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Lord Clement-Jones asked Her Majesty's Government:
- What assessment has been made of the likely impact on public health of the transfer of public health laboratories to their local National Health Service trusts.[HL543]
Lord Hunt of Kings Heath: The transfer of some of the laboratories of the Public Health Laboratory Service to National Health Service trusts is one part of the preparation for creating the proposed health protection agency, which is itself one element of implementing the Chief Medical Officer's strategy for combating infectious diseases, Getting Ahead of the Curve. Our assessment of the impact of each element is therefore in the context of the entire strategy.
The transfers of these laboratories to NHS trusts will bring public health activities within the mainstream of the NHS and thereby strengthen and enhance its arrangements for protection of public health. In particular, the transfer will strengthen the four public health functions of all NHS laboratories (reporting the occurrence of infectious diseases, submitting relevant samples to reference laboratories
for detailed testing, assisting with the investigation of outbreaks and with the development and implementation of local policies in infectious disease control) by providing the opportunity and incentive for all NHS microbiology laboratories to build on the examples of good practice in current PHLS laboratories. These transfers are essential to create a comprehensive, coherent surveillance and outbreak response system, as described in Getting Ahead of the Curve, and to ensure robust microbiology services to help implement the action plans for turberculosis, healthcare acquired infections, antibiotic resistance and blood-borne viruses.
Lord Clement-Jones asked Her Majesty's Government:
- What proportion of public health laboratories have adopted standard methods; and what are the comparable figures for National Health Service microbiology laboratories.[HL573]
Lord Hunt of Kings Heath: All public health laboratories have adopted standard methods. Information on the adoption of standard methods by National Health Service pathology laboratories is not collected centrally. Through its Pathology Modernisation Programme, the Department of Health is encouraging NHS pathology laboratories to adopt standard procedures and methods. We anticipate that this is one area where the example of good practice current in the PHLS will be taken up more widely as PHLS laboratories are transferred to the NHS.
Lord Clement-Jones asked Her Majesty's Government:
- How many public health laboratories scheduled for transfer to National Health Service trusts hold Clinical Pathology Accreditation accreditation; and how this compares with National Health Service microbiology laboratories.[HL574]
Lord Hunt of Kings Heath : All of the 31 Public Health Laboratory Service laboratories scheduled for transfer to National Health Service trusts are accredited with Clinical Pathology Accreditation (26 unconditional and five conditional).
Eighty-one NHS microbiology laboratories are accredited with Clinical Pathology Accreditation (UK) Ltd (CPA), plus a further 13 which are managed jointly by both the PHLS and the NHS (Source: CPA web-site).
Lord Clement-Jones asked Her Majesty's Government:
- What number of public health laboratories report to the Communicable Disease Surveillance Centre; what are the comparable figures for National Health Service microbiology laboratories; and what proportion of the surveillance data collected comes from each source.[HL575]
Lord Hunt of Kings Heath : Information available from the Communicable Disease Surveillance Centre
shows that a total of 157,499 reports (46 per cent) were received from 191 National Health Service laboratories in 2001 and 180,503 reports (54 per cent) from 57 Public Health Laboratory Service laboratories. Additionally, CDSC received 137 reports in the same year from 24 laboratories belonging to neither the NHS nor the PHLS.Pathology Services: Strategic Review
Lord Clement-Jones asked Her Majesty's Government:
- What has been achieved as a result of the strategic review of pathology conducted by the Department of Health in 1995.[HL571]
Lord Hunt of Kings Heath: The Strategic Review of Pathology Services, published by the then NHS Executive in 1995, focused on key issues relating to the provision and commissioning of NHS pathology services. The review emphasised local decision-making and provided a number of possible models. In addition, it flagged up some of the ways in which anticipated advances in technology were likely to impact on the pathology services, for example, through improved communication with service users and better collaboration between services. The report was widely disseminated to NHS pathology services to consider, in the light of the recommendations made, how to maintain and develop high quality, cost-effective clinical services responsive to the needs of patients and users.
The NHS Plan, subsequently published in 1997, set out the vision for the NHS to offer people fast and convenient care delivered to a consistently high standard. This overtook the recommendations of the Strategic Review of Pathology Services. Where relevant, for example, on collaboration on service reconfiguration, appropriate access to 24-hour services, and developing guidance on specialised pathology, the recommendations have been implemented. The Department of Health recognised the critical role of pathology services in the effective treatment and care of patients, in protecting the public health and in national screening programmes. We also recognised the pressure on them to maintain quality in the face of increasing workloads and the challenges facing them of technological and scientific change. As part of our modernisation programme for the NHS, in 1999 we therefore established the pathology modernisation programme (PMP), a 10-year programme to modernise NHS pathology services.
