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993447

	registered interest
	date	23/10/2018
	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	Flour: Folic Acid
	house id	1
	legislature	25259 pref label House of Commons
	question text	What progress he has made on implementing proposals for the mandatory fortification of flour with folic acid.
	tabling member constituency	Cumbernauld, Kilsyth and Kirkintilloch East
	tabling member printed	Stuart C. McDonald
	uin	907229
	answer	answer is ministerial correction date of answer 23/10/2018 answer text <p>The Government is continuing to review advice from our expert advisory groups on safe levels of folate intake. Alongside this, we will be issuing a public consultation on the issue of adding folic acid to flour. This will explore this complex issue in detail and allow us to take an informed decision on whether to introduce mandatory fortification of flour. We will announce the date for the consultation soon.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 23/10/2018 16:43:47 answering member 4067 label Biography information for Steve Brine
	tabling member	4393 label Biography information for Stuart C McDonald

993448

	registered interest
	date	23/10/2018
	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	Foetal Alcohol Spectrum Disorder
	house id	1
	legislature	25259 pref label House of Commons
	question text	What assessment he has made of the proportion of children born in the UK with foetal alcohol spectrum disorders in each of the last five years.
	tabling member constituency	Sefton Central
	tabling member printed	Bill Esterson
	uin	907231
	answer	answer is ministerial correction date of answer 23/10/2018 answer text <p>Foetal alcohol syndrome disorders can have a significant impact on the early years development of children, their behaviours and their life chances.</p><p>Public Health England collects some data on fetal alcohol sydrome, but we recognise that this data does not reflect the range of fetal alcohol spectrum disorders (FASD), as these are very difficult to diagnose. That is why we are engaging experts and those affected by FASD to explore what more could be done to improve our understanding.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 23/10/2018 16:44:55 answering member 4067 label Biography information for Steve Brine
	tabling member	4061 label Biography information for Bill Esterson

987817

	registered interest
	date	15/10/2018
	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	Haematological Cancer
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, whether the initiatives announced by the Prime Minister on 3 October 2018 on early detection rates for cancer include blood cancer; and if he will make a statement.
	tabling member constituency	Crawley
	tabling member printed	Henry Smith
	uin	179183
	answer	answer is ministerial correction date of answer 23/10/2018 answer text <p>NHS England is completely clear that the new 75% early diagnosis ambition announced by the Prime Minister covers all cancers, and not just the 10 currently included in the Public Health Outcomes Framework (PHOF) early diagnosis metric. NHS England is keen to work with the voluntary sector organisations and charities representing some of the other cancers not currently included in the PHOF metric on how we best measure progress towards the ambition moving forwards.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 23/10/2018 16:57:18 answering member 4067 label Biography information for Steve Brine
	tabling member	3960 label Biography information for Henry Smith

987799

	registered interest
	date	15/10/2018
	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	Air Pollution: Health Hazards
	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 assessment he has made of the effect of air quality in London on children’s health.
	tabling member constituency	Bethnal Green and Bow
	tabling member printed	Rushanara Ali
	uin	179227
	answer	answer is ministerial correction date of answer 23/10/2018 answer text <p>The Exploration of Health and Lungs in the Environment (EXHALE) programme is a London focussed study that identifies links between pollution and children’s lung health. The Department has commissioned a review on adverse birth outcomes and early life effects associated with exposure to air pollution.</p><p> </p><p>The Public Health Outcomes Framework 3.01 indicator, updated every year, provides the fraction of mortality attributable to long-term exposure to human-made particulate air pollution at local authority level which is 6.4% for the London region.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 23/10/2018 16:58:08 answering member 4067 label Biography information for Steve Brine
	tabling member	4138 label Biography information for Rushanara Ali

987882

	registered interest
	date	15/10/2018
	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	Diabetes: 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 proportion of patients with Type 1 diabetes had access to (a) an insulin pump, (b) a continuous glucose monitoring device and (c) other devices for measuring blood glucose levels in each clinical commissioning group area in the last 12 months.
	tabling member constituency	Knowsley
	tabling member printed	Mr George Howarth
	uin	179118
	answer	answer is ministerial correction date of answer 23/10/2018 answer text <p>This information is not held centrally by the Department or NHS England but is collected individually by clinical commissioning groups.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 23/10/2018 16:47:29 answering member 4067 label Biography information for Steve Brine
	tabling member	481 label Biography information for Sir George Howarth

