following information has been kindly supplied by Amanda Callaghan,
Public Affairs Manager, BPAS.
British Pregnancy Advisory Service
Parliamentary References on Reproductive
Health No 18. October/November/December 2000
Dr Jenny Tonge MP asked the Secretary of State for Health
what plans he has to make emergency contraception available
from (a) community pharmacists and (b) school nurses.
Yvette Cooper MP (Minister
for Public health) replied that an application has been
received to reclassify levonorgestrel 0.75mg (marketed as
Levonelle-2) for emergency contraception from prescription
only to pharmacy availability for women aged 16 and over.
Public consultation was completed on 30 June. The application
has now been considered by the Medicines Commission. If
we decide to proceed, an Order will be laid shortly. In
addition there are pilot schemes running whereby emergency
contraception is issued by pharmacists under National Health
Service arrangement using patient group direction. Sex and
Relationship Education Guidance issued by the Department
for Education and Employment in July this year states that
health professionals can provide pupils with specific and
up-to-date information about sexual health and contraception.
Health professionals can also play an important part in
ensuring young people know about their local advice services.
The specific role of school nurses in providing services
to young people is at the discretion of school governing
bodies, in consultation with parents and the school community.
Written answer 20 November 2000
When pregnancy begins
John Gummer MP asked the Secretary of State for Health what
recent advice he has taken and from whom on the point at
which pregnancy can be said to begin.
Yvette Cooper MP replied
that the accepted legal and medical view is that a pregnancy
begins at implantation. This has been the policy of successive
Governments and is based on advice given to the Department
by the Attorney-General in 1983, about the legal position
under the Abortion Act
Written answer 23 October 2000
The impact of emergency contraception
John Gummer MP asked the Secretary of State for Health
what evidence his Department has collated on the impact
of the morning after pill on the abortion rate; and if he
will make a statement.
Yvette Cooper MP replied that a study of self-administration
of emergency contraception following advance prescribing
has been performed by Glasier et al in Edinburgh. This concluded:
'making emergency contraception more easily available .
. . may reduce the rate of unwanted pregnancies.' However,
the number of women studied was small and at the present
time there are insufficient data to know how availability
of emergency contraception might affect outcome measures
such as therapeutic abortion rates. It should be noted that
fluctuations in the abortion rate may be subject to a number
of different factors and it is therefore difficult to attribute
changes to one intervention or event.
Glasier A, Baird D. The Effects of Self-Administering Emergency
Contraception. New England Journal of Medicine 1998; 339:
No 1 1-4.
Written answer 23 October 2000
John Gummer MP asked the Secretary of State for Health
what plans he has to frame the proposed re-classification
of levonorgestrel 0.7 mg as an over the counter product
so that it does not contravene Section 58a of the Medicines
Act 1968 in relation to its side-effects; and if he will
make a statement. Gisela Stuart MP (Minister for Public
Health) replied that proposals to widen availability of
emergency contraception follow an application to reclassify
levonorgestrel 0.75 mg for emergency contraception from
prescription only to pharmacy availability for women aged
16 years and over. The application was referred for independent
expert advice to the Committee on Safety of Medicines (CSM).
In formulating their advice, the CSM carefully considered
each of the relevant criteria for prescription control laid
down in Section 58A of the Medicines Act 1968. The Committee
concluded that all the steps required to safely supply emergency
contraception could be successfully completed in a pharmacy
and advised that levonorgestrel 0.75 mg for emergency contraception
may safely be supplied as a pharmacy medicine for women
aged 16 and above. The Committee noted that information
on correct use would be provided with the product including
any possible side effects and advice on what action to take.
The results of a public consultation on the proposal, and
the advice of the Medicines Commission, were presented to
Ministers for a decision.
