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994496

registered interest
date	25/10/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Tramadol
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what steps he is taking to limit the prescription of Tramadol.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	183935
answer	answer is ministerial correction date of answer 31/10/2018 answer text <p>The Department expects all clinicians to act responsibly when prescribing schedule three drugs such as Tramadol. The responsibility for prescribing and any necessary follow-up rests with the doctor or prescriber who has clinical responsibility for that particular aspect of a patient's care. Decisions on which drugs are prescribed should be based on clinical assessments. Good communication between practitioners and patients is essential and prescribers should always involve patients in decisions about the treatment proposed, including informing them of any possible side effects from their prescribed medicines.</p><p> </p><p>The Advisory Council on the Misuse of Drugs published advice on the use of Tramadol in 2013. This advice can be found at the following link:</p><p> </p><p><a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/144116/advice-tramadol.pdf" target="_blank">https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/144116/advice-tramadol.pdf</a></p><p> </p><p>Advice to prescribers includes warnings that repeated use is associated with psychological and physical dependence.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 31/10/2018 12:09:42 answering member 4067 label Biography information for Steve Brine
tabling member	4131 label Biography information for Jim Shannon

994497

registered interest
date	25/10/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Breast Cancer: Screening
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, when he plans to introduce the new blood test for breast cancer screening to improve the rate of early diagnosis.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	183936
answer	answer is ministerial correction date of answer 02/11/2018 answer text <p>There are no immediate plans to introduce the new blood test into screening or referral pathways. This is not included in National Institute for Health and Care Excellence Guidelines (NG101) on referral and diagnosis (published in July 2018).</p> answering member constituency Winchester answering member printed Steve Brine question first answered 02/11/2018 13:33:28 answering member 4067 label Biography information for Steve Brine
tabling member	4131 label Biography information for Jim Shannon

994509

registered interest
date	25/10/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Department of Health and Social Care: Migrant Workers
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, how many citizens of non-UK EU countries work in (a) his Department, (b) its agencies and (c) its non-departmental public bodies.
tabling member constituency	Carshalton and Wallington
tabling member printed	Tom Brake
uin	183818
answer	answer is ministerial correction date of answer 02/11/2018 answer text <p>The Department and the National Institute for Health and Care Excellence do not hold this information. Evidence of nationality is checked at the point of recruitment into the Civil Service as part of wider pre-employment checks, but there is no requirement on departments to retain this information beyond the point at which it has served its purpose.</p><p> </p><p>The Health Research Authority, Human Tissue Authority and the Human Fertilisation and Embryology Authority have nationality data available. However, due to low numbers we are able to provide this information due to the risk that individuals may be identified.</p><p> </p><p>The Department’s remaining agencies and non-departmental bodies hold nationality data and this has been included in the following table. Data is accurate as of 30 September. Contextual information to this data should be noted as it has a significant impact on the validity of the data held.</p><p> </p><table><tbody><tr><td><p>Organisation</p></td><td><p>Number of employees who are citizens of non-United Kingdom European Union countries</p></td><td><p>Contextual Information</p></td></tr><tr><td><p>Medicines and Health products Regulatory Agency</p></td><td><p>126</p></td><td><p>Not applicable</p></td></tr><tr><td><p>Public Health England</p></td><td><p>383</p></td><td><p>Nationality data is not held for 135 members of staff.</p></td></tr><tr><td><p>Care Quality Commission</p></td><td><p>94</p></td><td><p>Nationality data is not monitored once individuals have been verified at the recruitment stage. As a result, the actual number of EU nationals could differ. This also does not account for EU citizens married to UK nationals, or those who hold dual nationality.</p></td></tr><tr><td><p>NHS Digital</p></td><td><p>60</p></td><td><p>Not applicable</p></td></tr><tr><td><p>Health Education England</p></td><td><p>46</p></td><td><p>Not applicable</p></td></tr><tr><td><p>NHS Improvement</p></td><td><p>30</p></td><td><p>Nationality data is not held for 54.9% of staff.</p></td></tr><tr><td><p>NHS England</p></td><td><p>128</p></td><td><p>Nationality data is not held for 29.1% of staff as this is based on individuals wishing to disclose this information.</p></td></tr></tbody></table> answering member constituency Gosport answering member printed Caroline Dinenage question first answered 02/11/2018 13:09:43 answering member 4008 label Biography information for Dame Caroline Dinenage
tabling member	151 label Biography information for Tom Brake

