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Baroness Pitkeathley: My Lords, does my noble friend agree that the most important thing from the patients' point of view is not where the meal is prepared or even how it is prepared but its taste and the variety that is available to them? Could she therefore expand a little on her answer about the better hospital food programme, particularly in relation to the choice available to patients?
Baroness Andrews: My Lords, the whole purpose of the better hospital food programme which was introduced in the NHS Plan in 2000 was to put taste, quality and flavour back into hospital food. Among the initiatives that have been introduced over the past couple of years are snack boxes so that people who miss meals when they go to surgery have a nice meal when they return. What we are really proud ofI have here a visual aidare the menus in which three dishes a day on offer in every hospital are designed by leading chefs. For example, Loyd Grossman is leading our panel implementing the programme. Some of the dishes are absolutely delicious, such as cauliflower cheese with extra cheesy sauce or sticky toffee pudding.
Baroness Andrews: My Lords, we set ambitious targets because we knew that patients really appreciate good food in hospitals. It proved difficult to meet those targets, but I am delighted to say that we are making progress all the time with 24-hour catering, ward kitchens and snack boxes. Two additional snacks a day are available on the wards for patients and a really nice hot meal in the evening. So we are making very good progress.
Lord Walpole: My Lords, where does this leave the Answer given last week to the noble Baroness, Lady Miller of Chilthorne Domer, by the Minister of Agriculture about the use of local food produced within 30 miles of where it is consumed?
Baroness Andrews: My Lords, the NHS Purchasing and Supply Agency is anxious to involve as many local suppliers as possible. They are supporting that in different ways; for example, the PASA speaks of supplier events. It produces booklets and information and supports the DTI, regional development agencies and small business services. We are very anxious to play a part in sustainable development in that way.
Lord Addington: My Lords, I declare an interest as a local boy. Hearing that food must be transported across the eastern counties to our newer hospitals, I wonder whether the Government are aware that we have "beautifully tender turkeys"I believe that was the expressionin Norfolk. We also have an excellent catering department in Norwich City College. Are those assets not being under-utilised in this process?
Baroness Andrews: My Lords, I would very much like to see those local assets being used as part of the cook-chill experience. It would be excellent if we could get the local college involved. Because we are looking for innovation and choice, we are prepared to consider several different ways in which best to do things.
Baroness Andrews: My Lords, I did not say that there was no kitchen. It is a particular type of kitchen that can cater for reheating large quantities of meals. Each ward has a little kitchen where snacks can be prepared.
Baroness Andrews: My Lords, the Committee on Safety of Medicines and the Medicines Commission fully considered all the safety and medical issues when pharmacy supply of this medicine was being considered during 2000. They advised that emergency contraception could be safely supplied by pharmacists. The Royal College of Nursing has not provided us with any evidence that emergency contraception is being supplied without proper health checks. However, officials from my department would be happy to meet with the RCN to hear its specific concerns.
Baroness Seccombe: My Lords, I thank the noble Baroness for that reply. Two years ago the Royal College of Nursing was in favour of the pill being dispensed over the counter, but now it is calling for tighter controls. Does the Minister share my concern that there appears to be a lack of advice, information and health checks before the pill is prescribed or sold over the counter? The assurances that were given to this House when the relevant Bill was going through the House seem to have been disregarded. I admit that the Minister suggested that she was willing to listen, but what will the Government do to ensure that those assurances are upheld?
Baroness Andrews: My Lords, we are very anxious that the system should work well. The pharmacists themselves are committed to offering an excellent advice service. We have had no evidence, information or feedback that that is not working well. Health checks are made when pharmacists assess patients for their appropriateness to receive emergency contraception, as they are for any other medicine sold by pharmacists.
The noble Baroness may have seen the press notice issued yesterday by the Royal Pharmaceutical Society, which reiterated its commitment. It referred to the very detailed professional guidance that underpins the sale of hormonal contraception. We are content that the system is safe and working well, but we are happy to meet the RCN if it is concerned.
Lord Clement-Jones: My Lords, is the Minister aware that the RCN Congress made absolutely no change to its policies, which were to supportand are still to supportthe dispensing of emergency contraception by pharmacists? Is it not the case that no hard evidence was produced in that debate? It was all anecdotal. Would the Minister agree that the benefits
Lord Hylton: My Lords, do the Government agree that the recent introduction of the morning-after pill into schools at a time of rising teenage pregnancies shows the ineffectiveness of much conventional sex education? Will the Government therefore study the success of abstinence education in the United States and discuss it with education authorities here?
Baroness Andrews: My Lords, most contraceptive advice for young people is offered by general practitioners and family planning services. If a school's governing body decides to provide a school-based health service, it can offer contraceptive advice as part of a holistic service. That might happen through extended school services that involve a health service on site, so that we do not have the situation of school nurses prescribing contraceptives.
As regards the evidence from the United States, my information is that no abstinence-only programmes have shown strong evidence that they either delay sex or reduce teenage pregnancies. We are very concerned about teenage pregnancy; our own teenage pregnancy strategy, into which we put £47 million, seeks to inform, advise and support young people as well as possible so that they make the right choices.
Baroness Gardner of Parkes: My Lords, will the Minister say what the proper health checks are to which she referred? What are the contra-indications and how would ordinary people be aware of them, or would only pharmacists and doctors have such information?
Baroness Andrews: My Lords, with reference to the correspondence from the Royal Pharmaceutical Society, the society has issued mandatory standards. Practice guidance is being prepared and based on advice. The standard provisions are used: women are asked whether they have taken the medicine before, and whether there have been contra-indications, especially with regard to liver problems. That is the standard practice advice.
Baroness Andrews: My Lords, the only contra-indication of which we are aware is that offered by the WHO, and it is simply pregnancy. It is a very safe medicine that has been passed by the Committee on Safety of Medicines. We have absolute confidence that there is no problem with it. Pharmacists are in a good position to give sound advice because they are part of
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