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Mr. Lansley: To ask the Secretary of State for Health (1) pursuant to the answer of 21 January 2008, Official Report, column 1689W, on departmental public expenditure, what the cost was of writing-off date expired vaccines broken down by type of vaccine 2006-07; 
(2) how many expired vaccines were written-off, broken down by type of vaccine. [Official Report, 26 March 2008, Vol. 474, c. 1MC.] 
243,000 doses of the Bacille Calmette Guerin (BCG) vaccine;
123,954 doses of the measles, mumps and rubella (MMR) vaccine;
71,568 doses of combined diphtheria, tetanus and pertussis (DTaP) vaccine;
49,799 doses of Haemophilus influenzae type B (Hib) vaccine; and
136 doses of tetanus and diphtheria (Td) vaccine.
70 doses of pneumococcal conjugate vaccine;
69 doses of diphtheria, tetanus, pertussis, inactivated polio and haemophilus influenzae; type B, (DTaP/IPV+Hib) vaccine;
21 doses of meningococcal C vaccine vaccine; and
12 doses of the MMR vaccine
Anne Milton: To ask the Secretary of State for Health what discussions his Department has had about the potential adverse effects of administering (a) 20mg and (b) 40mg of Paroxetine to a patient. 
Dawn Primarolo: The safety of paroxetine (brand name Seroxat) has been under review by the Medicines and Healthcare products Regulatory Agency (MHRA) since first marketing and remains under close review. Paroxetine is licensed in the dose range 10 to 60mg, depending on the indication. The recommended daily dose is 20 mg, with the exception of obsessive compulsive disorder and panic disorder for which the recommended daily dose is 40mg. Clinical experience is that some patients not responding to the recommended dose may benefit from having their dose increased. Prescribers have been advised that in the absence of evidence of a benefit from increasing the dose, good practice would be to maintain patients on the lowest efficacious dose.
Guidance on how to use paroxetine safely and effectively along with information on potential adverse effects is provided in the product information for prescribers, the Summary of Product Characteristics, and in the patient information leaflet which accompanies the medicine. These documents are authorised by the MHRA at the time of licensing and updated through the life of the product as new information on potential adverse effects and benefits emerges.
Paroxetine belongs to a class of antidepressants known as Selective Serotonin Reuptake Inhibitors (SSRIs). The safety profile of the SSRIs is a topic which has been the subject of considerable public interest and scientific debate over recent years. In May 2003, in response to continued public concern, the Government established an expert working group to further investigate the safety of SSRIs, with a particular focus on suicidal behaviour and withdrawal reactions. The conclusions and key findings of the expert group were communicated to health professionals on 6 December 2004 and the supporting evidence base was detailed in the Group's comprehensive report entitled Report of the CSM Expert Working Group on the safety of Selective Serotonin Reuptake Inhibitor Antidepressants published on the MHRA website at:
The publication of the Report was timed to coincide with the publication of guidelines on the treatment of depression by the National Institute of Health and Clinical Excellence. Overall it was concluded that SSRIs are effective medicines in the treatment of depression and anxiety conditions, and that the balance of risks and benefits of all SSRIs in adults remains positive in their licensed indications.
Mr. Evans: To ask the Secretary of State for Health what steps his Department has taken to ensure that employment by the NHS of doctors trained in the developing world does not adversely affect health care standards in developing countries. 
Ann Keen [holding answer 18 February 2008]: The United Kingdom was the first, and remains the only, developed country to implement and review systematic policies that explicitly prevent the targeting of developing countries in the area of international recruitment. As such, the Department published a code of practice for the International Recruitment of Healthcare Professionals in 2001 and updated it in December 2004.
Mr. Evans: To ask the Secretary of State for Health (1) how much was spent on locums for junior doctors at (a) Chorley Hospital, (b) South Ribble Hospital, (c) Blackburn Royal Infirmary and (d) Royal Preston Hospital in each of the last 12 months; 
(2) how many junior doctor posts were unfilled for more than (a) three months, (b) six months and (c) nine months at (i) Chorley Hospital, (ii) South Ribble Hospital, (iii) Blackburn Royal Infirmary and (iv) Royal Preston Hospital, in each of the last five years; 
(3) how many junior doctor posts were unfilled at (a) Chorley Hospital, (b) South Ribble Hospital, (c) Blackburn Royal Infirmary and (d) Royal Preston Hospital on the most recent date for which figures are available. 
