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1139909

registered interest
date	17/07/2019
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	Social Security Benefits: Haemochromatosis
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what recent steps he has taken to improve her Department's support for people with haemochromatosis in (a) England and (b) Yorkshire and the Humber.
tabling member constituency	Leeds North West
tabling member printed	Alex Sobel
uin	278593
answer	answer is ministerial correction date of answer 22/07/2019 answer text <p>Services for patients with genetic haemochromatosis are commissioned locally through clinical commissioning groups (CCGs) which have a statutory responsibility to commission services which meet the needs of their local population. For example, Leeds CCG commissions the consultant led haematology service at Leeds Teaching Hospitals, which includes support for haemochromatosis. Sustainability and transformation partnerships (STPs) are enabling service coordination across wider footprints and the NHS Long Term Plan sets out the ambition for all STPs to evolve into integrated care systems (ICSs) by April 2021. ICSs are an ‘evolved’ form of a STP, making faster progress in integrating care across their area, bringing together organisations to provide more seamless care for patients.</p><p>The Government is committed to making the United Kingdom a leader in embedding genomics in healthcare and offer a consistent, world class approach to the genetic identification of rare diseases, including genetic hemochromatosis. The Genomics Medicine Service was announced in October 2018, supported by the National Genomic Test Directory which specifies which genomic tests are commissioned by the NHS in England, the technology by which they are available, and the patients who will be eligible to access a test. Genetic haemochromatosis is included in the National Genomic Test Directory.</p><p> </p><p><strong> </strong></p><p> </p><p> </p> answering member constituency Gosport answering member printed Caroline Dinenage question first answered 22/07/2019 16:27:07 answering member 4008 label Biography information for Dame Caroline Dinenage
tabling member	4658 label Biography information for Alex Sobel

1139911

registered interest
date	17/07/2019
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	Post-traumatic Stress Disorder: Veterans
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 his Department has taken to improve support for ex-military personnel with post-traumatic stress disorder.
tabling member constituency	Leeds North West
tabling member printed	Alex Sobel
uin	278594
answer	answer is ministerial correction date of answer 22/07/2019 answer text <p>In addition to mainstream mental health services, NHS England commissions two bespoke services for veterans experiencing mental health difficulties.</p><p>The first is the Transition, Intervention and Liaison Service (TILS) which supports serving personnel who need additional support as they are leaving the armed forces and veterans who have mental health issues. The TILS is also the entry point to the Complex Treatment Service (CTS), the second service commissioned by NHS England. The CTS is able to provide a range of more intensive care and treatment for veterans with military related complex mental health difficulties, many of whom will have experienced trauma. Veterans can often access bespoke and quicker referral pathways such as TILS, which is commissioned to provide an initial assessment within two weeks.</p><p>In December last year, NHS England also announced an extra £10 million to expand the already established Veterans’ Mental Health TILS and the Veterans’ Mental Health CTS, as well as seeking to close the gaps in current mental health provision to capture those individuals that are nearing crisis.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price question first answered 22/07/2019 16:08:41 answering member 4065 label Biography information for Dame Jackie Doyle-Price
tabling member	4658 label Biography information for Alex Sobel

1137511

registered interest
date	08/07/2019
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
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what plans he has in place to ensure that every cancer patient who would benefit from radiotherapy is able to access that treatment.
tabling member constituency	Leeds North West
tabling member printed	Alex Sobel
uin	274632
answer	answer is ministerial correction date of answer 16/07/2019 answer text <p>The NHS Long Term Plan reaffirmed the commitment to modernise radiotherapy, as well as making specific commitments to commission the National Health Service new state-of-the-art Proton Beam facilities in London and Manchester. The plan also committed to reforming the specialised commissioning payments for radiotherapy hypofractionation to support further equipment upgrades.</p><p>The Long Term Plan also set out NHS England’s commitment to review the National Tariff, in particular to ensure that appropriate incentives are in place to encourage providers to deliver modern techniques, including hypofractionation, and to upgrade and replace equipment.</p><p>Over the last two years, £130 million has been invested in modernising radiotherapy equipment, with over 80 machines funded for replacement or upgrade across the country since October 2016.</p><p> </p><p> </p><p><strong> </strong></p><p><strong> </strong></p> answering member constituency South Ribble answering member printed Seema Kennedy question first answered 16/07/2019 14:37:11 answering member 4455 label Biography information for Seema Kennedy
tabling member	4658 label Biography information for Alex Sobel

