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Diagnostic Tests: Waiting Time

Lord Marlesford asked Her Majesty's Government:

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Lord Hunt of Kings Heath: There is no recommended maximum waiting time from referral by a consultant to receipt of a Magnetic Resonance Imaging (MRI) scan, Computerised Tomography (CT) scan, nerve conduction studies (EMG) or bone scan. The waiting time at Ipswich Hospital NHS Trust for some of these investigations has improved over the past six months (since August 2000). For example CT scans have improved to four weeks from 13 weeks. However, how long patients wait should depend on their clinical need. We do acknowledge that some patients can wait a long time for tests. Through initiatives such as the National Booked Admissions Programme, the Cancer Services Collaborative and the Coronary Heart Disease Partnership Programme, we are encouraging hospitals to streamline their services so that tests are carried out, and a diagnosis made, as quickly as possible.

Food Origin Labelling

Lord Tebbit asked Her Majesty's Government:

    Whether a sausage made in England of pork imported from Denmark may be described as English; and[HL1193]

    Whether rashers of bacon cut and packed in England from a side of bacon imported from Denmark may be described as English; and [HL1194]

    Whether a pastie made in Devon from imported lamb may be described as either Cornish or English; and[HL1195]

    Whether a sausage made in England of beef imported from Germany may be described as English.[HL1192]

Lord Hunt of Kings Heath: Government guidelines issued last year make clear that if the place of origin of a food is not the same as the place of origin of its ingredients, additional information may need to be provided on the label to avoid misleading consumers. Failure to do this may result in contravention of existing legislation governing false and misleading labelling and presentation. The guidelines make clear in particular that products containing meat should not be described as "British" if they contain imported meat, but could be described as "made in Britain from" with either a specific (e.g. "German" or "Danish") or general (e.g. "imported") indication of the origin of the meat ingredients they contain.

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Public Health Expenditure Comparisons

Lord Lester of Herne Hill asked Her Majesty's Government:

    How total public expenditure on health care compares between the United Kingdom and France, in terms of (a) per capita expenditures; and (b) percentage of gross national product.[HL1199]

Lord Hunt of Kings Heath: The following table provides figures for public expenditure on health care in 1999.

Public expenditure on health care-- £ per capitaPublic expenditure on health care as a percentage of GDP
United Kingdom£8805.9%
France£1,0947.3%

Notes:

1. The source of the data is the Organisation of Economic Corporation and Development database published in October 2000.

2. The data are presented as a percentage of gross domestic product (GDP), because comparable data on gross national product are not available.

3. The expenditure for France is converted from US dollars to pounds sterling at an exchange rate of £0.62 to the dollar. This is the exchange rate in the OECD database.

In 2000-01, gross National Health Service expenditure in the United Kingdom is expected to increase to £968 per capita, and 6.1 per cent of GDP. The most recent available data for France are 1999.


Deep Vein Thrombosis

Lord Higgins asked Her Majesty's Government:

    Further to the Written Answer by Lord Hunt of Kings Heath on 12 March (WA 62), whether staff, capable of diagnosing deep vein thrombosis in the 25 hospitals referred to in the answer and who will be on call but not on site during the Easter holiday period, will be summoned automatically if a patient is suspected of having a deep vein thrombosis; and[HL1230]

    Further to the Written Answer by the Lord Hunt of Kings Heath on 12 March (WA 62), how hospitals which do not have staff to use the relevant equipment out of normal working hours will know how serious the condition is; and what treatment is appropriate if tests are not carried out for up to three or more days.[HL1231]

Lord Hunt of Kings Heath: If a patient is suspected of having a deep vein thrombosis (DVT) then all 31 Accident and Emergency Departments in London will have staff available 24 hours, seven days a week to diagnose this condition, and treatment will commence. The 25 hospitals referred to in my Answer of 12 March (WA 62) will have staff on call to operate the equipment to confirm this diagnosis. As is normal National Health Service practice, if a member of staff is not on site but is on call, he or she will be contacted if it is deemed clinically necessary.

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Decisions on the seriousness of a medical condition are matters for clinical judgment. The signs and symptoms of DVT are swelling and tenderness in the calf especially when the foot is flexed. The calf may also be tender and red. If the clot has travelled to the lungs (pulmonary embolus), there is chest pain and breathlessness.

The initial treatment is with heparin, which rapidly thins the blood and prevents the DVT from becoming larger and causing a pulmonary embolus. Heparin is used because warfarin, the oral treatment, takes between 24 and 48 hours to have an effect.

