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Lord Laird asked Her Majesty's Government:

Lord Hunt of Kings Heath: The NHS Plan (Cm 4818-I) sets out the Government's commitment that if and when screening and treatment techniques have developed sufficiently, a prostate cancer screening programme will be introduced. The evidence to support the introduction of a screening programme will be kept under careful review by the UK National Screening Committee. The UK National Screening Committee and the Health Technology Assessment Programme have been working with researchers to pull together several existing research protocols for a prostate cancer screening trial into a bid for one coherent and integrated trial. This has now been submitted to the Medical Research Council and a decision on whether to pursue the trial is expected towards the end of 2000.

Lord Ezra asked Her Majesty's Government:

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Lord Hunt of Kings Heath: Cancer is a top government priority and research is essential to the development of modern and effective cancer services. The estimated figures for annual government expenditure on breast cancer and prostate cancer in 1999-2000 are £9.02 million and £1.52 million respectively. These figures do not include research allocations to universities from the Higher Education Funding Council for England, or Research Councils other than the Medical Research Council, These figures further underestimate the total government research and development expenditure in these areas, as detailed estimates of National Health Service support funding are not collected routinely.

The Department of Health has recently made £1 million extra available this year for prostate cancer research. The NHS Plan states that a further £1 million will be made available for each of the next three years. In addition, a Prostate Cancer Action Plan encompassing research, diagnosis, early detection, treatment and care will be built into the National Cancer Plan to be published this autumn.

Part of the additional money mentioned above will be used to fund two research projects into prostate cancer. The first of these examines the effectiveness and acceptability of treatment options for prostate cancer in screen-detected individuals. The second project is a highly innovative study to create and test new less invasive treatment for prostate cancer using magnetic resonance imaging and high intensity focussed ultrasound.

We are working with the Medical Research Council and other members of the Cancer Research Funders Forum to identify priorities for prostate cancer research. An expert review group has been set up and will be finalising its report shortly. We will be considering with our partners how we can help improve research capacity in prostate cancer and develop research on key issues in the light of the Expert Review Group report.

Details of projects directly funded by the department or supported through the NHS research and development budget can be found on the National Research Register. This is available in the Library and most medical libraries on CDROM, and on the Internet: http://www.doh.gov.uk/nrr.htm.

Crawley Hospital

Lord Ezra asked Her Majesty's Government:

    Why it proposed to reduce essential services at Crawley hospital at the same time as over 5,000 new homes are intended to be built in that area.[HL3707]

Lord Hunt of Kings Heath: The issue of population growth was carefully considered by West Surrey and West Sussex health authorities before they issued their proposals on the future configuration of acute services at Surrey and Sussex Healthcare National Health Service Trust. The decision, announced on 26th June, was made to ensure that local residents have access to modern, effective, dependable and affordable health

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services facilities that are fit for the 21st century. Ministers have recognised the importance of providing a clear strategic future of services across the health economy and have instructed the South East Regional Office of the National Health Service Executive to facilitate the establishment of a new working group made up of as many key local stakeholders as possible. This group will be responsible for producing recommendations on the long-term provision of acute, primary and intermediate care services and will consider the effect of long-term population growth in the area.

Smuggled Cigarettes and Teenage Smoking

Lord Mason of Barnsley asked Her Majesty's Government:

    What research has been conducted into the increase in smoking among young people due to the smuggling of cheap cigarettes; and whether research can be conducted into the harmful effects of the high tar content of smuggled tobacco.[HL3660]

Lord Hunt of Kings Heath: Teenage smoking is falling. Regular smoking among 11 to 15 year-olds has fallen from 13 per cent in 1996 to 9 per cent in 1999. It is not possible accurately to assess the volume of smuggled cigarettes smoked by this age group. There is no firm evidence on whether smuggled tobacco products have significantly higher tar levels than domestic products.

Artificial Limbs: Expenditure

Baroness Lockwood asked Her Majesty's Government:

    What are the final figures for the artificial limb services for the years 1998-99 and 1999-2000; and what are the estimates for the years 2000-01 and 2001-02.[HL3503]

Lord Hunt of Kings Heath: Expenditure on artificial limb services is not collected by the Department of Health. Expenditure estimates are made by the NHS Purchasing and Supply Agency from:


    (a) suppliers' reports on the value of orders placed by the National Health Service for hardware and componentry; and,


    (b) the value of service contracts placed with prosthetic companies.

Having reviewed Prosthetic Centre contracts and predicted levels of annual uprating, the Purchasing and Supply Agency estimated that these contracts amounted to around £36 million during 1998-99; that is, £9.7 million for hardware and componentry and £26.3 million for service contracts.

