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Treatment Costs

Mr. Flight: To ask the Secretary of State for Health what the average cost of (a) a general practitioner consultation and (b) an attendance at an accident and emergency department was in the last period for which figures are available. [215135]

Mr. Hutton: The average cost of a general practitioner surgery consultation was £18 in 2003–04. (Source: Unit costs of health and social care 2004 by the Personal Social Services Research Unit).

The Department collects unit cost and activity data from all national health service providers in England each financial year. This information is available in the document, Payment by Results, Core Tools, 2004", a copy of which is available in the Library.

The average cost of a patient attending an accident and emergency department, and being either referred on from the department or discharged, in 2003–04 was £66.


David Taylor: To ask the Secretary of State for Health whether NHS counselling and family support services have been made available to the relatives of victims and witnesses of the Indian Ocean tsunami who are resident in the UK. [215638]

Ms Rosie Winterton: All the families bereaved by the tsunami have been allocated a family liaison officer to provide immediate support and help. For others who have been affected by the disaster, psychological therapy, counselling and support services are available in every strategic health authority.


Sandra Gidley: To ask the Secretary of State for Health how many people in each primary care trust have received the (a) flu and (b) pneumonia vaccine this winter; and what percentage of eligible people this represents in each case. [213088]

Miss Melanie Johnson: The information requested has been placed in the Library.


Paul Flynn: To ask the Secretary of State for Health (1) how many people in the UK were prescribed the painkiller Vioxx in each year since 1999; [211470]

(2) how many people in the UK suffered (a) heart attacks and (b) fatal heart attacks while prescribed the painkiller Vioxx in each year since 1999; [211471]

(3) how many people in the UK have been prescribed painkillers in the category of Cox-2 inhibitors in each of the last five years. [211472]

Ms Rosie Winterton: The number of reports of heart attack (myocardial infarction) received in association with rofecoxib (Vioxx) through the yellow card scheme is shown in table 1. It is important to note that doctors are asked to report suspected adverse reactions
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regardless of any doubts about a causal association. Therefore, a report of a particular adverse reaction on the database does not necessarily mean that the drug caused it, and other factors such as the patient's underlying condition may have played a part. As with all spontaneous reporting schemes, under-reporting is an inherent feature and reporting may be stimulated by publicity. 12 of these reports were received following the withdrawal of rofecoxib on 30 September 2004.
Table 1

Number of reports of myocardial infarction (Ml)Number of reports of Ml with a fatal outcome

Table 2 shows the number of prescription items of cyclo-oxygenase 2 (COX-2) selective inhibitors that have been dispensed in the community in England from 1999 to 2003.
Table 2
Number of prescription items (thousand)

Rofecoxib (Vioxx)Celecoxib (Celebrex)Valdecoxib (Bextra)Etoricoxib (Arcoxia)

Prescription cost analysis data from the Prescription Pricing Authority.

Volunteer First Aiders

Nick Harvey: To ask the Secretary of State for Health whether attendance by an unqualified volunteer
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first-aid 'responder' at the scene of an emergency call to the ambulance service is assessed as fulfilling his Department's target response time. [216327]

Ms Rosie Winterton: Guidance is set out in the statistical bulletin 'Ambulance services, England: 2003–04', which states that an emergency response may be by:

Although the initial emergency response may be to send a rapid response vehicle or approved first responder, a fully equipped ambulance vehicle (car or ambulance) able to transport the patient in a clinically safe manner is still required to attend the incident within 14 to 19 minutes of the initial call, not within 14 to 19minutes from arrival of initial responder.

A copy of the statistical bulletin 'Ambulance services, England: 2003–04' is available in the Library. A copy of the 'Data set change control procedure', which details this information will be placed in the Library.

Yorkshire, Wolds and Coast PCT (Office Accommodation)

Mr. Greg Knight: To ask the Secretary of State for Health what the total cost was of the acquisition and refurbishment of the Four Winds office accommodation at Driffield for the Yorkshire, Wolds and Coast primary care trust. [215070]

Miss Melanie Johnson [holding answer 10 February 2005]: North and East Yorkshire and Northern Lincolnshire strategic health authority reports that the rental cost of the Four Winds office accommodation in Driffield to the Yorkshire Wolds and Coast primary care trust is £72,500, plus value added tax, per annum. The accommodation was refurbished at the expense of the landlord.
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Monday 21 February 2005


Air Quality

Sarah Teather: To ask the Secretary of State for Environment, Food and Rural Affairs what assessment she has made of the link between trees in urban areas and air quality. [214937]

Alun Michael: Trees provide benefits to urban air pollution, but can also have adverse effects on air quality.

Adverse effects of trees on air quality

Trees can have adverse effects on air quality. They can release biogenic emissions known as volatile organic compounds (VOCs), which in combination with oxides of nitrogen (NOx), can contribute to the formation of other pollutants, especially ozone and particles. Ozone and particles are known to damage human health when in the lower atmosphere. In addition, trees release pollen, which can cause allergic reactions in sensitive people, and can be associated with hay fever and asthma.

Beneficial effects of trees on air quality

Trees deliver air quality benefits in two ways. Firstly, the cooling effect of their shade can directly reduce evaporative emissions from vehicles and other fuel storage, and by cooling homes and offices, power generation emissions are also lessened. Cooling also reduces the speed at which atmospheric chemical reactions occur.

Secondly, trees can remove various pollutants from the atmosphere via deposition to their leaves and needles. Trees can remove pollutants typically associated with urban air pollution such as ozone, nitrogen dioxide, sulphur dioxide, and ammonia reducing atmospheric concentrations and improving air quality. The pollutants generally collect in the leaves or bark which are then shed as part of the tree's life cycle. Trees also reduce concentrations of harmful particulate matter when leaf surfaces collect airborne particles, that are subsequently washed to the ground when it rains. The trees most suited to removal of particles are those with large leaf areas, or sticky or hairy leaves. Studies indicate that the hairy leaves of lime trees can collect four times as many PM10 particles than plane trees.

In addition, trees can have a positive benefit in terms of global warming by acting as a sink for carbon dioxide, which is the most common greenhouse gas. Trees remove carbon dioxide from the air and release oxygen during photosynthesis. The carbon is stored in the tree and the oxygen is released back into the atmosphere.

A recent report entitled Trees and Sustainable Urban Air Quality", produced under the Natural Environment Research Council's Urban Regeneration and the Environment (URGENT) programme by the University of Lancaster and the Centre for Ecology and Hydrology Edinburgh, investigated the role of trees in reducing urban air pollution. The report concluded that trees that emit the least reactive VOCs and have large leaf surface areas have the best effect on air quality.
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Scots pine, common alder, larch, Norway maple, field maple, ash and silver birch were found to remove the most pollutants without contributing to the formation of new pollutants, whereas oaks, poplars and willows were found to have detrimental effects on air quality downwind.

In general, the report concludes that the effects on air quality of large scale planting of most tree species in cities would be positive and for example, by doubling the number of trees in the West Midlands, the concentration of small particles could be reduced by 25 per cent., avoiding 140 deaths that are currently caused by airborne particles each year in the West Midlands.

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