Internet Service Providers and Tobacco Advertising

Lord Lucas asked Her Majesty's Government:

    Whether the Tobacco Advertising and Promotion Bill, which defines an Internet Service Provider (ISP) as a publisher, is concordant with Article 12 of the Electronic Commerce Directive, which defines an ISP as a "mere conduit" of information, and with Article 15 of that directive, which states that ISPs have no obligation to monitor content and are not liable for it.[HL1232]

Lord Hunt of Kings Heath: The Tobacco Advertising and Promotion Bill does not define Internet Service Providers (ISPs) as publishers but provides a defence in certain circumstances if a court were to hold that an ISP had published a tobacco advertisement. We believe that the Bill is fully compatible with the Electronic Commerce Directive. It provides appropriate defences for ISPs in circumstances where they are unaware that they are handling a tobacco advertisement.

Organic Foods: Authenticity

Lord Vinson asked Her Majesty's Government:

    Further to the Written Answer by Lord Hunt of Kings Heath on 28 February (WA 143), as the regulatory bodies have no universal method of differentiation between organic foodstuffs and that grown conventionally, whether any safeguards exist to ensure the authenticity of organic foods.[HL1246]

Lord Hunt of Kings Heath: The principal safeguard of the authenticity of organic food lies in the organic certification system, established by Regulation (EEC) 2092/91 and administered by the UK Register of Organic Food Standards, for which the Ministry of Agriculture, Fisheries and Food has responsibility. It is the responsibility of local authorities to verify organic claims at the retail level.

Variant CJD

Lord Morris of Manchester asked Her Majesty's Government:

    What response they have made to the representations by Professor Michael Banner, a senior Government adviser on vCJD, on the

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    Department of Health's attitude to and support for the vCJD Incident Panel, and to his allegation that Ministers have been misleading the public on the risks of vCJD; and what action they will be taking.[HL583]

Lord Hunt of Kings Heath: A response to Professor Banner's representations has been made through a letter of 21 February 2001 from the Chief Medical Officer. Professor Banner is a recently appointed Chairman of a sub-committee; he is not a member of the main Spongiform Encephalopathy Advisory Committee (SEAC), which advises the Government on vCJD and BSE.

The letter from the Chief Medical Officer points out that the panel was established to advise on incidents involving the potential transmission of CJD or vCJD through clinical interventions. The role of the panel as a sub-group of the Advisory Committee on Dangerous Pathogens (ACDP)/Spongiform Encephalopathy Advisory Committee (SEAC) Joint Working Group, is to advise health authorities on the appropriate action to be taken on specific incidents involving clinical interventions on patients who went on to develop CJD or vCJD.

SEAC at their meeting on 28 November were informed about the key elements of the strategy to protect patients against possible vCJD risk that was to be announced on 4 January 2001. The extract from the SEAC public statement describes this discussion as follows:


    "The Committee were informed of the Department of Health's strategy to combat the theoretical and presently unquantifiable risk of person to person transmission of vCJD via surgical instruments. A major initiative had been launched to improve standards of washing, decontamination and general hygiene, earlier identified by the Committee to be key steps in reducing risk. This would take some time to yield results. In the meantime, single use instrument sets for tonsillectomies were likely to be introduced in the first instance.


    The Committee welcomed the overall risk reduction strategy and the advances being made on decontamination. The committee also endorsed the concept of using tonsillectomy as a pilot scheme to see how single-use instruments would work in practice. In addition, the Committee recommended that the introduction of single-use instruments for other higher risk procedures should not be abandoned; that instrument labelling and tracking should be improved; that the monitoring of decontamination procedures should be both frequent and robust; and that it would be desirable for the reforms outlined to encompass private and military hospitals as well as the NHS."

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Thus, the strategy itself was broadly welcomed by SEAC, the parent committee. The announcement on 4 January 2001 drew on the public statement of SEAC.

The Government value the work that the panel is undertaking and are allocating appropriate resources to enable it to fulfil its remit.

Court Service: Key Performance Targets

Viscount Simon asked Her Majesty's Government:

    What are the key performance targets for the Court Service executive agency for 2001-02.[HL1312]

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The Lord Chancellor (Lord Irvine of Lairg): The table below illustrates the key performance targets that I have set the Court Service for 2001-02:

Performance IndicatorTarget 2001-02
KPI 1The quality of service provided to court users88%
KPI 2The percentage of administrative work in the civil courts processed within target time94%
KPI 3The percentage of Crown Court defendants/appellants whose cases begin within target time78%
KPI 4Percentage of asylum appeals completed (through both tiers of IAA) within four months65%
KPI 5Percentage of value recovered of enforceable (correctly directed) warrants72%



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