§ Mr. BurstowTo ask the Secretary of State for Health how many(a) mental health and (b) other patients, broken down by reason for their admission to hospital received ECT (i) having given informed consent in advance, (ii) not having given consent but having the matter put to a second opinion and (iii) not having given consent and not having the matter referred to a second opinion-appointed doctor, in each quarter over the last nine years; and how many patients for each of the quarters where figures are available were (A) under 16, (B) 16 to 59, (C) 60 to 75 and (D) 75 years and over. [13111]
§ Jacqui SmithThe information requested is not available.
The most recent information available is contained in a one-off survey covering the period from January 1999 to March 1999, England only, that was undertaken to provide an up to date and accurate snapshot picture of the use of electro-convulsive therapy (ECT). Prior to this survey, the information previously recorded on ECT did not provide an accurate picture on the use of ECT treatment.
The results of the survey are contained in the Department of Health Statistical Bulletin "Electro-Convulsive Therapy: Survey covering the period from January 1999 to March 1999, England", a copy of which is in the Library.
§ Mr. BurstowTo ask the Secretary of State for Health when his Department last undertook an evidence review into the use and efficacy of ECT that drew on(a) UK and (b) international research. [13110]
§ Jacqui SmithThe Department has commissioned a systematic review of the effectiveness and safety of electro-convulsive therapy (ECT). This review which682W covers both United Kingdom and international research led by Dr. John Geddes at the University of Oxford and is expected to report by the end of this year.
The Department has commissioned the Institute of Psychiatry to conduct a review of studies and information on consumers' perspectives on ECT.
The Department's health technology assessment (HTA) programme has commissioned a review, on behalf of the National Institute for Clinical Excellence, on the clinical cost-effectiveness of ECT due to be completed in May 2002. The HTA programme has also commissioned a trial of the clinical effectiveness and cost of repetitive transcranial magnetic stimulation versus ECT in severe depression. This report is due to be published in May 2006.
The National Health Service Centre for Reviews and Dissemination has conducted systematic reviews relating to the effectiveness of ECT including:
- Electro-convulsive therapy for depression
- Electro-convulsive therapy for schizophrenia
- Half a century of ECT use in young people.
The details of these reviews can be found in the Database of Abstracts of Reviews of Effectiveness available at: http://agantha.york.ac.uk/welcome.htm
§ Mr. BurstowTo ask the Secretary of State for Health what guidance has been issued to doctors relating to who should(a) administer and (b) receive ECT in hospitals; and if he will make a statement. [13109]
§ Jacqui SmithIn 1995, the Royal College of Psychiatrists issued guidance on the use of electroconvulsive therapy (ECT) called "The ECT Handbook—The Second Report of the Royal College of Psychiatrists' Special Committee on ECT". This is an important source of guidance to patients and include sections on clinical guidelines; the administration of ECT; the law and consent. The college expects to issue an updated edition of this guidance in 2002.
In September 1998 the Chief Medical Officer and the president of the Royal College of Psychiatrists sent a joint letter to all consultant psychiatrists, health authorities and national health service trusts. Clinicians and mental health trust managers were expected to ensure ECT is administered to patients in accordance with the college's guidance.
Decisions on clinical interventions remain the prerogative of clinical staff. However, evidence and research tends to support the use of ECT treatment on patients with severe depressive illness and puerperal psychosis.