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Independents' Day

Wales has highest rates of disease prevalence

Government statistics confirm stark differences in disease prevalence rates between England, Scotland and Wales.

Wales had the highest prevalence of longstanding or limiting longstanding illness, ahead of Scotland and England.

The figures added weight to Welsh GPs' argument that the Government's decision to use national disease prevalence data discriminated against them.

Some 38 per cent of patients in Wales had a longstanding illness, compared with 35 per cent in Scotland and 31 per cent in England. Almost a quarter said their illness was limiting, compared with 21 per cent of English people and 18 per cent of Scots.

GPC deputy-chair Dr Hamish Meldrum said the figures were subjective and the GPC would need data from the quality framework before it could challenge the decision to use national prevalence data.

Fears over the safety of third-generation oral contraceptives are receding, new statistics suggest.

Figures from the General Household Survey show 26 per cent of women aged 16 to 49 choose the Pill as their

usual contraceptive method, up from 24 per cent in 1998.

Uptake rose from 17 per cent to 24 per cent in 16- to 17-year-olds and from 43 to 46 per cent in 18- to 19-year-olds between 1998 and 2002.

The survey also showed the number of women choosing sterilisation is declining ­ down from 23 to 21 per cent between 1998 and 2002.

The number of women using the Pill fell dramatically

after 1995, because of adverse publicity following a warning from the Committee on Safety of Medicines. The committee warned that the third generation of oral contraceptives led to an increased risk of venous thromboembolism.

Dr Martyn Walling, a GP in Boston, Lincolnshire, and a member of the Primary Care Gynaecology Group, said GPs' efforts had been vital in restoring women's faith in third-generation oral contraceptives.

'I think it reflects what we have been doing in primary care ­ there's been a real drive since 2000, especially through clinics for teenagers,' he said.

There was a tremendous drop in Pill use after the DVT scare in 1995, he said, but the teenagers of that generation were now having their first

babies and younger women were less likely to have been

affected by the safety scare.

'The sad thing is that we are still not using the full range of Pills ­ although we're seeing a rise in the use of Depo-Provera and Implanon.'

Dr Walling welcomed the fall in sterilisations saying methods such as Depo-Provera and Implanon were much better as they were reversible and just as effective. 'All GPs have women who regret having a sterilisation,' he said.

Professor Philip Hanna-ford, professor of primary care at the University of Aberdeen, said: 'GPs have got the key role to explain what the risks of a treatment mean to the individual ­ and they need to understand the literature and extrapolate subtle but significant differences.'

Professor Hannaford, who is on the WHO specialist panel on epidemiological research in reproductive health, said: 'As a full-time academic I have

trouble keeping on top of the literature ­ how is a busy GP supposed to do it?'

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