The following information, about Parliamentary Questions asked during July 2000, has been kindly supplied by Amanda Callaghan, public affairs manager, BPAS.

Northern Ireland

Fiona Mactaggart MP asked the Secretary of State for Northern Ireland if he will make a statement on access to abortion and contraceptive services for women in Northern Ireland.

George Howarth MP (Parliamentary Under Secretary of State for Northern Ireland) replied that responsibility for this subject has been devolved to the Northern Ireland Assembly and is therefore no longer a matter for the Secretary of State for Northern Ireland.

Written answer 10 July 2000     

David Amess MP asked the Secretary of State for Health what requirements abortion clinics must meet to be licensed by his Department.

Yvette Cooper MP (Parliamentary Under Secretary of State for Health) replied that any independent sector place wishing to carry out termination of pregnancy must first of all be registered with the local health authority under the Registered Homes Act 1984. All units are inspected and must undertake to comply with the Department's Required Standard Operating Principles (RSOP), which cover a variety of topics. The RSOPs can be found in the Procedures For The Approval Of Independent Sector Places For The Termination Of Pregnancy. Copies are available in the Library.

Approved clinics are subject to regular unannounced inspections. Failure to comply with the RSOPs, or to maintain the standards required by my right hon. Friend the Secretary of State may lead to withdrawal of approval.

Written answer 19 July 2000     

David Amess MP asked the Secretary of State for Health how many consent forms were signed by women in the years 1995 to 2000 permitting the use of fetal tissue from their aborted babies to be used in (a) research and (b) other purposes.

Yvette Cooper MP replied that the information requested is not available centrally.

Written answer 19 July 2000

David Amess MP asked the Secretary of State for Health if he will list the private sector clinics and hospitals providing abortions, indicating (a) the number of approved beds they contain and (b) whether they are approved for (i) surgical day care abortions with or without general anaesthetic and (ii) late abortions, indicating the name of the proprietor in each case.

Yvette Cooper MP replied that the number of approved beds is controlled by local health authorities under the Registered Homes Act 1984 and this information is not collated centrally. The independent sector places approved to carry out termination of pregnancy are shown in the table. All of them are approved to undertake surgical day care abortions, subject to their conditions of registration under the above Act. Clinics approved to perform abortions from 20 weeks up to 24 weeks gestation are identified in the table. No independent sector place is approved to carry out termination of pregnancy after 24 weeks gestation.

Written answer 19 July 2000

David Amess MP asked the Secretary of State for Health if he will list the registered pregnancy advice bureaux.

Yvette Cooper MP replied that the following pregnancy advice bureaux are registered with the Department of Health.