The final expenditure on the service contracts may vary for a number of reasons, including the actual numbers of patients referred. The NHS Purchasing and Supply Agency does not collect actual expenditure detail at the year end.

Expenditure for the period 2000-2002 will be subject to trusts' negotiations with health authority commissioners.

Health Council, Luxembourg

Lord Dormand of Easington asked Her Majesty's Government:

    What was the outcome of the Health Council held in Luxembourg on 29 June.[HL3731]

Lord Hunt of Kings Heath: My honourable friend the Parliamentary Under-Secretary of State for Health (Ms Stuart) attended the Health Council on 29 June in Luxembourg on behalf of the United Kingdom.

The items in the table were discussed.

Agenda ItemIssueUK PositionOutcome
(1) Approval of provisional agenda
(2) Approval of "A" points
(3) Proposal for a directive on the approximation of the laws, regulations and administrative provisions of the member states concerning the manufacture, presentation and sale of tobacco products (recast)To agree a revised text on a proposal for a directive regarding the manufacture, presentation and sale of tobacco products. The directive consolidates and strengthens three previous directives. It would reduce tar and nicotine yields and introduces a new maximum carbon monoxide yield for all cigarettes manufactured in the EU; increase the size of health warnings and toughen them; ban misleading descriptions such as "light" and "mild"; and require and publicise information on additives.The UK supports the revised text.Commissioner Byrne outlined the proposal and a compromise text, containing the European Parliament's amendments, was tabled. Common position was reached, despite Germany voting against and Austria, Spain and Luxembourg abstaining.
(4) Communication from the Commission on the health strategy of the European Community and proposal for a decision adopting a programme of community action in the field of public health (2000-2006)To receive a communication on the health strategy. This includes a proposal for a public health action programme which will be subject to the co-decision procedure and will be negotiated by the Council and the Parliament in the Autumn.The UK broadly welcomes the proposals but with caveat that they should enhance our national efforts and focus on areas where Community action can bring genuine added value, without straying into areas where the Community has no competence.Commissioner Byrne presented the Communication and there was initial exchange of views between member states, with general approval of the overall direction.
(5) Follow up to the Evora Conference on health determinantsTo adopt a resolution on action on health determinants.The UK supports the resolution.The resolution was adopted.
(6) Follow up to the Lisbon Conference on medicinal products and public healthTo adopt conclusions on medicinal products and public health.The UK supports the conclusionsThe conclusions were adopted.
(7) WHO Framework Convention on Tobacco ControlUpdate on developments on the WHO Framework Convention on Tobacco Control.UK supports the objective of the convention in securing global action to support national initiatives.Oral report from Commissioner Byrne, underlining the need for co-ordinated action line with the Commission's negotiating mandate. There was no discussion on this item.
(8) Follow up to the Feira European CouncilTo take forward the public health aspects of the Feira Council conclusions including the integration of health into other Community policies, Food Safety White Paper and the Precautionary Principle.The UK welcomes the recognition of health as both a vertical and a horizontal issue. The UK's response to the proposals for a European Food Agency has been submitted to the Commission. The UK broadly welcomes the Commission's communication on the Precautionary Principle but it is still subject to inter-departmental discussion.Health Ministers noted the outcome of the Feira summit and the Commissioner's remit to look at ways in which the horizontal aspects of the health agenda could be addressed.
(9) Any other business
(a) Conference of experts on quality and safety in the transplantation of tissue and organs of human originThe Presidency gave an oral report on the outcome of the conference.
(b) Medical devices for self-diagnosis of HIVNote from the Danish delegation concerning proposals to prohibit the marketing and use of medical devices for self-testing of HIV in Denmark.The UK has legislation in place. It does not see the need for separate regulation in this area as the Medical Devices Directive allows member states to introduce national provisions.Commissioner Byrne agreed to bring this issue to the attention of Commissioner Liikanen, Commissioner for Enterprise.
(c) Follow up of the CIDEX caseA note from the Belgian delegation raising concerns about the recall of CIDEX, a medical device disinfectant produced in the UK, and proposed revisions to the Medical Devices Directive.The UK acknowledges the concerns raised by Belgium and is co-operating fully with the Belgian authorities. It agrees that there are some areas where the directive needs strengthening.Following a statement from the UK, Commissioner Byrne agreed to bring this issue to the attention of Commissioner Liikanen.
(d) Errors when administering intravenous medication in emergenciesNote from the Belgian delegation proposing that minimal standards or norms be defined at European level for emergency injectable drugs.The UK would resist any proposal to introduce more legislation on this issue as it is already adequately covered.Commissioner Byrne agreed to bring this issue to the attention of Commissioner Liikanen.

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