§ Ms Oona KingTo ask the Secretary of State for Health if he will examine the feasibility of making the morning-after pill available on a non-prescription basis; and what recent representations he has received on making the morning-after pill available through specific certified outlets without prescription. [128764]
§ Yvette CooperThe Medicines Control Agency is presently consulting on an application to reclassify levonorgestrel 0.75 milligramme for emergency contraception from prescription only to pharmacy availability for women aged 16 years and over. The consultation period ended on 29 June 2000. The responses will then be considered by the Medicines Commission and their recommendations presented to Ministers for a decision. If we decide to go ahead, an Order would be laid before the House later in the year.
Whatever is decided, emergency hormonal contraception, the morning after pill, will continue to be available, free of charge under existing National Health Service arrangements, from general practitioners, family planning clinics and some hospital accident and emergency departments.
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§ Shona McIsaacTo ask the Secretary of State for Health (1) if he will make a statement on the availability of emergency contraception; [129944]
(2) what plans he has to make emergency contraception available over the counter at pharmacists. [129943]
§ Yvette CooperEmergency hormonal contraception is currently available on prescription through general practitioners, family planning clinics, youth services, walk in centres, and some accident and emergency departments. The Sexual Health/HIV Strategy is looking at improving access to National Health Service contraception services including emergency contraception products.
The Medicines Control Agency is presently consulting on an application to reclassify levonorgestrel 0.75 milligramme for emergency contraception from prescription only to pharmacy availability for women aged 16 years and over. The consultation period ended on 29 June 2000. The responses are to be considered by the Medicines Commission and their recommendations presented to Ministers for a decision. If it were decided to proceed, an Order would be laid before the House later in the year.
§ Shona McIsaacTo ask the Secretary of State for Health (1) what assessment he has made of the recent trials of over-the-counter prescribing of emergency contraception; [129942]
(2) what assessment he has made on the impact on levels of abortion in the trial areas for emergency contraception; and if he will make a statement. [129941]
§ Yvette CooperThere are currently two pilot schemes run by health action zones (HAZs) in Manchester, Salford and Trafford and Lambeth, Southwark and Lewisham where emergency contraception is supplied by pharmacists, under a patient group direction. Both pilots form part of the HAZs' overall strategy to reduce the rate of unwanted pregnancies locally. Both pilots are to be fully evaluated and the results will be published.
Abortion data by health authority are published annually and provisional data for 2000 will not be available until May 2001. It is therefore too early to make any assessment on the impact on levels of abortion in the pilot areas. Fluctuations in the abortion rate may be subject to a number of different factors and it is therefore difficult to attribute any changes to one intervention or event. There have been no studies which have been able to predict the effect the availability of emergency contraception through pharmacies may have on unwanted pregnancy rates.
§ Mr. GummerTo ask the Secretary of State for Health (1) for what reasons his Department encourages increased use of the morning-after pill as part of its National Sexual Health Strategy; and if he will make a statement; [130693]
(2) for what reasons his Department promotes the morning-after pill as a way to reduce the rate of teenage pregnancies; and if he will make a statement. [130692]
§ Yvette CooperEmergency contraception is a safe and effective method of preventing pregnancy when a woman has had unprotected sex or when she knows something 219W has gone wrong with her usual method. We therefore want to ensure the best possible access to emergency contraception for those who need it. The sexual health/ HIV strategy is looking at improving access to the full range of National Health Service contraception services, including emergency contraception products. One of the aims of the strategy is to reduce the number of unintended pregnancies in all age groups, and reducing the rate of teenage pregnancy is one of my right hon. Friend the Secretary of State's key priorities.
Emergency contraception should not be seen as a replacement for regular contraception, as it is not as effective as regular hormonal contraception such as the pill and therefore should he used only as an occasional measure.
§ Mr. GummerTo ask the Secretary of State for Health (1) what measures are in place to ensure that a woman's medical history is known before she is issued with the morning-after pill; and if he will make a statement; [130683]
(2) what follow-up care is available to women prescribed the morning-after pill; and if he will make a statement. [130684]
§ Yvette CooperThe Faculty of Family Planning and Reproductive Health Care at the Royal College of Obstetricians and Gynaecologists have researched the available evidence and published updated Recommendations for Clinical Practice regarding emergency contraception in April of this year1.
The Faculty recommendations advise that established pregnancy is the sole contraindication for use of hormonal emergency contraception (HEC). The Faculty considers that for all other women the benefits of HEC, particularly the progestogen-only method, generally outweigh the risks.
