Liver disease registered as the underlying cause of death, accounts for 2% of all deaths in England and 3% if all mentions are counted. Viral liver disease is registered for less than 0.1% of all deaths.

The main liver viral hepatitides are; A, B, C, D, E. Occasionally, other viruses cause hepatitis. Most people with hepatitis clear the virus after an acute infection. Death from acute viral hepatitis is very rare, a very small number of patients will be referred for liver transplantation. A proportion of deaths from chronic hepatitis B maybe preventable by vaccination and treatment. A proportion of deaths from chronic hepatitis C may be preventable by antiviral therapies. A significant proportion of hepatitis B and C is acquired outside the United Kingdom and therefore it is important to identify people carrying the viruses and offer treatment and vaccination to the close contacts of people with chronic hepatitis as appropriate.

The Legal Aid Agency (LAA) is able to identify fees paid to counsel for inquest cases funded under the Legal Aid, Sentencing and Punishment of Offenders (“LASPO”) Act 2012 from April 2013 onwards. For the financial year 2013-14, the total value of counsel fees paid relating to inquests into the deaths of those in custody under the LASPO Act totalled £10,574.40.

This figure represents only those cases under the LASPO Act where payment has been made during 2013-14. Very few inquests that have been funded under the LASPO Act have been billed and paid in that period, as many are ongoing. Cases typically take over a year from approval of funding to payment of the final bill.

The total figure of £10,574.40 does not include information recorded in the LAA’s new costs management system, upon which a small pilot group of providers are currently processing their claims. The volume of claims being processed through this system represents around 1% of all claims.

The Legal Aid Agency does not hold the information requested centrally for cases funded under the Access to Justice Act 1999 (i.e. cases originally submitted prior to April 2013). Under the Access to Justice Act, ad hoc payments were made aggregating fees for the instructed solicitors and counsel on the case, and it is not possible to disaggregate the costs without checking each individual file.

All of the datasets supporting statements and images in the ‘Annual Report of the Chief Medical Officer Volume One 2011, On the State of the Public’s Health’, may be downloaded by following the link at:

www.gov.uk/government/news/cmo-annual-report-2011-volume-one-data-available

The datasets are not available in a hard copy format from the Department. It is anticipated that the figures will be updated later in the financial year.

In our mandate to the national health service, we set out the ambition to make England one of the most successful countries in Europe at preventing premature deaths from illnesses such as liver disease.

The UK National Screening Committee advises Ministers and the national health service in all four countries about all aspects of screening policy and supports implementation. It is currently reviewing the evidence for screening young people between the ages of 12 to 39 years for the major causes of sudden cardiac death. A public consultation will open shortly.

NHS England is working with the Chief Coroner to discuss what the coronial system can do to help reduce sudden cardiac death in the young. As a result, the Chief Coroner has written to local Coroners asking them to make families of those who have died of the condition aware that it may be inherited, and encouraging them to contact either the British Heart Foundation, Cardiac Risk in the Young, or their general practitioner for testing and counselling.

Severe maximum penalties, of 14 years imprisonment, are available for those who cause death through dangerous driving or under the influence of drink or drugs and statistics show that the overwhelming

majority of those convicted for these offences receive lengthy custodial sentences. The maximum penalty for causing death by careless driving is 5 years imprisonment and for causing death by disqualified, unlicensed or uninsured driving is two years imprisonment. We are keeping the law in this area under review. If any further changes are needed, we will bring forward proposals.

The Secretary of State for Justice made an announcement on 6 May about our plans to strengthen the law in relation to disqualified drivers who cause death or serious injury; increasing the maximum sentence for causing death by disqualified driving to 10 years and introducing a new offence of causing serious injury by disqualified driving, with a maximum penalty of 4 years.

The number of offenders found guilty and sentenced to an immediate custody at all courts and the average custodial sentence length (months) for 'careless' and 'dangerous' driving in England and Wales from 2008 to 2012 (latest available data) can be viewed in the table.

Court proceedings data for 2013 are planned for publication in May 2014.

I have been asked to reply on behalf of the Cabinet Office.

The information requested falls within the responsibility of the UK Statistics Authority. I have asked the authority to reply.

Letter from Glen Watson, dated May 2014:

As Director General for the Office for National Statistics, I have been asked to reply to your recent Parliamentary Question asking the Secretary of State for Health how many (a) overall deaths and (b) age-standardised deaths from viral hepatitis there have been in (i) England and (ii) each parliamentary constituency, in each year since 1997. [197869]

Table 1 provides the number of deaths and the age-standardised mortality rate where the underlying cause of death was a viral hepatitis in England for the years 1997 to 2012 (the latest year available).

Table 2 provides the number of deaths where the underlying cause of death was viral hepatitis in each parliamentary constituency for four-year periods from 1997 to 2012 (the latest year available). Figures have been presented for four-year periods, rather than for individual years, because of the very small numbers of deaths in each constituency in each year.

