§ Mr. NichollsTo ask the Secretary of State for Health what trends he has identified in the incidence of TB in the United Kingdom in the last 10 years; if he will make extra resources available for the detection and treatment of TB; and if he will make a statement. [30466]
§ Ms JowellThe numbers of notifications of tuberculosis (TB) in the United Kingdom are published in the Annual Abstract of Statistics. Information for the years 1987 to 1997 are given in the table:
Year Number of notifications of tuberculosis in the UK1 1987 5,745 1988 5,778 1989 6,059 1990 5,897 1991 6,078 1992 6,441 1993 6,564 1994 6,228 1995 6,174 1996 6,238 1997 26,430 1 Annual Abstract of Statistics. 2 Provisional. Sources:
Scottish Health Service Common Services Agency; Department of Health and Social Services (Northern Ireland); and Office of Population Censuses and Surveys.
There was a 90 per cent. decrease in notifications of TB in the UK between 1948 and 1987. There was a small increase in cases after the late 1980s, but figures have 263W now levelled out and the latest full year provisional figure is 6,430. This success is against a worldwide resurgence in TB in recent years which is having a small but important impact on trends in the UK. Data suggest that certain parts of the community—older white people who were exposed to TB when they were younger, homeless people, HIV infected individuals and certain ethnic minority populations—are at an increased risk from TB. Many of these groups are harder to reach, and inner city areas—London, in particular—do see a disproportionate amount of TB due to a concentration of risk groups in those areas.
No resources have been specifically identified for TB detection and treatment. Health authorities are given general allocations for hospital and community health services to commission health care services for their resident population. All 100 health authorities in England will receive a real terms cash boost in 1998–99. The 1.9 per cent. real terms increase in general allocations is the largest for five years. It is for individual health authorities to decide the level and type of services purchased, taking account of local circumstances and national policies and priorities. TB is an important public health concern and purchasers of health care need to ensure that adequate resources are provided to meet this in their contracting for TB services. While the details of local TB policies depend on local factors, local policies must be considered within a national context (especially for Bacille-Calmette-Guérin (BCG) immunisation) and national policy should prevail. The importance of this has been brought to the attention of health authorities. The Department continues to purchase the BCG vaccine and make it available free to the National Health Service. The Department is also funding the Public Health Laboratory Service, with around £400,000, to conduct a detailed Survey of Notifications of TB in 1998. The survey will provide important information on trends and incidence.
The UK has an excellent record of TB control and we are determined that this should remain the case. The BCG immunisation programme, treatment of identified cases and screening of their close contacts, screening and treatment for immigrants from countries with a high prevalence of TB and active surveillance of TB continue. We are responding positively to new adverse developments in other countries and strengthening policies to protect the health of the nation against TB.