety Executive that the highest profile industrial processes definitively linked to cancer by the International Agency for Research on Cancer, are as follows.
| Industrial process | Cancer type |
|---|---|
| Aluminium Production | Lung, bladder |
| Destructive distillation of coal | Skin, bladder, respiratory tract |
| Iron and steel founding | Lung |
| Boot and shoe manufacture and repair | Nose |
| Furniture and cabinet making | Nose |
| Manufacture of isopropyl alcohol | Paranasal sinuses |
| Production of paint and work as a painter (and decorator) | Lung cancer |
| Manufacture of rubber and rubber compounds | Bladder |
| Manufacture of dyes containing aromatic amines | Bladder |
| Manufacture of mustard gas | Lung, upper respiratory tract |
In addition, there are many agents and substances that have been proved to cause cancer, irrespective of industrial process. The highest profile of these are:
| Agent or substance | Cancer type |
|---|---|
| Asbestos | Lung, pleura, peritoneum |
| Ionising radiation | Wide variety including breast, leukaemia, lung, thyroid |
| Benzene | Leukaemia |
| Chromium VI compounds | Lung |
| Nickel compounds | Lung, nose |
| Vinyl chloride | Liver |
| Coal tar pitches | Lung |
| Arsenic and arsenical compounds | Skin, lung |
| Ultraviolet radiation | Skin |
| Bischloromethyl ether | Lung |
| Mineral acid mists | Larynx |
| Diesel engine exhaust | Lung |
| Cadmium | Lung |
There are hundreds of other chemicals and processes for which there is some evidence of a link with cancer, but for which a causal association has not been confirmed.
The Government have funded a number of studies by the Small Area Health Statistics Unit at Imperial College, London, of cancer rates in people living near industrial installations. Details of the cancers and the geographical regions studied are given in the published reports of these studies, details of which are given.
Cancer incidence and mortality near the Baglan Bay petrochemical works, South Wales; by S. Sans, P. Elliott, I. Kleinschmidt, G. Shaddick, S. Pattenden, P. Walls, C. Grundy and H. Dolk, published in Occupational and Environmental Medicine (1995), volume 52, pages 217–224.
Lympho-haematopoeitic malignancy around all industrial complexes that include major oil refineries in Great Britain; by P. Wilkinson, B. Thakrar, P. Walls, M. Landon, S. Falconer, C. Grundy and P. Elliott, published in Occupational and Environmental Medicine (1999), volume 56, pages 577–80.
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Incidence of cancer of the larynx and lung near incinerators of waste solvents and oils in Great Britain; by P. Elliott, M. Hills, J. Beresford, I. Kleinschmidt, D. Jolley, S. Pattenden, L. Rodrigues, A. Westlake, G. Rose, published in the Lancet (1992), volume 339, pages 854–58.
Angiosarcoma of the liver in Great Britain in proximity to vinyl chloride sites; by P. Elliott and I. Kleinschmidt, published in "Occupational and Environmental Medicine" (1997), volume 54, pages 14–18.
Cancer incidence and mortality around the Pan Britannica Industries pesticide factory, Waltham Abbey; by P. Wilkinson, B. Thakrar, G. Shaddick, S. Stevenson, S. Pattenden, M. Landon, C. Grundy and P. Elliott, published in "Occupational and Environmental Medicine" (1997), volume 54, pages 101–107.
In its third report, the Committee on Medical Aspects of Radiation in the Environment (COMARE) recommended an investigation of the geographical distribution of childhood cancer and leukaemia in Great Britain and how the pattern of cases around nuclear installations compares with the national pattern. This study in nearing completion. The database will also allow investigation of other environmental factors and their potential relevance to the temporal and spatial distribution of childhood cancer.
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