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My Lords, the Department of Health is evaluating the effectiveness of latent TB screening in migrant populations. NICE produces clinical guidelines
on testing for diagnosing latent TB. It also advises on which is the most accurate approach in diagnosing latent TB in those who have recently arrived in the UK from high incidence countries.
My Lords, the Department of Health is evaluating the effectiveness of latent TB screening in migrant populations. NICE produces clinical guidelines
on testing for diagnosing latent TB. It also advises on which is the most accurate approach in diagnosing latent TB in those who have recently arrived in the UK from high incidence countries.
To ask Her Majesty’s Government whether they will introduce blood tests for latent tuberculosis for immigrants from countries where tuberculosis is common.
My Lords, is the Minister aware that the moment you arrive here you become the responsibility of the National Health Service? Would it therefore not be much wiser to have these tests carried out in the country of origin where the visa application is made? As I understand it, something like three-quarters of the people diagnosed in the past year would have been missed with the present test. Can he assure me that, if country-of-origin testing is introduced, the Home Office will take action to ensure that the tests are up to standard and not subject to interference or even possible corruption?
My Lords, is the Minister aware that the moment you arrive here you become the responsibility of the National Health Service? Would it therefore not be much wiser to have these tests carried out in the country of origin where the visa application is made? As I understand it, something like three-quarters of the people diagnosed in the past year would have been missed with the present test. Can he assure me that, if country-of-origin testing is introduced, the Home Office will take action to ensure that the tests are up to standard and not subject to interference or even possible corruption?
My Lords, my noble friend is absolutely right. Overseas tests already take place, first by X-ray and then by a sputum test in the event of a positive result. This results in cost savings because we do not need to treat someone suffering from tuberculosis if they come to the UK.
My Lords, my noble friend is absolutely right. Overseas tests already take place, first by X-ray and then by a sputum test in the event of a positive result. This results in cost savings because we do not need to treat someone suffering from tuberculosis if they come to the UK.
My Lords, my noble friend is absolutely right. Overseas tests already take place, first by X-ray and then by a sputum test in the event of a positive result. This results in cost savings because we do not need to treat someone suffering from tuberculosis if they come to the UK.
My Lords, is the Minister aware that the moment you arrive here you become the responsibility of the National Health Service? Would it therefore not be much wiser to have these tests carried out in the country of origin where the visa application is made? As I understand it, something like three-quarters of the people diagnosed in the past year would have been missed with the present test. Can he assure me that, if country-of-origin testing is introduced, the Home Office will take action to ensure that the tests are up to standard and not subject to interference or even possible corruption?
My Lords, given that tuberculosis is not exclusive to immigrants, does the Minister agree that everyone coming into the United Kingdom from some of the suspect countries should be tested?
My Lords, given that tuberculosis is not exclusive to immigrants, does the Minister agree that everyone coming into the United Kingdom from some of the suspect countries should be tested?
My Lords, sadly, about 30% of the world’s population have latent TB. We would not test people from other European states even if they have a TB problem.
My Lords, sadly, about 30% of the world’s population have latent TB. We would not test people from other European states even if they have a TB problem.
My Lords, sadly, about 30% of the world’s population have latent TB. We would not test people from other European states even if they have a TB problem.
My Lords, given that tuberculosis is not exclusive to immigrants, does the Minister agree that everyone coming into the United Kingdom from some of the suspect countries should be tested?
My Lords, TB and HIV co-exist. The NHS is required to test all new healthcare workers for tuberculosis and blood-born viruses, including HIV. In relation to overseas recruitment, it is recommended that the tests are performed in the country of origin before applying for employment. Can the Minister confirm that compliance with this guidance is being maintained and is it possible to move towards the situation that currently pertains in Australia, New Zealand and Canada?
My Lords, TB and HIV co-exist. The NHS is required to test all new healthcare workers for tuberculosis and blood-born viruses, including HIV. In relation to overseas recruitment, it is recommended that the tests are performed in the country of origin before applying for employment. Can the Minister confirm that compliance with this guidance is being maintained and is it possible to move towards the situation that currently pertains in Australia, New Zealand and Canada?
