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Whether the statement by the Chief Secretary to the Treasury, Mr Andy Burnham, on 19 November (Official Report, col. 981) that the European Union accounts for 58 per cent of our economy is based on official figures. [HL640]
Lord Davies of Oldham: As the Chief Secretary to the Treasury explained (Official Report, col. 981) the EU is the UK's largest trading partner. The 57 per cent figure that he cited refers to Table 9.3 (Trade in goods and services) of the 2007 edition of the Office of National Statistics Pink Book, which indicates that in 2006 UK import trade with its European Union partners equated to 57.3 per cent of total UK imports. Export trade with our European Union partners amounted to 55.5 per cent of total exports.
The Parliamentary Under-Secretary of State, Department for Communities and Local Government (Baroness Andrews): The UK made application to the fund on 20 August, 2007. On 31 October Commissioner Danuta HÃ1/4bner announced that she would recommend an award of approximately £110 million. The Commissioner's recommendation is subject to approval by the College of Commissioners. A budget amendment proposal has then to be agreed by the Council of Ministers and EU Parliament. It is unlikely that any funds would be available before the end of March 2008.
Whether they have made an assessment of the research by the Nuffield Council on Bioethics regarding overall potential benefits and harms deriving from fluoridation of drinking water; and whether they are reviewing their policy on this issue. [HL335]
The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): We welcome the recommendation in the report, Public Health: Ethical Issues, that decisions on fluoridation schemes should be taken locally since this is the guiding principle of the Water Fluoridation (Consultation) Regulations approved by Parliament in 2005. We do not therefore intend to change our policy, but we are acting on the report's other main recommendation by continuing to commission research into the effects of water fluoridation.
Lord Darzi of Denham: Following consultations in which the local population were found to be in favour, the areas in the strategic health authorities listed in the following table receive drinking water to which fluoride has been added to a target concentration of 1 part per million. We would encourage other areas with high levels of tooth decay to consider fluoridation, but this is for local decision.
|Strategic health authority||Percent of population with fluoridated water supply|
The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): There have been claims in the press that the European Union wants to ban food labels that say made in Britain. The European Commission has confirmed that there is no basis to this story.
What savings they expect to make from moving the public counter service of the Foreign and Commonwealth Office's Legalisation Office; and whether they have estimated the additional cost to users of the service. [HL425]
The Minister of State, Foreign and Commonwealth Office (Lord Malloch-Brown): The move of the Legalisation Office is not a cost-saving exercise. The current premises are not able to cope with the increasing demand for legalisation services, and allow no room for expansion. The move to Milton Keynes will provide the space required and further enable the Foreign and Commonwealth Office to provide a significantly improved service. In order to respond to the needs of business, we will retain a small operation in London.
As part of this exercise we will review the fee for this service. No figures are yet available, as lease negotiations are ongoing and refurbishment costs have yet to be finalised, before any decision on a fee increase is made.
It is intended that, should the fee increase, the bulk will fall on business customers using the London processing centre, as the running costs for providing this service will be higher than for the Milton Keynes operation.
What plans they have to assess the impact on the ability of the National Health Service to meet an 18-week waiting-time target for coronary artery bypass surgery should the National Institute for Health and Clinical Excellence's decision not to recommend treatment with drug-eluting stents in the National Health Service be upheld; and [HL582]
In the light of the National Institute for Health and Clinical Excellence's decision not to recommend treatment with drug-eluting stents in the National Health Service, what advice they will give to primary care trusts which find their budgetary provision for coronary artery bypass surgery is inadequate as a result of increased demand. [HL583]
The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): The National Institute for Health and Clinical Excellence (NICE) is reviewing its October 2003 guidance on the use of drug-eluting stents for the treatment of coronary artery disease. NICE is currently considering the responses it has received from stakeholders during the recent consultation on its draft recommendations. I understand that NICE expects to publish final guidance in March 2008. In the mean time, the recommendations in its original appraisal continue to apply.
How many isolations of meticillin-resistant staphylococcus aureus from England and Wales were analysed by the Staphylococcus Reference Laboratory of the Health Protection Agency to identify their type in each of the last three years, and, of these, how many were tested using the method known as pulsed field gel electrophoresis[HL207]
The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): The Health Protection Agency Staphylococcus Reference Laboratory received a total of 18,290 staphylococcus aureus (S. aureus) for typing in the past three years (2004, 2005 and 2006) from England, Wales and Northern Ireland. The majority (about 70 per cent) are meticillin-resistant staphylococcus aureus. Pulsed field gel electrophoresis (PFGE) was performed on 5,186 (28 per cent) of S. aureus received (see following table).
|Year||Number of S. aureus referred for typing||Number of S. aureus tested by PFGE|
What processes exist for resolving disputes in relation to the assumptions made by a National Institute for Health and Clinical Excellence Appraisal Committee and used as the basis for appraisal determination. [HL585]
The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): Stakeholders are consulted during the development of National Institute for Health and Clinical Excellence (NICE) technology appraisals and any comments received are carefully considered by the appraisal committees. Stakeholders also have the opportunity to appeal against NICE's final appraisal determination and final guidance is not published until all appeals have been heard.