BPAS Basingstoke Branch

BPAS Bath Branch

BPAS Birmingham Branch

BPAS Bournemouth Branch

BPAS Brighton Branch

BPAS Bristol Branch

BPAS Cannock Branch

BPAS Central London Branch

BPAS Chester Branch

BPAS Coventry Branch

BPAS Doncaster Branch

BPAS Finsbury Park Branch

BPAS High Wycombe Branch

BPAS Leeds Branch

BPAS Leigham Lodge, London

BPAS Liverpool Branch

BPAS Luton Branch

BPAS Manchester Branch

BPAS Milton Keynes Branch

BPAS Newcastle Branch

BPAS Peterborough Branch

BPAS Preston Branch

BPAS Richmond Branch

BPAS Sheffield Branch

BPAS Swindon Branch

BPAS Telford Branch

BPAS Torquay Branch

Choice Pregnancy Advisory Service, Bolton

Choice Pregnancy Advisory Service, Warrington

East Midlands Pregnancy Advisory Service, Nottingham

Marie Stopes Basildon Centre

Marie Stopes Bolton Centre

Marie Stopes Bradford Centre

Marie Stopes Brighton Centre

Marie Stopes Bristol Centre

Marie Stopes Canterbury Centre

Marie Stopes Chatham Centre

Marie Stopes Colchester Centre

Marie Stopes Crawley Centre

Marie Stopes Darlington Centre

Marie Stopes Ealing Centre

Marie Stopes Essex Centre

Marie Stopes Golders Green Centre

Marie Stopes House, London

Marie Stopes Leeds Centre

Marie Stopes Maidstone Centre

Marie Stopes Manchester Centre

Marie Stopes Milton Keynes Centre

Marie Stopes Newcastle Centre

Marie Stopes North London Centre

Marie Stopes Reading Centre 1

Marie Stopes Reading Centre 2

Marie Stopes Sittingbourne Centre

Marie Stopes South London Centre

Marie Stopes Staines Centre

Marie Stopes Tottenham Centre

Marie Stopes Watford Centre

Marie Stopes Woking Centre

Pregnancy Advisory Service, Blackpool

Pregnancy Advisory Service, Manchester

Pregnancy Advisory Service, Stoke

Pregnancy Advisory Service, Wolverhampton

Regents Park Clinic, London

South Manchester Pregnancy Advice Services, Stockport

The Calthorpe Clinic, Birmingham.

Written answer 19 July 2000

Chris McCafferty MP asked the Secretary of State for Health if he will make a statement on progress made on his Department's national publicity campaign to tell young people they can talk to health professionals about sex and contraception in confidence; and what funding has been allocated to the campaign.

Yvette Cooper MP replied that our media campaign on teenage pregnancy will begin in autumn 2000, following a period of research into promising approaches by similar campaigns elsewhere. Levels of funding for this current year are to be decided, and for future years will depend on the outcome of the Spending Review.

Chris McCafferty MP To ask the Secretary of State for Health how many local co-ordinators for teenage pregnancy have been established since the publication of the Social Exclusion Unit report "Teenage Pregnancy", in June 1999.

Yvette Cooper MP replied that every area in England now has a local teenage pregnancy co-ordinator, jointly nominated by the local authority and health authority. In total there are 141 co-ordinators, with some working to social services boundaries and some to health authority boundaries, depending on local circumstances.

Written answers 10 July 2000

Chris McCafferty MP asked the Secretary of State for Education and Employment when he expects his Department's sex and relationships education guidance to be published.

Jacqui Smith MP (Parliamentary Under Secretary of State for Education and Employment) replied that the Secretary of State for Education and Employment published the sex and relationship education guidance on Friday and sent a copy to each Member of Parliament. It will be a significant step forward in supporting schools, teachers and governors to deliver effective sex and relationship education. It is underpinned by the Personal, Social and Health Education framework and the National Healthy School Standard. This fulfils a commitment in the Government's Teenage Pregnancy Report to issue new guidance on sex education as part of our drive to tackle teenage pregnancy. Copies are available in the Library.

Written answer 10 July 2000

Chris McCafferty MP asked the Secretary of State for Education and Employment how many 16 and 17-year-old parents (a) have taken and (b) are taking part in the education maintenance allowance pilots following the publication of the Social Exclusion Unit report, "Teenage Pregnancy", in June 1999.

Malcolm Wicks (Parliamentary Under Secretary of State for Education and Employment) replied that this information is not available at the present time. There is no special treatment of teenage parents in the main EMA pilots, but the evaluation should provide an indication of the numbers involved and will provide an assessment of any factors which are particularly relevant to teenage parents. The first results from this evaluation should be available towards the end of this year. Also, from September two of the 15 original EMA pilot areas (Stoke-on-Trent and Cornwall) will test out additional flexibilities intended to help teenage parents participate in education, while still maintaining the 'something for something' principle.

Written answer 10 July 2000     

Laurence Robertson MP asked the Secretary of State for Health what discussions he has had with the Family Planning Association regarding the contents of its information booklet on abortion; and if he will make a statement.

Yvette Cooper MP replied that the FPA (formerly the Family Planning Association) did not discuss with the Department the contents of their booklet Abortion--Just so you know. The FPA invited the Department's comments on the final draft to ensure that legal and medical information was accurate.

The booklet should help young people to have a better understanding of abortion. However, any young woman facing an unwanted pregnancy should seek advice from her general practitioner or family planning clinic, in order to explore all options available to her.

