---

28 Oct 2005 : Column 570W—continued

Carbon Monoxide Poisoning

Mr. Hancock: To ask the Secretary of State for Health pursuant to the answer of 12 October 2005 Official Report, column 538W, on carbon monoxide poisoning, how many general practitioner surgeries will receive the leaflets; which support groups will be included in the leaflet; and if she will make a statement. [20736]

Caroline Flint: The patient information leaflet, Indoor air pollution—Carbon monoxide", will be distributed to all general practitioners' surgeries in England—of which there are approximately 93,000—in late November 2005. The leaflet will also be made available on the Department's website with links to pages providing further advice on the prevention and symptoms of carbon monoxide poisoning, provided by the Health and Safety Executive (HSE), Heating Equipment Testing and Approval scheme, the Council
 
28 Oct 2005 : Column 571W
 
for Registered Gas Installers and the Solid Fuel Association. The support group, CO-Gas Safety, has been directly involved in the production of this leaflet.

NHS Direct also provides information on carbon monoxide (CO) poisoning in its website at http://www.nhsdirect.nhs.uk/he.asp?articleID=417P, which includes information on causes, diagnosis, prevention, symptoms, treatment and complications. Medical advice on CO poisoning is available on the Chief Medical Officer's (CMO) website in his and the Chief Nursing Officer's letter to GPs, which was sent in February 2002. Further advice will be provided to GPs in the CMO's update in November 2005.

Mr. Hancock: To ask the Secretary of State for Health pursuant to the answer of 12 October 2005, Official Report, column 538W, on carbon monoxide poisoning, what the relevant support group is in (a) north and (b) south England for (i) information on awareness of carbon monoxide and (ii) medical advice on carbon monoxide; and if she will make a statement. [21069]

Caroline Flint: The support groups CO-Gas Safety and AIRSAY, supported by the Department through Section 64 funding cover the whole of England. Section 64 funding is provided by the Department to voluntary organizations in England whose activities support the Department of Health's policy priorities and priority is given to applications with innovative proposals of national significance that will complement statutory services and so help secure provision of high quality health and social care and promote the nation's health.

CO-Gas Safety provides information on awareness of carbon monoxide. Medical advice on carbon monoxide poisoning is provided by NHS Direct in its website at: www.nhsdirect.nhs.uk/he.asp?articleID=417, and on the Chief Medical Officer's (CMO) website in his and the Chief Nursing Officer's letter to general practitioners (GPs), which was sent in February 2002. Further medical advice will be provided to GPs in the CMO's update in November 2005.

Cataract Operations

Tim Loughton: To ask the Secretary of State for Health what changes have taken place in the last two years in the threshold level on sight tests before referrals for cataract operations are made. [19026]

Ms Rosie Winterton: The Sight Testing (Examination and Prescription) Regulations 1989 require optometrists to check for signs of disease or abnormality within the eye and refer the patient on should that be considered necessary for further investigation.

Judgments on when a referral should be made, or when a patient should be listed for a cataract operation, will be made on an individual basis.

Chase Farm Hospital

Mr. Walker: To ask the Secretary of State for Health if she will take steps to ensure Chase Farm Hospital retains its accident and emergency department; and if she will make a statement. [18562]

Jane Kennedy: It is for local primary care trusts working with national health service trusts to determine how the needs of the local population can best be met.
 
28 Oct 2005 : Column 572W
 
Local NHS organisations have a responsibility to engage with local people in formulating proposals and to consult formally on proposals for change.

I understand that a discussion document published by the Barnet and Chase Farm NHS Trust last December has since been re-drafted in light of an earlier engagement process and it is expected to be issued for formal consultation early next year.

Child Cancer Drugs

Tim Loughton: To ask the Secretary of State for Health what discussions she has had with her medical advisers about possible links between child cancer drugs and deafness. [19023]

Ms Rosie Winterton: There have been no formal discussions with medical advisers about any possible links between child cancer drugs and deafness.

Some drugs used to treat childhood cancers may have long-term side effects including, in a minority of cases, loss of hearing. It would be the norm for the treating clinician to monitor the patient in these cases.

The National Institute for Health and Clinical Excellence has produced guidance for the national health service which emphasises the need for clinicians to discuss all aspects of treatments, including any adverse side effects, with patients and their parents or carers.

Tim Loughton: To ask the Secretary of State for Health whether the Medicines and Healthcare Products Regulatory Agency has made an assessment of the impact of platinum based chemotherapy drugs on deafness in children. [19024]

Jane Kennedy: Platinum-based medicinal products are effective in the treatment of certain cancers, including childhood cancers. They are, however, associated with a number of serious adverse effects. These are documented in the product information, together with warnings and advice, where possible, on how to reduce or avoid these adverse effects. When treating a patient with cancer, the doctor has to weigh up the risks of the treatment against the potential benefits and prescribe accordingly.

The two platinum-based medicinal products licensed for human use have well-defined safety profiles and both are known to cause damage to hearing in both adults and children. Information relating to this appears in the summaries of product characteristics (SmPC) and the patient information leaflets (PIL) of the two products.

The SmPC for cisplatin, which is authorised for use in children as well as adults, contains statements relating to its potential to cause hearing loss. The SmPC notes that cisplatin should not be given to patients with existing hearing impairment as this may be associated with increased toxicity. It also warns that the damage to hearing caused by cisplatin is cumulative and that audiometric testing should be performed before starting treatment and before each subsequent course of treatment with cisplatin. In addition, the SmPC warns that the simultaneous use of other medicines that cause hearing damage, such as certain antibiotics, may make such damage worse. The SmPC describes in some detail
 
28 Oct 2005 : Column 573W
 
the hearing impairment in patients receiving cisplatin and notes that it is worse in children. This information is also presented in the patient information leaflet.

Carboplatin is not authorised for use in children, but nevertheless, the SmPC contains a warning that clinically significant hearing loss has occurred in children given high doses of carboplatin in combination with other medicines that cause hearing damage. There is also general information about the incidence and degree of hearing loss caused by carboplatin, which is generally less damaging to hearing than cisplatin.

The Medicines and Healthcare products Regulatory Agency (MHRA) continually monitors the safety of medicines in clinical use. To date, that is from 1963 to 18 October 2005, the MHRA has received nine reports (of nine suspected reactions) of ear and labyrinth disorders associated with carboplatin. Of these, only one was in a child (one-year-old) who experienced deafness following therapy with carboplatin and gentamycin. During the same time period, a total of 19 reports (of 26 suspected reactions) of ear and labyrinth disorders associated with cisplatin have been received. Of these, three were in children (10 years old and younger) and the reported reactions were deafness for two cases and hearing impaired and tinnitus in the third case.

Childhood Obesity

Anne Snelgrove: To ask the Secretary of State for Health what progress is being made in tackling childhood obesity. [18772]

Caroline Flint: Reducing obesity is one of the six overarching priorities of the Choosing Health" White Paper, published in November 2004. In July 2004, the Government set a Public Service Agreement target 'to halt the year-on-year increase in obesity among children under 11 by 2010 in the context of a broader strategy to tackle obesity in the population as a whole'.

The White Paper delivery plan, Delivering Choosing Health: making healthier choices easier" together with discrete plans focusing on nutrition, Choosing a Better Diet: a food and health action plan" and physical activity, Choosing Activity: a physical activity action plan" published in March 2005 set out how the White Paper commitments will be delivered and how they will contribute to delivery of the obesity target.

---