My Lords, eventually for all the 82 high- risk countries, you will not be able to get a visa to the UK unless you are clear of TB. To clarify further my answer to the noble Lord, Lord Morris, arrivals from the other European states are not tested for TB because of course they do not need to be tested. They can come and go as they please.
My Lords, eventually for all the 82 high- risk countries, you will not be able to get a visa to the UK unless you are clear of TB. To clarify further my answer to the noble Lord, Lord Morris, arrivals from the other European states are not tested for TB because of course they do not need to be tested. They can come and go as they please.
My Lords, eventually for all the 82 high- risk countries, you will not be able to get a visa to the UK unless you are clear of TB. To clarify further my answer to the noble Lord, Lord Morris, arrivals from the other European states are not tested for TB because of course they do not need to be tested. They can come and go as they please.
My Lords, TB and HIV co-exist. The NHS is required to test all new healthcare workers for tuberculosis and blood-born viruses, including HIV. In relation to overseas recruitment, it is recommended that the tests are performed in the country of origin before applying for employment. Can the Minister confirm that compliance with this guidance is being maintained and is it possible to move towards the situation that currently pertains in Australia, New Zealand and Canada?
My Lords, is the noble Earl aware that the growing incidence of TB is actually a feature now in the UK, particularly in cities such as London and Birmingham? What priority are the Government giving within the National Health Service to dealing with a problem that is causing a great deal of concern?
My Lords, is the noble Earl aware that the growing incidence of TB is actually a feature now in the UK, particularly in cities such as London and Birmingham? What priority are the Government giving within the National Health Service to dealing with a problem that is causing a great deal of concern?
The noble Lord is absolutely right: it is a problem in the big conurbations, due to deprivation and very dense accommodation. I can assure the noble Lord that the Government are on the case. We regard it as a serious problem. Further to the article in the Financial Times, we recognise that we must not let it get out of control. That is partially why we are insisting on testing people outside the UK so that we do not incur the costs for the NHS. It costs about £6,000 to treat someone who is very susceptible to treatment with antibiotics but if they are multiresistant it can cost £100,000 to treat them. We need to make sure that we do not import health problems and we concentrate on solving our own health problems—not just by activities in the NHS but also by improving housing, which I am sure all Governments have striven to do over the years.
The noble Lord is absolutely right: it is a problem in the big conurbations, due to deprivation and very dense accommodation. I can assure the noble Lord that the Government are on the case. We regard it as a serious problem. Further to the article in the Financial Times, we recognise that we must not let it get out of control. That is partially why we are insisting on testing people outside the UK so that we do not incur the costs for the NHS. It costs about £6,000 to treat someone who is very susceptible to treatment with antibiotics but if they are multiresistant it can cost £100,000 to treat them. We need to make sure that we do not import health problems and we concentrate on solving our own health problems—not just by activities in the NHS but also by improving housing, which I am sure all Governments have striven to do over the years.
The noble Lord is absolutely right: it is a problem in the big conurbations, due to deprivation and very dense accommodation. I can assure the noble Lord that the Government are on the case. We regard it as a serious problem. Further to the article in the Financial Times, we recognise that we must not let it get out of control. That is partially why we are insisting on testing people outside the UK so that we do not incur the costs for the NHS. It costs about £6,000 to treat someone who is very susceptible to treatment with antibiotics but if they are multiresistant it can cost £100,000 to treat them. We need to make sure that we do not import health problems and we concentrate on solving our own health problems—not just by activities in the NHS but also by improving housing, which I am sure all Governments have striven to do over the years.
My Lords, is the noble Earl aware that the growing incidence of TB is actually a feature now in the UK, particularly in cities such as London and Birmingham? What priority are the Government giving within the National Health Service to dealing with a problem that is causing a great deal of concern?
My Lords, as blood tests for latent TB are already available to migrants through their GPs, is not the answer to encourage greater voluntary take-up in areas such as the noble Lord opposite mentioned—Birmingham, Hounslow and Newham—and enlist the help of diaspora organisations from the 67 countries where TB is most prevalent to increase the rates of take-up? Since the countries that undertake pre-emptive screening all depend on X-rays, as we are now doing with overseas checking of would-be migrants from those countries where active TB exists, and none is contemplating pre-emptive blood testing, should we not have discussions with those countries to concert a common approach on what should be done about pre-entry blood testing in overseas countries?