987886

	registered interest
	date	15/10/2018
	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	Diabetes
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what guidance his Department has issued to (a) GPs, (b) GP practice nurses, (c) diabetes nurse specialists, (d) diabetologists and (e) psychology and psychiatric specialists on the treatment of Type 1 diabetes in each of the last five years.
	tabling member constituency	Knowsley
	tabling member printed	Mr George Howarth
	uin	179122
	answer	answer is ministerial correction date of answer 23/10/2018 answer text <p>The National Institute for Health and Care Excellence (NICE) has published a range of diabetes related clinical guidelines for the treatment and care for type 1 diabetes patients:</p><p>- NICE NG 3 - Diabetes in pregnancy: management from preconception to the postnatal period. Published February 2015;</p><p>- NICE NG 17 - type 1 Diabetes in adults: diagnosis and management. Published August 2015;</p><p>- NICE NG 18 - Diabetes (type 1 and type 2) in children and young people: diagnosis and management. Published August 2015; and</p><p>- NICE NG 19 - Diabetic foot problems: prevention and management. Published August 2015.</p><p> </p><p>Further supporting material for the treatment of type 1 patients can be accessed at the following link:</p><p> </p><p><a href="https://www.nice.org.uk/Search?pa=2&amp;ps=50&amp;q=Diabetes" target="_blank">https://www.nice.org.uk/Search?pa=2&amp;ps=50&amp;q=Diabetes</a></p><p> </p><p>NHS England also issued advice in January 2018 to support a consistent approach to the availability of blood glucose monitoring systems and related technologies for people with type 1 diabetes at the following link:</p><p> </p><p><a href="https://www.england.nhs.uk/publication/blood-glucose-monitoring-systems/" target="_blank">https://www.england.nhs.uk/publication/blood-glucose-monitoring-systems/</a></p><p> </p><p>Although this advice was targeted at clinical commissioning groups, consistent approaches will support specialist diabetes staff and primary care staff to effectively manage and support their patients.</p><p> </p><p>NHS England has issued a NHS Right Care diabetes pathway to support local improvement by defining the core components of an optimal diabetes service for people with diabetes which should support better value in terms of outcomes and cost. This is available at the following link:</p><p> </p><p><a href="https://www.england.nhs.uk/rightcare/products/pathways/diabetes-pathway/" target="_blank">https://www.england.nhs.uk/rightcare/products/pathways/diabetes-pathway/</a></p><p> </p><p>On 21 March 2018 NHS England and NHS Improvement, along with the National Collaboration Institute for Mental Health published the Improving Access to Psychological Therapies pathway for people with long-term physical health conditions and medically unexplained symptoms which provides evidence based treatments for people with anxiety and depression (implementing NICE guidelines).</p><p><strong> </strong></p><p><strong> </strong></p> answering member constituency Winchester answering member printed Steve Brine question first answered 23/10/2018 16:53:49 answering member 4067 label Biography information for Steve Brine
	tabling member	481 label Biography information for Sir George Howarth

987887

	registered interest
	date	15/10/2018
	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	Diabetes: 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 assessment he has made of the potential merits of the use of artificial pancreas devices for the treatment of people with Type 1 diabetes.
	tabling member constituency	Knowsley
	tabling member printed	Mr George Howarth
	uin	179123
	answer	answer is ministerial correction date of answer 23/10/2018 answer text <p>Artificial pancreas devices are an emerging technology. The Medtronic 670G, currently available in the United States of America, is also soon to become available in the United Kingdom. This is a hybrid artificial pancreas device that provides some automated insulin delivery between meals and overnight, but still requires manual insulin delivery with food. Some supporting data are available which suggest that the device can increase the time period in which glucose values are within target range.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 23/10/2018 16:54:12 answering member 4067 label Biography information for Steve Brine
	tabling member	481 label Biography information for Sir George Howarth