Age standardised mortality rates for viral hepatitis by parliamentary constituency have not been provided. This information is not readily available and could only be obtained at a disproportionate cost.

A copy of table 2 has been placed in the Library of the House.

The information requested falls within the responsibility of the UK Statistics Authority. I have asked the authority to reply.

Letter from Glen Watson, dated May 2014:

As Director General for the Office for National Statistics, I have been asked to reply to your recent Parliamentary Questions asking the Secretary of State for Health:

1. How many people have died from cold-related causes in the winter of (a) 2012-13 and (b) 2013-14 (198092)

2. How many people died from heat-related causes in the summer of (a) 2012 and (b) 2013 (198095).

There are no official definitions of ‘cold-related’ and ‘heat-related’ causes of death.

National Statistics estimates of excess winter deaths are calculated annually, and are based on the difference between the number of deaths during the four winter months (December to March) and the average number of deaths during the preceding four months (August to November) and the following four months (April to July).

Table 1 provides the number of excess winter deaths that occurred in England and Wales from 2008/9 to 2012/13 (the latest figures available). Figures on the number of excess winter deaths in the winter of 2013-14 will be available in November 2014.

The majority of excess winter deaths are from respiratory and circulatory diseases, but it is not possible to say whether these deaths were specifically cold-related.

More information on excess winter mortality and the causes contributing to excess winter deaths can be found in the excess winter mortality bulletin:

www.ons.gov.uk/ons/rel/subnational-health2/excess-winter-mortality-in-england-and-wales/index.html

In addition, Public Health England use ONS death registration data to monitor excess weekly mortality. More information on this can be found at:

www.gov.uk/government/uploads/system/uploads/attachment_data/file/229819/Excess_winter_mortality_2012.pdf

Estimates of the excess deaths during a summer heat wave are only calculated when temperatures remain abnormally high over a sustained period. The most severe heat wave of recent times occurred in August 2003, and was associated with significant excess mortality. Summer 2012 was relatively cool, though high temperatures occurred on 19 August in the East and South East of England. There were several days in July 2013 when high temperatures triggered a health heat wave alert in one or more regions. However, analysis by Public Health England showed that no significant excess in weekly all-cause mortality was seen during the heat wave periods in 2012 and 2013. Public Health England publish a heat wave plan containing further details on heat wave alert thresholds:

www.gov.uk/government/uploads/system/uploads/attachment_data/file/201039/Heatwave-Main_Plan-2013.pdf

The information requested falls within the responsibility of the UK Statistics Authority. I have asked the authority to reply.

Letter from Glen Watson, dated May 2014:

As Director General for the Office for National Statistics, I have been asked to reply to your recent Parliamentary Questions asking the Secretary of State for Health:

1. How many people have died from cold-related causes in the winter of (a) 2012-13 and (b) 2013-14 (198092)

2. How many people died from heat-related causes in the summer of (a) 2012 and (b) 2013 (198095).

There are no official definitions of ‘cold-related’ and ‘heat-related’ causes of death.

National Statistics estimates of excess winter deaths are calculated annually, and are based on the difference between the number of deaths during the four winter months (December to March) and the average number of deaths during the preceding four months (August to November) and the following four months (April to July).

Table 1 provides the number of excess winter deaths that occurred in England and Wales from 2008/9 to 2012/13 (the latest figures available). Figures on the number of excess winter deaths in the winter of 2013-14 will be available in November 2014.

The majority of excess winter deaths are from respiratory and circulatory diseases, but it is not possible to say whether these deaths were specifically cold-related.

More information on excess winter mortality and the causes contributing to excess winter deaths can be found in the excess winter mortality bulletin:

www.ons.gov.uk/ons/rel/subnational-health2/excess-winter-mortality-in-england-and-wales/index.html

In addition, Public Health England use ONS death registration data to monitor excess weekly mortality. More information on this can be found at:

www.gov.uk/government/uploads/system/uploads/attachment_data/file/229819/Excess_winter_mortality_2012.pdf

Estimates of the excess deaths during a summer heat wave are only calculated when temperatures remain abnormally high over a sustained period. The most severe heat wave of recent times occurred in August 2003, and was associated with significant excess mortality. Summer 2012 was relatively cool, though high temperatures occurred on 19 August in the East and South East of England. There were several days in July 2013 when high temperatures triggered a health heat wave alert in one or more regions. However, analysis by Public Health England showed that no significant excess in weekly all-cause mortality was seen during the heat wave periods in 2012 and 2013. Public Health England publish a heat wave plan containing further details on heat wave alert thresholds:

www.gov.uk/government/uploads/system/uploads/attachment_data/file/201039/Heatwave-Main_Plan-2013.pdf

The information requested falls within the responsibility of the UK Statistics Authority. I have asked the authority to reply.