Ann Keen [holding answer 18 February 2008]: This information is not collected centrally. These are local matters which are the responsibility of the relevant national health service trusts concerned. Information relating to the Chorley and South Ribble Hospital can be obtained from the Lancashire Teaching Hospitals NHS Foundation Trust and for the Royal Blackburn Hospital from the East Lancashire Hospitals NHS Trust.
Dawn Primarolo: Prevention of the emergence and spread of any type of drug-resistant tuberculosis (TB) is being addressed as part of the DOHs overall strategy to improve TB prevention and control through Stopping Tuberculosis in England: An Action plan from the Chief Medical Officer (published in October 2004). As well as improvements to public health surveillance systems, this critically requires fast and comprehensive detection of cases, rapid identification of drug resistance if it exists and good clinical management including measures to ensure treatment is both appropriate and completed by the patient. Patients with drug-resistant strains of TB are treated by appropriate multiple drug therapy for a minimum of six months which also helps public health control by breaking the cycle of TB transmission from infectious patients.
The National Institute for Health and Clinical Excellence (NICE) clinical guideline on the treatment and diagnosis of TB published in March 2006 includes specific guidance on treatment and rapid contact tracing of people in contact with any type of drug resistant TB. The Departments TB toolkit (published in June 2007) aims to help commissioners and TB service providers implement the action plan in line with the NICE guideline.
NICE recommends that if a risk assessment suggests a patient has multi-drug resistant (MDR) TB, rapid diagnostic tests should be conducted for rifampicin resistance. The Health Protection Agency (HPA) reference laboratory service identifies TB cultures from national health service patients in England and determines if they are drug resistant. The selection of appropriate second line drugs for the clinical treatment of MDR TB and extensively drug resistant (XDR) TB is determined by the HPA National Mycobacterium Reference Unit (MRU), which has recently developed newer and faster methods for drug susceptibility testing. The HPA MRU also carries out DNA fingerprinting on drug resistant TB strains in England to help determine patterns of transmission and is working with the World Health Organization on the surveillance of XDR TB.
None of the promotional output for FRANK, including advertising, is exclusively designed to promote the FRANK helpline. All FRANK printed and broadcast output delivers messages to young people while always signposting the FRANK helpline and website.
The following table provided by the Central Office of Information shows total campaign expenditure and total advertising expenditure for FRANK from the years 2003-04 to 2007-08. The Department did not directly allocate money for campaigns on drug misuse prior to 2003.
|Total campaign expenditure||Expenditure on advertising only|
Mr. Gale: To ask the Secretary of State for Health what estimate he has made of the percentage of addicts receiving low-dose methadone on prescription who are thought to also be using heroin. 
Low dose methadone is not recommended in national guidance and should not be a feature of local drug treatment systems. Rather than low-dose, clinicians should ensure that the dose prescribed for each individual is appropriate to their needs and in line with the available evidence base. The recently revised National Clinical technological appraisals on substitute prescribing, published January 2007, clearly states that methadone treatment must be optimised to ensure that each patient receives maximum benefit.
Tim Loughton: To ask the Secretary of State for Health how many and what proportion of (a) adult men, (b) adult women, (c) boys aged 16 years or under and (d) girls aged 16 years or under attended contraception clinics in the last 12 months. 
|First contacts at community contraceptive clinics by gender and age 1996-97 to 2006-07England|
|All ages( 1)||Under 15||15||Total||16-17||18-19||Total||20-24||25-34||35 and over|
|(1) All ages: first contacts with females/males aged 13-44. Under 15, first contacts with females/males aged 13-14. Under 16, first contacts with females/males aged 13-15. 35 and over, first contacts with females/males aged 35-44.|
(2) Rates per 100 resident population for 1995-96 to 2005-06 calculated using population estimates for mid-1995 to mid-2005 for each equivalent gender and age group.
(3) 2005-06 data has been revised.
The Information Centre KT31 return
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