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776760

registered interest
date	24/10/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Pregnancy: Sodium Valproate
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether UK guidance on the use of valproate-based medicines during pregnancy has been reviewed in the light of recent findings on the intergenerational effects of that drug.
tabling member printed	Baroness Ford
uin	HL2424
answer	answer is ministerial correction date of answer 07/11/2017 answer text <p>Valproate is an effective treatment for epilepsy and bipolar disorder that should only be used in girls and women of childbearing potential if other treatments are ineffective or not tolerated because of the risks in pregnancy. For some women there may be no other treatment option. Due to ongoing concerns about women’s awareness of the risks, the Medicines and Healthcare products Regulatory Agency has worked with professional bodies, voluntary organisations and patient groups to develop a set of materials to aid communication between health professionals and women and girls. The adequacy of measures taken to date is being evaluated in a Europe-wide review that started in March 2017. An expert working group of the Commission on Human Medicines has been convened to inform the United Kingdom position during the ongoing European Union review and will consider all relevant data on intergenerational effects.</p><p> </p><p>The Government has great sympathy for those families who have been affected by the use of valproate in pregnancy. However, there is currently no proposal to offer compensation for those affected by the use of valproate during pregnancy in the UK. For any child born with a disability, clinical commissioning groups and local authorities, as commissioners of health and social care, must secure services to meet that child’s needs.</p><p> </p><p>Where a child has a very complex health need, they may need additional health support to that which is routinely available from general practitioner practices, hospitals or in the community, called continuing care. Health, social care and education should work together to meet the needs of children and young people with special educational needs.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL2425 HL2426 question first answered 07/11/2017 15:47:34 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	3791 label Biography information for Baroness Ford

776761

registered interest
date	24/10/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Pregnancy: Sodium Valproate
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether they have any plans to offer compensation to women and children who have been affected by the use of valproate-based medicines during pregnancy.
tabling member printed	Baroness Ford
uin	HL2425
answer	answer is ministerial correction date of answer 07/11/2017 answer text <p>Valproate is an effective treatment for epilepsy and bipolar disorder that should only be used in girls and women of childbearing potential if other treatments are ineffective or not tolerated because of the risks in pregnancy. For some women there may be no other treatment option. Due to ongoing concerns about women’s awareness of the risks, the Medicines and Healthcare products Regulatory Agency has worked with professional bodies, voluntary organisations and patient groups to develop a set of materials to aid communication between health professionals and women and girls. The adequacy of measures taken to date is being evaluated in a Europe-wide review that started in March 2017. An expert working group of the Commission on Human Medicines has been convened to inform the United Kingdom position during the ongoing European Union review and will consider all relevant data on intergenerational effects.</p><p> </p><p>The Government has great sympathy for those families who have been affected by the use of valproate in pregnancy. However, there is currently no proposal to offer compensation for those affected by the use of valproate during pregnancy in the UK. For any child born with a disability, clinical commissioning groups and local authorities, as commissioners of health and social care, must secure services to meet that child’s needs.</p><p> </p><p>Where a child has a very complex health need, they may need additional health support to that which is routinely available from general practitioner practices, hospitals or in the community, called continuing care. Health, social care and education should work together to meet the needs of children and young people with special educational needs.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL2424 HL2426 question first answered 07/11/2017 15:47:34 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	3791 label Biography information for Baroness Ford