Regarding follow up action, the recommendations suggest that future contraception should be discussed sympathetically and, preferably arranged. Advice should be given as to when the woman can expect her next period and an appointment offered and/or arrangements made to discuss any problems including on-going contraception information/supply.
1 Recommendations for clinical practice: emergency contraception. Faculty of Family Planning and Reproductive Health Care. April 2000 update.
§ Mr. GummerTo ask the Secretary of State for Health how many prescriptions of the morning after pill there were in the last 10 years for which figures are available; and if he will provide a breakdown by age. [130727]
§ Yvette CooperThe information requested is in the tables.
Table 1 shows the number of prescriptions dispensed in the community in England. A breakdown by age of the patient receiving these prescriptions is not available. Table 2 shows the number of prescriptions for hormonal emergency contraceptives prescribed at National Health Service family planning clinics in England from 1989 to 1998. Table 3 shows the number of prescriptions for hormonal emergency contraceptives prescribed at NHS family planning clinics in 1998–99, by age.
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Table 1: Number of prescriptions dispensed in the community for Schering PC4 ('morning after pill'), 1989 to 1999 England Thousand Year Number of prescriptions 1989 122.7 1990 189.6 1991 232.8 1992 272.2 1993 313.3 1994 363.8 1995 475.4 1996 565.6 1997 552.8 1998 559.8 1999 536.8 Notes:
1. The data for 1989 and 1990 are not strictly consistent with data from 1991 onwards.
2. Figures for 1989 and 1990 are based on fees and on a sample of 1 in 200 prescriptions dispensed by community pharmacists and appliance contractors only.
3. Figures for 1991 onwards are based on items and cover all prescriptions dispensed by community pharmacists, appliance contractors dispensing doctors and prescriptions submitted by prescribing doctors for items personally administered.
Table 2: Number of prescriptions for hormonal emergency contraceptives prescribed at NHS Family Planning Clinics in England from 1989 to 1998 Thousand Year Number of prescriptions 1989 36.9 1990 45.5 1991 63.0 1992 76.7 1993 92.2 1994 112.1 1995 157.6 1996 193.7 1997 205.1 1998 209.9 Source:
Department of Health Statistics Division SD2B
KT31
Table 3: Number of prescriptions for hormonal emergency contraceptives prescribed at NHS Family Planning Clinics in 1998–99, by age Thousand Age group Number of prescriptions All ages 209.9 Under 16 21.5 16–19 83.4 20–24 55.0 25–34 40.0 35 and over 10.0 Source:
Department of Health Statistics Division SD2B
KT31
Information about NHS Family Planning Clinic activity is derived from the Department of Health annual return KT31 and is published each year. The latest information is contained in the Statistical Bulletin "NHS Contraceptive Services, England: 1998–99". A copy of the bulletin is in the Library and can also be found on the Department of Health website www.gov.uk/public/sb9930.htm.
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§ Mr. GummerTo ask the Secretary of State for Health what discussions he has held with the All-Party Pharmacy Group on the morning-after pill; and if he will make a statement. [130688]
§ Yvette CooperThere have been no discussions between Health Ministers and the All-Party Pharmacy Group on the issue of emergency contraception. However there has been correspondence between my hon. Friend the Member for Dartford (Dr. Stoate), chair of the group, and myself following the group's report on extending access to emergency contraception through community pharmacies.
§ Mr. GummerTo ask the Secretary of State for Health if he defines the morning-after pill as an abortifacient; and if he will make a statement. [130691]
§ Yvette CooperThe accepted legal and medical view is that emergency contraception is not a method of abortion. Emergency contraception pills work before implantation and so before a pregnancy has been established. Emergency contraceptive pills will not cause an abortion if taken after implantation.
My right hon. Friend the Attorney-General, in answering a parliamentary question in 1983, stated that medical practitioners would not be prosecuted for illegal abortion if they sought to prevent implantation by the use of the 'morning-after pill' or an inter-uterine device.
Mr. RobertsonTo ask the Secretary of State for Health what advice he has issued to general practitioners on prescribing of the morning-after pill; and if he will make a statement. [131381]
§ Yvette Cooper[holding answer 18 July 2000]: None. Prescribing of emergency contraception is a matter for the clinical judgment of the practitioner concerned. The Faculty of Family Planning and Reproductive Health Care at the Royal College of Obstetricians and Gynaecologists recently researched the available evidence and published updated recommendations for clinical practice for emergency contraception in April this year.