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Mr. Lammy: Over the last 18 months we have spent £100 million on modernising National Health Service dentistry. £10 million of this was for the Dental Care Development Fund and the Dentistry Action Plan Fund to support local plans to improve access. This money enables health authorities to assist dentists seeking to set up new practices and to expand and modernise existing ones.
During 2001 the Chief Dental Officer led a working group to look at "Options for Change" to modernise NHS dentistry building on the Government's strategy document "Modernising NHS dentistry: Implementing the NHS Plan", published in September 2000.
Brian Cotter: To ask the Secretary of State for Health (1) if he will instigate an investigation into the change of treatment for haemophilia patients in the 1970s from a cryoprecipitate treatment originating from a single donor to an unheated treatment derived from large donor pools; 
We understand that treatment with cryoprecipitate carried a number of disadvantages compared to pooled clotting factors. It required the patient to be treated in hospital, it could not be given to children, it was unsterilised and carried the risk of a number of side effects.
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1980s that the risks from hepatitis C were fully understood by which time viral inactivation of pooled plasma products had been introduced.
Mr. Heald: To ask the Secretary of State for Health, pursuant to his answer of 14 May 2002 to the hon. Member for Falkirk East (Mr. Connarty), Official Report, column 618W, on haemophilia, if he will make a statement on the length of time the Government are taking to make a decision on whether to make recombinant clotting factors available to all haemophiliacs. 
Ms Blears: We have nothing further to add to our earlier response. We are still considering the provision of recombinant clotting factors for all haemophilia patients in England and will make a decision later this year.
Mr. Nicholas Winterton: To ask the Secretary of State for Health (1) upon whose recommendation, and for what reasons, disposable instruments were introduced for use in hospital operating theatres in England; what tests were carried out on the new disposable instruments; from which manufacturers the disposable instruments were sourced; what procedures were established to monitor the introduction and use of the instruments; and if he will make a statement; 
(3) on what date a surgeon first complained to the authorities about the quality of the newly introduced disposable operating instruments; and how many complaints have been made since then; 
(4) what steps his Department has taken to identify and contact parents and relatives of patients who have suffered adverse incidents in hospital operating theatres as a result of the use of disposable instruments who were not informed of their use at the time of the operations; and if he will make a statement. 
Mr. Lammy: The move to single use instruments for tonsil and adenoid surgery was part of the Department's strategy to reduce the risk of transmitting variant Creutzfeldt Jakob Disease (vCJD) through surgical instruments. This was in accordance with advice received from the Spongiform Encephalopathy Advisory Committee (SEAC).
When the tenders for the contract were returned, a visual inspection of the instruments offered by all suppliers was undertaken. Once specific suppliers had been short-listed, their products were sent out to randomly selected ear, nose and throat surgeons to be used during operations. After each operation, the surgeons were asked to complete an evaluation form. The results of this evaluation were used during the selection of the successful suppliers.
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B+H Surgical Instrument Makers
Rocialle Medical Ltd.
Trust Sterile Services
Axis Medical Ltd.
In October 2001, the Department sent a questionnaire to all members of the British Association of Otorhinolaryngologists to ask their opinion of the single use instruments. As a result of the comments made, minor alterations were made to the product specification of some products, such as mouth gags.
The medical devices regulations require device manufacturers to demonstrate that their devices meet essential safety requirements prior to placing them on the market. The safety and performance of devices in service is monitored by a mandatory vigilance system. Manufacturers are obliged to inform the competent authority (in the UK this is the Medical Devices Agency (MDA)) when an incident has occurred, involving their device, which may have caused a death or serious injury or which has the potential to cause death or serious injury.
In addition, the MDA also operates a voluntary user reporting system for users to report any adverse incident involving a medical device. The MDA first received an adverse incident report from a user in April 2001. Since then, the MDA has received reports of incidents concerning all the manufacturers listed above. The MDA has identified from its adverse incident database a total of 125 reports in relation to non-powered instruments, (108 prior to December 2001). 24 reports have also been received relating to powered instruments (diathermy). Each incident has been investigated in conjunction with the device manufacturers and appropriate action taken. One death has been formally reported to the MDA. We are aware of a second, which is presently under investigation.
There are possible risks in all surgical procedures. Therefore, before each operation, the clinician should explain the risks involved and any alternative treatment, to allow the patient or their family to give informed consent to the surgery. Tonsil and adenoid surgery is a relatively low risk operation, but where adverse incidents occur they are treated on a case by case basis by the NHS trust where the operation took place. Patients who have had their tonsils removed with single use instruments should not be concerned of any long-term effects following the surgery.
Ms Blears: Data are not available for the prevalence of food allergy by individual year. The number of individuals suffering allergic reactions to food in the developed countries of the western world appears to be
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on the increase, which is in line with increases seen in other atopic diseases such as hay fever and asthma. In the UK general population, the calculated prevalence of adverse reactions to food (including food allergy) is less than 2 per cent.
Ms Blears: The joint committee on vaccination and immunisation (JCVI) has identified issues relating to the development of policies for the future use of pneumococcal vaccines, which they are addressing. Studies on the interaction between pneumococcal vaccine and the current childhood immunisation programme are under way. The JCVI will review these when they are complete.
Dr. Fox: To ask the Secretary of State for Health, pursuant to the answer of 17 April, Official Report, column 1019W, what the cost per tube was of toothpaste distributed; what areas of the country were targeted for the project; and what evaluation of the scheme has taken place. 
£1 million has been set aside for the project. It initially covered the 21 health authorities with the highest levels of dental decay11 in the North, 5 in Yorkshire and 5 in Londonand also all areas not in receipt of fluoridated water where there are Sure Start schemes. However, we have since added 5 more in the North, 3 in Yorkshire and 2 in Devon, bringing the total health authorities benefiting from this scheme to 31.
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