776762

registered interest
date	24/10/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Pregnancy: Sodium Valproate
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what support they will put in place for children born with birth defects resulting from the use of valproate-based medicines by their mothers during pregnancy.
tabling member printed	Baroness Ford
uin	HL2426
answer	answer is ministerial correction date of answer 07/11/2017 answer text <p>Valproate is an effective treatment for epilepsy and bipolar disorder that should only be used in girls and women of childbearing potential if other treatments are ineffective or not tolerated because of the risks in pregnancy. For some women there may be no other treatment option. Due to ongoing concerns about women’s awareness of the risks, the Medicines and Healthcare products Regulatory Agency has worked with professional bodies, voluntary organisations and patient groups to develop a set of materials to aid communication between health professionals and women and girls. The adequacy of measures taken to date is being evaluated in a Europe-wide review that started in March 2017. An expert working group of the Commission on Human Medicines has been convened to inform the United Kingdom position during the ongoing European Union review and will consider all relevant data on intergenerational effects.</p><p> </p><p>The Government has great sympathy for those families who have been affected by the use of valproate in pregnancy. However, there is currently no proposal to offer compensation for those affected by the use of valproate during pregnancy in the UK. For any child born with a disability, clinical commissioning groups and local authorities, as commissioners of health and social care, must secure services to meet that child’s needs.</p><p> </p><p>Where a child has a very complex health need, they may need additional health support to that which is routinely available from general practitioner practices, hospitals or in the community, called continuing care. Health, social care and education should work together to meet the needs of children and young people with special educational needs.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL2424 HL2425 question first answered 07/11/2017 15:47:34 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	3791 label Biography information for Baroness Ford

776776

registered interest
date	24/10/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS: VAT
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what action they have taken to ensure that when NHS bodies set up wholly owned subsidiaries in order to claim VAT refunds, NHS staff transferred to those subsidiary companies retain their terms and conditions, including membership of the NHS Pension Scheme.
tabling member printed	Lord Hunt of Kings Heath
uin	HL2440
answer	answer is ministerial correction date of answer 07/11/2017 answer text <p>National Health Service organisations are responsible for deciding locally the most appropriate structures they need to deliver services to their patients within available resources, meeting any tax liabilities that may arise. Recent guidance to NHS trusts and foundation trusts from the Department states ‘the only tax advice that the Department deems acceptable is that necessary for the fulfilment of statutory functions and or to assist with compliance with tax rules beyond in house expertise. Tax avoidance schemes should not be entered into under any circumstances.’</p><p> </p><p>Any NHS staff compulsory transferred to subsidiary companies that may be set up by NHS bodies should, subject to legal advice, be covered by Transfer of Undertaking Protection of Employment legislation, in respect of their terms and conditions of service, and Her Majesty’s Treasury’s New Fair Deal guidance, in respect of their continued access to the NHS Pension Scheme.</p><p> </p><p>NHS Improvement is working with the NHS to ensure adherence to relevant legislation and guidance, as well as encouraging the sharing and adoption of best practice in working with employee representatives and unions on these issues.</p><p> </p><p><em>Note: </em>HM Treasury’s New Fair Deal guidance requires that NHS employees who transfer compulsorily from a NHS body to an independent organisation retain access to the NHS Pension Scheme in their new employment. This occurs where the function performed by the transferring employees has been outsourced by the provider or the service put to tender by the commissioner.</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 07/11/2017 14:03:35 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

776777

registered interest
date	24/10/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS: VAT
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether they intend to ensure that when NHS bodies set up wholly owned subsidiaries in order to claim VAT refunds, new staff who join those subsidiary companies are (1) employed on NHS terms and conditions, including membership of the NHS Pension Scheme, and (2) classified as NHS employees.
tabling member printed	Lord Hunt of Kings Heath
uin	HL2441
answer	answer is ministerial correction date of answer 07/11/2017 answer text <p>National Health Service bodies are responsible for deciding locally the most appropriate structures they need to put in place to deliver services to their patients within available resources, meeting any tax liabilities that may arise. Recent guidance to NHS trusts and foundation trusts from the Department states that ‘the only tax advice that the Department deems acceptable is that necessary for the fulfilment of statutory functions and or to assist with compliance with tax rules beyond in house expertise. Tax avoidance schemes should not be entered into under any circumstances.’</p><p> </p><p>It would be for those subsidiary companies to decide what terms and conditions they need to offer new staff to enable them to attract the skills and talents required to deliver their services. They would need to apply for new, eligible staff to access the NHS Pension Scheme. To be eligible, they would have to be employed under a standard NHS contract (or sub contract to a NHS standard contract) and wholly or mainly (i.e. more than 50% of their work) either directly or supporting the delivery of clinical services to patients under that contract. These new staff would be classified as employees of the subsidiary company, not the NHS.</p><p> </p><p>NHS Improvement is working with the NHS to ensure adherence to relevant legislation and guidance, as well as encouraging the sharing and adoption of best practice in working with employee representatives and unions on these issues.</p><p> </p><p><strong> </strong></p> answering member printed Lord O'Shaughnessy question first answered 07/11/2017 14:02:01 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

