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Mr. Burstow: To ask the Secretary of State for Health pursuant to the answer of 28 June 2005, Official Report, column 1503W, on electroconvulsive therapy, when her Department will repeat its survey of electroconvulsive therapy. 
Ms Rosie Winterton: There are no plans to conduct a further survey on electroconvulsive therapy. In future, information on the use of electroconvulsive therapy will be available from the mental health minimum dataset.
Mr. Amess: To ask the Secretary of State for Healthpursuant to her reply of 14 July 2005, Official Report, column 1188W, on endof-life decision making, if she will list the stakeholders who have made representations to her Department on end-of-life issues during each of the last five years; and if she will make a statement. 
Ms Rosie Winterton: The Department has received an estimated 870 letters and emails from the public and organisations over the last five years on end-of-life issues, expressing a wide range of views and opinions.
Jane Kennedy: The Department is fully committed to the equality and diversity agenda and has policies and processes in place to ensure that there is no unfair discrimination on any grounds. The equality and human rights group, formerly the equality strategy group, was established in 2002 to develop policy and support and promote equality and diversity within the Department and the national health service. It had a central programme budget of £1.3 million in 200203, £1.1 million in 200304 and £1.12 million in 200405. A major focus of the group's work is to support action that builds equality and diversity into the design and delivery of all health and social care programmes and into the capacity of the health and social care workforce to provide individually appropriate services. The promotion of equality and diversity has therefore become an integral component within many wider policy initiatives, such that it is not possible to disaggregate spending.
Mr. Wallace: To ask the Secretary of State for Health what reciprocal financial arrangements her Department and her overseas counterparts will be putting in place under the European health insurance card scheme. 
Jane Kennedy: The European health insurance card (EHIC) scheme, like the E111 arrangements which it will replace, has its origins in Regulations 1408/71 and 574/72, which provide that member states shall pay each other for treatments given to each other's insured persons. Regulation 574 specifies how this shall be done, but member states may bilaterally agree to other mutually acceptable methods of payment. These arrangements already apply in respect of E111 and will also apply to the EHIC.
Mr. Davidson: To ask the Secretary of State for Health what assessment she has made of the likely effect of the EU Directive on Services in the Internal Market on UK regulation of privately-owned care homes where they are owned by an entity based in another EU member state. 
Ms Rosie Winterton: Negotiations on the draft directive on services in the internal market are at an early stage. Until the text is finalised, it is difficult to assess its precise effects on particular sectors.
A number of general impact assessments are available. The Department for Trade and Industry (DTI) has performed a partial regulatory impact assessment for the proposal, which indicates that the general benefits are likely to be substantial. This is available on the DTI website at:
An independent consultancy, Copenhagen Economics, has also assessed the general economic impact of the directive. It predicted that the services directive would add £25 billion to the European Union economy, create an extra 600,000 jobs, boost EU gross domestic product by 0.6 percent. and lead to an increase in real wages of 0.4 percent. Copies of both documents are available in the Library.
In addition to these general impact assessments, the Department has held informal consultations and taken the views of relevant parties concerning the possible impact of the services directive on social care providers. No economic analysis has been carried out to date.
Ms Rosie Winterton: Negotiations on the draft Directive on Services in the Internal Market are at an early stage. Until the text is finalised, it is difficult to assess its precise effects on particular sectors.
A number of general impact assessments are available. The Department of Trade and Industry (DTI) has performed a partial regulatory impact assessment for the proposal, which indicates that the general benefits are likely to be substantial. This is available on the DTI website at:
An independent consultancy, Copenhagen Economics, has also assessed the general economic impact of the Directive. It predicted that the Services Directive would add £25 billion to the European Union economy, create an extra 600,000 jobs, boost EU gross domestic product by 0.6 percent., and lead to an increase in real wages of 0.4 percent. Copies of both documents are available in the Library.
In addition to these general impact assessments, the Department has held informal consultations and taken the views of relevant parties concerning the possible impact of the Services Directive on the national health service. No economic analysis has been carried out to date. The United Kingdom position is to seek an exclusion for publicly-funded healthcare from the scope of the Directive, plus a derogation for all healthcare from the country-of-origin principle and the deletion of Article 23 on the assumption of healthcare costs.
However, the NHS Purchasing and Supply Agency (PASA) is committed to purchasing fairly-traded food and beverages. A fairly-traded policy has been published, with a number of products available on national frameworks to all trusts. PASA will be looking to expand the range of products available.
Ethically traded products are not just from the fair trade brand; they are also obtained from suppliers who have their own procedures for sourcing this type of product, for example, the Tea Sourcing Partnership.
