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Mr. David Amess (Southend, West) (Con): I congratulate the hon. Member for Derby, North (Mr. Laxton) on securing the debate, and I agree with absolutely everything that he said. He and I are fellow officers of the all-party group on hepatology, which was formed in July 2003. We are very grateful for the advice we have been given by the Hepatitis C Trust, which has such diverse patrons as Robbie Williams, Miss Emilia Fox, the Marchioness of Bute and the former Eurovision song contest winner, Miss Sandy Shaw.
As far as the all-party group is concerned, this is a very big problem. It is clear that the Government have accepted that it is a problem. It is certainly encouraging that the Government launched a public awareness campaign in December, but I and other Members are unclear about whether the Government also see it as a big problem. Certainly, the Government are not running a big awareness campaign. There are no billboards and no messages on television or radio. Nor has there been any serious attempt to reach ethnic minorities, although the high prevalence of the disease in countries of origin suggests that those communities may contain many undiagnosed sufferers. Can the Minister tell us what the Government's plans are, apart from translating English information leaflets into other languages?
At the launch in December, the chief medical officer promised that the awareness campaign would be effective, and it is vitalliterally, because the lives of those hundreds of thousands of young, undiagnosed people are at riskthat it be effective. Can the Minister assure the all-party group that a full evaluation will be made and that the results will be published?
The campaign is for two years, but I believe that the issue is too important to wait until then to assess its effectiveness. When will the market research exercise by the Minister's Department commence and will it be repeated? What can the Minister tell the House about the first results of the national outcomes indicators, such as the total number of laboratory confirmed hepatitis C infection reports for 2005? I believe that she answered a question put by my hon. Friend the Member for West Chelmsford (Mr. Burns) a few months ago on that point.
If the campaign is ineffective, hundreds of thousands of people will remain undiagnosed and may become seriously ill. Many of them will need liver transplants. How will the Government cope, given that the liver
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transplant service is already stretched? I have one constituent who, according to the consultants attending him, is No. 1 on the list for a liver transplant, but he has been in that position since just before Christmas. The shortage of livers for people who need transplants is very serious. If the Minister does not have time to reply to those points tonight, I hope that she will write to the all-party group and tell us what the Government plan to do in the next few months.
The Parliamentary Under-Secretary of State for Health (Caroline Flint): I congratulate my hon. Friend the Member for Derby, North (Mr. Laxton) on his success in obtaining this debate. I commend him for his work as the vice-chair of the all-party parliamentary hepatology group, and I congratulate the hon. Member for Southend, West (Mr. Amess) on his work as chair of the group.
Despite what my hon. Friend has said this evening, I hope that I will be able to assure him that the Government recognise the importance of hepatitis C as a public health issue, both globally and nationally. The Hepatitis C Trust and others in the voluntary sector will continue to lobby Government, because that is their function, but I can assure my hon. Friend that we have good working relationships with the trust and other voluntary sector organisations and, indeed, we provide grant funding for some of their activities. Officials also have regular contact with the trust and have sought to involve it in the awareness campaign. The trust will no doubt continue to press for more, as that is part of their remit.
We are fortunate to have, but are not for one minute complacent about, a relatively low prevalence of hepatitis C compared with other developed countries and many other parts of the world. Even so, hepatitis C represents a major challenge in terms of preventing new infections, reducing the level of undiagnosed infections and ensuring that patients with the disease get the care that they need.
My hon. Friend mentioned the chief medical officer's work to try to highlight the issue in the health community through his infectious disease strategy, "Getting Ahead of the Curve". Demonstrating that the condition was an infectious disease problem required intensified action. Subsequently, in 2002, we published the hepatitis C strategy for England for consultation, with proposals to improve prevention, diagnosis and treatment. Last year, we followed that up with a hepatitis C action plan for England.
I have listened carefully to what my hon. Friend and the hon. Member for Southend, West said this evening. I shall not be able to answer every point, but I am open to meeting representatives of the all-party group to go through its report and recommendations and to discuss the issues further. I hope that we can offer some reassurance that we have begun work in several fields. The four key areas are surveillance and research, increasing awareness and detecting undiagnosed infections, high-quality services for people with hepatitis C and prevention.
Raising awareness is an essential part of the campaign and in July 2004, after we launched the action plan, we sent all general practitioners and practice nurses in
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England a comprehensive hepatitis C information pack for health care professionals. We also sent it to a range of other relevant health professionals because, unfortunately, the knowledge base among those at the front line of our services was quite low.
We also established a new hepatitis C awareness website for health care professionals and the public: www.hepc.nhs.uk. These are still early days, but I am pleased that use of the website is growing; currently, there are about 4,500 visits per month, with a 56 per cent. increase in June 2005 compared with the previous month. That is to be welcomed.