776778

registered interest
date	24/10/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS: VAT
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how many approvals and letters of comfort have been given by the NHS Business Authority to enable NHS staff who transfer to wholly owned subsidiaries which have been set up for the purposes of claiming VAT refund, to continue to access the NHS Pension Scheme.
tabling member printed	Lord Hunt of Kings Heath
uin	HL2442
answer	answer is ministerial correction date of answer 07/11/2017 answer text <p>National Health Service organisations are responsible for deciding locally the most appropriate structures they need to put in place to deliver services to their patients within available resources, meeting any tax liabilities that may arise. Recent guidance to NHS trusts and foundation trusts, from the Department states “The only tax advice that the Department deems acceptable is that necessary for the fulfilment of statutory functions and or to assist with compliance with tax rules beyond in house expertise. Tax avoidance schemes should not be entered into under any circumstances.”</p><p> </p><p>VAT status is irrelevant in respect of the application of Her Majesty’s Treasury’s New Fair Deal guidance which requires that NHS employees who transfer compulsorily from a NHS body to an independent organisation retain access to the NHS Pension Scheme in their new employment.</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 07/11/2017 14:00:51 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

776804

registered interest
date	24/10/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Hepatitis
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government further to the Written Answer by Lord O'Shaughnessy on 17 July (HL530), what support they are giving to Operational Delivery Networks which did not achieve their run rates in the period 2016–17 to meet those targets in the future.
tabling member printed	Baroness Randerson
uin	HL2468
answer	answer is ministerial correction date of answer 07/11/2017 answer text <p>In 2016-17, Operational Delivery Networks achieved 94% of the planned treatment run rate of 10,000 patients, with all but two treating over 90% of their run rate. NHS England has a Commissioning for Quality and Innovation scheme in place for hepatitis C virus (HCV), which provides a substantial opportunity for hospitals to earn additional income available to invest in their contribution to the sustainable rollout of HCV treatments. NHS England also invested £1 million in fibroscanning equipment to identify patients at the highest unmet clinical need. Clinical and commissioning support is provided at regional and national level to share best practice.</p> answering member printed Lord O'Shaughnessy question first answered 07/11/2017 15:48:47 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4230 label Biography information for Baroness Randerson

776805

registered interest
date	24/10/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Hepatitis: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the Written Answer by Lord O'Shaughnessy on 18 July (HL529), whether the figure of £200 million represents only the cost of medicines for the treatment of hepatitis C, or whether it includes the cost of associated ancillary treatments; whether the NHS procurement process for hepatitis C drug treatments has achieved any cost savings; and if so, what is the value of those savings.
tabling member printed	Baroness Randerson
uin	HL2469
answer	answer is ministerial correction date of answer 02/11/2017 answer text <p>NHS England spent in excess of £200 million on direct acting antivirals for hepatitis C in 2016-17. This figure does not include associated ancillary treatments. Through twice yearly drug procurements and working closely with industry, NHS England has secured reduced prices, which is on course to generate savings of more than £50 million. Reductions in drug price enables the year on year expansion in treatments to remain affordable.</p> answering member printed Lord O'Shaughnessy question first answered 02/11/2017 15:27:12 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	4230 label Biography information for Baroness Randerson

