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Haemophilia Patients: Information on Product Contamination
Lord Morris of Manchester asked Her Majesty's Government:
- Further to the Written Answer by Lord Hunt of Kings Heath on 29 January on haemophilia patients and vCJD in blood products (WA 37), what consultations the Department of Health had with the Haemophilia Society, as the national patient group, to help determine what information should be provided to haemophilia patients about the fact
- that a blood donor whose plasma was used in haemophilia products had been found to have vCJD; and whether in future the department will consult the Haemophilia Society on the management of such incidents.[HL578]
Lord Hunt of Kings Heath: The Department of Health had discussions with the United Kingdom Haemophilia Centre Doctors Organisation on their strategy for providing information to patients but not directly with the Haemophilia Society. The CJD Incident Panel is currently developing a framework for the management of such incidents. This will be subject to consultation with interested bodies, including the Haemophilia Society.
Haemophilia Patients: Recombinant Clotting Factor Treatment
Lord Morris of Manchester asked Her Majesty's Government:
- How many adults with haemophilia in England are currently receiving (a) plasma-derived haemophilia treatment products and (b) recombinant treatment products; and[HL579]
What would be the additional cost to the National Health Service of treating with recombinant genetically engineered products all adults with haemophilia in England currently receiving plasma treatment products.[HL580]
Lord Hunt of Kings Heath: Based on figures provided by the United Kingdom Haemophilia Centre Doctors Organisation, we estimate that approximately 13 per cent of adult haemophilia A patients and 4 per cent of haemophilia B patients in England are currently receiving recombinant clotting factors. We estimate that the additional cost of providing all adult haemophilia patients with recombinant clotting factors at around £50 million per annum.
Lord Morris of Manchester asked Her Majesty's Government:
- What differences exist between the provision of recombinant genetically engineered haemophilia treatment product in England, Scotland, Wales and Northern Ireland; and[HL581]
Further to the Written Answer by Lord Hunt of Kings Heath on 29 January on haemophilia patients and vCJD in blood products (WA 37), whether all adults with haemophilia in England will in future be treated with recombinant genetically engineered treatment products, as is provided for children under 16 in England and all haemophilia patients in Scotland, Wales and Northern Ireland.[HL582]
Lord Hunt of Kings Heath: In England, all new haemophilia patients and children under 16 are treated with recombinant clotting factors. Scotland, Wales and Northern Ireland provide, or are in the process of providing, recombinant clotting factors for all haemophilia patients. The Government are currently
considering whether all adult haemophilia patients in England should also be treated with recombinant clotting factors.Tuberculosis
Baroness Byford asked Her Majesty's Government:
- How, if the symptoms are identical, it is possible to separate bovine tuberculosis in humans from human bovine tuberculosis.[HL480]
Lord Hunt of Kings Heath: Most human cases of tuberculosis are caused by the bacterium Mycobacterium tuberculosis, which is not a zoonosis. Man is the natural host for M. tuberculosis. Mycobacterium bovis is the cause of tuberculosis in cattle but can also be highly infectious for man and can pose a zoonotic risk.
Since human infections caused by M. tuberculosis and M. bovis are clinically and radiologically indistinguishable, diagnosis can only be made by typing and isolating the aetiologic agent. Routine diagnosis of tuberculosis in cattle is by the tuberculin test.
The Hospice Movement: NHS Funding
Baroness Jeger asked Her Majesty's Government:
- Whether they are able to increase contributions to the work of the hospice movement.[HL560]
Lord Hunt of Kings Heath: By 2004 the National Health Service will invest an extra £50 million to end inequalities in access to specialist palliative care to enable the NHS to make a realistic contribution to the cost hospices incur in providing agreed levels of service. What this means is that by 2004 the overall NHS investment in specialist palliative care services will match the overall contribution from the voluntary sector. This unprecedented increase in funding will be used to ensure greater cohesion between the efforts of the voluntary sector and the NHS.
Sexual Advice to Young People
Lord Hylton asked Her Majesty's Government:
- Whether they will issue guidance to health professionals advising them to commend sexual abstinence for young people under 16 for the sake of their health and personal development.[HL547]
Lord Hunt of Kings Heath: Best practice guidance on the provision of effective contraception and advice services for young people was sent to all local teenage pregnancy co-ordinators and posted on the Department of Health's teenage pregnancy website in December. The guidance highlights the importance of services having staffed trained in counselling skills and providing sufficient time and support to allow young people to make informed choices about their relationships.
