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Dr. Whitehead: To ask the Secretary of State for Health what estimate he has made of the number of prisoners infected with (a) HIV and (b) hepatitis C; and what proportion of that number have been diagnosed in each case as infected. 
Mr. Ivan Lewis: The last major study of HIV, hepatitis B and hepatitis C prevalence in prisoners in England and Wales found that of 3,942 prisoners surveyed in 1997 and 1998, 0.4 per cent. were infected with HIV, and 7 per cent.(1) with hepatitis C.
Prevalence of HIV, hepatitis B and hepatitis C antibodies in prisoners in England and Wales: a national survey. Weild A. R., Gill O. N., Bennett D., Livingstone S. J. M., Parry J. V., Curran L. (2000). Communicable Disease and Public Health 2000;3:121-6.
Dr. Whitehead: To ask the Secretary of State for Health whether he plans to ensure that prisoners who are at risk of contracting HIV and hepatitis C in prisons receive harm reduction measures equivalent to those offered outside prisons. 
The Integrated Drug Treatment System (IDTS) has introduced National Treatment Agency models of care to prisons, through the amalgamation of existing clinical drug treatment services and psychosocial programmes. IDTS aims to get prisoners off illegal drugs and away from risky behaviours through clinical interventions such as maintenance and managed withdrawal.
Since October 2007, prisons across England and Wales have introduced disinfecting tablets and dispensers. These can be used to sterilise illicitly held needles which may be used for drug-injecting. Their use can prevent and control the transmission of blood borne viruses (BBVs) including HIV and hepatitis C.
The Hepatitis C Action Plan for England (July 2004) applies to prisoners, copies have already been placed in the Library. It envisages that prisoners should have access to the testing, diagnostic, assessment and treatment services that it specifies. Prisons and their national health service partners draw up, and regularly review, prison health delivery plans within which prisoners health care needs are assessed, prioritised, resources allocated and delivery monitored.
Mr. Ivan Lewis: For HIV and hepatitis C, the disease surveillance systems organised by the Health Protection Agency (HPA), (the Survey of Prevalent HIV Infections Diagnosed (SOPHID), which collects data on prevalent HIV infections, and KC60 statutory returns, which identify diagnoses made in genito-urinary clinics and collect data on new diagnoses of sexually transmitted infections) do include diagnoses of prisoners.
Mr. Hancock: To ask the Secretary of State for Health what estimate his Department has made of the number of people taking anti-epileptic drugs unnecessarily as a result of misdiagnosis; and what estimate he has made of the annual cost to the NHS of such drug-taking. 
Mr. Hancock: To ask the Secretary of State for Health (1) what estimate his Department has made of the effects of full implementation of the National Institute for Health and Clinical Excellence's guidelines on the treatment of epilepsy on mortality rates among those with the disease; 
(2) what estimate his Department has made of the number of people with epilepsy and prone to seizures who will become seizure-free when the National Institute for Health and Clinical Excellence's guidelines on epilepsy care are fully implemented. 
Ann Keen: We have made no estimate of the effect of full implementation of the National Institute for Health and Clinical Excellence (NICE) guidelines on the number of people who would be seizure-free, or on the mortality rate for those with epilepsy.
NICE guidelines have the status of clinical guidelines for health professionals. It is the responsibility of health professionals to use their clinical judgment, in consultation with the individual patient, to decide on the most appropriate treatment options taking into account all relevant guidelines.
Mrs. May: To ask the Secretary of State for Health what funding his Department provided for (a) the prevention of female genital mutilation and (b) the treatment of cases arising from female genital mutilation in each of the last 10 years. 
Ann Keen: The Department has provided £20,000 for a female genital mutilation (FGM) prevalence study and £31,000 for the development of FGM DVD for health professionals. We have also core funded the specialist organisation Foundation for Women's Health, Research and Development (FORWARD), which includes core funding of £30,000 in 2007-08.
Sir Nicholas Winterton: To ask the Secretary of State for Health (1) what research he has (a) commissioned and (b) evaluated on the health effects of fluoridation of public water supplies in the last three years; 
(3) what research he has (a) commissioned and (b) evaluated on the relationship between fluoride and the incidence of (i) bone cancer, (ii) thyroid gland complaints and (iii) brain disorders in the last three years. 