We have supplemented those resources with features in a range of health care journals for professionals and through exhibition stands at conferences. The public awareness campaign for hepatitis C began last December with the introduction of the new NHS hepatitis C telephone information line, which provides confidential information and advice through personal communication and will complement the website and the more general service offered by NHS Direct.
Mr. Lindsay Hoyle (Chorley) (Lab): As my hon. Friend is aware, there are two prisons in my constituency. Is there information for inmates and for staff to warn them about the consequences of hepatitis C and how contagious it can be?
Caroline Flint: I am sure that there is, but I will check. In my former position at the Home Office, I had responsibility for the national drugs strategy and it is important that such links be recognised. Injecting drug users are a vulnerable group, which is why the strategy refers to drug agency teams and multi-agency working. I hope that will include prisons to ensure that effective work is done. As primary care trusts will have a greater role in prison health, they will be looking into those points. As Members will be aware, new legislation introduces drug testing on charge and arrest and mandatory drug assessments, so we shall be addressing hepatitis C and other issues with such people even before they get to court. Home Office officials have assured us that that is part of the package of support given to people whose use of drugs leads to their offending behaviour. I have three prisons in my constituency, and I am aware that the issue is important; the risks are high for people in prison, especially from the shared use of needles.
We are closely monitoring usage of the telephone helpline. In March, for example, there were 242 calls. About six in 10 callers were women and only four in 10 were male, which is interesting given the prevalence of hepatitis C. About eight in 10 callers were calling for themselves, a family member or friend. More than four in 10 calls were for information and advice about the different ways in which hepatitis C can be spread and nearly three in 10 calls were about hepatitis C testing. More than half the callers were aged between 26 and 55. More than one fifth of calls resulted in a referral to another agencya general practitioner or a specialist voluntary organisationso that people could take up the support they needed. So I hope that that gives an indication of some of the work that we are doing through the awareness campaign to provide practical access to advice for those people who seek it.
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Another aspect and a novel activity in the public awareness campaign is the open-air exhibition of photographs of people with hepatitis C taken by a professional photographer who herself has been successfully treated for hepatitis C. The first exhibition took place in Leicester square in March and has recently begun to tour regional cities, starting in Nottingham last week. The exhibition provides a helpful focus to say that these are people like us and to find another way to reach a wider community in city centres. That approach involves the strategic health authority, primary care trust and others, so where the exhibition takes place, the local health services are geared up to respond to the demand for services or information.
Local and regional media are also involved, and the combination of those three factors has given a tangible sense of focus to the photographic exhibition campaign. We are keeping an eye on the nature and scale of that campaign and how it has worked, as well as anything else that we may be doing. We are not waiting to the end of the programme to decide what works and what does not; we are trying to make assessments as we go along to see what is working. Obviously, we have to look at what is not working as well.
My hon. Friend the Member for Derby, North mentioned improving surveillance of hepatitis C, and I agree that it is important to improve the evidence base as a way to measure progress. We have funded the Health Protection Agency, which is responsible for the national surveillance of hepatitis C, to carry out several projects so that we can get better estimates, identify any trends and model the possible future disease burden to help in the planning of services. For example, the HPA is running a project to improve the data collected when people are tested for hepatitis C, including clinical and risk factor information.
Of local interest to my hon. Friend will be the Trent cohort study of patients infected with hepatitis C, which is co-ordinated by Nottingham university. That study, which the Department is also funding, is investigating the natural history of hepatitis, trends of referral in the region and the effect of antiviral drug therapy on the long-term outcome of hepatitis C-related liver disease. Derby city hospital is participating in that study.
My hon. Friend asked whether, as is proposed by the Scottish Executive, there should be a national database in England to collect information. We will consider the benefits and feasibility of establishing such a database in England when the output of the Scottish system becomes available next year. However, we must judge that against the Trent work to find out what added benefits we would achieve by extending the database even further.
Injecting drug users are an important target group, as they are at greatest risk of hepatitis C. We provided the National Treatment Agency for Substance Misuse with £1 million for local projects to increase the hepatitis C testing of injected drug users and related activities. About 45 local projects were funded, including one by the Derbyshire drug and alcohol action team to develop a new hepatitis C service for drug users in north Derbyshire. Those projects should help forge local partnerships and, we hope, drive up good practice and prevention. We are also funding the NTA to carry out a national audit of needle exchange schemesone of the actions in the hepatitis C action plan for England. The
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drug interventions programme, as I said, gives us another opportunity to capture a group of people for whom hepatitis C is a real possibility and certainly to screen and test them and get them appropriate treatment for the future.
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