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390583

registered interest
date	16/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Stem Cells
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what assessment they have made of the research, recently published in <i>Nature</i>, into using stem cells to rid organs of mutant mitochondria without recourse to three-parent IVF; and whether it is their policy that human embryos should be destroyed if alternatives are available.
tabling member printed	Lord Alton of Liverpool
uin	HL1523
answer	answer is ministerial correction date of answer 24/07/2015 answer text <p>The research by the Centre for Embryonic Cell and Gene Therapy in Oregon, USA, published in Nature, is at a very early stage but may possibly offer hope of health improvement for those who already have a mitochondrial disease. The purpose of the mitochondrial donation treatment, which will be allowable through Regulations from 29 October 2015, is to prevent the transmission of serious mitochondrial disease from mother to child in the first instance.</p><p> </p><p> </p><p> </p><p>The Human Fertilisation and Embryology Act 1990 provides that embryos can only be used in research where the research is necessary and desirable and the use of embryos is necessary. However, that provision does not apply to treatment<em>.</em> Decisions about whether to use eggs or in vitro fertilisation embryos in treatment, including mitochondrial donation, are made according to clinical judgment, if authorised by the Human Fertilisation and Embryology Authority.</p><p> </p><p> </p><p> </p> answering member printed Lord Prior of Brampton question first answered 24/07/2015 11:25:27 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	738 label Biography information for Lord Alton of Liverpool

390584

registered interest
date	16/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Embryos
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how many human embryos were experimented on or destroyed in the last 12 months for which figures are available; and what are the cumulative figures since such procedures were made legal.
tabling member printed	Lord Alton of Liverpool
uin	HL1524
answer	answer is ministerial correction date of answer 24/07/2015 answer text <p>The Human Fertilisation and Embryology Act 1990, as amended (1990 Act), provides that human embryos created by in vitro fertilisation that are not transferred to a patient cannot be allowed to develop beyond a maximum of 14 days. The 1990 Act also provides that the Human Fertilisation and Embryology Authority (HFEA) cannot licence research using human embryos unless the research is necessary or desirable for the purposes specified in the Act and the use of embryos is necessary.</p><p> </p><p>The HFEA has advised that the number of embryos allowed to perish in the last 12 months for which figures are available (1 July 2013 - 30 June 2014) is 174,316.</p><p> </p><p>In relation to the number of embryos allowed to perish since the 1990 Act came into force, the figures are as follows:</p><p> </p><table><tbody><tr><td><p>Year</p></td><td><p>Embryos allowed to perish</p></td></tr><tr><td><p>1990</p></td><td><p>6</p></td></tr><tr><td><p>1991</p></td><td><p>8,164</p></td></tr><tr><td><p>1992</p></td><td><p>23,035</p></td></tr><tr><td><p>1993</p></td><td><p>27,466</p></td></tr><tr><td><p>1994</p></td><td><p>32,176</p></td></tr><tr><td><p>1995</p></td><td><p>37,270</p></td></tr><tr><td><p>1996</p></td><td><p>47,808</p></td></tr><tr><td><p>1997</p></td><td><p>48,024</p></td></tr><tr><td><p>1998</p></td><td><p>57,427</p></td></tr><tr><td><p>1999</p></td><td><p>77,269</p></td></tr><tr><td><p>2000</p></td><td><p>85,938</p></td></tr><tr><td><p>2001</p></td><td><p>88,039</p></td></tr><tr><td><p>2002</p></td><td><p>96,377</p></td></tr><tr><td><p>2003</p></td><td><p>96,309</p></td></tr><tr><td><p>2004</p></td><td><p>98,348</p></td></tr><tr><td><p>2005</p></td><td><p>100,547</p></td></tr><tr><td><p>2006</p></td><td><p>108,080</p></td></tr><tr><td><p>2007</p></td><td><p>116,342</p></td></tr><tr><td><p>2008</p></td><td><p>112,050</p></td></tr><tr><td><p>2009</p></td><td><p>132,536</p></td></tr><tr><td><p>2010</p></td><td><p>155,557</p></td></tr><tr><td><p>2011</p></td><td><p>168,613</p></td></tr><tr><td><p>2012</p></td><td><p>166,631</p></td></tr><tr><td><p>2013</p></td><td><p>169,644</p></td></tr><tr><td><p>Total</p></td><td><p>2,053,656</p></td></tr></tbody></table><p> </p><p> </p><p> </p><p>This includes embryos that have been thawed and allowed to perish, either because they have reached the end of their permitted storage period or at the request of the patient, and those discarded in the course of treatment.</p><p> </p><p>The HFEA does not hold data in its register of the number of embryos experimented upon.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 24/07/2015 12:11:11 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	738 label Biography information for Lord Alton of Liverpool

