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The expenditure on pharmaceuticals is included as its primary aim is prevention. Nevertheless, strictly, expenditure on pharmaceuticals is not included in the OECD prevention and public health category. Hence, for comparison with other countries using OECD data, these "medication" figures should be excluded. Excluding pharmaceuticals in line with OECD methodology gives a total expenditure on public health and prevention of £3.7 billion. If pharmaceuticals were included, the overall total for 2006-07 would be £5 billion.
Total health expenditure for England for the same period was approximately £93.5 billion. This suggests that about 4 per cent. of health expenditure is directed towards prevention (using the figure without pharmaceuticals and without health-related expenditure, so that this can be compared with other OECD countries).
Mr. Syms: To ask the Secretary of State for Health (1) what medical evidence there is of any negative side effects of Epilim (sodium valproate) on (a) embryos and (b) those under the age of 18 years; 
Mr. Mike O'Brien: The safety, efficacy and quality of every medicine is thoroughly evaluated by the Medicines and Healthcare products Regulatory Agency as part of the licensing procedure and its safety is monitored continuously while it is on the market.
Animal studies have shown that Epilim has teratogenic effects. In humans, studies have shown an association between pregnancy exposure and neural tube defects such as myelomeningocele and spina bifida.
The product information which consists of the Summary of Product Characteristics for healthcare professionals and the Patient Information Leaflet contains extensive information to support the appropriate use of the medicine. These documents are available on the internet at www.medicines.org.uk. This information is also reflected in the prescribing advice provided in the British National Formulary, which is sent to all doctors within the NHS.
The product information for Epilim contains detailed advice in relation to the use of Epilim during pregnancy. It is currently advised that women of childbearing potential should not be started on Epilim without specialist neurological advice and the benefits of Epilim use should be weighed against the risks to the foetus.
Information on possible side effects which may occur during treatment with Epilim are also outlined in the product information. These side effects may have been reported during clinical trials or since Epilim has been marketed and have been assessed as either having a causal association or a strong suspicion of an association. Of the known side effects it is recognised that children who are treated with Epilim are at particular risk of developing liver damage and pancreatitis.
The NHS Litigation Authority (NHSLA) handles negligence claims against National Health Service bodies in England. However, due to the way that data are organised on the NHSLA's database, this answer could be provided only at disproportionate cost.
Ann Keen: This information is not available. NHS Prescription Services cannot supply exemption category data, e.g. children under 18, after December 2007 because the processes for pricing prescriptions and for capturing prescription charge exemption status has changed. Therefore, NHS Prescription Services cannot reliably estimate the data for each exemption category relating to the age of the patient from that date.
Mr. Syms: To ask the Secretary of State for Health what research is being undertaken in the NHS on the use of Epilim (sodium valproate) for treatment in the NHS of diseases other than epilepsy. 
The NIHR health technology assessment programme commissions research where there is a gap in the knowledge the national health service has about healthcare treatments and tests. Suggestions for research topics can be made via the programme's open access form at:
Mr. Stephen O'Brien: To ask the Secretary of State for Health what estimate he has made of (a) the proportion of obese children, (b) the proportion of overweight children, (c) the percentage of people who smoke, (d) the percentage of people who drink, (e) the percentage of people who take drugs, (f) the teenage pregnancy rate and (g) the rate of sexually transmitted infections in respect of (i) Spearhead and (ii) non-Spearhead primary care trusts in each year since the inception of the Spearhead primary care trust programme. 
Spearhead areas are defined based on local authority (LA) data. Spearhead primary care trusts (PCTs) are those that overlap geographically, either wholly or partly, with the Spearhead LAs. Where available, information is shown based on the 62 Spearhead PCTs (14 of which only partly overlap with the Spearhead LAs). Where information is not available by PCT, figures are based on the 70 Spearhead LAs. The Spearhead Group was launched in 2005.
