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Jeff Ennis: To ask the Secretary of State for Health how many retailers in (a) Barnsley, (b) Doncaster, (c) South Yorkshire and (d) England are registered to accept Healthy Start Scheme vouchers. 
Dawn Primarolo: On 23 July 2008, the Healthy Start registered retailer database contained 76 individual retail outlets in Barnsley, 173 in Doncaster, and approximately 720 in South Yorkshire. Around 24,500 individual outlets accept vouchers across England as a whole.
Jeff Ennis: To ask the Secretary of State for Health how many families in Yorkshire and the Humber have signed up for the Healthy Start Scheme; and how the scheme is being promoted in Yorkshire and the Humber. 
Dawn Primarolo: The number of people supported by Healthy Start fluctuates from week to week as families apply or cease to qualify. The scheme supported around 35,600 families in Yorkshire and the Humber between 4 August 2008 and 31 August 2008. This is the most recent four week period for which figures are available.
The Department ensures that information about Healthy Start is included in Government leaflets about the qualifying benefits and tax credits, and in the Pregnancy and Birth to Five books routinely given to first time pregnant women and new mothers by midwives. The National Service Framework for Children, Young People and Maternity Services asks midwives and other health care professionals to signpost the scheme. We produce a range of posters, application leaflets, and other resources which NHS and other organisations can order in bulk for local use and we encourage our network of nominated Healthy Start contacts in every primary care trust to order these. General practitioner surgeries participating in the Waiting Room Information Services initiative also receive their own stocks of the application leaflets. All families with children under four years old notified by Her Majestys Revenue and Customs as newly qualifying for Healthy Start receive a personal invitation from the Healthy Start Issuing Unit to apply for the scheme, followed by two further reminders at four-weekly intervals if they do not take up the offer.
Dawn Primarolo: The number of deaf children in England is not collected centrally. Instead, data are collected on the number of children who are registered as deaf or hard of hearing. Inclusion on the register is voluntary and therefore, does not provide a complete picture of the number of children in England who are deaf or hard of hearing.
Sandra Gidley: To ask the Secretary of State for Health how many children aged 18 years and under received (a) unilateral and (b) bilateral cochlear implants in each year since 2001, broken down by primary care trust. 
Dawn Primarolo: Unfortunately, Hospital Episode Statistics cannot provide these data by primary care trust as the data would need to be suppressed due to small numbers, therefore providing little information. Instead a break down provided by strategic health authority of residence has been placed in the Library.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what the (a) primary diagnosis count and (b) all diagnosis count of finished consultant episodes for all hepatitis B-related conditions was in each year since 1997-98 for all (i) inpatients and (ii) outpatients as recorded by the Hospital Episodes Statistics database, broken down by primary care trust area; and which hepatitis B-related 4-character diagnosis codes are covered by the Hospital Episodes Statistics database. 
Dawn Primarolo: The information requested for in-patients has been placed in the Library, for years 1997-98 to 2006-07. However, outpatient data are not included as clinical coding is not mandatory for the out-patients dataset and coverage is very low.
Mr. Stephen O'Brien: To ask the Secretary of State for Health how many notifications of hepatitis B have been made to the Health Protection Agency and its predecessor bodies; and what estimate he has made of the overall prevalence of hepatitis B (a) in England in total and (b) in each primary care trust area in each year since 1997. 
The Department estimates that about 0.3 per cent. of the United Kingdom population is chronically infected with hepatitis B virus (about 180,000 people)(2). Estimates of hepatitis B prevalence at primary care trust level are not available.
|Statutory notifications of hepatitis B in England: 1997 to 2007|
|Number of hepatitis B notifications( 1)|
|(1) Hepatitis B is notifiable under the Public Health (Infectious Diseases) Regulations 1988.|
(2) The increase in statutorily notified cases of hepatitis B is considered to be due primarily to reports of chronic hepatitis B cases detected through increased patient testing as part of clinical investigation and screening. The increase coincided with the introduction of universal antenatal testing for hepatitis B.
Health Protection Agency
Mr. Stephen O'Brien: To ask the Secretary of State for Health what guidance his Department (a) has issued and (b) plans to issue to primary care trusts regarding the management of hepatitis B services. 