Written answer 7 November 2000
Emergency contraception as prescription only medicine
On 12 December 2000, the Government laid an Order before
the House, that the Medicines - Prescription Only Medicine
(Human Use) Act be amended to allow the sale of emergency
contraception in pharmacies, without prescription. After
40 days this will become law, unless challenged. On 18 December
2000, the Leader of the Opposition, William Hague, challenged
the Order (known as praying against) using an Early Day
Motion (No 120). The Motion, which calls for the annulment
of the Order, may be debated in January. If a majority of
MPs vote in favour of annulment, the Order will be rescinded.
The Early Day Motion has the support of 13 Conservative
Statutory Instruments 20 December 2000. EDM 120 18 December
Early Day Motions on emergency contraception
On 12 December, Alice Mahon MP put down an Early Day Motion
entitled Morning After Pill. It was supported by 31 Members
and reads: 'That this House congratulates the Government
on making the morning-after pill available for sale without
prescription in chemists to all women over the age of 16
years; and recognises that this will prevent many abortions
and unplanned teenage pregnancies.'
EDM 87 12 December 2000
On 13 December, Harry Cohen MP, supported by six MPs put
down an Early Day Motion about the cost of emergency contraception:
'That this House believes that the cost of the emergency
oral contraceptive known as the morning after pill is too
high at the likely price of £20 and that this may
deter those who would most benefit from it.'
EDM 113 13 December 2000
Cost to the NHS of sexually transmitted infections
Gerald Howarth MP asked the Secretary of State for Health
(1) what the total cost to the NHS was of treating sexually
transmitted diseases including in-patient and outpatient
treatment and prevention in (a) 1970, (b) 1980, (c) 1990
and (d) 1999; (2) what the total cost was of providing abortions
on the NHS in (a) 1970, (b) 1980, (c) 1990 and (d) 1999;
(3) what the cost was to the NHS of treating cancer of the
cervix and other cervical abnormalities in (a) 1970, (b)
1980, (c) 1990 and (d) 1999; (4) what the cost to the NHS
was of infertility treatment in (a) 1970, (b) 1980, (c)
1990 and (d) 1999; and of this, how much was as a consequence
of previous sexually-transmitted disease, with particular
reference to chlamydia.
Yvette Cooper MP replied that the information requested
is not available centrally.
Written answer 23 October 2000
Sexual health and HIV strategy
Sandra Gidley MP asked the Secretary of State for Health
if he will make a statement on progress on his sexual health
and HIV strategy.
Yvette Cooper MP replied that following the merger of the
Sexual Health and HIV Strategies earlier this year, considerable
progress has been made with producing an integrated strategy.
The strategy will set a programme of action on sexual health
and HIV for England.
Written answer 21 Nov 2000
Human papilloma virus
Dafydd Wigley MP asked the Secretary of State for Health
(1) what plans he has to introduce human papilloma virus
testing as part of the National Cervical Screening Programme;
(2) for what reason the plan to pilot human papilloma virus
testing for women has been delayed until March 2001; (3)
what representations he has received concerning the need
for human papilloma virus testing as part of improvements
to the National Cervical Screening Programme.
Yvette Cooper MP replied that the National Health Service
cancer plan sets out our commitment to introducing new developments
to the cervical screening programme. Plans to pilot the
new techniques in liquid based cytology (LBC) and human
papilloma virus (HPV) testing are highlighted in the plan
as the means for informing service improvement. After receiving
advice from the National Institute for Clinical Excellence
in June 2000, we decided to pilot LBC and HPV jointly. A
joint protocol was developed which will provide more useful
information and be more convenient for women as a number
of tests can be carried out from the same sample. Sites
in England have now been chosen and the joint pilot will
start in March 2001.
Written answer 21 December 2000
Jim Cunningham MP asked the Secretary of State for Health
what steps he is taking to reduce the number of unplanned
teenage pregnancies (a) nationally and (b) in the West Midlands.
Yvette Cooper MP replied that the Social Exclusion Unit's
report on teenage pregnancy, published on 14 June 1999,
sets out a 30-point action plan working across Government.