390588

registered interest
date	16/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Eastman Dental Hospital
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, in the light of the proposed relocation of the Eastman Dental Hospital, what steps are being taken to ensure the continuation of the specialised dental postgraduate training and research facilities currently offered.
tabling member printed	Baroness Gardner of Parkes
uin	HL1528
answer	answer is ministerial correction date of answer 23/07/2015 answer text <p>We understand there are no plans to reduce the specialised dental postgraduate training and research currently offered as a consequence of the proposed move from the current site.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 23/07/2015 11:13:13 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	3596 label Biography information for Baroness Gardner of Parkes

390599

registered interest
date	16/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Anaemia
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what action they are taking to address the problems associated with the late diagnosis of pernicious anaemia, in the light of the results of the survey published in the <i>British Nursing Journal</i> in April 2014.
tabling member printed	The Countess of Mar
uin	HL1539
answer	answer is ministerial correction date of answer 24/07/2015 answer text <p>It is important that patients suffering from pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, receive a prompt and appropriate diagnosis. Pernicious anaemia develops gradually, and can cause a range of symptoms, including fatigue, lethargy, feeling faint and headaches, which vary from patient to patient. Because of the gradual progression of the condition, the variety of symptoms, which are shared with a range of other conditions, diagnosis at early onset can be challenging.</p><p>To support the diagnosis of pernicious anaemia, the British Committee for Standards in Haematology (BCSH) has published <em>Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders,</em> which sets out that cobalamin status is the recommended first line diagnostic test. However, the guidance states that there is no gold standard test for the condition and makes it clear that the clinical picture of a patient is the most important factor in assessing the significance of the test results. This means clinicians should take into account all of the symptoms the patent is experiencing, their medical history, age and other relevant factors when considering the implications of a patient’s cobalamin status. The BCSH guidance highlights the risk of neurological impairment if treatment is delayed.</p><p><br /> The BCSH operates independently of Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate. A copy of the BCSH guidance document <del class="ministerial">has already been placed in the Library and</del> is attached.</p><p><br /> More general clinical guidance on the diagnosis and management of pernicious anaemia can also be found on the National Institute for Health and Care Excellence (NICE) Clinical Knowledge Summaries website. This is a freely accessible online resource that covers the causes, symptoms, diagnosis and treatment of pernicious anaemia, as well as potential complications of the condition. In addition to this, NHS Choices provides similar, though less technical, information on pernicious anaemia for the public.</p> answering member printed Lord Prior of Brampton question first answered 24/07/2015 13:21:19 question first ministerially corrected 14/10/2015 11:21:08 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name colbalamin and folate disorders.pdf title BCSH Guidelines pernicious anaemia previous answer version 17459 answering member printed Lord Prior of Brampton answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name colbalamin and folate disorders.pdf title BCSH Guidelines pernicious anaemia
tabling member	1861 label Biography information for The Countess of Mar

390600

registered interest
date	16/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Anaemia
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how they propose to alert medical practitioners to the severe and irreversible nerve damage that can occur when pernicious anaemia is misdiagnosed.
tabling member printed	The Countess of Mar
uin	HL1540
answer	answer is ministerial correction date of answer 24/07/2015 answer text <p>It is important that patients suffering from pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, receive a prompt and appropriate diagnosis. Pernicious anaemia develops gradually, and can cause a range of symptoms, including fatigue, lethargy, feeling faint and headaches, which vary from patient to patient. Because of the gradual progression of the condition, the variety of symptoms, which are shared with a range of other conditions, diagnosis at early onset can be challenging.</p><p>To support the diagnosis of pernicious anaemia, the British Committee for Standards in Haematology (BCSH) has published <em>Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders,</em> which sets out that cobalamin status is the recommended first line diagnostic test. However, the guidance states that there is no gold standard test for the condition and makes it clear that the clinical picture of a patient is the most important factor in assessing the significance of the test results. This means clinicians should take into account all of the symptoms the patent is experiencing, their medical history, age and other relevant factors when considering the implications of a patient’s cobalamin status. The BCSH guidance highlights the risk of neurological impairment if treatment is delayed.</p><p><br /> The BCSH operates independently of Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate. A copy of the BCSH guidance document <del class="ministerial">has already been placed in the Library and</del> is attached.</p><p><br /> More general clinical guidance on the diagnosis and management of pernicious anaemia can also be found on the National Institute for Health and Care Excellence (NICE) Clinical Knowledge Summaries website. This is a freely accessible online resource that covers the causes, symptoms, diagnosis and treatment of pernicious anaemia, as well as potential complications of the condition. In addition to this, NHS Choices provides similar, though less technical, information on pernicious anaemia for the public.</p> answering member printed Lord Prior of Brampton question first answered 24/07/2015 13:21:19 question first ministerially corrected 14/10/2015 11:21:19 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name colbalamin and folate disorders.pdf title BCSH Guidelines pernicious anaemia previous answer version 17460 answering member printed Lord Prior of Brampton answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name colbalamin and folate disorders.pdf title BCSH Guidelines pernicious anaemia
tabling member	1861 label Biography information for The Countess of Mar

