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Earl Howe asked Her Majesty's Government:

Lord Warner: Food supplements, like other foods, are not required to demonstrate their efficacy before marketing, nor are they subject to prior approval unless they are genetically modified or are "novel". Therefore, the Food Standards Agency does not hold detailed information about food supplements on the United Kingdom market.

According to information provided by industry, Annex II of the Food Supplements Directive presently omits many chemical sources of vitamins and minerals currently used in food supplements on the UK market. The list of these missing substances is available in the Library.

Lord Clement-Jones asked Her Majesty's Government:

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Lord Warner: The Expert Group on Vitamins and Minerals (EVM) consulted widely on a draft of its report in 2002. It carefully considered all responses before finalising its report. Although the Government have no plans to review the report of the EVM at this stage, the evidence base on issues relating to vitamin and mineral supplements will be monitored closely as it develops.

Lord Clement-Jones asked Her Majesty's Government:

    What specific actions they intend to take to promote to the European Commission, other European Union Member States and the European Food Standards Agency their policy objectives for the setting of maximum permitted levels for nutrients in food supplements; and what those policy objectives are.[HL3413]

Lord Warner: The Government's view is that these maximum limits should be based on consideration of safety rather than supposed nutritional need so as to not unnecessarily limit consumer choice or unduly restrict trade.

The Food Standards Agency (FSA), which is responsible for negotiations on this issue, takes every opportunity to press this case bilaterally with member states and with other interested parties. In May, the FSA wrote to European Union Member States as well as to the European Commission and the European Food Safety Authority to advise them of the conclusions of the United Kingdom Expert Group on Vitamins and Minerals (EVM) on safe intakes of vitamins and minerals. The EVM's advice will form the basis of the UK's position when substantive discussions at EU level take place in due course. Rebo

Lord Clement-Jones asked Her Majesty's Government:

    What steps they are taking to ensure that Article 5 of the Food Supplements Directive is interpreted in such a way as to ensure that maximum permitted levels for nutrients in food supplements are set on the basis of safety, not nutritional need or other political considerations. [HL3414]

Lord Warner: Article 5 of the Food Supplements Directive sets out principles for setting maximum permitted levels for vitamins and minerals in food supplements. The Government's view is that these should be based on consideration of safety rather than supposed need or other considerations, so as to neither unnecessarily limit consumer choice nor unduly restrict trade.

The Food Standards Agency, which is responsible for negotiations on this issue, takes every opportunity to press this case bilaterally with member states. In May, the Food Standards Agency wrote to European Union member states to advise them of the conclusions of the United Kingdom Expert Group on Vitamins and Minerals (EVM) on safe intakes of vitamins and minerals. The EVM's advice will form the basis of the United Kingdom's position when

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substantive discussions at European Union level take place in due course.

Lord Clement-Jones asked Her Majesty's Government:

    What consideration was given by the Food Standards Agency to the submission of Consumers for Health Choice on the Draft Food Supplements (England) Regulations; and why the final regulatory impact assessment on these regulations identifies only one submission having been received from a consumer group and that that submission supported the principle of the regulations. [HL3415]

Lord Warner: The Food Standards Agency formally consulted on the draft Food Supplements (England) Regulations 2003 from 23 October 2002 to 15 January 2003. A summary of responses received is on the Food Standards Agency's website with all comments clearly attributed. In amending the draft regulations, the Food Standards Agency carefully considered all responses received, including the comments from Consumers for Health Choice. The one consumer group referred to in the regulatory impact assessment is Foodaware.

Lord Clement-Jones asked Her Majesty's Government:

    Whether they share the view of Food Standards Agency officials expressed at a meeting with industry representatives and the Minister for Public Health on 9 June that the European Union is now likely to set maximum permitted levels for nutrients in food supplements on the basis of nutritional need, not safety. [HL3445]

Lord Warner: The Government are firmly committed to the view that, in the interests of consumer choice, the law should allow food supplements that are safe and properly labelled to be freely marketed. The European Commission has not yet proposed maximum limits for nutrients in food supplements.

The view expressed at this meeting was that many European Union member states would prefer a more restrictive approach to setting of maximum limits based on supposed nutritional need, rather than the safety-based approach the United Kingdom is pressing for. The Government recognise that there is a risk that these member states will argue for limits that are lower than levels currently in the UK market place. Rebo

NHS: "University Hospitals"

Lord Walton of Detchant asked Her Majesty's Government:

    What criteria and what facilities and functions are necessary to enable any National Health Service hospital to assume the title of "University Hospital".[HL3447]

Lord Warner: There are no defined criteria, functions or facilities required for any National Health

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Service hospital to use the title "University Hospital". The term has traditionally been used to denote an affiliation between a hospital and a university where a significant amount of teaching is carried out within the hospital. A hospital would be expected to reach agreement with its associated university before using it. "University Hospitals" remain part of the NHS.

NHS: Healthcare Audit and Inspection

Baroness Masham of Ilton asked Her Majesty's Government:

    Whether they will list all the government bodies which have a role in:


    (a) inspecting hospitals and care homes and investigating patient standards and complaints; and


    (b) for each body, state their function. [HL3519]

Lord Warner: The only body that undertakes a full inspection and investigation of National Health Service hospitals is the Commission for Health Improvement (CHI), which undertakes a rolling programme of clinical governance reviews.

The Health Act 1999 requires the CHI to undertake local reviews (known as clinical governance reviews) to examine the quality of care provided by NHS bodies; CHI comment on where and when they think the potential to deliver good care is compromised. The commission may also undertake investigations into the management, provision and quality of healthcare NHS bodies provide.

The only body that undertakes a full inspection and investigation of care homes is the National Care Standards Commission (NCSC). The Care Standards Act 2000 established the NCSC as the independent regulatory body responsible for registering and inspecting care homes and private and voluntary health care providers.

The commission carries out regular inspections of services against new national minimum standards set by the Secretary of State for Health and has strong powers of enforcement to ensure that services meet the required standards. It is also there to support service users by investigating complaints and providing information to the public about regulated services.

Subject to the passage of the Health and Social Care (Community Health and Standards) Bill, the Commission for Health Improvement will be replaced by a new Commission for Healthcare, Audit and Inspection (CHAI). CHAI will encompass the current and proposed work of CHI with the independent healthcare work of the NCSC and the national NHS value for money work of the Audit Commission. The functions of CHAI were set out in Delivering the NHS Plan, which also stated that CHAI will provide an independent scrutiny of patient complaints.

A separate social care inspectorate, the Commission for Social Care Inspection (CSCI) comprising the work of the Social Services Inspectorate (SSI) with the social care related functions of the NCSC and the Joint

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Review team of the SSI/Audit Commission, will also be formed. The CSCI will also have functions in relation to the consideration and investigation of complaints about the social services provided by local social services authorities in England.

There are other organisations which inspect and investigate different particular aspects of the provision of hospital care, including patient standards and complaints at infrequent intervals but these are not full inspections. These include community health councils, which can inspect hospitals at any time and patient environment action teams, which visit NHS hospitals annually to assess standards of cleanliness.


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