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Health: Tuberculosis

Volume 694: debated on Monday 23 July 2007

asked Her Majesty’s Government:

How they intend to respond to present levels of incidence of human tuberculosis in light of current migratory patterns.

My Lords, the Department of Health recommends that TB services follow the National Institute for Health and Clinical Excellence guideline on the prevention, treatment and control of tuberculosis. It contains specific guidance on the follow-up of new entrants. The advice is also emphasised in the toolkit recently published by the department to help NHS trusts plan, procure and deliver TB services relevant to the local demography and incidence of TB.

My Lords, I thank the Minister for that reply. Having had TB in my teens, I know how infectious it is. Does she agree with me that everyone coming into this country for more than six months, specifically from the 22 burden countries that suffer very much from the disease, should be tested?

My Lords, we currently have a pilot project with the seven countries in which TB is most prevalent, in which we test people before they receive their visas to come to the UK. That scheme is now being evaluated, and we will probably roll it out to more countries such as China and India on the basis of that evaluation.

My Lords, the Minister will be aware of the case of the American gentleman who recently travelled to Europe knowing that he had TB. Does that not assist the case of the noble Baroness, Lady Sharples, that, although TB has a higher incidence in some countries, it happens in most? How soon will that pilot project be rolled out and on what basis will it be extended to different countries, such as the USA?

My Lords, the project is being evaluated. I do not know the timescale of the rollout, but I will inform noble Lords. It is true that tuberculosis is an infectious disease, but it is not very infectious. The incidence of TB in this country is grossly exaggerated in the press from time to time. I understand that at the beginning of this century there were about 100,000 people in this country with TB. That figure now stands at somewhere between 7,000 and 8,000.

My Lords, is the Minister aware—well, she is obviously not aware—that her statement about TB not being highly infectious is quite wrong? When I was a chairman of a local public health body, we had one contact who infected 40 people within one week. It is a highly infectious condition. Does she not think that, although you can do a certain amount in terms of immigration, it is very important to see that children are immunised against TB and protected in that way?

My Lords, I respect the views expressed by noble Lords. However, I have been informed by the Department of Health that TB is quite difficult to catch and usually requires prolonged or repeated contact with a person with infectious TB, such as living in the same household. It is important that children who are going to be subjected to contact with people with TB are immunised, and for that very reason the Government now have a targeted approach to immunisation. All new-born babies who are living in areas where TB is prevalent will now be immunised.

My Lords, has the apparent shortage of vaccine of about a year ago now been overcome? Is there plenty of vaccine available?

My Lords, I was not aware that there had been a shortage of vaccine. I understand by that that now there is no such shortage. If that is not the case, I will inform noble Lords.

My Lords, I am sure the Minister is aware that many incidents of virulent TB are coming into our prisons with foreign national prisoners. Is she satisfied that all primary care trusts are enabling all prisons that receive such prisoners to carry out the necessary tests on arrival and subsequent treatment?

My Lords, that is something PCTs are working hard on with the Prison Service. The Government are considering extending the screening of target groups, and that may be something prisons and PCTs will be contemplating.

My Lords, does the Minister agree that poor housing, in particular overcrowding, is a huge contributory factor in catching TB? What do the Government intend to do about this, particularly in the immigrant and asylum-seeker communities?

My Lords, TB is prevalent in areas of poor housing and homelessness. I am sure that the Statement later today by my honourable friend Yvette Cooper will have a bearing on this.

My Lords, can the noble Baroness explain how, in one breath, she talks about analysing a review and, in the next, about rollout to further countries before the review’s analysis is complete? Can she explain the logic of that?

My Lords, I will check Hansard, but I hope that I said that the rollout would be on the basis of the evaluation. First, we want to evaluate the pilot projects; thereafter, provided that the evaluation shows that the schemes should be rolled out, we will seek to do so.