§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will list all the facilities for hyperbaric oxygen therapy provided by health authorities in England; if he has received any further proposals for establishing such treatment; and if he will make a statement.
§ Mr. John PattenHyperbaric oxygen chambers are located in the following hospitals.
- Heatherwood hospital, Ascot
- Addenbrooke's hospital, Cambridge
- Frenchay hospital, Bristol
- Royal Hampshire county hospital, Winchester
- Preston hall hospital, Aylesford, near Maidstone
- Monsall hospital, Manchester
- St. George's hospital, Lincoln
- The London hospital, E1
- St. Thomas' hospital, SE1
- University college hospital, WC1
- Westminster hospital, SW1
- Whipps cross hospital, E11
204 - Mount Vernon hospital, Northwood, Middlesex
- Royal Marsden hospital, Sutton, Surrey
- Good Hope hospital, Sutton Coldfield
In addition, compresssion chambers for the emergency treatment of decompression illnesses are available in a number of Ministry of Defence establishments.
So far as multiple sclerosis is concerned, we are not aware that any health authority undertakes hyperbaric oxygen treatment and in the present state of knowledge we would not wish to encourage authorities to do so except in the context of a controlled clinical trial. The organisation Action for Research into Multiple Sclerosis has been in touch with the Department about its plans to develop treatment centres on a voluntary basis.
§ Mr. Carter-Jonesasked the Secretary of Stale for Social Services what research has been undertaken on hyperbaric oxygen therapy; and if he will make a statement.
§ Mr. John PattenI assume that the hon. Member refers to the use of this therapy in the treatment of multiple sclerosis.
The current experimental and clinical data on hyperbaric oxygen treatment in multiple sclerosis is reviewed in a paper by Dr. J. Mertin and Professor W. I. McDonald published in the British Medical Journal for 31 March 1984. This refers to experimental evidence that the treatment may be beneficial through its effects on the function of the immune system, but points out that only one controlled clinical trial (in the United States) has so far been reported of its use in treating multiple sclerosis. In this trial mild or definite improvement was seen in 12 of 17 patients treated with hyperbaric oxygen, but was maintained throughout the year of observation in only five of them. These results have to be viewed with caution because of the small number of patients in the trial and the relatively short treatment and follow-up periods. The review quotes the opinion of the American investigators that although their results
indicate that further investigation should be given to hyperbaric oxygen as a treatment for multiple sclerosis, this therapeutic regimen cannot yet be generally recommended for these patients".The review concludes that further controlled trials are needed to substantiate the benefits claimed for the treatment, and that meanwhile the possibility of adverse effects should deter clinicians from recommending their patients for uncontrolled trials or for treatment by non-medically qualified personnel.
I understand that clinical trials of the treatment are to be supported by the Multiple Sclerosis Society at four centres in the United Kingdom and at a fifth by the organisation Action for Research into Multiple Sclerosis, and that a further trial is planned in the United States of America. Some animal experiments on the effects of hyperbaric oxygen on the immune system are to be undertaken at the Medical Research Council's clinical research centre.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services what information is available to him on (a) the incidence and (b) the prevalence of multiple sclerosis, analysed by age and sex; what is his estimate of the percentage of sufferers from multiple sclerosis who would benefit from hyper baric oxygen therapy; and if he will make a statement.
205W
§ Mr. John PattenThe available data relate to deaths and to in-patients treated in hospital. It is not possible to estimate the incidence or prevalence of multiple sclerosis from this information since not all patients receive hospital in-patient treatment. The following table shows the rates of deaths and hospital discharges in 1981, the latest year for which complete information is available. We are not able in the present state of knowledge to estimate the percentage of sufferers from multiple sclerosis who might benefit from hyper baric oxygen therapy.
Multiple sclerosis—England and Wales 1981 Age and sex Deaths per million population Estimated NHS hospital discharge rates* per million population 0 to 14 M nil nil F nil nil 15 to 44 M 3.9 136.7 F 8.7 225.1 45 to 64 M 26.5 307.1 F 38.2 456.1 65 and over M 29.0 144.8 F 30.1 179.1 TOTAL M 11.2 146.5 F 17.4 224.5 * Hospital discharge rates include deaths in hospitals.