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Abortion

Baroness Masham of Ilton asked Her Majesty's Government:

Baroness Andrews: We are not aware of the procedure referred to as "partial-birth abortion" being used in Great Britain. It is the Royal College of Obstetricians and Gynaecologist's (RCOG) belief that this method of abortion is never used as a primary or pro-active technique and is only ever likely to be performed in unforeseen circumstances in order to reduce maternal mortality or severe morbidity.

The RCOG's evidence-based guideline The Care of Women Requesting Induced Abortion (2000) sets out the recommended methods of abortion for each gestation which practitioners are expected to follow. For all abortions over 21-weeks gestation, the method chosen should ensure the foetus is born dead.

Baroness Masham of Ilton asked Her Majesty's Government:

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Baroness Andrews: The Royal College of Obstetricians and Gynaecologists' guideline Termination of pregnancy for fetal abnormality in England, Wales and Scotland (1996) and letter Further issues relating to late abortion, fetal viability and registration of births and deaths (April 2001) state that for all terminations at gestational age of more than 21 weeks and six days (the threshold of viability), the method chosen should ensure that the foetus is born dead.

Reproductive Health: DoH Funding

Baroness Masham of Ilton asked Her Majesty's Government:

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    Which organisations in the field of reproductive health they fund, how much they gave in each of the last five years for which figures are available; and whether they will indicate whether each takes (a) a pro-life position, or (b) a pro-abortion position on abortion-related issues.[HL2638]

Baroness Andrews: Department of Health funding for organisations active in the field of reproductive health is set out in the following table. Brook, the Family Planning Association and Education for Choice take a pro-choice position on abortion. The department is not aware of Fertility UK's position.

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1998–991999–20002000–012001–022002–03Total
Brook Advisory Centres£158,953£126,460£121,000£120,000£240,000£646,413
fpa (formerly the Family Planning Association)£189,400£315,500£212,000£209,000£110,000£1,005,900
fpa (Contraceptive Education Service)£900,000£900,000£900,000£900,000£975,500£4,575,000
Education for ChoiceNilNil£31,000£52,000Nil£83,000
Fertility UK£25,000£35,000£30,000£30,000Nil£120,000
£1,248,353£1,341,960£1,264,000£1,311,000£1,325,000£6,490,313

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Female Circumcision

Baroness Masham of Ilton asked Her Majesty's Government:

    Whether they believe that the Prohibition of Female Circumcision Act 1985 regulates a medical procedure.[HL2639]

Baroness Andrews: The Prohibition of Female Circumcision Act 1985 does not regulate a medical procedure. The Act exists to render this barbaric procedure a criminal offence if carried out for non-therapeutic reasons as set out in Section 1. The Act does however make provision for surgical interventions in exceptional circumstances if the operation is for a genuine therapeutic purpose for the physical or mental health of the patient or when it is performed on a woman in labour or who has just given birth.

NHS: Cardiac Care

Earl Howe asked Her Majesty's Government:

    How many National Health Service patients were awaiting (a) cardiac surgery, and (b) angiograms on the latest date for which figures are available.[HL2698]

Baroness Andrews: At the end of December 2002, a total of 6,028 patients were waiting for elective admission for heart surgery in England.

Data regarding patients waiting for angiograms is not currently held centrally.

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NHS Patients: Treatment Abroad

Earl Howe asked Her Majesty's Government:

    How many National Health Service patients have been treated overseas during each month following the Department of Health press release dated 6th March 2002 (reference 2002/0118).[HL2699]

Baroness Andrews: National Health Service patients can be referred for treatment abroad under the European Union-wide health-care co-ordination regulations (the E112 scheme) or through direct referral from their NHS trust.

The table shows the monthly breakdown of direct referrals of NHS patients abroad, and E112 forms issued for the whole of England, Scotland and Wales. In addition, 190 patients were referred abroad as part of an overseas treatment pilot programme between January and April 2002. No monthly breakdown for the patients referred under this scheme is available.

Of the direct referrals abroad, 243 patients were referred for orthopaedic procedures, and 2 patients were referred under the cardiac choice pilot.

