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Group B Streptococcus
Bob Spink: To ask the Secretary of State for Health (1) what research his Department has conducted into group B streptococcus testing during pregnancy; [131562]
- (2) what advice his Department has given to health care professionals on Group B streptococcus testing during pregnancy; [131563]
(3) if he will make it his policy to provide Group B streptococcus testing on the NHS near the end of pregnancy; and if he will make a statement. [131564]
Dr. Ladyman: The UK National Screening Committee (NSC) makes recommendations to Ministers on all aspects of screening programmes. There is insufficient evidence to demonstrate that routine screening of all pregnant women in the United Kingdom and the treating of those carrying group B streptococcus with intravenous antibiotics during labour would be beneficial. The NSC has commissioned a further assessment of the existing evidence on screening against the criteria used to assess potential screening programmes. At the adjournment debate on this issue on 9 July 2003, Ministers asked the NSC to review the position thoroughly as quickly as possible and to consider recommendations at its meeting in December 2003.
The health technology assessment (HTA) programme considers research into screening for group B streptococcus to be a high priority for further research, add it will consider commissioning further research in more detail at its December meeting. The HTA programme is also currently considering detailed proposals for research into the effectiveness of a rapid test for group B streptococcus carriage that could be used during labour.
The Royal College of Obstetricians (RCOG) is producing clinical guidelines on prevention and treatment of early onset neonatal group B streptococcal disease. The Department has commissioned the National Institute for Clinical Excellence to produce guidelines, due in October 2003, on routine ante-natal
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care. These will both make an important contribution to ensuring that healthcare professionals are better informed about this condition.
Harefield Hospital
Mr. Randall: To ask the Secretary of State for Health when the last survey was conducted on staff attitudes at Harefield Hospital to the proposed move to Paddington Heath Campus; and if he will publish the results. [131864]
Mr. Hutton: Staff retention and recruitment is a major priority in the planning process for the Paddington Health Campus. The most recent Harefield staff survey was conducted by the Royal Brompton and Harefield National Health Service Trust in February 2003. This is a trust document and a copy is available from them on request.
Hospital Financing
Lynne Jones: To ask the Secretary of State for Health pursuant to his Answer of 10 June 2003, Official Report, column 835W, on hospital financing, what additional powers foundation trusts will have to enter into joint venture arrangements compared to (a) other NHS organisations and (b) local authorities' social services departments; and if he will make a statement on the reasons for differences. [120150]
Mr. Hutton: Subject to legislation, a national health service foundation trust will be able to enter into joint arrangements with local authorities social services departments where such arrangements are consistent with its primary purpose and terms of authorisation. This will allow for the organisation concerned to determine locally what the arrangements should be and is consistent with the Government's policy of decentralisation.
Under current arrangements, NHS trusts can only enter into joint arrangements with private bodies in circumstances specified in directions given by the Secretary of State, and with his consent. While NHS foundation trusts are not subject to directions given by the Secretary of State, and do not require his consent before entering into joint ventures (including the setting up of companies), they have no greater powers to do so than current NHS trusts.
Inpatients (Length of Stay)
Mr. Burstow: To ask the Secretary of State for Health what the average length of stay of in-patients admitted as (a) emergencies and (b) elective was in each of the last five years broken down by age. [131632]
Mr. Hutton: The information requested is shown in the table.
Notes:
Grossing—figures have not (yet) been adjusted for shortfalls in data (i.e. the date are ungrossed).
Source:
Hospital Episode Statistics (HES), Department of Health.
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Lung Disease
Harry Cohen: To ask the Secretary of State for Health what plans there are for a national service framework on lung disease; and if he will make a statement. [131775]
Miss Melanie Johnson: There are no plans for a national service framework (NSF). We are, however, taking steps to improve services for people with lung disease. The children's NSF will include childhood asthma as an exemplar condition. The NSF for chronic heart disease already has a reduction in cigarette smoking as one of its major targets. We have also banned tobacco advertising and made smoking reduction aids available on national health service prescription.
Additionally we have asked the National Institute for Clinical Excellence to prepare guidelines for the management and diagnosis of chronic obstructive pulmonary disease (COPD). We expect this guidance to be produced in 2004. Also, phase three of the national primary care collaborative (NPCC) focuses on chronic disease management, in particular COPD and diabetic care. The programme, which will be rolled out to every primary care trust (PCT) in the country by April 2004, will support frontline NHS staff and primary care trust managers and will involve 20 PCTs and more than 100 general practitioner practices. It will help them to develop skills and techniques to deliver improvements in care and work with patients to maximise their self-care and help improve outcomes.
Medicine and Management
Chris Grayling: To ask the Secretary of State for Health what actions he is taking following the report of the joint clinician/manager working group entitled Medicine and Management. [127733]
Mr. Hutton: The Chief Medical Officer is taking forward this important area of work, working closely with patients' organisations and those responsible for standards in the medical profession.
It is expected this work will be completed in early 2004.
Methotrexate
Tim Loughton: To ask the Secretary of State for Health if he will make a statement on the (a) availability and (b) side effects of methotrexate. [127554]
Miss Melanie Johnson: Methotrexate is a prescription only medicine widely available throughout the United Kingdom. The use of this disease-modifying anti-rheumatic drug (DMARD) has increased in recent
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years. The National Institute for Clinical Excellence (NICE) has recommended the use of methotrexate and other DMARDs as first line therapy prior to the use of the newer tumour necrosis factor (TNF-a) blockers for the treatment of rheumatoid arthritis (RA).
As with all medicines the Medicines and Healthcare products Regulatory Agency (MHRA) and the Committee on Safety of Medicines (CSM) have continued to closely monitor the safe use of methotrexate. Reports of suspected adverse drug reactions (ADRs) to medicines are collected by the MHRA and the CSM through the spontaneous reporting scheme, the Yellow Card Scheme. To date the MHRA/CSM have received 876 UK ADR reports associated with methotrexate. The most common side effects of methotrexate include nausea, abdominal pain, a reduced number of white blood cells and soreness of the mouth and lips. Other rare but more serious side effects include fibrosis and cirrhosis of the liver, bone marrow suppression and pneumonitis.
In 1997 the product information was amended to advise that patients who receive methotrexate therapy are required to have a full blood count and renal and liver function tests measured on a regular basis. An article was also published in the MHRA/CSM drug safety bulletin "Current Problems in Pharmacovigilance (Vol. 23, September 1997).
In September 2000 health professionals were advised, via another article in "Current Problems in Pharmacovigilance" (Vol. 26 September 2000), to exercise caution when prescribing and dispensing methotrexate. In 2001 the CSM established a working group to review medicines labelling in order to reduce the likelihood of medication error occurring and within the review advised that all oral dose preparations should prominently display a warning to check the dose and frequency of methotrexate on the front face of the carton.
In September 2002 the CSM reviewed the increasing number of UK reports of pneumonitis which had been received by the MHRA in association with methotrexate. The CSM recommended updating the product information to provide clearer guidance to prescribers and patients, recognising that the increase was probably a direct consequence of the recent dramatic increase in methotrexate use in patients with early RA. The MHRA is continuing to work closely with the National Patient Safety Agency to reduce the risk of medication errors associated with methotrexate.
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