HL Deb 07 May 2003 vol 647 cc1090-2

2.51 p.m.

Baroness Seccombe asked Her Majesty's Government:

What action they intend to take in response to the concern of some nurses that the morning-after pill is being dispensed to women without proper health checks.

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 support—and are still to support—the 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 of emergency contraception in terms of unwanted pregnancies vastly outweigh the issues that have arisen?

Baroness Andrews

My Lords, the noble Lord is right in every respect.

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.

I cannot remember the second part of the question asked by the noble Baroness.

Baroness Gardner of Parkes

My Lords, I asked how the public would be aware of those contra-indications.

Baroness Andrews

My Lords, the only contraindication 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 the community and people are confident in dealing with them. Again, I can reiterate that we are happy with the situation.

Baroness Whitaker

My Lords, can my noble friend confirm that the rate of teenage pregnancy is actually coming down a little now?

Baroness Andrews

My Lords, yes, I can confirm that. As a result of the teenage pregnancy initiative it has dropped by 10 per cent. That figure is for over-16s and under-16s. It is still too high, but we are seeing improvement.

Baroness Noakes

My Lords, can the Minister confirm that the rate of use of emergency contraception fell slightly in 2001, after the morning-after pill was made available from pharmacists, thus undermining one of the initial rationales? Does she join me in being concerned that the proportion of women obtaining the morning-after pill from their doctor has plummeted from 59 per cent to 43 per cent, thus increasing the likelihood that sexually transmitted infections will go undetected?

Baroness Andrews

My Lords, I do not have the figures that the noble Baroness quoted. I would be most interested in seeing them, if there has been a drop in prescribing. However, we should bear in mind that the morning-after pill, prescribed in this way, was not intended to deal with teenage pregnancy. It was intended to be provided for older women, in fact, and the average age for prescribing is 28. That figure comes from Schering's own research. We are looking at a particular part of the population.

The increase in sexually transmitted diseases has many causes, and I do not see any parallel.