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Dr. Gibson: To ask the Secretary of State for Health(1) whether her Department has adopted the World Health Organisation 1992 recommendation that all countries adopt a universal vaccination for hepatitis B; 
(2) what plans she has for changing the hepatitis B vaccination regime. 
Caroline Flint: The Department has not implemented the World Health Organisation recommendation about universal immunisation against hepatitis B. The Joint Committee on Vaccination and Immunisation is currently reviewing the United Kingdom's hepatitis B immunisation programme to assess whether it needs to be altered.
Dr. Gibson: To ask the Secretary of State for Health if her Department will issue warnings about the possible risks of contracting hepatitis B associated with international travel. 
Caroline Flint: Health advice for travellers abroad, including about hepatitis B, is provided on the Department's website at http://www.dh.gov.uk/Policy AndGuidance/HealthAdviceForTravellers/General HealthAdvice/Diseases/DiseasesArticle/fs/en?CONTENT_ ID=4080299&chk=7pc2C2.
We have also produced a booklet, Health advice for travellers", which is available free of charge from post office outlets and provides advice about hepatitis B in the context of international travel. Further details about the booklet is available on the Department's website at http://www.dh.gov.uk/PolicyAndGuidance/Health AdviceForTravellers/fs/en.
In addition, the Department has funded the national travel health network and centre (NaTHNaC), which provides up to date advice for health professionals and travellers. This includes advice about hepatitis B, which is available from the NaTHNaC website at http://www.nathnac.org/travel/factsheets/hep_b_vaccine.htm.
Bob Spink: To ask the Secretary of State for Health what measures she is taking to encourage patients with hepatitis C to complete their self-administered courses of treatment to achieve viral clearance. 
The Department's hepatitis C awareness campaign provides advice and information about hepatitis C, including its treatment. The
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campaign includes patient leaflets, a national health service hepatitis C awareness website, a freephone hepatitis C information line and regional hepatitis C awareness events.
We are also providing grant funding to voluntary sector organisations that provide information, advice and support to individuals with hepatitis C.
The care of individual patients is a matter for their clinician and health care team.
Mr. Love: To ask the Secretary of State for Health what steps she is taking to improve the convenience and comfort of administration of treatment for hepatitis C. 
Caroline Flint: In line with Shifting the Balance of Power", most national health service funding is now passed on to NHS organisations so that they can make decisions about provision of local services.
The configuration of services for providing treatment for hepatitis C, including any outreach services, is therefore a matter for local determination. Treatment usually consists of a weekly injection and daily tablets and many patients can be taught to self-inject.
Mr. Burns: To ask the Secretary of State for Health what assessment she has made of future levels of hepatitis C infection if rates of identification and treatment of the disease remain unchanged. 
Caroline Flint [holding answer 20 July 2005]: The Department has funded the Health Protection Agency, working with the Medical Research Council's biostatistics unit at Cambridge, to provide estimates of future levels of hepatitis C infection and of hepatitis C-related liver disease.
The results of this on-going study will be submitted soon to a peer-reviewed journal for publication.
Tim Loughton: To ask the Secretary of State for Health pursuant to her answer of 20 June, Official Report, column 794W, on hepatitis C, how the National Institute for Health and Clinical Excellence recommendation that people with mild disease should remain under observation is being implemented for those individuals who have not received an initial diagnosis. 
Caroline Flint: National Institute for Health and Clinical Excellence guidelines on chronic hepatitis C infection can only apply to those who have been diagnosed.
The Department's hepatitis C awareness campaign aims to increase the number of patients being diagnosed so that they can be referred for specialist assessment.
To ask the Secretary of State for Health (1) when Ministers of her Department next expect to meet representatives of herbal product manufacturers todiscuss the costs associated with the implementation of the Traditional Herbal Medicinal Products Directive; 
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(2) what assessment she has made of the impact on business of the way that the Traditional Herbal Medicinal Products Directive is being interpreted and implemented. 
Jane Kennedy: Our current assessment of the impact on business of the European Directive on Traditional Herbal Medicinal Products is set out in the updated partial regulatory impact assessment included with the public consultation document MLX 325. The Medicines and Healthcare products Regulatory Agency (MHRA) has given the industry extensive help in preparing for the Directive, for example, via early website guidance, workshops, individual company meetings and dialogue with the herbal manufacturing industry's herbal forum. The MHRA has also advised the herbal forum on the possibilities for industry to make a reasoned case to the relevant European scientific committee, the Herbal Medicinal Products Committee, if it sees a need for further elaboration or adjustment of the European guidelines on herbal medicinal products.
David Tredinnick: To ask the Secretary of State for Health what assessment she has made of the implications for consumer safety of the potential for growth in internet and mail order sales of herbal products. 
Jane Kennedy: In most cases, it is not currently possible for consumers to tell which herbal medicines are made to acceptable standards of safety, quality and patient information, irrespective of the means by which they are sold. While unlicensed herbal medicines purchased over the internet and by mail order may be of variable standards, many of the unsafe unlicensed medicines found on the United Kingdom market by the Medicines and Healthcare products Regulatory Agency have been sold or supplied in clinics or other retail outlets. Following the European Directive on Traditional Herbal Medicinal Products, the introduction of a registration scheme for traditional herbal medicines, alongside licensed herbal medicines, should progressively allow consumers to make an informed choice from a wider range of herbal medicines made to assured standards.
David Tredinnick: To ask the Secretary of State for Health (1) if she will base the product release specification of compound herbal products under the Traditional Herbal Medicinal Products Directive upon thin layer chromatography linked to standard patterns; and if she will meet with industry representatives to discuss this matter; 
(2) what assessment she has made of whether the guidelines on quality and stability for herbal medicinal products are appropriate for multi-component traditional herbal products. 
Jane Kennedy: European guidelines concerning the quality and stability of herbal medicinal products have been in place since 1988. These guidelines were updated and amended in agreement between member states and the industry from 1998 to 2001 and the final version came into operation in January 2002.
Many herbal medicinal products contain a number of active substances and the guidelines recognise that in such cases it may not be possible to measure the
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individual active substances. It is for the applicant to establish suitable methodologies for control of their product and to present these in the application dossier.
In the case of products to be registered under the Directive on Traditional Herbal Medicinal Products, we anticipate that many will be multi-component and that ensuring reproducibility of the products will be challenging.
Mr. Amess: To ask the Secretary of State for Health (1) how many (a) men and (b) women who had a hip replacement operation required a further operation due to the failure of the first hip replacement in each of the last 10 years; 
(2) how many hip replacement operations were unsuccessful in each of the last 10 years for which figures are available; and how many people were permanently disabled as a result of the failure of the operation in each year; 
(3) how many hip replacement operations have resulted in the patient becoming disabled in the last 10 years; and if she will make a statement. 
Mr. Byrne: This information is not collected centrally in the form requested. Figures are available for the number of hip revisions undertaken over the past five years on the national clinical health and outcomes knowledge base website at http://www.nchod.nhs.uk. These figures do not differentiate between those operations which were necessary due to an unsuccessful hip replacement operation and those revisions required for other medical reasons.
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