§ Ms PrimaroloTo ask the Secretary of State for Health what target she has received from the World Health Organisation in relation to hepatitis B universal vaccination; and what plans she has to meet that target;
(2) what plans she has to implement a hepatitis B universal vaccination strategy; and if she will make a statement.
§ Mr. SackvilleTargets for the introduction of hepatitis B vaccine into national immunisation programmes were set by the global advisory group of the World Health Organisation's expanded programme on immunisation in 1991, the recommendations being endorsed by the World
532Wreceptionists, administrators and practice managers in each of the 12 family health services authority areas which fell wholly or partly within the London initiative zone in each of the last five years.
§ Dr. MawhinneyThe available information is shown in the table.
Health Assembly in 1992. These targets called for countries with a prevalence of hepatitis B virus carriers of 8 per cent. or greater to include hepatitis B immunisation into their national immunisation programmes by 1995 and for all countries to include the vaccine by 1997. Target groups and strategies may vary with local epidemiology. The carrier rate in the United Kingdom is significantly below 1 per cent.
Hepatitis B vaccine was introduced into the United Kingdom in 1982 and is recommended for those at high risk of infection. Immunisation strategy is kept under review in the light of a range of factors, including the current low prevalence of the disease in this country.
533W
§ Ms PrimaroloTo ask the Secretary of State for Health if she will list the bodies and individuals from whom she has received representations calling for a universal hepatitis B vaccination programme in children.
§ Mr. SackvilleNo recent representations have been received from organisations. We are aware that some professional interests favour universal immunisation. Policy is kept under review in the light of a range of factors including current prevalence.
Occasional letters have been received from interested individuals. These cannot be listed for reasons of confidentiality.
§ Ms PrimaroloTo ask the Secretary of State for Health what studies her Department has undertaken of(a) the most common method of transmission of hepatitis B and (b) the causes of primary liver cancer.
§ Mr. SackvilleIn the United Kingdom the most common form of acquisition of hepatitis B is known to be through unprotected sexual activity both between men and women and between men. This accounts for perhaps 60 per cent. of those cases in which a cause is identified. Transmission routes for hepatitis B are well understood. The Department has not received recent proposals for further study in this area or of the causes of primary liver cancer.
§ Ms PrimaroloTo ask the Secretary of State for Health what research her Department has commissioned into the duration of antibody responses to hepatitis B vaccination in children.
Private income of the national health service Region, Special Health Authority, National Health Service Trust 1988–89 1989–90 1990–91 1991–92 1992–93 Northern regional health authority 1,579,019 1,801,937 2,071,309 1,877,310 1,332,230 Yorkshire regional health authority 3,837,428 4,070,335 5,044,191 4,541,752 2,551,178 Trent regional health authority 2,838,649 3,183,545 2,877,057 3,464,673 2,615,399 East Anglia regional health authority 3,911,425 4,743,750 5,278,653 7,318,941 6,068,307 North West Thames regional health authority 10,251,108 11,765,016 13,377,772 13,984,258 11,082,874 North East Thames regional health authority 11,064,093 14,063,599 16,267,305 11,158,170 9,893,003 South East Thames regional health authority 7,857,124 8,636,174 11,023,826 11,692,162 12,558,427 South West Thames regional health authority 2,808,233 3,368,424 4,150,714 3,527,592 2,966,909 Wessex regional health authority 2,233,589 2,516,311 3,322,716 4,383,335 3,530,475 Oxford regional health authority 5,812,328 8,138,495 9,510,480 9,724,622 10,803,281 South Western regional health authority 3,192,220 3,643,156 4,821,114 2,111,512 1,484,225 West Midlands regional health authority 3,704,756 4,405,253 5,612,685 6,326,507 5,525,374 Mersey regional health authority 2,070,550 1,706,556 2,051,833 2,006,183 312,253 North Western regional health authority 4,568,630 5,382,332 6,644,907 4,949,840 4,127,700 Hospitals for Sick Children special health authority 2,843,674 3,459,624 3,578,948 5,066,294 4,987,994 National hospitals for nervous diseases special health authority 1,014,771 1,099,076 1,234,224 1,707,059 1,508,084 Moorfield eye hospital special health authority 636,115 676,430 739,885 884,570 944,319 Bethlem Royal/Maudsley special health authority 111,959 128,768 134,547 183,815 155,266 National heart and chest hospitals special health authority 2,805,264 3,660,196 3,636,114 4,256,510 4,429,254 Royal Marsden hospital special health authority 2,986,469 3,883,394 4,586,605 6,390,534 8,159,002 Hammersmith and Queen Charlotte's special health authority 1,512,684 2,232,927 2,753,572 3,003,772 3,735,534 Eastman dental hospital special health authority 19,463 24,097 13,298 20,140 23,321 National health service trusts n/a n/a n/a 32,254,000 58,520,000 Total income 77,659,551 92,589,395 108,731,755 140,833,551 157,314,409 Source: Annual accounts for regional health authorities, district health authorities, London postgraduate special health authorities and NHS trusts.
Notes:
1. The figures in the table include money received from national health service patients paying for accommodation in single rooms or small wards (section 63 NHS Act 1977), private in-patients (section 65) and private non-resident patients (section 66).
2. Overseas visitors (section 211) not eligible for free treatment have been excluded (as they are charged national health service patients).
534W
§ Mr. SackvilleNone, but the possibility of the need for booster doses of vaccine continues to be kept under review.
§ Ms PrimaroloTo ask the Secretary of State for Health what was the incidence of hepatitis B in each EC country in each of the last five years for which figures are available.
§ Mr. SackvilleThe available information on reported cases among European Community countries which have submitted data to the World Health Organisation is:
1991 1992 Denmark 71 51 Germany 5,081 5,987 Italy 3,262 2,985 Netherlands 264 252 Portugal 609 738 England and Wales 488 488 Differences in populations and surveillance systems should be borne in mind in assessing these figures.