1128955

registered interest
date	03/06/2019
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	Antibiotics: Rivers
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 reduce the concentration of antibiotics in UK rivers.
tabling member constituency	Leeds North West
tabling member printed	Alex Sobel
uin	259425
answer	answer is ministerial correction date of answer 06/06/2019 answer text <p>The United Kingdom’s national action plan for antimicrobial resistance (AMR), published on 24 January 2019, takes a fully integrated and comprehensive One-Health approach for tackling AMR, and includes challenging five-year commitments across human and animal health, agriculture, the environment and food.</p><p>Without more research into AMR in the environment we cannot design effective interventions to minimise risk and protect public health, food production and natural ecosystems. The national action plan therefore includes commitments to deepen our understanding about AMR in the environment, including a specific commitment to explore the establishment of a river catchment-based research programme with clear standards for sample collection, analysis and review, with the aim of delivering AMR monitoring data that can be used to evaluate existing management interventions and inform new policy initiatives.</p><p>The Environment Agency is working with the Department for Environment, Food and Rural Affairs and water companies to undertake an extensive programme of investigations to assess a wide range of chemicals entering rivers through wastewater treatment works. As part of this programme, levels of four antibiotics have been monitored in treated sewage effluent in order to quantify levels. The choice of antibiotics was based on the levels of prescription and environmental toxicity studies. Outputs will inform the development of future policy and regulatory decisions.</p><p>The Department is establishing a UK AMR national action plan delivery board which will drive and oversee delivery of this work.</p><p><strong> </strong></p> answering member constituency South Ribble answering member printed Seema Kennedy question first answered 06/06/2019 13:21:36 answering member 4455 label Biography information for Seema Kennedy
tabling member	4658 label Biography information for Alex Sobel

1122120

registered interest
date	18/04/2019
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	Heart Diseases: Health Services
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 his Department is taking to prepare cardiac units for the UK leaving the EU without a deal.
tabling member constituency	Leeds North West
tabling member printed	Alex Sobel
uin	245973
answer	answer is ministerial correction date of answer 30/04/2019 answer text <p>We have now reached agreement with the European Union on an extension until 31 October 2019 at the latest, with the option to leave earlier as soon as a deal has been ratified. Although Parliament has rejected leaving without a deal multiple times, this remains the legal default at the end of the extension period, unless a deal is passed by Parliament.</p><p>In light of the extension, Departments will make sensible decisions about the timing and pace at which some of this work is progressing, but we will continue to prepare for all exit scenarios. We remain focused on ensuring our smooth and orderly withdrawal from the EU with a deal as soon as possible.</p><p>The Department is considering the impact on our EU exit preparations and we are working closely with our stakeholders to review our position.</p><p>While we never give guarantees, we are confident that, if everyone does what they need to do, the supply of medicines and medical products, including for supplies of clinical trials and investigations, will be uninterrupted in the event we leave the EU without a deal.</p><p>In terms of EU exit preparations for local National Health Service organisations, on 18 April 2019 Professor Keith Willett, EU Exit Strategic Commander at NHS England and NHS Improvement, wrote to clinical commissioning group and trust Chief Executives to update them on the further extension to Article 50, and the actions that now need to be taken locally to continue to prepare for the United Kingdom’s exit from the EU. Further details are available in Professor Willett’s letter that NHS England and NHS Improvement has published online at the following link:</p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2019/04/20130418-KW-EU-exit-letter-final-.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2019/04/20130418-KW-EU-exit-letter-final-.pdf</a></p><p>These actions will also apply to cardiac units as they are within trusts.</p> answering member constituency Wimbledon answering member printed Stephen Hammond question first answered 30/04/2019 10:04:54 answering member 1585 label Biography information for Stephen Hammond
tabling member	4658 label Biography information for Alex Sobel

1105241

registered interest
date	26/03/2019
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	Cerliponase Alfa
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 make Cerliponase alfa, marketed as Brineura, available on the NHS for the treatment of ceroid lipofuscinosis type 2.
tabling member constituency	Leeds North West
tabling member printed	Alex Sobel
uin	237175
answer	answer is ministerial correction date of answer 02/04/2019 answer text <p>The National Institute for Health and Care Excellence (NICE) is currently developing highly specialised technology (HST) guidance on Brineura (cerliponase alfa) for treating neuronal ceroid lipofuscinosis type 2. Further information can be found at the following link:</p><p> </p><p><a href="https://www.nice.org.uk/guidance/indevelopment/gid-hst10008" target="_blank">https://www.nice.org.uk/guidance/indevelopment/gid-hst10008</a></p><p> </p><p>Through its HST programme, NICE makes recommendations on whether very high cost drugs for very small numbers of patients represent an effective use of the National Health Service resources. NHS England is required to fund medicines recommended in NICE’s HST guidance, normally within three months of the publication of final guidance.</p><p> </p><p>In the absence of positive guidance from NICE, it is for commissioners to make decisions on whether to fund this treatment based on an assessment of the available evidence.</p> answering member constituency Gosport answering member printed Caroline Dinenage question first answered 02/04/2019 15:46:55 answering member 4008 label Biography information for Dame Caroline Dinenage
tabling member	4658 label Biography information for Alex Sobel