994541

registered interest
date	25/10/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Carers: Nottinghamshire
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what information his Department holds on (a) respite care and (b) other practical support available to carers from local authorities in Nottinghamshire.
tabling member constituency	Mansfield
tabling member printed	Ben Bradley
uin	183952
answer	answer is ministerial correction date of answer 01/11/2018 answer text <p>This information is not held centrally. Through the Government’s Better Care Fund, local areas set out plans which indicate the level of resource that will be dedicated to carer-specific support, including respite and carers’ breaks. The exact breakdown on spend for carers’ breaks is not collected centrally.</p><p> </p><p>Information covering other practical support available to carers from local authority’s is not held centrally, either. However, the Care Act 2014 introduced important new rights for carers, for the first time putting them on the same footing as the people for whom they care. Carers have legal rights to an assessment of, and support for, their needs where eligible. Local authorities also have a wider duty to offer information and advice to all carers, including signposting the carer to support available locally.</p> answering member constituency Gosport answering member printed Caroline Dinenage question first answered 01/11/2018 13:14:37 answering member 4008 label Biography information for Dame Caroline Dinenage
tabling member	4663 label Biography information for Ben Bradley

994551

registered interest
date	25/10/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Health Services: Autism
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, if he will take to (a) tackle health inequality faced by autistic people and (b) ensure NHS England adopts NICE’s 2017 recommendation to adopt local autism registers; and if he will make a statement.
tabling member constituency	Enfield, Southgate
tabling member printed	Bambos Charalambous
uin	183957
answer	answer is ministerial correction date of answer 01/11/2018 answer text <p>Following an announcement in June 2018, the Prime Minister has asked the National Health Service to develop a long-term plan for the service, setting out how the NHS will develop over the coming years supported by the significant additional funding. Learning disabilities and autism are one of four clinical priority areas so this provides an opportunity to consider how the NHS can work to address the inequalities experienced by people with autism. NHS England is currently involved in discussions with autistic people and partner organisations to explore the potential of general practitioners registers.</p> answering member constituency Gosport answering member printed Caroline Dinenage question first answered 01/11/2018 13:15:33 answering member 4008 label Biography information for Dame Caroline Dinenage
tabling member	4610 label Biography information for Bambos Charalambous

994558

registered interest
date	25/10/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Mental Health Services: Rheumatoid Arthritis
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what steps he is taking to improve access to mental health services for people living with rheumatoid arthritis.
tabling member constituency	Mansfield
tabling member printed	Ben Bradley
uin	183958
answer	answer is ministerial correction date of answer 02/11/2018 answer text <p>We recognise that living with a long-term condition, such as rheumatoid arthritis, can also have an impact upon a person’s mental wellbeing. The guideline Rheumatoid arthritis in adults: management, updated by the National Institute for Health and Care Excellence in 2018, sets out best practice in the diagnosis treatment care and support of people with rheumatoid arthritism. The guidance recommends that patients should be offered psychological interventions (for example, relaxation, stress management and cognitive coping skills to help them to adjust to living with their condition). Anyone suffering with a long-term condition who is suffering with their mental wellbeing should speak to their general practitioner in the first instance. The guidance can be accessed via the following link:</p><p> </p><p><a href="https://www.nice.org.uk/guidance/ng100" target="_blank">https://www.nice.org.uk/guidance/ng100</a></p> answering member constituency Thurrock answering member printed Jackie Doyle-Price question first answered 02/11/2018 13:30:08 answering member 4065 label Biography information for Dame Jackie Doyle-Price
tabling member	4663 label Biography information for Ben Bradley

994559

registered interest
date	25/10/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Lung Cancer
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what steps he is taking to improve the (a) diagnosis and (b) treatment of lung cancer.
tabling member constituency	Mansfield
tabling member printed	Ben Bradley
uin	183959
answer	answer is ministerial correction date of answer 02/11/2018 answer text <p>NHS England is extending targeted lung health checks to clinical commissioning groups with high mortality rates and high incidence of lung cancer. In Greater Manchester, introducing low dose CT health checks saw an almost five-fold reduction in stage 4 disease, with 80% of cancers diagnosed at an early stage.</p><p> </p><p>A new cancer diagnosis standard, designed to ensure that patients find out within 28 days whether or not they have cancer, will be introduced in 2020. NHS England has published guidance for lung cancer on how to speed up the start of the pathway, to meet this new standard and to maximise the number of patients who might benefit from potentially curative surgery. The National Health Service has been asked to implement this pathway in Refreshing NHS Plans for 2018/19 (annual planning guidance). Transformation funding was provided to Cancer Alliances in 2018/19 to ensure the pathway will be implemented across England. Guidance on the best practice timed diagnosis pathways is available at the following link:</p><p> </p><p><a href="https://www.england.nhs.uk/publication/rapid-cancer-diagnostic-and-assessment-pathways/" target="_blank">https://www.england.nhs.uk/publication/rapid-cancer-diagnostic-and-assessment-pathways/</a></p> answering member constituency Winchester answering member printed Steve Brine question first answered 02/11/2018 13:37:40 answering member 4067 label Biography information for Steve Brine
tabling member	4663 label Biography information for Ben Bradley