It sets out a £60 million package to tackle the issue,
and highlights two main goals: reducing the number of teenage
conceptions, with the specific aim of halving the rate of
conceptions among under 18s by 2010; and getting more teenage
parents into education, training or employment to reduce
their risk of long term social exclusion. Following the
launch of the report, every area in England now has a local
teenage pregnancy co-ordinator in place, making a total
of 141. Their role is to develop strategies to tackle teenage
pregnancy in their area, in consultation with local communities.
They will report annually on progress to the Department
of Health. £7.5 million has been made available for
innovative local projects in the current financial year.
The NHS Plan has set an interim target of achieving a 15
per cent reduction in under-18 conception rates by 2004.
New guidance on sex and relationship education was issued
to schools in July. A national media campaign began at the
end of October, when the first adverts appeared in teenage
magazines. The campaign was developed drawing on comprehensive
research on what works best with young people. It is aimed
as much at boys as at girls. During 2000-01, Government
provided funding of over £1 million to the West Midlands
to develop local services to prevent teenage pregnancy and
support teenage parents. Specific initiatives include a
Sexual Health and Drugs Outreach Work (SHADOW) project in
Coventry that addresses sexual health, pregnancy and healthy
lifestyles for young people. This will link to a one-stop
shop, due to open shortly in Coventry city centre, to deliver
a number of services such as Connexions, youth information
and a general advice and counselling service for young people.
A mobile sexual health and advice clinic has been set up
in North Staffordshire, enabling young people to access
services in youth and leisure facilities.
Written answer 6 November 2000
John Bercow MP asked the Secretary of State for Education
and Employment what guidance is issued to schools about
the approach towards sexual relationships between pupils
aged (a) under 16 years and (b) 16 years or above.
Jacqui Smith MP (Parliamentary Under Secretary of State,
Education and Employment) replied that sexual relationships
involving children under 16 are a criminal offence. Recently
published Sex and Relationship Education guidance sets out
the procedure teachers should follow if they become aware
that a child under the age of 16 is having, or contemplating
having, sex. The guidance also explains the benefits of
and the reasons for young people delaying sexual activity,
and this is backed up by the campaign to reduce teenage
Written answer1 November 2000
Chris Ruane MP asked the Secretary of State for Education
and Employment (1) how many female pupils were excluded
from school because of pregnancy in England between 1980
to 2000; and if he will make a statement; and (2) if he
will list the 10 education authorities with (a) the highest
and (b) the lowest percentage rates of school exclusions
because of pregnancy;
and if he will make a statement.
Jacqui Smith MP replied that the detailed information requested
is not held centrally by the Department. The latest information
on permanent exclusions will be published in a Statistical
Bulletin, a copy of which will be placed in the Library.
The DfEE issued guidance in 1999 to all local education
authorities and schools, which made it clear that pregnancy
on its own was
not a reason for exclusion from school. In addition to the
Government drive to cut truancy and school exclusions, it
is also working to cut teenage pregnancy rates and to reduce
the social exclusion often experienced by teenage parents
and their children. Government is issuing some guidance
to help schools to support teenage parents in school and
also funding reintegration work in selected LEAs to help
girls back in to education after they have had their baby.
Written answer 28 November 2000
Laurence Robertson MP asked the Secretary of State for International
Development what advice she gives to people in the third
world about contraception; and if she will make a statement.