Letter from Glen Watson, dated May 2014:

As Director General for the Office for National Statistics, I have been asked to reply to your recent Parliamentary Question asking the Secretary of State for Health, what assessment he has made of the biggest cause of preventable premature deaths in people up to the age of 60 years old. [197910]

In 2012 (the latest year available), the leading cause of preventable premature death in England and Wales for persons up to the age of 60 was ischaemic heart disease. The total number of deaths from this cause for males and females combined was 5,735.

Figures for avoidable mortality in England and Wales are published annually on the ONS website at:

http://www.ons.gov.uk/ons/rel/subnational-health4/avoidable-mortality-in-england-and-wales/index.html

Trends in mortality by causes considered preventable (preventable mortality) or amenable to healthcare (amenable mortality), which are subsets of total avoidable mortality are also presented.

I have been asked to reply on behalf of the Cabinet Office.

The information requested falls within the responsibility of the UK Statistics Authority. I have asked the authority to reply.

Letter from Caron Walker, dated May 2014:

On behalf of the Director General for the Office for National Statistics, I have been asked to reply to your recent Parliamentary Question asking the Secretary of State for Health how many (a) overall deaths and (b) age-standardised deaths from liver disease there have been in (i) England and (ii) each parliamentary constituency, in each year since 1997. [197870]

Table 1 provides the number of deaths and the age-standardised mortality rate where the underlying cause of death was a liver disease in England for the years 1997 to 2012 (the latest year available).

Table 2 provides the number of deaths where the underlying cause of death was liver disease in each parliamentary constituency for the years 1997 to 2012 (the latest year available).

A copy of table 2 has been placed in the Library of the House.

Age standardised mortality rates for liver disease, for each year from 1997 by parliamentary constituency have not been provided. This information is not readily available and could only be obtained at a disproportionate cost.

The Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Mr Hunt) has had no discussions with the Royal Colleges on actions to reduce the health impacts of air pollution. The actions the Government is taking to reduce the health impacts of air pollution have been given in a previous reply to the hon. Member for Liverpool, Wavertree (Luciana Berger) on 28 April 2014, Official Report, columns 474-75W.

In 2010, the Department’s expert advisory Committee on the Medical Effects of Air Pollutants published an estimate of the mortality effect in 2008 of long-term exposure to particulate air pollution arising from human activities. The mortality burden for the United Kingdom was estimated as an effect equivalent to nearly 29,000 deaths. While this includes mortality attributable to particulate matter arising from diesel engines, separate figures for the impact of diesel-fuelled vehicles have not been produced by the Department.

I have known of Brake’s work for many years, as one of its founding members was the relative of a victim who died in my constituency. I think that the whole question of driver distraction is important. I am still amazed by the number of people who use mobile phones while driving. In August 2013 the Government increased the penalty for using a mobile phone while driving from £60 to £100. I will look at the matter and review it in due course.

Driver distraction is a major cause of death and serious injury on our roads, and it has been the focus of a leading campaign by the charity Brake. What are the Government doing to work with such organisations to tackle driver distraction? By way of a digression, I was given the “parliamentarian of the year” award by Brake for campaigning on road safety.

The Government do not comment on the investigation of individual cases as these are the operational responsibility of the respective police force involved.

Her Majesty’s Courts and Tribunal Service (with which appeals are lodged) do not have figures relating the number of appellants that have died during the appeals process.

The information requested is not readily available.

Estimates of the fraction of mortality in English local authority areas and regions in 2010 and 2011 attributable to long-term exposure to particulate air pollution arising from human activities are published by Public Health England (PHE) as one of the indicators in the Department of Health’s Public Health Outcomes Framework. For Portsmouth unitary authority this figure was 5.9% in both 2010 and 2011; for Hampshire county council this figure was 5.3% in 2010 and 5.4% in 2011; and for the South East this figure was 5.5% in both 2010 and 2011.

PHE has also published mortality estimates for 2010 as attributable deaths¹ and associated years of life lost. The estimated mortality burdens attributable to long-term exposure to particulate air pollution arising from human activities were: 95 attributable deaths and 1059 associated years of life lost in Portsmouth unitary authority; 601 attributable deaths and 6211 associated years of life lost in Hampshire county council; and 4,034 attributable deaths and 41,729 associated years of life lost in the South East.¹ The ‘number of deaths’ attributable to a risk factor is a metric which is widely used in communicating about public health risks. Nonetheless, a calculated figure of ‘attributable deaths’ does not represent the number of individuals whose length of life has been shortened by air pollution. Long-term exposure to air pollution is understood to be a contributory factor to deaths from

respiratory and, particularly, cardiovascular disease, ie unlikely to be the sole cause of deaths of individuals. This means that it is likely that air pollution contributes a smaller amount to the deaths of a larger number of exposed individuals rather than being solely responsible for a number of deaths equivalent to the calculated figure of ‘attributable deaths’. The distribution of the mortality effect within the population is unknown.