My Lords, as blood tests for latent TB are already available to migrants through their GPs, is not the answer to encourage greater voluntary take-up in areas such as the noble Lord opposite mentioned—Birmingham, Hounslow and Newham—and enlist the help of diaspora organisations from the 67 countries where TB is most prevalent to increase the rates of take-up? Since the countries that undertake pre-emptive screening all depend on X-rays, as we are now doing with overseas checking of would-be migrants from those countries where active TB exists, and none is contemplating pre-emptive blood testing, should we not have discussions with those countries to concert a common approach on what should be done about pre-entry blood testing in overseas countries?
My Lords, I look forward to reading my noble friend’s comments in Hansard in the morning but it is important that testing is targeted. The health professionals will offer tests where they are most effective and most likely to find a problem.
My Lords, I look forward to reading my noble friend’s comments in Hansard in the morning but it is important that testing is targeted. The health professionals will offer tests where they are most effective and most likely to find a problem.
My Lords, I look forward to reading my noble friend’s comments in Hansard in the morning but it is important that testing is targeted. The health professionals will offer tests where they are most effective and most likely to find a problem.
My Lords, as blood tests for latent TB are already available to migrants through their GPs, is not the answer to encourage greater voluntary take-up in areas such as the noble Lord opposite mentioned—Birmingham, Hounslow and Newham—and enlist the help of diaspora organisations from the 67 countries where TB is most prevalent to increase the rates of take-up? Since the countries that undertake pre-emptive screening all depend on X-rays, as we are now doing with overseas checking of would-be migrants from those countries where active TB exists, and none is contemplating pre-emptive blood testing, should we not have discussions with those countries to concert a common approach on what should be done about pre-entry blood testing in overseas countries?
To ask Her Majesty’s Government whether they will introduce blood tests for latent tuberculosis for immigrants from countries where tuberculosis is common.
To ask Her Majesty’s Government whether they will introduce blood tests for latent tuberculosis for immigrants from countries where tuberculosis is common.
My Lords, the Department of Health is evaluating the effectiveness of latent TB screening in migrant populations. NICE produces clinical guidelines
on testing for diagnosing latent TB. It also advises on which is the most accurate approach in diagnosing latent TB in those who have recently arrived in the UK from high incidence countries.
To ask the Secretary of State for Health when he last met Ministers in the Scottish Government to discuss the incidence of tuberculosis.
[130147]
To ask the Secretary of State for Health when he last met Ministers in the Scottish Government to discuss the incidence of tuberculosis.
[130147]
I refer the hon. Member to the reply given on 12 November 2012, Official Report, column 76W, to the right hon. Member for Stirling (Mrs McGuire).
This Library Note provides background reading on the successor framework to the Millennium Development Goals.
This Library Note provides background reading on the successor framework to the Millennium Development Goals.
To ask the Secretary of State for Health which local authority areas have the 20 highest incidences of tuberculosis; and if he will make a statement.
[127803]
To ask the Secretary of State for Health which local authority areas have the 20 highest incidences of tuberculosis; and if he will make a statement.
[127803]
The information requested is shown in the following table.
| Three-year
average tuberculosis case report, rates (2009-11) and
proportion of culture confirmed cases (2011) by selected local
authority | |
| Local
authority | Average
number of cases
2009-11 |
| Newham | 329 |
| Brent | 303 |
| Hounslow | 183 |
| Ealing | 225 |
| Leicester
UA | 201 |
| Harrow | 143 |
| Tower
Hamlets | 145 |
| Slough
UA | 72 |
| Redbridge | 149 |
| Haringey | 123 |
| Greenwich | 117 |
| Luton
UA | 99 |
| Waltham
Forest | 110 |
| Hillingdon | 126 |
| Hackney | 99 |
| Blackburn
with Darwen
UA | 60 |
| Manchester | 207 |
| Islington | 79 |
| Birmingham | 410 |
| Hammersmith
and
Fulham | 66 |
| Notes: 1. Numbers may vary substantially year on year just by chance because the numbers per year are often small in local authorities. For this reason, three-year average numbers are provided. Small numbers can result in deductive disclosure. 2. The local authorities presented have the 20 highest average incidence rates (2009 to 2011). 3. Rates calculated using middle year ONS mid-year population estimates (2010). 4. Data as at June 2012. Source: Enhanced Tuberculosis Surveillance. Office for National Statistics mid-year population estimates. |
To ask the Secretary of State for Health what discussions he has had with Ministers in the devolved Administrations on trends in the incidence of tuberculosis; and if he will make a statement.
