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7 Nov 2002 : Column 508Wcontinued
Dr. Fox: To ask the Secretary of State for Health pursuant to his answer of 15 October 2002, Official Report, column 795W, what access to information on a patient's religious affiliation a hospital chaplain will have in the event of needing to administer the last rites to an unconscious persion in extremis. 
Ms Blears: Where a patient is incapable of providing consent, perhaps through serious or terminal illness, it is possible for hospital staff to disclose their religious affiliation to a hospital chaplain, as this may in the circumstances be in the best interests of the patient concerned.
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Ms Blears: NHS Direct nurse advisors use their experience and expertise alongside a computerised decision support system (algorithms), as part of the National Health Service clinical assessment system (CAS) to enable them to identify the nature of the call and assess the needs of the caller.
NHS Direct defines what it requires of its nurses through a set of competency statements. Nurses can be recruited from any specialty provided they meet these competencies, although they must have between three to five years post-qualification experience.
Ms Blears: On 1 August this year, the Food Standards Agency wrote to approximately one hundred interested parties to seek preliminary views on the drafting of new Jams and Similar Products Regulations. This letter was also placed on the Agency's website. A copy of the letter, together with a list of recipients, has been placed in the Library.
Mr. Lidington: To ask the Secretary of State for Health for what reasons the Government did not secure reserved descriptions in the EC Jams Directive (2001/113/EC) for (a) curd, (b) flavour curd, (c) lemon cheese and (d) mincemeat. 
Since fruit curd and mincemeat products are not produced in any significant quantities in other Member States, it is more appropriate for the composition of these products to be controlled in national, rather than European Union, legislation.
Ms Blears: Between 1 January 2002 and 14 October 2002, the United Kingdom is aware that 19 rapid alerts, sent via the EU's rapid alert system for food and feed, have been issued regarding the detection of nitrofurans
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in 28 samples of Brazilian poultry meat. The average level of nitrofuran metabolites in the samples was 26mg/kg. Five samples exceeded 50mg/kg with the highest level being 120mg/kg for the nitrofuran metabolite AMOZ. Residues of nitrofurans should not be present at any level in food. No conclusion can be drawn regarding the frequency of contamination, as there is no data on how many samples of Brazilian poultry meat have been the subject of testing.
Ms Blears: There are five positron emission tomography (PET) scanners in National Health Service hospitals in England used for routine clinical assessments. They are situated at Guys, St. Thomas', Middlesex, Mount Vernon and Hammersmith Hospitals. An additional private scanner is situated in Harley Street. Four other PET scanners are used primarily for research and are located in dedicated research facilities in London, Cambridge and Manchester.
Lynne Jones: To ask the Secretary of State for Health what assessment he has made of the effect of taking HRT long term on (a) the incidence of (i) breast cancer and (ii) osteoporosis and (b) the quality of life of women. 
Ms Blears: The Committee on Safety of Medicines (CSM) and its Expert Working Group on Hormone Replacement Therapy (HRT) have reviewed the long-term safety of HRT as new information has become available. In 2001, the United Kingdom was actively involved in a European-wide review of all available evidence relating to HRT use in order to provide consistent core product information throughout Europe. Following the publication of further studies relating to the long-term effects of HRT earlier this year, the CSM re-convened its Expert Working Group (EWG) on HRT to examine in detail all the latest evidence. In light of the findings of its EWG, CSM has made further recommendations for product information to ensure that the advice for women and doctors accurately reflects current knowledge.
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A very small increase in the risk of developing breast cancer in women on long-term HRT was first recognised in 1997. Women and health professionals were warned of this risk through an article in the drug safety bulletin ''Current Problems in Pharmacovigilance'' and product information was updated. Among women aged 50 who do not use HRT, approximately 45 in every 1000 will develop breast cancer by the age of 70. Recently published studies have confirmed that this number will increase to about 47 per 1000 women who take HRT for 5 years, about 51 per 1000 women who take HRT for 10 years, and about 57 per 1000 women who take HRT for 15 years.
In the UK, HRT products are indicated for the treatment of menopausal symptoms, and some products are also licensed for the prevention of osteoporosis. Data relating to the effectiveness of HRT in preventing bone fractures were reviewed by CSM at the time of licensing and were judged to support ''the prevention of osteoporosis'' as an indication for HRT. Further evidence was provided in studies published earlier this year for a significant reduction in the number of hip fractures with long-term HRT use.
A recent trial in women with pre-existing heart disease examined cardiovascular effects of long-term HRT and also considered ''quality of life'' indicators. Although the findings of this trial were mixed, the women suffering from post-menopausal symptoms experienced an overall improvement in ''quality of life''. Based on all currently available evidence, the benefits of short-term use of HRT for the relief of menopausal symptoms are judged to outweigh the risks. The decision to use HRT should be discussed by a woman with her doctor on an individual basis and the risks and benefits regularly reappraised with continued HRT use.
Ms Blears: Automated dispensing systems are seen as part of the Integrated Care Record Service (ICRS). The ICRS implementation will run up to 2008 by which time a unified patient record system will exist for all National Health Service patients. This will include the functionality of electronic prescribing, pharmacy systems and, where appropriate, robotic dispensing systems. Funding for this programme over the next three years will be announced in the autumn.
In this context the Department is considering the recommendation from the Audit Commission that a national specification for automated dispensary systems should be commissioned and that earmarked funds should also be considered for the introduction of these systems.
Mr. Heald: To ask the Secretary of State for Health what the reporting rates are to the Communicable Disease Surveillance Centre by (a) public health laboratories and (b) NHS microbiology laboratories. 
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Ms Blears: Information on reporting rates from Public Health Laboratory Service and National Health Service laboratories is not available. However, information available from the communicable disease surveillance centre shows that a total of 157,499 reports were received from NHS laboratories in 2001 and 180,503 reports from PHLS laboratories. It is estimated that the PHLS carries out over 40 per cent. of the NHS microbiology testing requirements.
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