§ Lord Alton of Liverpoolasked Her Majesty's Government:
How many abortions have been performed after 30 weeks gestation for each of the past five years; and at what specific point of gestation each of these abortions has been performed. [HL5354]
§ Lord Hunt of Kings HeathThe information requested is given in the following table:
patients; and what controls and safeguards are in place for the use of ECT. [HL5683]
§ Lord Hunt of Kings HeathThe most recent information available concerning trends in the administration of electro-convulsive therapy (ECT) is contained in the Department of Health statistical bulletinElectro Convulsive Therapy; Survey covering the period from January 1999 to March 1999, England. It looked at information gathered from a one-off survey of National Health Service and independent sector care settings, including nursing homes, and was undertaken to provide data on ECT that are not currently available elsewhere.
The survey collected data on total number of administrations of ECT in NHS and independent sector care settings; sex, age, ethnicity, legal status and method of consent.
In the three-month period surveyed it was found that:
there were about 16,500 administrations of electro-convulsive therapy;
2,800 patients received ECT treatment;
there were 900 male patients receiving treatment, compared with 1,900 female patients;
44 per cent of female patients and 36 per cent of male patients receiving ECT treatment were aged 65 and over;
15WA75 per cent of ECT patients were not formally detained under the Mental Health Act 1983;
of the 700 ECT patients formally detained while receiving ECT treatment, 59 per cent did not consent to treatment.
The survey did not reveal anything surprising or untoward about the use of ECT but it did confirm a downward trend in its use.
In the past ECT was believed to be effective with a wide range of mental health conditions but is now recognised to be of most benefit in the treatment of a narrower band of conditions. Evidence and research tend to support the use of ECT to help people with very severe, generally psychotic, depression and puerpural psychosis, either of which can be life-threatening if left untreated. People who are this severely depressed may refuse or be unable to eat and drink, with a consequent high mortality, as well as being at very high risk of suicide. For these people ECT can produce a faster onset of therapeutic action than is the case with drug-based treatments and can be a life-saving treatment.
Health professionals and mental health services managers are expected to ensure that ECT is administered to patients in accordance with the detailed guidance published by the Royal College of Psychiatrists' Special Committee on ECT entitled The ECT Handbook—The Second Report of the Royal College of Psychiatrists' Special Committee on ECT.
ECT is administered if consent is given, but where the patient does not consent, or a doctor certifies that
16WA
Estimated UK Emissions of Mercury to Air 1990–2000 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 per cent in 2000 Combustion in Public Power Production (tonnes) Coal 7.1 7.0 6.6 4.5 4.2 3.9 2.4 1.6 2.3 1.6 1.3 16 per cent Fuel Oil 0.4 0.4 0.3 0.2 0.2 0.2 0.2 0.0 0.0 0.0 0.0 0 per cent Waste Incineration 0.9 0.9 1.1 0.2 0.4 0.3 0.3 1.3 0.4 0.1 0.11 1 per cent Other Combustion in Energy Production & Transfer (tonnes) Petroleum Refining Plants 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.0 0 per cent Combustion in Commercial Institutional Residential & Agricultural (tonnes) Residential Plant 1.0 1.2 1.0 1.2 1.0 0.8 0.8 0.7 0.6 0.6 0.5 6 per cent Commercial, Public & Agricultural Combined 1.0 1.0 0.8 0.4 0.4 0.3 0.3 0.3 0.2 0.2 0.1 1 percent Combustion in Industry (tonnes) Iron & Steel 0.6 0.5 0.5 0.5 0.6 0.6 0.6 0.6 0.6 0.6 0.5 6 per cent Non-Ferrous Metals 2.9 3.0 2.9 3.1 2.9 2.9 2.3 1.9 1.4 0.3 0.7 9 per cent Other Combustion in Industry 2.4 2.4 2.6 2.5 2.4 2.3 2.0 1.9 1.7 1.3 1.0 12 per cent the patient is mentally incapable of consenting or refusing, the responsible medical officer must seek a second opinion from a second opinion appointed doctor, who will be asked to confirm the clinical need for ECT as a treatment of choice.