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22 Jul 2004 : Column 641W—continued
Qualifications (Mutual Recognition)
Mr. Baron: To ask the Secretary of State for Health whether in the negotiations on a separate directive on mutual recognition of qualifications, safeguards will be adopted to ensure that regulated health professionals will be covered by processes designed to protect public safety. [183936]
Mr. Hutton [holding answer 13 July 2004]: Yes. The text of the draft, as agreed by the Council, largely consolidates the existing directives which already include safeguards for those professions which benefit from automatic recognition: the current draft includes specific safeguards on service provision for professions having public health or safety implications.
Residential Care (Visually Impaired)
Mr. David Atkinson: To ask the Secretary of State for Health what obligations there are on social services authorities in relation to provision of residential care for the visually impaired; and if he will make a statement. [185139]
Dr. Ladyman: Social services departments are required to assess the needs of adults in accordance with the principles set out in Fair Access to Care Services, effective from 7 April 2003. Those eligible for care, including those who may have a sensory impairment, should receive care appropriate to their assessed needs in an appropriate setting. Except where an individual has complex or multiple needs, those with sensory impairments will often receive services in their own home.
Schizophrenia
Ann Winterton: To ask the Secretary of State for Health how many people have been diagnosed with schizophrenia in England in each of the last 30 years for which figures are available. [184427]
Ms Rosie Winterton: Information on the number of people diagnosed with schizophrenia in England in each of the last 30 years is not available. Figures are, however, available on the number of finished consultant episodes with a primary diagnosis of schizophrenic psychoses for the years 1995–96 to 2002–03, and are provided in the table.
| Number | |
|---|---|
| 1995–96 | 35,960 |
| 1996–97 | 35,500 |
| 1997–98 | 35,820 |
| 1998–99 | 36,920 |
| 1999–2000 | 36,420 |
| 2000–01 | 36,460 |
| 2001–02 | 30,080 |
| 2002–03 | 30,250 |
Source:
Hospital Episode Statistics.
Seroxat
Janet Anderson: To ask the Secretary of State for Health what advice he has received about the prescribing of Seroxat to people in the 18 to 29 years age group. [184292]
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Ms Rosie Winterton: In May 2003, the Government's independent scientific advisory committee, the Committee on Safety of Medicines (CSM), established an expert working group on the safety of Selective Serotonin Reuptake Inhibitors (SSRIs) because of continuing concerns about withdrawal reactions and possible suicidal behaviour associated with these products. The expert working group is still considering evidence regarding the safety of all SSRIs (including paroxetine). The group is expected to report on its findings later this year, and its report will be made available to the public with copies placed in the Library.
In June 2003, the CSM considered newly received clinical trial data for paroxetine in children and adolescents and, on the basis of these data and advised that paroxetine should not be used in patients under 18 years of age in the treatment of major depressive illness, because of evidence of an increased risk of suicidal behaviour and a lack of efficacy in this population group. This advice was communicated to prescribers and patients in June 2003 and again in December 2003.
In March 2004, the CSM issued advice to remind prescribes of the recommended starting and daily doses of paroxetine, as stated in the summary of product characteristics for this medicine.
A Europe wide review of the risks and benefits of paroxetine has also been undertaken by European Committee for Proprietary Medicinal Products (CPMP), with the United Kingdom in the lead. This review included an assessment of whether some young adults as well as those in the under 18 patient group may have an increased risk of suicidal behaviour when using this drug. No strong evidence has been found to support an increased risk and the CSM and the CPMP have advised that the balance of risks and benefits for paroxetine in the treatment of major depressive illness and anxiety disorders in patients of 18 years or older is favourable.
The CPMP has recommended that patients at high baseline risk of suicidal behaviour should be closely monitored during treatment with paroxetine. These include patients with a known history of suicidal behaviour or thoughts prior to starting treatment, and possibly young adults as a patient group. In April, a summary of the opinion of the CPMP referring to the need for monitoring during paroxetine treatment of patients at risk of suicidal behaviour, including those with a history of suicidal behaviour and young adults was released by both the European Medicines Agency and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
The CPMP review and recommendations are now being considered by the European Commission, with final decisions expected in the near future. When decisions have been reached by the Commission, a review of the evidence will be made public. If necessary, the product information for prescribers and patients will be updated and communicated, with details harmonised across the European Union.
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The MHRA emphasises that the patient information leaflet for Seroxat currently advises that symptoms of depression, including suicidal behaviour, may increase in the first few weeks of treatment and that patients should seek urgent medical attention if they have any distressing thoughts or experiences during this initial period or at any other time.
St. Helens and Knowsley Hospital Trust
Mr. Watts: To ask the Secretary of State for Health what major capital projects have taken place in St. Helens since 1994; and what projects are planned over the next two years. [184620]
Miss Melanie Johnson: The information requested has been placed in the Library.
Strategic Health Authority Spending
Mr. Cameron: To ask the Secretary of State for Health what the spending per head of population was in each strategic health authority in the last year for which figures are available. [186000]
Mr. Hutton: Information for 2002–03, the latest year available, is available in the Library.
Thimerosal
Mr. Burstow: To ask the Secretary of State for Health what evidence has been presented to his Department concerning health risks in relation to thimerosal. [184097]
Ms Rosie Winterton: The only vaccine currently used in the United Kingdom routine childhood immunisation programme that contains a mercury compound is the diphtheria, tetanus and whole cell pertussis (DTwP) vaccine which is given combined with haemophilus influenzae type B vaccine. The mercury is present as ethylmercury in the excipient thiomersal (also known as thimerosal). As with all medicinal products, vaccine safety is continually monitored by the Medicines and Healthcare products Regulatory Agency (MHRA) with advice from the independent expert advisory body, the Committee on Safety of Medicines (CSM). The MHRA and CSM have thoroughly reviewed the safety of mercury-containing vaccines, including alleged links with neurodevelopmental disorders, on a number of occasions.
In 2001, the CSM conducted a major review of the available evidence and has since then considered new data as it has emerged. In 2003, following a review of further studies, including two UK studies involving more than 100,000 children, CSM advice was placed on the MHRA website at http://medicines.mhra.gov.uk. Further studies from Denmark involving almost half a million children and a study from the United States have also specifically investigated the suggested link between mercury-containing vaccines and autism. None of these studies have found any evidence of a causal association with autism.
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On the basis of the available data, the CSM's advice remains that there is no evidence of harm from the very small quantities of thiomersal contained in some vaccines, with the exception of possible hypersensitivity reactions (typically skin rashes or local swelling at the site of injection). This view concurs with that of the World Health Organisation, the United States Institute of Medicine and the European Medicines Agency (EMEA).
There is a global goal to minimise environmental exposure to mercury compounds. In line with this and despite the strong evidence supporting the safety of thiomersal in vaccines, the EMEA continues to promote the development of vaccines without thiomersal or with the lowest possible levels of thiomersal. However, the EMEA acknowledges that during some manufacturing processes, the use of mercury compounds is necessary and in such cases, residual levels might be present in the final vaccine product.
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