Dawn Primarolo: The Department has issued a number of guidance documents to the national health service about hepatitis B services. Copies have been placed in the Library and are also available on the following websites:
Addendum to HSG (93)40: Protecting healthcare workers and patients from hepatitis BEL (96)77(1996)
Children in need and bloodborne viruses: HIV and hepatitis (January 2002)
Good practice guidelines for renal dialysis/transplantation units: prevention and control of blood-borne virus infection (September 2002)
Guidance for clinical healthcare workers: protection against infection with blood-borne viruses (April 1998)
Health clearance for tuberculosis, hepatitis B, hepatitis C and HIV: new healthcare workers (March 2007)
Hepatitis B infected health care workers and antiviral therapy (March 2007)
Hepatitis B infected healthcare workers: Guidance on implementation of Health Service Circular 2000/020 (June 2000)
Hepatitis B immunisation of homosexual and bisexual men attending GUM clinics: provision of extra vaccine (June 2002)
HSC 1998/127: Screening of pregnant women for hepatitis B and immunisation of babies at risk (July 1998)
Immunisation against infectious diseaseThe Green Book (includes a chapter on hepatitis B) (October 2007)
Information for midwives: hepatitis B testing in pregnancy (January 2002)
Screening for infectious diseases in pregnancy: Standards to support the UK antenatal screening programme (August 2003)
The national strategy for sexual health and HIVImplementation action plan (June 2002)
Extending the childhood immunisation data collected through the COVER (cover of vaccination evaluated rapidly) system by the Health Protection Agency: uptake of hepatitis B immunisation in babies born to infected mothers (DSC Notice 25/2004) (November 2004)
Drug misuse and dependence: UK guidelines on clinical management (includes advice about hepatitis B) (September 2007)
The Department is not currently planning further guidance to the NHS about hepatitis B but keeps this under review, including in the light of advice from its expert scientific advisory committees, the Advisory Group on Hepatitis and the Joint Committee on Vaccination and Immunisation.
Mr. Stephen O'Brien: To ask the Secretary of State for Health what (a) technology appraisals, (b) interventional guidelines, (c) clinical guidelines and (d) public health guidelines which have an effect on hepatitis B services are issued by the National Institute for Health and Clinical Excellence (NICE); what effect each has on hepatitis B; on what date each was issued; which workstreams under consideration by NICE have an effect on hepatitis B services; and if he will make a statement. 
Adefovir dipivoxil and pegylated interferon alpha-2a for the treatment of chronic hepatitis B (22 February 2006).
Entecavir for the treatment of hepatitis B (27 August 2008)
Telbivudine for the treatment of chronic hepatitis B (27 August 2008)
A technology appraisal on tenofovir disoproxii fumarate for the treatment of hepatitis B will be published in May 2009. It was formally referred to NICEs workstream to appraise its clinical and cost effectiveness.
There are no published clinical guidelines or guidelines in development that directly address the management of hepatitis B services. However, Drug Misuse, psychological interventions (July 2007) addresses the need for those who misuse drugs to reduce their exposure to blood-borne viruses where hepatitis B testing is recommended. A copy of this guidance has been placed in the Library and is available on NICEs website at:
Needle and syringe programmes: providing injecting equipment to people who will inject drugs (to be published in February 2009)
Guidance on differences in the uptake of immunisations (including targeted vaccines) in people younger than 19 (to be published in June 2009)
Mr. Stephen O'Brien: To ask the Secretary of State for Health how many drugs were dispensed for the treatment of hepatitis B in each year since 1997, broken down by primary care trust area; and what the net ingredient cost of the drugs was in each year. 
Dawn Primarolo: A significant number of primary care trusts dispensed less that 50 items each year in the community, in England. Releasing actual figures may potentially allow the identification of individual patients. Below are national dispensing figures with net ingredient cost (NIC).
|Number and NIC of prescription items used in the treatment of hepatitis B which were dispensed in the community in England|
|Number of items (thousand)||NIC (£000)|
Prescription Cost Analysis (PCA)
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