[127447]
To ask the Secretary of State for Health what discussions he has had with Ministers in the devolved Administrations on trends in the incidence of tuberculosis; and if he will make a statement.
[127447]
No discussions have taken place between departmental Ministers and their devolved Administration counterparts regarding trends on the incidence of tuberculosis (TB). However, the Health Protection Agency collaborates with public health colleagues in Health Protection Scotland, Public Health Service, Wales and Public Health Agency for Northern Ireland mainly by sharing surveillance data and recommendations on TB control initiatives.
To ask Her Majesty’s Government what steps have been taken to advise medical practitioners of the threat to life caused by tuberculosis, in the light of the report by the Health Protection Agency that tuberculosis cases are increasing.[HL2725]
To ask Her Majesty’s Government what steps have been taken to advise medical practitioners of the threat to life caused by tuberculosis, in the light of the report by the Health Protection Agency that tuberculosis cases are increasing.[HL2725]
The department recognises the public health importance of tuberculosis (TB) and is currently funding TB Alert, the United Kingdom's
national TB charity, to raise awareness among general practitioners and other primary care professionals. TB Alert is also developing an online learning module in collaboration with the Royal College of General Practitioners and a training pack for TB nurses to use in running training sessions with primary care professionals.
The Health Protection Agency (HPA) plays a significant role in advising medical practitioners about trends in TB in the population. They are involved in raising awareness through the National Knowledge Service for TB. This was set up to provide information that would be directly relevant to people who need to be aware of, and take action about, treatment, prevention and management of TB.
The National Institute for Health and Clinical Excellence has published clinical and public health guidance to support the National Health Service in commissioning and providing effective services to prevent, diagnose and treat TB, including in relation to raising awareness. This guidance is promoted both by the HPA and TB Alert as part of raising awareness. The Health and Social Care Act 2012 will require clinical commissioning groups to act with a view to securing continuous improvement in the quality of services provided to individuals in relation to the prevention, diagnosis or treatment of illness, including TB.
To ask Her Majesty’s Government what guidance they provide to medical practitioners on testing for active tuberculosis if a patient has a recorded history of latent tuberculosis and they fall ill with another significant illness and remain ill despite treatment. [HL2726]
To ask Her Majesty’s Government what guidance they provide to medical practitioners on testing for active tuberculosis if a patient has a recorded history of latent tuberculosis and they fall ill with another significant illness and remain ill despite treatment. [HL2726]
The department recognises the public health importance of tuberculosis (TB) and is currently funding TB Alert, the United Kingdom's
national TB charity, to raise awareness among general practitioners and other primary care professionals. TB Alert is also developing an online learning module in collaboration with the Royal College of General Practitioners and a training pack for TB nurses to use in running training sessions with primary care professionals.
The Health Protection Agency (HPA) plays a significant role in advising medical practitioners about trends in TB in the population. They are involved in raising awareness through the National Knowledge Service for TB. This was set up to provide information that would be directly relevant to people who need to be aware of, and take action about, treatment, prevention and management of TB.
The National Institute for Health and Clinical Excellence has published clinical and public health guidance to support the National Health Service in commissioning and providing effective services to prevent, diagnose and treat TB, including in relation to raising awareness. This guidance is promoted both by the HPA and TB Alert as part of raising awareness. The Health and Social Care Act 2012 will require clinical commissioning groups to act with a view to securing continuous improvement in the quality of services provided to individuals in relation to the prevention, diagnosis or treatment of illness, including TB.
To ask Her Majesty’s Government how many persons seeking to enter the United Kingdom were screened positive for active tuberculosis in each of the last five years; from which countries those persons originated; and what action they have taken to enhance co-operation with those countries in combating the spread of...
