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Human Fertilisation and Embryology Regulations

Lord Alton of Liverpool asked Her Majesty's Government:

12 Mar 2001 : Column WA61

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): An application for permission for the Pro-Life Alliance to bring a judicial review was considered in the High Court on Friday 26 January. The application was adjourned to allow time for both parties to prepare their cases before the resumed application for permission and the substantive arguments were heard together on or after 15 June this year.

The court order set out a timetable for this process, including time for statements to be made by both sides about the scientific principles on which each side would rely. Lawyers for the Secretary of State for Health did not ask for five months to prepare a statement on the scientific principles but were granted six weeks to do so by the court.

Neo-natal Hearing Screening

Lord Swinfen asked Her Majesty's Government:

    Further to the Written Answer by Lord Hunt of Kings Heath on 24 January (WA 20) in which he gave an assurance that "the lessons from the pilots will help inform and plan a national implementation" and in light of the Government's National Health Service Plan reference to "introducing effective and appropriate screening programmes for women and children by 2004", when they will provide a firm commitment to, and timetable for, national roll-out of the universal neo-natal hearing screening.[HL704]

Lord Hunt of Kings Heath: Universal neo-natal hearing screening is being piloted, initially in 20 health authorities. This phase was started in March 2001, and will be staged over 12 months. An announcement will be made early next year about a timetable for national implementation, taking account of the initial findings of the pilot which will enable us to plan a national roll-out to a feasible time-scale.

Variant CJD: Location of Clusters

Lord Lucas asked Her Majesty's Government:

    Whether any clusters of nvCJD cases are associated with, or close to, rendering plants, abattoirs or meat and bone meal storage facilities.[HL741]

Lord Hunt of Kings Heath: The National Creuztfeldt Jakob Disease Surveillance Unit collates data on the past residential histories of variant CJD patients as part of its routine investigations into cases. Data where cases are associated geographically are studied in conjunction with the Communicable Disease Surveillance Centre, the London School of Hygiene and Tropical Medicine, and the local public health team to determine if there are any common factors. To date, no association with the location of abattoirs, rendering plants or meat and bone meal storage facilities has been found.

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Deep Vein Thrombosis

Lord Higgins asked Her Majesty's Government:

    Further to the Answer by Lord Hunt of Kings Heath on 21 February (H.L. Deb., col. 809) regarding deep vein thrombosis, how many of the 25 hospitals referred to in the Answer will have staff continuously on site capable of diagnosing deep vein thrombosis throughout the Easter holiday period; and[HL1054]

    Further to the Answer by Lord Hunt of Kings Heath on 21 February (HL Deb, col. 809) regarding deep vein thrombosis, whether any of the hospitals which will have staff capable of diagnosing deep vein thrombosis on call but not on site throughout the Easter holiday period will automatically have staff called if a patient is suspected of having a deep vein thrombosis.[HL1055]

Lord Hunt of Kings Heath: All 31 accident and emergency departments in London have access to equipment and staff to diagnose deep vein thrombosis. Out of the 25 hospitals referred to in my Answer of 21 February (H.L. Deb., col 809) that will have staff available to operate diagnostic equipment out of hours, all will have staff on call who can come in as and when needed. Staff can also stay in National Health Service accommodation if required. It is not necessary to have staff continuously on site. This is normal NHS practice.

Those hospitals that do not have the staff to access the equipment out of normal working hours would generally admit the patient, start treatment and do tests on the first working day. The response by hospitals would vary according to clinical need.

Enbrel

Lord Roberts of Conwy asked Her Majesty's Government:

    Whether the drug Enbrel used to treat rheumatoid arthritis is generally available through the National Health Service in England to patients who meet the criteria for its use. [HL1043]

Lord Hunt of Kings Heath: We have no detailed statistics on the prescribing of etanercept (brand name Enbrel).

Etanercept is currently being appraised by the National Institute for Clinical Excellence (NICE). Until NICE has completed its appraisal, National Health Service bodies have been advised to use their existing arrangements to determine local policies on the publicly available evidence.