Whether they will require the National Institute for Health and Clinical Excellence to employ list prices or market average prices for medical devices evaluated under its technology appraisal programme. [HL586]
Lord Darzi of Denham: The National Institute for Health and Clinical Excellence's approach to medical device evaluation is set out in its guide to the methods of technology appraisal. The current version of this document is published on the NICE website at www.nice.org.uk/page.aspx?o=201973. This guidance is being reviewed and NICE has begun a public consultation on its revised draft.
How the National Institute for Health and Clinical Excellence might take into account new information pertaining to mortality benefit of a medical technology if that information becomes available after the publication of an appraisal consultation document or final appraisal determination. [HL587]
Lord Darzi of Denham: The National Institute for Health and Clinical Excellence (NICE) makes exhaustive efforts to identify and consider relevant information during the course of an appraisal. New evidence can be submitted to NICE in response to a consultation on an appraisal consultation document (ACD) and, if important and genuinely new evidence becomes available after consultation on an ACD has closed but prior to the issuing of a final appraisal determination (FAD), then NICE will make every effort to consider its impact on the relevant appraisal. However, NICE will not generally consider new evidence once a FAD is issued.
Further to the Written Answers by Lord Darzi of Denham on 22 October (WA78-79), why the Human Fertilisation and Embryology Authority does not hold data on the numbers of in vitro fertilisation patients who have produced 20 or more eggs when this is considered to be associated with an increased incidence of hospitalisation due to ovarian hyperstimulation syndrome; and [HL77]
Further to the Written Answers by Lord Darzi of Denham on 22 October (WA 78-79), as the Human Fertilisation and Embryology Authority appears to have incomplete records regarding ovarian hyperstimulation syndrome such that this is not necessarily reported by clinics unless treatment was discontinued, whether treatment has always been discontinued whenever ovarian hyperstimulation syndrome was or is suspected; and [HL130]
Further to the Written Answers by Lord Darzi of Denham on 22 October (WA 78-79), whether they will describe the incidents in which adverse clinical effects associated with ovarian hyperstimulation syndrome have been recorded by the Human Fertilisation and Embryology Authority at each respective licensed centre since records began. [HL131]
The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): The Human Fertilisation and Embryology Act 1990 requires a report to be made to the Human Fertilisation and Embryology Authority (HFEA) on every cycle of in vitro fertilisation (IVF) treatment carried out in the United Kingdom. This report includes information on the number of eggs retrieved from the patient.
While the HFEA has responsibility for the overall regulation of IVF treatment, decisions on whether to discontinue treatment in individual cases are matters of clinical judgment, taking account of professional guidance on the management of ovarian hyperstimulation syndrome (OHSS). In many cases it may be possible to continue with treatment after an adjustment to the patient's ovarian stimulation regime. Details of decisions made on patient care are recorded in local health records, which can be examined by HFEA inspectors when they visit the clinic.
The seventh edition of the HFEA's code of practice, which came into effect on 5 July 2007 to coincide with the introduction of the Human Fertilisation and Embryology (Quality and Safety) Regulations 2007 that implemented EU directive 2003/23/EC setting standards of safety and quality for human tissue intended for human application in respect of reproductive cells, requires any occurrence that is inconsistent with routine patient care to be reported to the authority. The HFEA expects an incident report from a licensed clinic whenever the clinic is made aware of a case of severe OHSS resulting in prolonged hospitalisation.
The HFEA recognises that licensed clinics might not always be made aware of developments in patient care after initial treatment, so the data submitted via the incident reporting system are not sufficiently comprehensive to allow statistical analysis of all OHSS cases.
The Parliamentary Under-Secretary of State, Department for Communities and Local Government (Baroness Andrews): There are no plans for the Environment Agency to be given powers to veto planning applications for development in flood risk areas. We have made the Environment Agency a statutory consultee on planning applications in flood risk areas and introduced a flooding direction so local authorities heed the agency's advice. Planning authorities and the agency must work closely together to achieve appropriate planning outcomes where there is a risk of flooding.
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