The first three years of the PMP (from 1999–2000 to 2001–02) concentrated on capital investment to support service modernisation: £28 million capital funding was awarded to 39 demonstration projects for smaller-scale service reconfigurations; technology and IT upgrades; rationalisation of specialist services; and larger-scale reconfiguration projects to support the development of managed pathology networks.
In 2002 the PMP has developed and published for consultation draft guidance Pathology—the Essential
Service for the NHS. We are currently considering the responses to the consultation and will publish final guidance, revised in the light of the views received, in 2003.Misuse: Alcohol
Lord Avebury asked Her Majesty's Government:
- Whether they consider that the spending on alcohol prevention and treatment is commensurate with the level of alcohol-related harm.[HL618]
Lord Hunt of Kings Heath : It is difficult to arrive at an estimate of the cost to society attributable to alcohol-related harm, as there are a number of widely different factors which need to be taken into account. The majority of the funding for prevention and treatment is spent via the general budgets of primary care trusts and local social service departments, which is consistent with provision being determined following a local consideration of need. This method of funding means that it is not possible to give details of the amount spent on the prevention and treatment of alcohol misuse. However, latest estimates indicate that £95 million per year is spent on alcohol treatment in England, and that most of this funding is provided by the Government.
Lord Avebury asked Her Majesty's Government:
- What estimate they have made of the number of deaths directly attributable to alcohol misuse in each of the years from 1994 to 2001.[HL619]
Lord Hunt of Kings Heath: Information collected centrally about the cause of deaths does not systematically record whether a death is attributable to alcohol misuse. A number of health and lifestyle factors can contribute to diseases such as cancer, stroke and coronary heart disease, and it can be difficult to isolate alcohol consumption as the most important of these factors.
Estimates of the number of deaths range between 5,000 and 40,000 deaths per annum in England and Wales, reflecting the wide range of methods of calculation used in studies covering the number of alcohol related deaths. Consequently the trend data requested are not available.
HFEA: Licences
Lord Alton of Liverpool asked Her Majesty's Government:
- When was the first licence for embryonic stem cell research issued by the Human Fertilisation and Embryology Authority; to whom; and for what purposes.[HL621]
Lord Hunt of Kings Heath: The Human Fertilisation and Embryology Authority issued the first licence on 4 March 1996 to the Assisted Conception Unit at the Royal Infirmary of Edinburgh, later varied to the
Centre for Genome Research, for the culture of multipotential human embryo cells under the purposes specified in paragraph 3(2)(a), (b) and (e) of Schedule 2 to the Human Fertilisation and Embryology Act 1990.
Lord Alton of Liverpool asked Her Majesty's Government:
- How many licences have been issued to date by the Human Fertilisation and Embryology Authority for embryonic stem cell research; to whom; and for what purposes.[HL622]
Lord Hunt of Kings Heath: The Human Fertilisation and Embryology Authority has licensed six such research projects. Three of these included proposals to derive embryonic stem cells for purposes specified under paragraph 3(2) of Schedule 2 to the Human Fertilisation and Embryology Act 1990, and three projects proposed to derive embryonic stem cells under the Human Fertilisation and Embryology (Research Purposes) Regulations 2001. The information on the recipients of the licenses and the purpose of the projects is in the following tables.
| Location | Project | Status |
| Assisted Conception Unit at the Royal Infirmary of Edinburgh, later varied to the Centre for Genome Research, Edinburgh | culture of multipotential human embryo cell | Licensed April 1996, expired 30 September 2002 |
| Sheffield Fertility Centre, Section of Reproductive and Developmental Medicine | investigation of embryonic- endometrial dialogue during the peri-implantation period in vitro | Licensed September 1998, ongoing |
| Reproductive Medicine Centre for Life | isolation and characterisation of cell-lines from human pre- implantation embryos | Licensed September 2000, ongoing |
| Location | Project | Status |
| Centre for Genome | ||
| Research, | ||
| Edinburgh | ||
| Derivation of | ||
| pluripotent human | ||
| embryo cell lines | ||
| Licensed April | ||
| 2002, ongoing | ||
| Guy's and | ||
| St Thomas's Hospital, | ||
| London | ||
| correlation of | ||
| embryo | ||
| morphology with | ||
| ability to generate | ||
| embryonic stem cell | ||
| lines and | ||
| subsequent growth | ||
| and differentiative | ||
| characteristics | ||
| Licensed April | ||
| 2002, ongoing | ||
| London Fertility | ||
| Centre | ||
| Functional | ||
| genomics of | ||
| pluripotent stem | ||
| cells and their | ||
| progeny | ||
| Licensed November | ||
| 2002, ongoing |
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