Ann Keen: We continue to refer to key research reports commissioned since 1999. A Systematic Review of Public Water Fluoridation published by the University of York in 2000 found no significant association between water fluoridation and goitre, bone disease or any other systemic illness, but called for further research to strengthen the evidence base. Water Fluoridation and Health, published by the Medical Research Council in 2002, endorsed the University of Yorks recommendations and suggested priorities for further research. Copies of both reports are available in the Library. Accordingly, the Department commissioned the University of Newcastle upon Tyne to investigate bio-availability (absorption of fluoride, The report, the Bioavailability of Fluoride in Drinking Water, a Human Experimental Study published in 2004, showed no statistically significant differences between absorption of fluoride from naturally fluoridated and artificially fluoridated water. Copies of this publication have already been placed in the Library.
Evidence to date shows that dental fluorosis in a minority of children remains the only proven effect of the fluoridation of water, besides protection against tooth decay. Dental fluorosis is characterised by a flecking, or more rarely a mottling, of teeth, often only visible when teeth are dried. We are supporting research into the assessment of fluorosis using intra-oral cameras. If, as we expect, it shows that the measurement of dental fluorosis can be standardised, we will undertake a further study of its prevalence and aesthetic impact.
Sir Nicholas Winterton: To ask the Secretary of State for Health what research he has (a) commissioned and (b) evaluated on alternative sources of fluoride available for ingestion by the public to promote dental health in the last three years. 
An appraisal of our Brushing for Life scheme, published in 2005, showed that providing young families with free packs containing fluoridate toothpaste, a toothbrush, and guidance on dental hygiene, is capable
of increasing the frequency with which parents and carers brush their children's teeth. However, experience shows that oral health promotion campaigns aimed at changing behaviour in respect of diet and tooth-brushing do not achieve the reductions in dental decay offered by the fluoridation of water. Copies of the publication have been placed in the Library.
Sir Nicholas Winterton: To ask the Secretary of State for Health whether he has evaluated research carried out in other European Union member states on the fluoridation of public water supplies in the last three years. 
Ann Keen: The Department has evaluated the report Assessing The Impact Of Exposure To Fluoride In Water On The Oral Health Of 16 Year Olds In A Border Region Of Ireland, published by Queen's University Belfast in March 2007. It showed that 31 per cent. of 16-year-old residents of fluoridated areas in the Republic of Ireland had no obvious tooth decay experience compared with 22 per cent. in Northern Ireland, where there are no fluoridation schemes.
Sir Nicholas Winterton: To ask the Secretary of State for Health what assessment he has made of the levels of tooth decay in countries (a) that fluoridate and (b) do not fluoridate public water supplies for the purposes of benchmarking in the last three years. 
Ann Keen: Some 170 million people in the United States of America drink fluoridated water. Studies reported by the American Dental Association show that fluoridation of water reduces dental decay by over 50 per cent. Experience elsewhere shows that it is possible to achieve similarly low levels of dental disease in affluent areas with as many as 60 per cent. of 12-year-old children with no tooth decay, but the attraction of fluoridation is its potential for reducing inequalities in oral health.
ACRA has recently completed an extensive review of the key elements of the funding formula. The 2009-10 and 2010-11 PCT revenue allocations will be announced in the autumn alongside the NHS Operating Framework for 2009-10 and ACRAs report will be published at that time.
|NHS hospital and community health services: Health visitors and district nurses in the Gloucestershire Primary Care Trust( 1) (PCT) area as at 30 September in each specified year|
|(1) In October 2006 Cheltenham and Tewkesbury PCT, Cotswold and Vale PCT and West Gloucestershire PCT merged to form Gloucestershire PCT. Figures prior to 2006 are an aggregate of these predecessor organisations.|
(2) The numbers of district nurses are shown, as evidence suggests that there have been some coding issues around health visitors and district nurses during the merger of the three PCTs.
The Information Centre for health and social care Non-Medical Workforce Census
Dr. Gibson: To ask the Secretary of State for Health what selection criteria were applied to the tender process for a human papilloma virus vaccine; what role the criteria played in the decision-making process on the tender; and what weight was given to each criterion. 
Offers that reduce the risk of wastage if the vaccine is subject to temperatures above 8°C (this include the provision of temperature indicators and evidence based guidance on the stability of the vaccines at higher storage temperatures and subsequent safe administration.)
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