|Proportion of children aged 2 to 15 who are overweight and obese, by Spearhead group, 2008|
| Notes: 1. Figures are based on the 62 Spearhead PCTs (so are based on a larger population than the 70 Spearhead LAs). 2. Figures are shown for 2008 only. In 2008 the definitions used in the analysis were revised from those used in previous years to correct an error in the classification of children as either "overweight" or "obese". Results were not significantly different from those presented previously; however, revised data sets have not yet been made available for previous years. 3. Figures are based on children aged 2-15 with a valid body mass index (BMI) measurement. 4. Categories are mutually exclusive, i.e. overweight does not include those who are obese. 5. Overweight was defined as at or above the 85th but below the 95th UK National BMI percentile; obese was defined as at or above the 95th UK National BMI percentile. Source: Data from Health Survey for England, published in "Health Survey for England 2008 Volume 1-physical activity and fitness", The NHS Information Centre for health and social care, 2009 (table 13.5).|
|Proportion of adults aged 16 and over who drink alcohol or smoke cigarettes, by Spearhead group, 2005-08|
|(1 )PCTs for 2008. Notes: 1. Figures for 2005-07 are based on the 70 Spearhead LAs. Figures for 2008 are based on the 62 Spearhead PCTs (so are based on a larger population than the 70 Spearhead LAs). 2. "Adults who drink! is based on answers to two questions: Those who answer, "yes" to "Do you drink alcohol nowadays?" are classified as drinkers. Those who answer "no" are then asked, "Could I just check, does that mean you never have an alcoholic drink nowadays or do you have an alcoholic drink very occasionally, perhaps for medicinal purposes or on special occasions like Christmas or New Year?". Those who answer "Very occasionally" are also classed as drinkers. Source: Unpublished analysis from the General Lifestyle Survey, Office for National Statistics.|
|Proportion of 16 to 59-year-olds reporting use of any illicit drug, by Spearhead group, 2004-05 to 2008-09 British Crime Survey|
| Notes: 1. Figures are based on the 70 Spearhead LAs (so are based on a smaller population than the 62 Spearhead PCTs). 2. Based on a sample survey. Unweighted base numbers for 2008-09 are 6,793 (Spearhead LAs) and 19,013 (non-Spearhead LAs); bases will be similar in earlier years. 3. "Any drug" comprises powder cocaine, crack cocaine, ecstasy, LSD, magic mushrooms, heroin, methadone, amphetamines, cannabis, tranquilisers, anabolic steroids, amyl nitrite, glues, any other pills/powders/drugs smoked, plus ketamine since 2006-07 and methamphetamine since 2008-09. Source: Unpublished analysis from the British Crime Survey (BCS).|
|Under-18 conception rates, by Spearhead group, 2004-06 to 2006-08|
|(1) Provisional. Notes: 1. Figures are based on the 70 Spearhead LAs (so are based on a smaller population than the 62 Spearhead PCTs). 2. Rates are per 1,000 female population aged 15-17. 3. Figures are three-year average rates. Figures for 2006-08 are provisional. Source: Unpublished analysis of data from Office for National Statistics and Teenage Pregnancy Unit.|
Data on STIs diagnosed in genitourinary medicine (GUM) clinics are currently collected only by strategic health authority. Data on the rates of STIs for the period 2004 to 2008, the latest data for which figures are available, are published in "Selected ST1 diagnoses numbers and rates from GUM clinics in the UK: 2004-2008", a copy of which has been placed in the Library.
Mr. Todd: To ask the Secretary of State for Health whether he has reviewed the effectiveness of the swine flu pandemic campaign in changing influenza patients' behaviour in visiting their GP to seek treatment. 
People who developed swine flu symptoms, who had a serious underlying illness or were pregnant, as well as people who had a sick child under one year of age, were advised to contact their general practitioner directly. Other members of the public were encouraged to access the National Pandemic Flu Service if they developed swine flu symptoms. Over 2.7 million assessments were completed using the online and phone self-care services between July and February.
Alan Johnson: The number of persons found guilty at all courts for being drunk and disorderly, England and Wales 1998 to 2008 (latest available) can be viewed in the following table. A penalty notice for disorder (PND) can also be issued for offences of being drunk and disorderly. The number of PNDs issued 2004 to 2008 is included in the table.
|The number of persons issued with a penalty notice for disorder and found guilty at all courts for drunk and disorderly related offences in England and Wales, from 1998 to 2008( 1,2,3)|
|Offences||1998||1999||2000( 4)||2001||2002||2003||2004||2005||2006||2007||2008( 5)|
|n/a = not applicable|
(1) The statistics relate to persons for whom these offences were the principal offences for which they were dealt with. When a defendant has been found guilty of two or more offences the principal offence is the offence for which the heaviest penalty is imposed. Where the same disposal is imposed for two or more offences, the offence selected is the offence for which the statutory maximum penalty is the most severe.
(2) Data include the following offence descriptions and corresponding statutes:
Being found drunk in a highway or other Public place whether a building or not, or a licensed premises.
|Licensing Act 1872 Sec 12.|
Any person who in any public place is guilty, while drunk, of disorderly behaviour.
Criminal Justice Act 1967 Sec.91.
(3) Every effort is made to ensure that the figures presented are accurate and complete. However, it is important to note that these data have been extracted from large administrative data systems generated by the courts, and police forces. As a consequence, care should be taken to ensure data collection processes and their inevitable limitations are taken into account when those data are used.
(4) Staffordshire police force were only able to submit sample data for persons proceeded against and convicted in the magistrates' courts for the year 2000. Although sufficient to estimate higher orders of data, these data are not robust enough at a detailed level and have been excluded from the table.
(5) Excludes convictions data for Cardiff magistrates court for April, July, and August 2008.
Justice Statistics Analytical Services in the Ministry of Justice
Ref: IOS 60-10
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