994560

registered interest
date	25/10/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Suicide: Wirral
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what data sources his Department uses to measure the number of attempted suicides in the (a) Birkenhead constituency and (b) Wirral local authority area.
tabling member constituency	Birkenhead
tabling member printed	Frank Field
uin	183866
answer	answer is ministerial correction date of answer 02/11/2018 answer text <p>Information on numbers of attempted suicides is not collected centrally.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price question first answered 02/11/2018 13:28:32 answering member 4065 label Biography information for Dame Jackie Doyle-Price
tabling member	478 label Biography information for Lord Field of Birkenhead

994562

registered interest
date	25/10/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Radiotherapy: Medical Treatments Abroad
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, how much his Department spent on travel and accommodation for adults taking part in the NHS Proton Beam Therapy Service Overseas programme in (a) 2010, (b) 2015, (c) 2016 and (d) 2017.
tabling member constituency	Harlow
tabling member printed	Robert Halfon
uin	183919
answer	answer is ministerial correction date of answer 02/11/2018 answer text <p>NHS England’s financial data for the National Health Service Proton Beam Therapy (PBT) Service Overseas programme does not differentiate between adults and children. Data for 2010 data is unavailable as this is before the creation of NHS England.</p><p> </p><p>The costs per year from 2013/14 to 2017/18 are in the following table.</p><p> </p><p>Cost of PBT Overseas patients 2013/14 to 2017/18 (£ million)</p><table><tbody><tr><td><p>2013/14</p></td><td><p>2014/15</p></td><td><p>2015/16</p></td><td><p>2016/17</p></td><td><p>2017/18</p></td></tr><tr><td><p>£9.13</p></td><td><p>£12.63</p></td><td><p>£20.81</p></td><td><p>£24.51</p></td><td><p>£22.75</p></td></tr></tbody></table><p> </p><p>This includes accommodation.</p><p> </p><p>Travel cost figures are available in the following table. It should be noted that figures are only available for 2016/17 and 2017/18.</p><p> </p><p>Cost of PBT Overseas patients travel 2013/14 to 2017/18 (£ thousand)</p><table><tbody><tr><td><p>2013/14</p></td><td><p>2014/15</p></td><td><p>2015/16</p></td><td><p>2016/17</p></td><td><p>2017/18</p></td></tr><tr><td><p> </p></td><td><p> </p></td><td><p> </p></td><td><p>£0.44</p></td><td><p>£0.50</p></td></tr></tbody></table><p><strong> </strong></p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 183920 question first answered 02/11/2018 13:36:14 answering member 4067 label Biography information for Steve Brine
tabling member	3985 label Biography information for Robert Halfon

994563

registered interest
date	25/10/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Radiotherapy: Medical Treatments Abroad
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, how much his Department spent on travel and accommodation for children taking part in the NHS Proton Beam Therapy Service Overseas programme in (a) 2010, (b) 2015, (c) 2016 and (d) 2017.
tabling member constituency	Harlow
tabling member printed	Robert Halfon
uin	183920
answer	answer is ministerial correction date of answer 02/11/2018 answer text <p>NHS England’s financial data for the National Health Service Proton Beam Therapy (PBT) Service Overseas programme does not differentiate between adults and children. Data for 2010 data is unavailable as this is before the creation of NHS England.</p><p> </p><p>The costs per year from 2013/14 to 2017/18 are in the following table.</p><p> </p><p>Cost of PBT Overseas patients 2013/14 to 2017/18 (£ million)</p><table><tbody><tr><td><p>2013/14</p></td><td><p>2014/15</p></td><td><p>2015/16</p></td><td><p>2016/17</p></td><td><p>2017/18</p></td></tr><tr><td><p>£9.13</p></td><td><p>£12.63</p></td><td><p>£20.81</p></td><td><p>£24.51</p></td><td><p>£22.75</p></td></tr></tbody></table><p> </p><p>This includes accommodation.</p><p> </p><p>Travel cost figures are available in the following table. It should be noted that figures are only available for 2016/17 and 2017/18.</p><p> </p><p>Cost of PBT Overseas patients travel 2013/14 to 2017/18 (£ thousand)</p><table><tbody><tr><td><p>2013/14</p></td><td><p>2014/15</p></td><td><p>2015/16</p></td><td><p>2016/17</p></td><td><p>2017/18</p></td></tr><tr><td><p> </p></td><td><p> </p></td><td><p> </p></td><td><p>£0.44</p></td><td><p>£0.50</p></td></tr></tbody></table><p><strong> </strong></p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 183919 question first answered 02/11/2018 13:36:14 answering member 4067 label Biography information for Steve Brine
tabling member	3985 label Biography information for Robert Halfon