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Dr. Richard Taylor: To ask the Secretary of State for Health when she will bring forward the proposed amendment to the Clinical Trials Regulations of 2004 on consent; and what steps she is taking (a) to halt and (b) to reverse the reductions in emergency care research in the meantime. 
Andy Burnham: The Government are committed to the support for emergency care research. Following detailed consultation with those involved in emergency research, a provision was included in the UK Clinical Trials Regulations(1) which precludes incapacitated adults participating in trials without the prior consent of their legal representative. However, after the regulations came into force, researchers involved in a large trial requiring immediate administration of a clot busting drug to resuscitate patients following a heart attack found it was impracticable to obtain consent using the provisions of the regulations. This was because the patient had usually lost capacity to consent and the limited time available for administering the trial drug did not allow contact to be made with the legal representative.
The Government therefore consulted on a proposed amendment to the regulations which would enable incapacitated adults to be entered into trials prior to the consent of a legal representative having been obtained where the trial was of a medicine to be used in emergency situations. Consent would subsequently need to be obtained. The proposal received wide support.
However, the occurrence of serious adverse reactions in a drug trial in healthy volunteers in March has led to heightened scrutiny of all clinical trial regulation, including a re-examination of this proposal to ensure that it can be justified. That re-examination is ongoing.
(1 )The Medicines for Human Use (Clinical Trials) Regulations 2004 [SI 20004/1031].
Miss Widdecombe: To ask the Secretary of State for Health how many deaths have been caused by the bacterium Clostridium difficile in (a) Maidstone and Tunbridge Wells NHS and (b) England in the last three years; and what guidance her Department has issued to (i) hospitals and (ii) primary care trusts on preventing such deaths. 
Andy Burnham: The data requested is not available centrally. The Office for National Statistics published figures on the number of deaths where Clostridium difficile was mentioned on the death certificate from 1999 to 2004 in Health Statistics Quarterly 30 in May 2006. The number of deaths where Clostridium difficile was mentioned on the death certificate and the number where it was also the underlying cause of death are given in the following table. The full paper is available at www.statistics.gov.uk/downloads/theme_health/HS0 30.pdf. A copy has been placed in the Library.
|Number of death certificates with Clostridium difficile mentioned and as the underlying cause, England, 2002-04|
A joint professional letter from the Chief Medical Officer and the Chief Nursing Officer went out to NHS trusts in December 2005 to remind them of the importance of this infection. This letter listed the key actions to control Clostridium difficle and highlighted the guidance available.(1,2) The letter is available at www.dh.gov.uk/assetroot/04/12/55/23/04125523.pdf. A copy has been placed in the Library.
As part of our delivery programme Saving lives: a delivery programme to reduce healthcare associated infections including MRSA a high impact intervention that is a tool to help reduce Clostridium difficile infections was published in June 2006.
(1) Clostridium Difficile Infection, Prevention and Management A Report by a Department of Health/PHLS joint working group. 1994
(2) Guidelines for optimal surveillance of Clostridium difficile infection in hospitals Brazier JS and Duerden BI. Guidelines for optimal surveillance of Clostridium difficile infection in hospitals. Comm.Dis.Pub.Health. 1998:1;(4) 229-230.
Mr. Amess: To ask the Secretary of State for Health what types of contraceptive are available to (a) men and (b) women through family planning clinics; what the price of each item is; and what the cost of providing each contraceptive free of charge was in the last year for which figures are available. 
Oral contraceptive methods (pill)
Intrauterine devices (IUD)
Intrauterine system (IUS)
Male and female condoms (femidoms)
Female sterilisation (referral)
Natural family planning awareness
Andy Burnham: The Government are considering what else might be done to strengthen the overall system within which deaths are certified and investigated, to complement the draft Bill on coroner reform published by the Department for Constitutional Affairs on 12 June 2006(1).
(1 )Coroner Reform: The Governments draft BillImproving death investigation in England and Wales, June 2006, Cm 6849
As part of the obesity prevention programme, the Government have a well developed stakeholder engagement process to promote healthy
eating. The Department has been working closely with a development group of about 40 stakeholders drawn from the non-government organisations, physical activity, food manufacturing and food retailing sectors. The group also includes the frontline services within the national health service, local government, and the Departments for Culture, Media and Sports, for Education and Skills, for Transport and for Environment, Food and Rural Affairs. The work of the Department is well informed by an expert review group of leading experts from the fields of behavioural psychology, nutrition and physical activity.