MonthDirect referralsE112
March 2002Pilot project (see above)86
April 2002Pilot project (see above)110
May 2002078
June 2002085
July 20020109
August 20020111
September 20020131
October 20021290
November 20022273
December 2002462
January 20033970
February 20037664
March 20039287
April 2003288
Total2471,244

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Mortality and Morbidity

Earl Russell asked Her Majesty's Government:

    Whether they accept the finding of the Acheson report that reductions in mortality have not been matched by any corresponding reductions in morbidity. [HL2703]

Baroness Andrews: The report of Sir Donald Acheson's Independent Inquiry into Inequalities in Health, published in 1998, contained the finding that "Although death rates have fallen and life expectancy increased, there is little evidence that the population is experiencing less morbidity or disability than 10 or 20 years ago". This finding was largely based on morbidity data from the Office for National Statistics General Household Survey which show the prevalance of both long-standing and limiting long-standing illness increased steadily through the 1970s and early 1980s and that since the mid-1980s there has been no clear trend over time.

TB Sufferers

Lord Addington asked Her Majesty's Government:

    What is the percentage of tuberculosis sufferers who at the time of diagnosis were homeless, disentitled to benefit, or both. [HL2709]

Baroness Andrews: The information requested is not collected by the Department of Health. Notifications to the Health Protection Agency do not include detail of social issues such as homelessness and benefit entitlement.

Teenage Pregnancy Strategy

Lord Hylton asked Her Majesty's Government:

    Further to the Written Answer by the Baroness Andrews on 30 April (WA 112), whether the reviews of all evidence regarding sexual abstinence education included those published in the United States since 1996. [HL2712]

Baroness Andrews: The document referred to in the reply given by Baroness Andrews (Swann, C., Bowe, K., McCormick, G. and Kosmin, M. (2003) Evidence-Based briefing paper on teenage pregnancy and parenthood. Health Development Agency) reviewed the evidence contained in reviews of what works to prevent teenage pregnancy published in English since 1996. To be included reviews had to meet certain quality criteria around transparency and replicability.

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Reviews which included discussions of the effectiveness of sexual abstinence education and which had been published in the United States since 1996 were included, where they met these criteria.

Post Mortem Removal of Organs: Report into case of Mr Cyril Mark Isaacs

Lord Acton asked Her Majesty's Government:

    When the report will be published of the independent investigation into the case of the late Mr Cyril Mark Isaacs, which followed serious concerns raised by his widow, Mrs Elaine Isaacs, about the handling of the coroner's post mortem examination of her late husband and the retention of his brain for research. [HL2816]

Baroness Andrews: We are publishing today a report by Her Majesty's Inspector of Anatomy, Dr Jeremy Metters CB, into the case of the late Mr Cyril Mark Isaacs whose brain was removed following a coroner's post mortem in 1987 without the knowledge or consent of his widow.

The inspector found that Mr Isaac's brain was retained as part of an arrangement whereby the coroners' office in North Manchester would identify brains suitable for a research programme at Manchester University. The inspector also found evidence that brains were removed from adults in other locations.

The Secretary of State for Health asked HM Inspector to undertake this investigation following concerns raised by Mr Isaac's widow, Mrs Elaine Isaacs. We wish to pay tribute to Mrs Isaacs for bringing this case to public attention and to say how much we regret the distress that has been caused not only to her and her family but to others whose cases are mentioned in the inspector's report.

The events described in the report relate to unacceptable practices some years ago. Since then, and particularly in the light of other reports, including those into events at Alder Hey and Bristol, we have made considerable steps to improve arrangements relating to any removal, retention and use of human organs and tissue from adults or children. In doing so, we have worked very closely with many statutory, professional, family, voluntary and other bodies. We are grateful to them for helping to change the culture and practice in this area.

The report makes a number of specific recommendations with implications for the National Health Service, coroners, universities and medical researchers. We shall consider these carefully in the light of action already taken in this area and then respond more formally. Following extensive consultation, we have recently published an interim framework of guidance and other materials to reflect transparent new systems founded on consent. Steps have been taken to modernise the practice of pathology and to improve the management of joint NHS and academic posts. My right honourable friend

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the Home Secretary is considering the report of the fundamental review of the coroner's system. We have also consulted on changes to the law on human organs and tissue, which is outmoded and inadequate. We shall introduce new legislation as soon as parliamentary time allows.

We appreciate that some people may be concerned about organ retention in the light of the inspector's report. We have therefore asked the Retained Organs Commission to put specific arrangements in place for anyone who wishes to make an enquiry. A helpline has been established (0800 838909).

It is important that public confidence in medical research is not adversely affected by the findings in the report. Good quality research is essential if we are to meet today's public health challenges seriously. Our recently published interim statement on the use of human organs and tissue sets out clearly our expectations within the current law. This should help to reassure the public, as well as those who need to use organs and tissue for purposes that serve all our interests.

We are grateful to Dr Metters for investigating this matter in such detail and for producing such a helpful and comprehensive report. Copies of the report have been placed in the Library.


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