Cot Deaths

HC Deb 13 November 1991 vol 198 cc577-80W

Mr. Austin Mitchell

To ask the Secretary of State for Health when the Chief Medical Officer established the group of experts to examine evidence relating to cot deaths; and what evidence it is asking them to examine.

Mrs. Virginia Bottomley

I refer the hon. Member to the reply I gave him on 21 October at column423.

Mr. Austin Mitchell

To ask the Secretary of State for Health (1) what the increase in cot deaths between 1986 and 1989 has been attributed to; and what government-funded studies there have been into the sudden increase;

(2) what assessment he has made of the reasons for the apparent reduction in cot death rates in the last two years.

Mrs. Virginia Bottomley

An increase in the number of deaths attributed to sudden infant death—SID—occurred between 1986 and 1988. The rate of sudden infant death per 1,000 live births came down from the 1988 level of 2.35 to 1.81 in 1990.

The reasons for fluctuations and trends in the incidence of SID nationally are not clear. SID is more common in the winter months and the rate may vary according to the severity of the winter; but the relationship is not fully understood. There is now growing evidence that changes in child rearing practice have been accompanied by changes in mortality attributed to SID. These include: a reduction in the prone sleeping position for the infants; attention to the risk of overheating; and increased support to those infants thought to be at highest risk, for example, those children suffering from respiratory disease. In addition, it is believed that there is a trend in the pattern of certification of death towards certifying as sudden infant deaths, deaths that might previously have been certified as due to respiratory disease. The rates for respiratory disease fell over this period when SID was increasing.

For information relating to government-funded studies into cot death research, I refer the hon. Member to the reply my hon. Friend the Parliamentary Under-Secretary of State for Education and Science gave him on 7 November at column 206.

Mr. Austin Mitchell

To ask the Secretaryt of State for Health how much money the Government have giver to the Foundation for the Study of Infant Deaths since it was set up.

Mrs. Virginia Bottomley

Since 1983–84, the foundation has received a total of £97,500 in grants under section 64 of the National Health Service and Public Health Act, 1968. The foundation also currently receives a grant of £25,000 per annum payable over the two financial years, 1991–92 and 1992–93.

Mr. Austin Mitchell

To ask the Secretary of State for Health when he expects the inquiry he has set up into stillbirths and deaths in infancy to report; when it will issue a preliminary report on the recommended cot sleeping position for babies; and what steps he will take to communicate that recommendation to health service professionals.

Mrs. Virginia Bottomley

On 21 October, I announced the setting up of an expert group to report to the chief medical officer following its examination and assessment of available evidence on reducing the risk of cot death. After studying the group's recommendations, the chief medical officer made its advice public in a press release issued on 31 October. He also announced that he and the chief nursing officer would be writing specifically to health professionals about the expert group's advice.

I would like to take this opportunity to thank the members of the group for the speed and clarity of their advice.

The confidential inquiry into stillbirths and deaths in infancy, which I announced on 2 July, is a longer-term and more wide-ranging initiative which will organise detailed investigations into foetal losses, stillbirths and infant deaths.

Mr. Austin Mitchell

To ask the Secretary of State For Health what funding was made available to the Avon study into infant deaths.

Mrs. Virginia Bottomley

I understand that the most recent study in Avon was funded with the assistance of the Foundation for the Study of Infant Deaths. The Department was not approached directly to provide funding for this particular study, though financial assistance is provided for the foundation's administrative costs.

Mr. Austin Mitchell

To ask the Secretary of State for Health when the Medical Research Council was commissioned to review existing cot death research; and to what end.

Mrs. Virginia Bottomley

The Department commissioned the Medical Research Council in June 1989 to undertake a major review of the literature relating to sudden infant death syndrome—SIDS—and to advise on what further research was needed. This has been received and is under consideration.

Mr. Austin Mitchell

To ask the Secretary of State for Health how much extra was spent on research into cot deaths as a result of the recommendation of the Select Committee on Social Services (HC 54 Session 1988–89) that further research into the causes of sudden infant death syndrome should be conducted as a matter of urgency.

Mrs. Virginia Bottomley

Government expenditure on research into sudden infant death syndrome and

Hospital and Community Health Services (HCHS) Revenue Expenditure on salaries and wages
	1989–90	1978–79
	£ million (cash)	As a proportion of total revenue expenditure (per cent.)	£ million (cash)	As a proportion of total revenue expenditure (per cent.)
Medical and Dental Staff Consultants
Medical	672.0	5.0	158.4	3.6
Dental	13.7	0.1	3.7	0.1
Total	685.7	5.1	162.1	3.7
Other Medical Staff	765.7	5.6	212.4	4.8
Other Dental Staff	49.1	0.4	17.1	0.4
Nurses and Midwives	4,893.2	36.0	1,353.7	30.6
All Other Staff	3,861.3	28.5	1,533.2	34.7
Total	10,255.0	75.6	3,278.5	74.7

Source:

Annual accounts of regional and district health authorities in England and those of the special health authorities for the London postgraduate teaching hospitals 1989–90 (predecessor authorities 1978–89).

Notes:

1. HCHS covers all services managed by the health authorities concerned including hospital, community health, patient transport (i.e. ambulance), blood transfusion and other services. Capital expenditure and all expenditure incurred by Family Health Services Authorities (FHSAs) and certain supporting special health authorities and other bodies is excluded; however 1978–79 figures include small elements for administrative costs of the FHSA predecessor Family Practitioner Committees which were at that time included with the annual accounts of health authorities and were not separately identified.

2. The figures are gross salaries and wages costs and include employers' national insurance and superannuation contributions.

3. "All other staff' includes professional, technical, scientific, ancillary, maintenance, ambulance and administrative and clerical staff. The correspondingly small total costs incurred by the health authorities on employing all non-NHS (agency etc) staff are also included—£297.5 million (cash) in 1989–90 and £40.6 million (cash) in 1978–89.

Mr. Austin Mitchell

To ask the Secretary of State for Health whether his advice that young babies should be laid on their back includes premature babies.

Mrs. Virginia Bottomley

In individual cases, such as premature babies, this must be a matter for the clinical judgment of the doctor concerned with the baby's care.

respiratory distress syndrome in 1989–90 and 1990–91 amounted to £1,095,000, a 30 per cent. increase over the previous two-year period.