A national media campaign aimed at young people began in October. The central messages of the campaign are about encouraging young people to take control of their lives, personal responsibility and not to be pressurised into having sex. The design of the campaign was informed by a major piece of research into what media messages and advertising campaigns work best with young people.
Water Fluoridation
Earl Baldwin of Bewdley asked Her Majesty's Government:
- Whether they agree with the statement by the authors of the article Infants' Fluoride Ingestion from Water, Supplements and Dentifrice in the Journal of the American Dental Association 1995; 126:1625, that "The optimal level of fluoride intake has never been determined scientifically".[HL653]
Lord Hunt of Kings Heath: Numerous epidemiological studies indicate that, in temperate climates, the highest level of prevented dental decay associated with the least cosmetically significant dental fluorosis and no clear evidence of other effects is reached when approximately one part of fluoride is present in a million parts of drinking water.
Earl Baldwin of Bewdley asked Her Majesty's Government:
- Further to the Written Answer by Lord Hunt of Kings Heath on 30 January (WA 55), whether they accept the statements made by Professor Sheldon, who chaired the advisory group to the recent systematic scientific review of water fluoridation, in an open letter dated 3 January that (a) "the quality of the studies [on effectiveness] was generally moderate"; (b) "There was little evidence to show that water fluoridation has reduced social inequalities in dental health"; and (c) "The review did not show water fluoridation to be safe".[HL651]
Lord Hunt of Kings Heath: We prefer to refer to the report itself, which says that: "There appears to be some evidence that water fluoridation reduces the inequalities in dental health across social classes in 5 and 12 year-olds . . ." and, "Overall, no clear association between water fluoridation and incidence or mortality of bone cancers, thyroid cancer or all cancers was found". The report also noted that the best available evidence suggests that fluoridation of drinking water supplies does reduce caries prevalence.
We acknowledge that the systematic scientific review team found that there was a lack of good quality research on which to base their findings. We wish to remedy this and have asked the Medical Research Council to advise on what further research might be needed.
Earl Baldwin of Bewdley asked Her Majesty's Government:
- Further to the Written Answer by Lord Hunt of Kings Heath on 31 January (WA 66):
(a) whether they continue to support the fluoridation of water; and
(b) how the promotional role of the British Fluoridation Society is compatible with the production of objective, evidence-based information on the subject, in the particular light of the society's briefing on the systematic scientific review by the National Health Service Centre for Reviews and Dissemination, which stated inter alia that "The findings of the York review are unequivocal: water fluoridation is effective and it is safe".[HL652]
Lord Hunt of Kings Heath: We can confirm that the Government continue to support the fluoridation of water, subject to its effectiveness and safety being kept under regular review.
We accept that the York review identified a need for more good quality evidence and have asked the British Fluoridation Society to ensure that this is reflected in future briefings.
Earl Baldwin of Bewdley asked Her Majesty's Government:
Lord Hunt of Kings Heath: Safety was considered in the Department of Health Report on Health and Social Subjects No. 41: Dietary Reference Values for Food Energy and Nutrients for the United Kingdom.
The following nine studies have addressed effectiveness:
Whether they will specify the scientific studies that show the safety and effectiveness of fluoridated milk in preventing caries in schoolchildren.[HL654]
Effect of fluoridated milk on caries: 5-year results. Journal of the Royal Society of Health: 105(3), 99-103.
Effect of Fluoridated Milk on Caries: 10-year results. Journal of Clinical Dentistry: 3, 121-124.
Caries reduction and fluoride intake in Russian children receiving fluoride-milk. Journal of Dental Research: 77(IADR Abstracts); 712.
Dental caries reducing effects of a milk fluoridation project in Bulgaria. Journal of Public Health Dentistry 55(4); 234-237.
Fluoride addition to milk and its effect on dental caries in school children. American Journal of Clinical Nutrition: 11; 94-101.
Five-year double-blind fluoridated milk study in Scotland. Community Dentistry and Oral Epidemiology, 12(4); 223-229.
Caries prevention through fluoridated powdered milk in a Chilean rural community. Caries Research: 31, 303.
12 Feb 2001 : Column WA17
- The effect of fluoridated milk on caries in Arab children. Results after three years. Clinical Preventive Dentistry 9(4); 23-25.
- Report on the Winterthur study with fluoridation of household milk. Helvetica Paediatrica Acta: 19; 343-354.
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