776818

registered interest
date	24/10/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	IVF
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, in each year since 2008, what has been the incidence of (1) foetal abnormalities, and (2) autism or other neurological disorder, in birth or pregnancies resulting from the use of frozen oocytes after thawing and fertilisation.
tabling member printed	Lord Winston
uin	HL2482
answer	answer is ministerial correction date of answer 01/11/2017 answer text <p>Information on the incidence of foetal abnormalities is shown in the following table:</p><p> </p><table><tbody><tr><td><p><strong> </strong></p></td><td><p>Includes only cycles where exclusively embryos created from frozen eggs were transferred</p></td></tr><tr><td><p>Year of treatment</p></td><td><p>Foetal abnormalities</p></td></tr><tr><td><p>2008</p></td><td><p>0</p></td></tr><tr><td><p>2009</p></td><td><p>1 (observed)</p></td></tr><tr><td><p>2010</p></td><td><p>0</p></td></tr><tr><td><p>2011</p></td><td><p>1 (uncertain)</p></td></tr><tr><td><p>2012</p></td><td><p>0</p></td></tr><tr><td><p>2013</p></td><td><p>0</p></td></tr><tr><td><p>2014</p></td><td><p>0</p></td></tr><tr><td><p>2015</p></td><td><p>0</p></td></tr></tbody></table><p> </p><p><em>Note:</em> Data has been provided for the latest verified data period: to 30 June 2015 for births.</p><p><em>Source: </em>The Human Fertilisation and Embryology Authority</p><p> </p><p>The Human Fertilisation and Embryology Authority (HFEA) has advised that since October 2007 it has only collected data where a congenital abnormality was reported as either observed or uncertain following a birth event. The HFEA has also advised that it does not collect information on the incidence of autism or other neurological disorders in births or pregnancies resulting from the use of frozen oocytes after thawing and fertilisation.</p> answering member printed Lord O'Shaughnessy question first answered 01/11/2017 16:00:47 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1770 label Biography information for Lord Winston

776819

registered interest
date	24/10/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	IVF
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, in respect of oocytes frozen for a patient's own use, how many pregnancies, births, and miscarriages have resulted in each year since 2013, after the fertilisation of such oocytes in cases when those oocytes were collected and cryopreserved after the patient had reached the age of 35.
tabling member printed	Lord Winston
uin	HL2483
answer	answer is ministerial correction date of answer 01/11/2017 answer text <p>The information requested is shown in the following table:</p><p> </p><table><tbody><tr><td><p> </p></td><td colspan="3"><p>Includes only cycles where exclusively embryos created from frozen eggs were transferred</p></td></tr><tr><td><p>Year of treatment</p></td><td><p>Pregnancies</p></td><td><p>Miscarriages</p></td><td><p>Live birth events</p></td></tr><tr><td><p>2013</p></td><td><p>5</p></td><td><p>2</p></td><td><p>3</p></td></tr><tr><td><p>2014</p></td><td><p>8</p></td><td><p>0</p></td><td><p>7<sup>1</sup></p></td></tr><tr><td><p>2015</p></td><td><p>9</p></td><td><p>0</p></td><td><p>3<sup>2</sup></p></td></tr><tr><td><p>2016</p></td><td><p>10<sup>3</sup></p></td><td><p>n/a</p></td><td><p>n/a</p></td></tr></tbody></table><p> </p><p><em>Notes:</em></p><p><sup>1</sup>The outcome of one reported pregnancy in 2014 has yet to be notified to the Human Fertilisation and Embryology Authority (HFEA) by the clinic that carried out the treatment cycle.</p><p><sup>2</sup>Data for births has been provided for the latest verified data period: up to 30 June 2015.</p><p><sup>3</sup>Data for pregnancies has been provided for the latest verified data period: up to 30 June 2016</p><p> </p><p><em>Source: </em>HFEA</p> answering member printed Lord O'Shaughnessy question first answered 01/11/2017 16:58:42 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1770 label Biography information for Lord Winston