To ask Her Majesty’s Government how many persons seeking to enter the United Kingdom were screened positive for active tuberculosis in each of the last five years; from which countries those persons originated; and what action they have taken to enhance co-operation with those countries in combating the spread of...
Information on numbers screened positive by country of origin is not available in the format requested. However, information on the number of United Kingdom visa applicants screened for tuberculosis (TB) is shown in the following table.
| Number
of visa applicants from the United Kingdom screened for TB,
2005-10 | |||||||
| Country | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | Total |
| Bangladesh | 0 | 19,711 | 22,185 | 23,457 | 58,996 | 15,024 | 139,373 |
| Burkina
Faso | 0 | 0 | 6 | 32 | 22 | 6 | 66 |
| Cambodia | 0 | 64 | 76 | 80 | 127 | 83 | 430 |
| Cote
d'Ivoire | 0 | 0 | 116 | 339 | 263 | 145 | 863 |
| Eritrea | 0 | 0 | 58 | 45 | 30 | 25 | 158 |
| Ghana | 0 | 0 | 10,896 | 8,446 | 4,065 | 2,809 | 26,216 |
| Kenya | 0 | 0 | 2,859 | 2,981 | 2,529 | 1,676 | 10,045 |
| Laos | 1 | 16 | 25 | 22 | 25 | 19 | 108 |
| Niger | 0 | 0 | 5 | 34 | 18 | 4 | 61 |
| Pakistan | 0 | 0 | 50,251 | 61,896 | 55,944 | 42,142 | 210,233 |
| Somalia | 0 | 0 | 316 | 458 | 519 | 429 | 1,722 |
| Sudan | 5 | 817 | 819 | 1,020 | 1,006 | 659 | 4,326 |
| Tanzania | 354 | 1,934 | 1,906 | 2,054 | 1,362 | 751 | 8,361 |
| Thailand | 634 | 8,731 | 8,314 | 8,690 | 7,866 | 6,122 | 40,357 |
| Togo | 0 | 0 | 17 | 86 | 55 | 33 | 191 |
| Total | 994 | 31,273 | 97,849 | 109,640 | 132,827 | 69,927 | 442,510 |
Source: International Organisation for Migration
In relation to those screened at our ports, currently on entry screening for TB is undertaken at Heathrow Airport by chest X-ray. Screening stopped at Gatwick Airport because numbers screened were very low. As a chest X-ray is not considered sufficient to make a definitive diagnosis of TB, any entrant who is suspected of having TB is referred to a local chest clinic or hospital at their intended destination in the UK.
The department liaises with the Department for International Development (DfID) on World Health Organisation reports, resolutions and guidance on global TB. DfID's support to the product development of new vaccines, diagnostics and treatment will have a direct benefit to control TB in the UK.
The Home Office is responsible for managing pre-entry screening for TB, working closely with the Health Protection Agency to providing medical and scientific input. The Home Office requires screening providers to provide treatment referral letters, results of drug susceptibility testing as well as to comply with any reporting on TB strategies in these countries.
To ask Her Majesty’s Government what action they have taken following the coroner's report on the death of Alina Sarag.[HL2519]
To ask Her Majesty’s Government what action they have taken following the coroner's report on the death of Alina Sarag.[HL2519]
The Cluster Director of Public Health for Birmingham and Solihull has responded to the coroner's letter of 6 August, stating that the recommendations have been implemented, that they are monitored through their contracting arrangements with National Health Service providers and reported to the Cluster Clinical Quality Group; and that she is assured that the recommendations are on track. There is a strong focus in the report on enhanced general practitioner (GP) knowledge and awareness, with provision for training and awareness sessions.
The Health Protection Agency has also responded to the coroner's letter of 6 August, highlighting a number of strategic initiatives, which include TB cohort review meetings and action to raise the knowledge and awareness of GPs, other health care workers and people in the most affected communities.
The department recognises the public health importance of tuberculosis (TB) and is currently funding TB Alert, to raise awareness of TB amongst general practitioners and other primary care professionals. TB Alert is developing an online learning module in collaboration with the Royal College of General Practitioners and a training pack for TB nurses to use in running training sessions with primary care professionals.
The department intends to respond to the coroner's letter shortly.