Clare Short MP (Secretary of State for International Development)
replied that the Government is committed to the principles
of freedom and choice in reproductive health services as
agreed at the 1994 International Conference on Population
and Development, and to the International Development to
attain universal access to reproductive health services
Written answer 8 November 2000
Chris McCafferty MP asked the Secretary of State for International
Development if she will make a statement on her Department's
contributions to the provision of contraceptives in the
developing world. George Foulkes MP (Parliamentary Under
Secretary of State for International
Development) replied that Government is committed to the
International Development target to attain universal access
to reproductive health services before 2015 and has substantial
involvement in efforts to ensure women and men in developing
countries can access contraceptives and other reproductive
health commodities. The recent pledge to contribute an additional
£25 million to the United Nations Population Fund,
on top of the annual core contribution of £15 million,
will help meet immediate and short-term needs, and assure
continued access to essential reproductive health commodities,
including condoms for family planning and HIV/AIDS prevention,
in a number of countries which are facing shortages. Chris
McCafferty MP asked the Secretary of State for International
Development what representations she has made to other donor
Governments about the supply of contraceptives in the developing
world. George Foulkes MP replied that the recent pledges
by this Department and the Government of the Netherlands,
to contribute an additional £51 million to the United
Nations Population Fund to help fund immediate and short-term
needs in developing countries for reproductive health commodities,
is a further demonstration of the commitment of both Governments
to the health of poor people. Government will continue to
encourage other donors and developing countries to make
every effort to meet the rising demand for contraception
in the developing world.
Written answer 20 November 2000
Gerald Howarth MP asked the Secretary of State for Health,
how many (a) sterilisations and (b) reversals of sterilisation
were carried out by the NHS in (i) 1970, (ii) 1980, (iii)
1990 and (iv) 1999. How many were requested as a result
of people getting married or acquiring new partners; and
what the total cost to the NHS was in each of those years.
Yvette Cooper MP gave the following information
|Female sterilisation reversal
|Male sterilisation reversal
Data were collected via
the Hospital In-Patient Inquiry, which was based on a 1
in 10 sample of discharges and deaths from non-Psychiatric
and non-Maternity NHS Hospitals in England.
Written answer 20 November 2000
Northern Ireland assembly
Health and Personal Social Services Bill: Second Stage Jim
Shannon MLA spoke on the Bill as follows:
I would also like to address Part IV of the Bill, which
has direct implications for the pharmaceutical chemist.
I have made it my business to speak to some chemists, and
they expressed specific concern that they could be forced
to sell, on prescription, the "morning after pill",
the PC4. Under this legislation, will chemists be forced
to make a moral decision? Some will neither stock, prescribe
nor sell this pill. Will the Minister confirm that, under
the legislation, pharmaceutical chemists will not be constrained
to prescribe? Not enough research has been done on this,
and chemists have a real concern that the pill will be taken
off prescription and they will be asked to sell it over
the counter. Not enough research has been done to determine
if the effects of the pill could be detrimental. Following
hard on the abortion debate and the overwhelming vote against
it, I urge the Department of Health to be cautious towards
pharmaceutical chemists who will, generally, refuse to accept
any directive or ruling from the Health Department. Will
the Minister confirm her position on the PC4 pill?
Bairbre de Brun MLA (Minister for Public Health, Social
Services and Public Safety) declined to respond.
23 October 2000
Members in this issue
John Bercow MP. Con, Buckingham
Harry Cohen MP. Lab, Leyton and Wanstead
Yvette Cooper MP. Lab, Pontefract and Castleford
Jim Cunningham MP. Lab, Coventry South
George Foulkes MP. Lab, Carrick, Cummnock and Doon Valley
Sandra Gidley MP. LibDem, Romsey
John Gummer MP. Con, Suffolk Coastal
William Hague MP. Con, Richmond (Yorks)
Gerald Howarth MP. Lab, Knowlsey North and Sefton East
Alice Mahon MP. Lab, Halifax
Chris McCafferty MP. Lab, Calder Valley
Estelle Morris MP. Lab, Birmingham Yardley
Laurence Robertson MP. Con, Tewkesbury
Chris Ruane MP. Lab, Vale of Clwyd
Clare Short MP. Lab, Birmingham Ladywood
Jacqui Smith MP. Lab, Redditch
Gisela Stuart MP. Lab, Birmingham Edgbaston
Dr Jenny Tonge MP. LibDem, Richmond
Dafydd Wigley MP. PC, Caernarfon
Jim Shannon MLA. DUP, Strangford
Bairbre de Bruin MLA. SF, Belfast West