Mr. Stewart Jackson: To ask the Secretary of State for Health when she expects to receive the report from the Scientific Advisory Committee on nutrition regarding the fortification of foods with folic acid as a preventative measure in respect of neural tube defects. 
Dr. Iddon: To ask the Secretary of State for Health what assistance she proposes to provide to the UK food supplements industry following the recent ruling of the European Court of Justice on the Food Supplements Directive; if she will make representations for the reopening of the text of the directive; and how she intends to take forward the commitments given to the meeting of hon. Members organised by the hon. Member for Bolton South East on 6 July. 
Caroline Flint: In May 2005, the Food Standards Agency (FSA) provided additional resource to assist the industry in producing dossiers to ensure that as many substances could continue to be used in food supplements after 1 August. The FSA has forwarded all dossiers received from industry to the European Commission and has given derogation to all substances submitted in dossiers, including dossiers where only very basic information has been provided.
The validity of the Food Supplements Directive was upheld by the European Court of Justice (ECJ). Following the ECJ judgement, I have spoken with the European Commission regarding the potential for further derogation to be provided by the directive and will discuss this again when the Commission has considered the judgment in detail.
Mr. Burns: To ask the Secretary of State for Health what guidance she has issued on the application of the Food Supplements Directive to (a) synthetically-produced nutrients and (b) naturally-occurring nutrients; and if she will make a statement. 
[holding answer 21 July 2005]: The Food Standards Agency (FSA) has published general guidance on the Food Supplements Directive. This is available on the FSA web site at http://www.food.gov. uk/foodindustry/vitmin/
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The FSA has not yet published any specific guidance on the application of the food supplements directive regarding synthetically produced nutrients and naturally occurring nutrients. The FSA has advised me that both forms of nutrients fall within the scope of the directive. The guidance will be updated following the final judgment from the European Court of Justice on 12 July to clarify any areas of uncertainty arising from the judgment, and in discussion with the European Commission.
Mr. Lansley: To ask the Secretary of State for Health (1) whether she expects nutrients contained in food supplements which are not listed in the annexes of the Food Supplements Directive to be banned on 31 December 2009; 
(2) what assessment she has made of the number of nutrient ingredients in food supplements on sale which have not had a dossier on their safety submitted to the Food Standards Agency and which are not included on positive lists in the annexes to the Food Supplements Directive; 
(3) what recent discussions she has had with the European Commission on the setting of maximum dosage levels for food supplements under the Food Supplements Directive; and when restrictions on maximum dosage levels will come into force; 
(4) what support she has provided to industry and small businesses to enable them to supply the evidence necessary to ensure that their products remain on the market after the Food Supplements Directive comes into force on 1 August. 
Caroline Flint: The European Commission Food Supplements Directive contains lists of vitamins and minerals permitted for use in food supplements. For those not listed in the annexes of the Directive, dossiers of safety information need to be submitted for assessment by the European Food Safety Authority (EFSA). If EFSA is unable to issue a positive opinion on the safety of the substance in question, then these will not be permitted in food supplements. EFSA has until 2009 to complete its assessment of dossiers.
The Food Standards Agency (FSA) has received over 500 dossiers and the industry has confirmed that this includes the majority of substances used in food supplements. Discussions between the FSA and the industry have not identified further ingredients which will not be covered by the dossiers.
The directive includes provisions for setting maximum permitted levels of vitamins and minerals in due course. The European Commission has yet to bring forward proposals on this and until it does so there are no restrictions on levels used in food supplements. I spoke with the European Commission on this matter on 12 July.
The FSA has provided £20,000 to the food supplements industry to pay an independent consultant employed by the industry to collate the information necessary for submitting dossiers. This funding was matched by the industry.
To ask the Secretary of State for Health what steps the Government are taking to ensure that the EU food supplements directive does not impact
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negatively on people (a) who use minerals and vitamins in connection with sport and (b) who use minerals and vitamins as a way of tackling chronic fatigue syndrome; and if she will make a statement. 
Caroline Flint: The Food Standards Agency (FSA) has granted derogation to all substances that have been supported by a dossier. These dossiers have been forwarded to the Commission and will be assessed for safety by the European Food Safety Authority (EFSA). The FSA has allowed basic information to be submitted in dossiers in order to maximise the number of substances which remain available for use in products pending advice from EFSA. This has resulted in the submission of over 500 dossiers and the trade manufacturers associations have confirmed that the list of substances for which derogation has been given include the majority of substances used by the supplements industry. This should therefore include those vitamins and minerals that may be used by some people in connection with sport and chronic fatigue syndrome.
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