Ms Rosie Winterton: Training opportunities are agreed locally between service and educational representatives. However, it is likely that most doctors in training posts in England, and who therefore have a reasonable expectation of competing successfully for further training, will be able to do so. As always, some doctors may need to be flexible about the specialities or locations in which they work.
Caroline Flint: NHS West Midlands reports that both Shropshire county primary care trust and Telford and Wrekin PCT provide two cycles of in vitro fertilisation treatment to couples in which the woman is aged 37.5 or under at the time of treatment. Their policy on eligibility for treatment was determined before the publication of the clinical guideline on the assessment and treatment for people with fertility problems produced by the National Institute for Health and Clinical Excellence.
Mr. Vara: To ask the Secretary of State for Health how many hospital patients have (a) contracted and (b) died from exposure to healthcare-acquired infections in the constituency of North-West Cambridgeshire since 1997. 
Andy Burnham [holding answer 5 July 2006]: The information requested is not available in the format requested. However, data for meticillin resistant Staphylococcus aureus (MRSA) blood stream infections, Clostridium difficile reports and glycopeptide resistant enterococci (GRE) blood stream infections have been set out in the following tables.
|Meticillin resistant Staphylococcus aureus|
|Number of MRSA bacteraemias|
|April to March each year:|
|Trusts in North West Cambridgeshire constituency||2001-02||2002-03||2003-04||2004-05|
|Clostridium difficile reports and glycopeptide resistant enterococci (GRE) blood stream infections|
|Trusts in North West Cambridgeshire constituency||Number of Clostridium difficile reports for patients 65 and over January 2004 to December 2004||Number of Glycopeptide resistant enterococci (GRE) blood stream infections reports October 2003 to September 2004|
Information on deaths due to hospital acquired infections is not available. The Office for National Statistics publishes statistics on deaths with Clostridium difficile(1) or MRSA(2) mentioned on the death certificate. However, no information is available on where these infections were acquired either in terms of hospital or community acquisition or of strategic health authority.
(1) Deaths involving Clostridium difficile: England and Wales, 1999 to 2004 Health Statistics Quarterly 30, summer 2006, pp56-60
(2) Deaths involving MRSA: England and Wales, 2000 to 2004 Health Statistics Quarterly 29, spring 2006, pp63-8.
Health Protection Agency
Andy Burnham [holding answer 5 July 2006]: The information requested is not available. The best available information is from the mandatory surveillance system which provides data on the number of reports of meticillin resistant Staphylococcus aureus (MRSA) blood stream infections from April 2001 to 30 September 2005 as shown in the table. Figures from October 2005 to March 2006 will be published later this month.
|MRSA blood stream infections in England from 1 April 2001 to 30 September 2005|
|Period||Number of MRS bloodstream infections|
Health Protection Agency
The total number of reports of Clostridium difficile associated disease in England between January and December 2004 was 44,350 and the total number of reports of clinically significant glycopeptide resistant enterococci blood stream infections in England from October 2003 to September 2004 was 620.
Information on deaths due to hospital acquired infections is not available. The Office for National Statistics publish statistics on deaths with Clostridium difficile(1) or MRSA(2) mentioned on the death certificate. However, no information is available on where these infections were acquired, either in terms of hospital or community acquisition or of strategic health authority.
(1) Deaths involving Clostridium difficile. England and Wales, 1999 to 2004 Health Statistics Quarterly 30, summer 2006, pp56-60
Sandra Gidley: To ask the Secretary of State for Health whether the human pappilloma virus vaccines will be considered at the meeting of the joint council on vaccination and immunisation in February 2007. 
Caroline Flint: A joint committee on vaccination and immunisation subgroup met in May 2006 to review all available information on human pappilloma virus vaccines and will hold further meetings during 2006, reporting to the main JCVI committee once they have all the relevant information.
Caroline Flint: The joint committee on vaccination and immunisation subgroup met in May 2006 to review all the available information on human pappilloma virus vaccines and will hold further meetings during 2006. Implementation plans will be based on the advice of JCVI as to the most effective immunisation schedule should HPV vaccine be judged to be beneficial.
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