Rheumatoid Arthritis: Therapies

Lord Roberts of Conwy asked Her Majesty's Government:

    Whether anti-TNF therapy for rheumatoid arthritis is available in rheumatology departments at teaching hospitals in England. [HL1114]

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Lord Hunt of Kings Heath: Infliximab (Remicade) and entanercept (Enbrel) are currently being appraised by the National Institute for Clinical Excellence (NICE). Until NICE has completed its appraisal, National Health Service bodies have been advised to use their existing arrangements to determine local policies on the publicly available evidence.

Wythenshawe Hospital

Lord Morris of Manchester asked Her Majesty's Government:

    What consideration is being given to the future of Wythenshawe Hospital's heart transplant centre; on what grounds it was not included among the regional centres whose future has been guaranteed; and when a decision on the centre's future can be expected. [HL1079)

Lord Hunt of Kings Heath: The Secretary of State for Health announced the development of an NHS Action Plan for organ and tissue transplantation last month, which will include the modernisation and reorganisation of organ transplant services. We are currently considering proposals from the National Specialist Advisory Group for the future of the English Cardiothoracic Transplant Service. Only two of the current seven adult centres, Papworth Hospital in Cambridge and the Freeman Hospital in Newcastle, met the requirements of a report on the future of organ transplant services by the Royal College of Surgeons. We intend to issue a discussion document setting out proposals for the remaining units soon.

Organophosphate Poisoning

The Countess of Mar asked Her Majesty's Government:

    How many cases of organophosphate poisoning in humans have been reported in the last 10 years by those with the statutory duty to report such cases; how many cases of organophosphate poisoning, either acute or chronic, have been diagnosed by the National Poisons Unit (Medical Toxicology Unit) for that period; and what have been the criteria for such a diagnosis. [HL1083]

Lord Hunt of Kings Heath: During the 10 year period 1990-1991 to 1999-2000, there were 18 cases of poisoning reported under the Reporting of Injuries Diseases and Dangerous Occurrences Regulations (RIDDOR) which can be attributed with certainty to organophosphates.

This number is likely to be a considerable underestimate of the actual number of cases of organophosphate poisoning, as RIDDOR is known to be subject to serious underreporting and, furthermore, it is not always possible from the information provided to attribute a poisoning to a specific substance.

12 Mar 2001 : Column WA64

A better (but still incomplete) indication of the extent of alleged organophosphate poisoning is available from the reports of cases assessed by the Pesticide Incidents Appraisal Panel (PIAP). PIAP considers all ill health incidents reported to the Health and Safety Executive or a local authority which are allegedly due to the use of pesticides in the workplace.

During the 10 year period 1990-1991 to 1999-2000, PIAP assessed 152 incidents, involving 198 people, where the pesticides used included an organophosphate active ingredient. In 58 of these incidents, involving 87 people, PIAP assessed the ill health reported as having a "confirmed" or "likely" link to pesticide exposure.

It was not part of the research carried out at the Medical Toxicology Unit (MTU) to compile statistics relating to the numbers of acute and chronic cases of organophosphate poisoning diagnosed as a result of information from the unit or clinical consultations with MTU medical staff. The criteria for diagnosis are in line with those now included in the report Organophosphate sheep dip; clinical aspects of long-term low-dose exposure, published by the Royal College of Physicians and Royal College of Psychiatrists, 1998.

Organophosphorus Sheep Dips: Draft Investigation Protocol

The Countess of Mar asked Her Majesty's Government:

    Whether the draft investigation protocol of 22 February 1993, Clinical investigation of symptomatic patients secondary to exposure to organophosphate containing sheep dips, resulted in a programme of medical investigations conducted by the National Poisons Unit; if they did, how many patients received these investigations; whether they were classed as "research" for the purposes of medical ethical control; if they were, whether Ethics Committee approval was obtained and written informed consent was obtained from each patient; and what was the outcome of the studies. [HL1084]

Lord Hunt of Kings Heath: The draft investigation protocol of 22 February 1993, Clinical investigation of symptomatic patients secondary to exposure to organophosphate containing sheep dips, was a pilot investigation on patients admitted at the request of their health authorities. The results of the investigations offered no useful evidence on which to base further research, so no formal research programme was developed.


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