Written answer 19 July 2000

Oona King MP asked 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.

Yvette Cooper MP replied that 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 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.

Written answer 19 July 2000     

Shona McIsaac MP asked ask the Secretary of State for Health (1) if he will make a statement on the availability of emergency contraception; (2) what plans he has to make emergency contraception available over the counter at pharmacists.

Yvette Cooper MP replied that emergency 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.

Written answer 19 July 2000

Shona McIsaac MP asked the Secretary of State for Health (1) what assessment he has made of the recent trials of over-the-counter prescribing of emergency contraception; (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.

Yvette Cooper MP replied that there 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.

Written answers 19 July 2000

John Gummer MP asked 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; (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.

Yvette Cooper MP replied that emergency contraception is a safe and effective method of preventing pregnancy when a woman has had unprotected sex or when she knows something 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 be used only as an occasional measure.

Written answer 19 July 2000

John Gummer MP asked 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; (2) what follow-up care is available to women prescribed the morning-after pill; and if he will make a statement.

Yvette Cooper MP the 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 year.¹

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.

Written answer 19 July 2000

Age breakdown of ECP prescriptions

John Gummer MP asked 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.

Yvette Cooper MP replied that the 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.

Table 1: Number of prescriptions dispensed in the community for Schering PC4 ('morning after pill'), 1989 to 1999

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)

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)

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.php.

Written answers 19 July 2000

John Gummer MP asked 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.

Yvette Cooper MP replied that there 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.

Written answer 19 July 2000

Yvette Cooper MP replied that the 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.

Written answer 19 July 2000

Laurence Robertson MP asked 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.

Yvette Cooper MP replied that none has been issued. Prescribing of emergency contraception is a matter for the clinical judgement 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.

Written answer 19 July 2000     

Mr. Amess asked the Secretary of State for Health (1) if he will publish the medical research and evidence on which the Committee for the Safety of Medicines based their recommendation that levonorgestrel 0.75 mg could be supplied as a pharmacy medication; [129410] (2) what trials have been conducted in the United Kingdom to test the safety and long-term health effects of levonorgestrel 0.75 mg.

Yvette Cooper MP (Parliamentary Under Secretary of State for Health) replied that product containing levonorgestrel 0.75 mg has been authorised in the United Kingdom as a prescription only medicine. This followed advice from the Committee on Safety of Medicines (CSM) who were satisfied as to the product's quality, safety and efficacy. The evidence considered included two World Health Organisation sponsored pivotal studies. One study involving approximately 3,000 women in 14 countries, including the UK, has been published in the Lancet (1998). The other, published in Human Reproduction (1993), involved 880 women. Copies are available in the Library. Other supporting data not in the public domain are confidential to the application.

Evidence of safety as stated was taken into account when the CSM considered the proposal for levonorgestrel 0.75 mg to be available without prescription. There is also evidence from a study of the effects of self-administering emergency contraception (New England Journal of Medicine, 1998). Levonorgestrel 0.75 mg has been available from pharmacies in France without a doctor's prescription since June 1999. The criteria for prescription control are defined in the legislation.

The CSM considered each of these criteria and advised that they did not apply to levonorgestrel 0.75 mg for emergency contraception in women of 16 and over. They considered that all the steps required to supply emergency contraception safely could be successfully completed in a pharmacy.

Written answer 24 July 2000

Fiona Mactaggart asked the Secretary of State for Health what action he has taken to promote the uptake of the Royal College of Gynaecologists' guidelines entitled The Care of Women Requesting Induced Abortion. 

Yvette Cooper MP (Parliamentary Under Secretary of State for Health) replied that the Department has alerted all independent sector places carrying out termination of pregnancy to this new guideline. One of the conditions for approval is that practice should be guided by authoritative guidelines such as those from the Royal Colleges and we will monitor implementation during inspection visits. We expect the guideline to be used as the basis of local protocols that will promote the development of high quality services and take account of local needs and service provision.

In addition, the guideline will be considered as part of the national sexual health and HIV strategy currently being developed.

Written answer 26 July 2000