1104818

registered interest
date	25/03/2019
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	Lumacaftor/ivacaftor
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 his Department is taking to secure a deal with Vertex on access for patients to the drug Orkambi on the NHS.
tabling member constituency	Leeds North West
tabling member printed	Alex Sobel
uin	236525
answer	answer is ministerial correction date of answer 01/04/2019 answer text <p>The National Institute for Health and Care Excellence (NICE) and NHS England are leading the dialogue with Vertex Pharmaceuticals on access to their portfolio of cystic fibrosis medicines, including Orkambi.</p><p> </p><p>The Government fully supports the approach that NICE and NHS England are adopting. It is crucial that patients have access to the most effective and innovative medicines at a price that represents value to the NHS.</p><p> </p><p>My Rt. hon. Friend the Secretary of State for Health and Social Care held a meeting on 11 March with all the parties to discuss how best to reach a deal so that people with cystic fibrosis and their families can benefit as soon as possible. Vertex, NICE and NHS England subsequently met on Thursday 21 March and have agreed to continue discussions.</p> answering member constituency Gosport answering member printed Caroline Dinenage question first answered 01/04/2019 11:40:40 answering member 4008 label Biography information for Dame Caroline Dinenage
tabling member	4658 label Biography information for Alex Sobel

1104821

registered interest
date	25/03/2019
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	Hospitals: Yorkshire and the Humber
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what recent steps his Department has taken to reduce waiting times (a) for NHS operations and (b) between admission and treatment at A&E in Yorkshire and the Humber.
tabling member constituency	Leeds North West
tabling member printed	Alex Sobel
uin	236528
answer	answer is ministerial correction date of answer 01/04/2019 answer text <p>Positive work has been delivered within Leeds Teaching Hospitals NHS Trust as well as the wider Leeds health and social care economy. Through this, significant improvements have been seen over the past 12 months, including over the winter period. Over winter, these improvements have included:</p><p>- A significant reduction in the the number of patients waiting longer than 52 weeks for operations;</p><p>- A 10% increase in the number of patients seen within four hours in emergency departments in February, compared to previous year; and</p><p>- Zero 12-hour breaches within emergency departments.</p><p> </p><p>In addition to this, further service improvements made across hospitals in the area over the last 12 months have included modelling to predict surges in demand, extra consultant presence in the emergency department and work to discharge patients earlier in the day.</p> answering member constituency Wimbledon answering member printed Stephen Hammond question first answered 01/04/2019 15:25:53 answering member 1585 label Biography information for Stephen Hammond
tabling member	4658 label Biography information for Alex Sobel

1104822

registered interest
date	25/03/2019
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	Cerliponase Alfa
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 make Brineura accessible to sufferers of Batten disease.
tabling member constituency	Leeds North West
tabling member printed	Alex Sobel
uin	236529
answer	answer is ministerial correction date of answer 28/03/2019 answer text <p>The National Institute for Health and Care Excellence (NICE) is currently developing guidance on Brineura (cerliponase alfa) for treating neuronal ceroid lipofuscinosis type 2 through the highly specialised technology (HST) programme. Further information can be found at the following link:</p><p> </p><p><a href="https://www.nice.org.uk/guidance/indevelopment/gid-hst10008" target="_blank">https://www.nice.org.uk/guidance/indevelopment/gid-hst10008</a></p><p> </p><p>Through its HST programme, NICE makes recommendations on whether very high cost drugs for very small numbers of patients represent an effective use of National Health Service resources. NHS England is required to fund medicines recommended in NICE’s HST guidance, normally within three months of the publication of final guidance.</p><p> </p><p>In the absence of positive guidance from NICE, it is for commissioners to make decisions locally on whether to fund this treatment based on an assessment of the available evidence, and in consultation with the patient.</p> answering member constituency Gosport answering member printed Caroline Dinenage question first answered 28/03/2019 15:15:01 answering member 4008 label Biography information for Dame Caroline Dinenage
tabling member	4658 label Biography information for Alex Sobel

1088695

registered interest
date	14/03/2019
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 Diseases: Medical Equipment
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 increase (a) patient and (b) clinician awareness of the (i) effect on carbon emissions of inhalers and (ii) range of low carbon inhalers available; and how he plans to measure progress on the increased use of low carbon inhalers in the NHS.
tabling member constituency	Leeds North West
tabling member printed	Alex Sobel
uin	232644
answer	answer is ministerial correction date of answer 21/03/2019 answer text <p>The Sustainable Development Unit (SDU), a joint NHS England and Public Health England unit, has established a cross sector working group on low carbon inhalers. The group includes representation from a number of patient and clinician groups, as well as cross Government representation.</p><p> </p><p>A cross system approach is now being developed into a system wide implementation plan, with specific actions being delivered by individual members of the group. All actions are supporting progress towards or exceed the NHS Long Term Plan commitment on low carbon inhalers. This will contribute to the overall National Health Service commitment in the Long Term Plan to reduce carbon emissions in line with the UK Climate Change Act.</p><p> </p><p>The SDU is also engaging centrally with systematic data collection and data provision systems for clinicians and local system leaders to help ensure that clinical and strategic decision makers are aware how their local area is performing with regards to achieving the national targets in the Long Term Plan and what options are available for them to further reduce the carbon emissions of local prescribing and inhaler waste management practice.</p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 232504 question first answered 21/03/2019 17:05:52 answering member 4067 label Biography information for Steve Brine
tabling member	4658 label Biography information for Alex Sobel