990259

	registered interest
	date	18/10/2018
	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	Buprenorphine
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what assessment he has made of the effect on access to Buprenorphine of the recent increase in the price of that drug.
	tabling member constituency	Leicester South
	tabling member printed	Jonathan Ashworth
	uin	181221
	answer	answer is ministerial correction date of answer 23/10/2018 answer text <p>As a consequence of a supply issue affecting buprenorphine earlier this year, some suppliers of buprenorphine have run out of stock and the market price has been increasing since May 2018. Although supplies continued to remain available from other suppliers, we are aware that some may have struggled to support the increase in demand at short notice. The delivery issues were resolved quickly and the overall supply of buprenorphine tablets improved shortly afterwards.</p><p> </p><p>Since this period, the Department has remained in regular contact with all United Kingdom licensed suppliers of buprenorphine and has been working closely with them to monitor their supply position. Based on these conversations, we have been assured that the available supplies are sufficient to meet the usual UK requirements for this drug. The Department continues to monitor this very closely.</p><p> </p><p>The increased purchase price is reflected in the reimbursement price paid to pharmacies, to ensure that supplies remain available to patients. The market for buprenorphine has generally been competitive and we expect the supply situation to improve over the coming weeks which is likely to result in an increasingly competitive market.</p><p><strong> </strong></p> answering member constituency Winchester answering member printed Steve Brine question first answered 23/10/2018 16:41:59 answering member 4067 label Biography information for Steve Brine
	tabling member	4244 label Biography information for Jonathan Ashworth

990404

	registered interest
	date	18/10/2018
	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
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what (a) financial support and (b) other resources his Department has provided to Cancer Alliances for long-term planning for breast cancer care.
	tabling member constituency	Newcastle upon Tyne North
	tabling member printed	Catherine McKinnell
	uin	181271
	answer	answer is ministerial correction date of answer 23/10/2018 answer text <p>NHS England provides funding, support and guidance to Cancer Alliances to ensure the delivery of improvements in early and faster diagnosis and quality of life for people living with and beyond cancer, including breast cancer patients.</p><p>For this year, all Cancer Alliances have agreed plans in place for using transformation funding, focused on the delivery of NHS England’s 2018/19 Planning Guidance priorities. As part of these plans, Alliances will:</p><p>- progress towards the 2020/21 ambition for all breast cancer patients to move to a stratified follow-up pathway after treatment; and</p><p>- have in place clinically agreed protocols for stratifying breast cancer patients and a system for remote monitoring by the end of 2018/19.</p><p>In addition to transformation funding, support that all Cancer Alliances will receive in 2018/19 to transform care for their cancer patients includes:</p><p>- dedicated support from the National Cancer Programme’s analysis, evidence and data service;</p><p>- support and assurance from NHS England regional offices;</p><p>- a tailored programme of leadership development; and</p><p>- a series of national events to share best practice and information across Cancer Alliances.</p><p>More information about the levels of transformation funding received by each Cancer Alliance in 2018/19, and how they are using this to improve cancer care, can be found on NHS England’s website at the following link:</p><p> </p><p><a href="https://www.england.nhs.uk/cancer/improve/cancer-alliances-improving-care-locally/nhs-england-support-and-funding-for-cancer-alliances/" target="_blank">https://www.england.nhs.uk/cancer/improve/cancer-alliances-improving-care-locally/nhs-england-support-and-funding-for-cancer-alliances/</a></p><p> </p><p> </p><p><strong> </strong></p> answering member constituency Winchester answering member printed Steve Brine question first answered 23/10/2018 16:45:11 answering member 4067 label Biography information for Steve Brine
	tabling member	4125 label Biography information for Catherine McKinnell

990352

	registered interest
	date	18/10/2018
	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	Cannabis: Medical Treatments
	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 steps to allow patients to have access to NHS doctors willing to prescribe cannabis-based medicine in cases where their NHS doctor is unwilling to do so.
	tabling member constituency	Cardiff West
	tabling member printed	Kevin Brennan
	uin	181179
	answer	answer is ministerial correction date of answer 23/10/2018 answer text <p>NHS England expects that cannabis-based products for medicinal use should only be prescribed for indications where there is clear evidence of benefit, and in patients where there is a clinical need which cannot be met by a licensed medicine and, where established treatment options have been exhausted.</p><p> </p><p>The decision to prescribe these unlicensed medicines must be made by a specialist doctor – not a general practitioner. These doctors focus on one field of medicine such as neurology or paediatrics and are listed on the General Medical Council’s specialist register. They must make decisions on prescribing cannabis-based products for medicinal use on a case by case basis, and only when the patient has an unmet special clinical need that cannot be met by licensed products. In addition, a specialist on the General Medical Council Register should only prescribe within their own area of practice, and the decision to prescribe should be agreed by the multidisciplinary team.</p><p> </p><p>NHS England, the British Paediatric Neurology Association and the Royal College of Physicians will provide clinical advice to doctors ahead of the law change. The National Institute for Health and Care Excellence has been commissioned to develop more detailed guidelines for clinicians in the longer term.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 23/10/2018 16:43:24 answering member 4067 label Biography information for Steve Brine
	tabling member	1400 label Biography information for Kevin Brennan