390602

registered interest
date	16/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Abortion: Neural Tube Defects
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what was the cost of terminations of pregnancies affected by neural tube defects in the latest period for which figures are available.
tabling member printed	Lord Rooker
uin	HL1542
answer	answer is ministerial correction date of answer 28/07/2015 answer text <p>Information about expenditure on abortions is not collected centrally.</p><p> </p><p> </p><p> </p><p> </p><p>The number of abortions carried out in England and Wales for pregnancies affected by neural tube defects for non-resident patients is given in the table below. The International Code of Diseases includes Q00 Anencephaly, Q01 Encephalocele and Q05 Spina Bifida as Neural Tube Defects.</p><p> </p><p> </p><p> </p><p> </p><table><tbody><tr><td><p>2010</p></td><td><p>2011</p></td><td><p>2012</p></td><td><p>2013</p></td><td><p>2014</p></td></tr><tr><td><p>34</p></td><td><p>26</p></td><td><p>22</p></td><td><p>44</p></td><td><p>44</p></td></tr></tbody></table><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL1544 question first answered 28/07/2015 10:09:12 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	302 label Biography information for Lord Rooker

390603

registered interest
date	16/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Neural Tube Defects
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, in each of the last five years for which figures are available, how many of the pregnancies affected by neural tube defects were second or subsequent pregnancies.
tabling member printed	Lord Rooker
uin	HL1543
answer	answer is ministerial correction date of answer 23/07/2015 answer text <p>This information is not collected centrally.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 23/07/2015 11:12:29 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	302 label Biography information for Lord Rooker

390604

registered interest
date	16/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Abortion: Neural Tube Defects
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how many of the terminations of pregnancies affected by neural tube defects carried out in England in each of the past five years involved a patient whose home postcode was not in England.
tabling member printed	Lord Rooker
uin	HL1544
answer	answer is ministerial correction date of answer 28/07/2015 answer text <p>Information about expenditure on abortions is not collected centrally.</p><p> </p><p> </p><p> </p><p> </p><p>The number of abortions carried out in England and Wales for pregnancies affected by neural tube defects for non-resident patients is given in the table below. The International Code of Diseases includes Q00 Anencephaly, Q01 Encephalocele and Q05 Spina Bifida as Neural Tube Defects.</p><p> </p><p> </p><p> </p><p> </p><table><tbody><tr><td><p>2010</p></td><td><p>2011</p></td><td><p>2012</p></td><td><p>2013</p></td><td><p>2014</p></td></tr><tr><td><p>34</p></td><td><p>26</p></td><td><p>22</p></td><td><p>44</p></td><td><p>44</p></td></tr></tbody></table><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL1542 question first answered 28/07/2015 10:09:12 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	302 label Biography information for Lord Rooker

390605

registered interest
date	16/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Employment: Disclosure of Information
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government when they plan to lay regulations implementing sections 148 and 149 of the Small Business, Enterprise and Employment Act 2015; and what plans they have to propose changes to existing regulations to bring student nurses in the National Health Service within the scope of the Public Interest Disclosure Act 1998.
tabling member printed	Lord Watson of Invergowrie
uin	HL1545
answer	answer is ministerial correction date of answer 24/07/2015 answer text <p>The Government intends to bring forward regulations to bring Section 148 of the Small Business, Enterprise and Employment Act 2015 into effect from April 2016, and Section 149 by December 2015 subject to Parliamentary approval.</p><p> </p><p> </p><p> </p><p>The Protected Disclosures (Extension of Meaning of Worker) Order 2015 (SI 2015/491) came into effect on 6 April 2015, bringing student nurses and student midwives into the definition of ‘worker’ for the purposes of Section 43K of the Employment Rights Act 1996.</p><p> </p><p> </p><p> </p><p>This change affects those student nurses and student midwives who undertake work experience as part of a course of education or training approved by, or under arrangements with, the Nursing and Midwifery Council.</p><p> </p><p> </p><p> </p><p>In line with the recommendation set out in the Freedom to Speak Up review the Department of Health intends to bring forward further secondary legislation to extend the definition to include other healthcare students.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 24/07/2015 13:22:03 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	1241 label Biography information for Lord Watson of Invergowrie

390606

registered interest
date	16/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Creating an Open and Honest Reporting Culture in the NHS Independent Review
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government when they plan to publish their response to their consultation on the implementation of the recommendations, principles and actions set out in the report of the Freedom to Speak Up review.
tabling member printed	Lord Watson of Invergowrie
uin	HL1546
answer	answer is ministerial correction date of answer 23/07/2015 answer text <p>Her Majesty’s Government’s response to the Freedom to Speak Up consultation (<a href="http://dhinfo.doh.gov.uk/Conthttps:/www.gov.uk/government/publications/learning-not-blaming-response-to-3-reports-on-patient-safetyactWeb/UploadPQScannedImage.aspx?corrid=948144&amp;casemode=" target="_blank">CM9113</a>) was laid on Thursday 16 July 2015 and is attached.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 23/07/2015 11:12:13 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name Learning_not_blaming_acc.pdf title Learning Not Blaming
tabling member	1241 label Biography information for Lord Watson of Invergowrie