§ Mr. Strang
To ask the Secretary of State for Health if he will make a statement on policy towards prevalence screening for HIV.
§ Mr. Kenneth Clarke
We have now completed consideration of comments arising from consultation on the report of the working group on the monitoring and surveillance of HIV infection and AIDS (the Smith report). Assisted by these comments we have reached a decision on anonymous and named screening for HIV. We are grateful to the large number of organisations which have let us have their comments.
Anonymous screening is the testing under conditions of total anonymity, for HIV infection of blood from patients who have voluntarily given it for other tests, but who have not specifically consented to an HIV test. Before any of the blood taken is tested for HIV identifying details are removed from the blood sample so as to render the test wholly anonymous. The balance of scientific opinion strongly favours such testing as the best way to obtain information about the overall prevalance of HIV infection by age and sex in the various parts of the country, and the rate at which it is spreading in the population at large. The Cox report, on short-term prediction of HIV infection and AIDS in England and Wales, which was published on 30 November, explicitly recommends anonymous testing.
The Government see no legal obstacle to such testing. From the layman's point of view, we also see no ethical objections to the testing for scientific purposes of blood samples taken property in the first place for another purpose from a patient no longer identifiable.
We are therefore inviting the Medical Research Council to bring forward proposals within three months for a programme of anonymous screening.
The Smith report recommended setting up large scale named antenatal studies, which the report believes should 438W play an important role in identifying how far the infection has spread beyond the at-risk groups. Two such studies have been already announced and have begun in Dundee and Edinburgh. These studies are extremely important because of the higher prevalence of HIV in drug abusers in Scotland. We accept in principle the case for a programme of named studies in England as recommended in the report but believe many important matters of detail as to scale and groups to be tested need to be determined. It is of course essential that the patients in these tests are volunteers who have been advised fully before the test and will if they wish to be told the results afterwards. We are therefore asking the MRC to let us have detailed proposals on such studies within three months. Further named studies will enable comparisons to be made of the results of surveys based on anonymous testing and on named testing.
The Smith report made a number of other useful recommendations concerning epidemiological studies of particular groups and improvements to the collection and collation of data. These recommendations were generally welcomed and we are asking the MRC, public health laboratory service and other bodies concerned to take them forward. £.1.7 million has been made available to the MRC in 1989–90 for research into the spread of HIV infection and AIDS including such studies. The adequacy of this sum will be kept under review.
§ Mr. Strang
To ask the Secretary of State for Health what steps he will take to ensure that the reporting of positive HIV test results is covered by the confidentiality provisions of paragraph 3 of the schedule to the AIDS (Control) Act 1987; and when he expects the reports under the Act to be published.
§ Mr. Mellor
Under the AIDS (Control) (Contents of Reports) (No. 2) Order 1988, the reporting of positive HIV test results in the reports required under the AIDS (Control) Act 1987 are covered by the confidentiality provisions of paragraph 3 of the schedule of that Act. Under section 3 of the Act, the reports have to be published by the health authority or board by which they are made. All the reports for the period April 1987 to March 1988 are now available.
§ Mr. Bermingham
To ask the Secretary of State for Health (1) what is the current annual cost to the national blood transfusion service of the use of existing tests to identify antibodies of the HIV-2 virus; and if he will make a statement;
(2) what is (a) the number and (b) the proportion of total blood donors currently screened in respect of the HIV-2 virus; and if he will make a statement;
(3) what would be the cost to the national blood transfusion service of full-scale testing of blood from all donors in respect of the detection of HIV-2 virus; and if he will make a statement.
§ Mr. Mellor
Potential blood donors are given preliminary screening by medical questionnaire. Donations from those who are accepted are routinely tested for HIV-1 and other diseases at the regional transfusion centres of the national blood transfusion service.
Since June 1988 samples of donations from donors who have visited specified West African countries where HIV-2 is more common have been referred to the public health laboratory service for testing for antibodies to HIV-2.439W
Of the donations collected between June and November 1988 around 4,500 (0.4 per cent.) have been tested and all have been found negative. The cost of these tests is not readily identifiable.
It is not possible to give the precise cost of testing all donations for HIV-2 because an evaluation programme to identify a suitable test for use by the NBTS has not yet been completed. However, it is estimated that testing all blood donations for antibodies to HIV-2 would cost the NBTS between £1 million and £2 million annually. The need for testing on a wider basis is kept under constant review.