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1139574

	registered interest
	date	16/07/2019
	answering body	Ministry of Defence
	answering dept id	11
	answering dept short name	Defence
	answering dept sort name	Defence
	hansard heading	Armed Forces: Mefloquine
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government, further to the Written Answer by Baroness Blackwood of North Oxford on 10 July (HL16834), what steps the Ministry of Defence has taken to address the concerns of the European Medicines Agency Pharmacovigilance Assessment Committee 2014 report on the toxicity of mefloquine (Lariam); and if they have not taken any such steps, why not.
	tabling member printed	The Countess of Mar
	uin	HL17221
	answer	answer is ministerial correction date of answer 22/07/2019 answer text <p>Anti-malarial drugs are prescribed to Service personnel with the UK product information leaflet. For mefloquine, this reflects the recommendations of the Pharmacovigilance Risk Assessment Committee of the European Medicines Agency.</p><p>All anti-malarial drugs have contraindications and a side effect profile which can be found in the British National Formulary or online at the Electronic Medicines Compendium. It is Ministry of Defence policy that healthcare professionals undertake a health risk assessment and to warn patients of the possible side effects of any anti-malarial drug.</p> answering member printed Earl Howe question first answered 22/07/2019 16:22:24 answering member 2000 label Biography information for Earl Howe
	tabling member	1861 label Biography information for The Countess of Mar

1135744

	registered interest
	date	01/07/2019
	answering body	Ministry of Defence
	answering dept id	11
	answering dept short name	Defence
	answering dept sort name	Defence
	hansard heading	Malaria: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether the health and wellbeing of all participants in the Surgeon-General’s 2016–17 research study on anti-malarial chemoprophylaxis (Ref: 713/MoDREC/15) was monitored to ensure that all adverse events occurring during the study were reported to the Medicines and Healthcare products Regulatory Agency (MHRA); whether participants have been monitored following the study to ensure that any adverse events that have occurred since are being reported to the MHRA; and what assessment they have made of whether suitable treatment is available to those participants suffering adverse events.
	tabling member printed	The Countess of Mar
	uin	HL16837
	answer	answer is ministerial correction date of answer 08/07/2019 answer text <p>Adverse events are reported to the Medicines and Healthcare products Regulatory Agency (MHRA) using the Yellow card scheme and can be undertaken by a healthcare professional or the individual experiencing the adverse effect. The demographics required by the Yellow card scheme do not include the occupation of the subject, so military personnel are not uniquely identified.</p><p>The aims of the &quot;713/MoDREC/15&quot; study do not include assessing whether individuals or their healthcare professional reported side effects to the MHRA or to follow-up whether any person experiencing side effects required any form of treatment, including an assessment of whether suitable treatment was available. Data collated in the study is self-reported by individuals and any symptoms reported may not necessarily be related to the anti-malarial taken.</p> answering member printed Earl Howe question first answered 08/07/2019 16:39:39 answering member 2000 label Biography information for Earl Howe
	tabling member	1861 label Biography information for The Countess of Mar

971901

	registered interest
	date	11/09/2018
	answering body	Ministry of Defence
	answering dept id	11
	answering dept short name	Defence
	answering dept sort name	Defence
	hansard heading	Armed Forces: Mefloquine
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government when they intend to publish the results of the research into the side effects of malaria chemo-prophylaxis referred to in their second and third six-monthly progress updates to the House of Commons Defence Committee on its report An acceptable risk? The use of Lariam for military personnel, published on 24 May 2016.
	tabling member printed	The Countess of Mar
	uin	HL10263
	answer	answer is ministerial correction date of answer 24/09/2018 answer text <p>Data collection for this research has been completed and data cleansing, analysis and production of a report is under way, with completion anticipated in 2019.</p> answering member printed Earl Howe question first answered 24/09/2018 13:49:15 answering member 2000 label Biography information for Earl Howe
	tabling member	1861 label Biography information for The Countess of Mar

825297

	registered interest
	date	17/01/2018
	answering body	Ministry of Defence
	answering dept id	11
	answering dept short name	Defence
	answering dept sort name	Defence
	hansard heading	Armed Forces: Mefloquine
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether they intend that an addendum should be added to the Defence Mental Health and Wellbeing Strategy Report 2017–2022 in order to address the effects of neurotoxicity from mefloquine; if so, when it will be published; and if not, why not.
	tabling member printed	The Countess of Mar
	uin	HL4830
	answer	answer is ministerial correction date of answer 30/01/2018 answer text <p>Mefloquine is effective in the prevention and treatment of malaria and is licensed for use by the Medicines and Healthcare products Regulatory Agency, which regulates medication in the UK. Bodies such as the Advisory Committee on Malaria Prevention, the World Health Organization and the United States Centers for Disease Control and Prevention continue to include mefloquine as an option for malaria chemoprophylaxis.</p><p> </p><p>The current product information for mefloquine states that neuropsychiatric adverse reactions may occur during treatment and includes warnings and precautions to minimise these risks. It also states that such adverse reactions may persist for months, or longer, even after discontinuation of the drug. It has not been established, however, that such adverse reactions may be permanent.</p><p> </p><p>For these reasons, there are no plans to add an addendum to the Defence Mental Health and Wellbeing Strategy Report 2017-2022.</p> answering member printed Earl Howe grouped question UIN HL4829 question first answered 30/01/2018 16:55:22 answering member 2000 label Biography information for Earl Howe
	tabling member	1861 label Biography information for The Countess of Mar

825296

	registered interest
	date	17/01/2018
	answering body	Ministry of Defence
	answering dept id	11
	answering dept short name	Defence
	answering dept sort name	Defence
	hansard heading	Armed Forces: Mefloquine
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government whether the Surgeon General of Her Majesty’s Armed Forces recognises the chronic neurotoxic effects on members of the Armed Forces and Veterans from the administration of mefloquine (Lariam); and whether they will be addressing the problems caused by those effects in the near future.
	tabling member printed	The Countess of Mar
	uin	HL4829
	answer	answer is ministerial correction date of answer 30/01/2018 answer text <p>Mefloquine is effective in the prevention and treatment of malaria and is licensed for use by the Medicines and Healthcare products Regulatory Agency, which regulates medication in the UK. Bodies such as the Advisory Committee on Malaria Prevention, the World Health Organization and the United States Centers for Disease Control and Prevention continue to include mefloquine as an option for malaria chemoprophylaxis.</p><p> </p><p>The current product information for mefloquine states that neuropsychiatric adverse reactions may occur during treatment and includes warnings and precautions to minimise these risks. It also states that such adverse reactions may persist for months, or longer, even after discontinuation of the drug. It has not been established, however, that such adverse reactions may be permanent.</p><p> </p><p>For these reasons, there are no plans to add an addendum to the Defence Mental Health and Wellbeing Strategy Report 2017-2022.</p> answering member printed Earl Howe grouped question UIN HL4830 question first answered 30/01/2018 16:55:22 answering member 2000 label Biography information for Earl Howe
	tabling member	1861 label Biography information for The Countess of Mar

788920

	registered interest
	date	14/11/2017
	answering body	Ministry of Defence
	answering dept id	11
	answering dept short name	Defence
	answering dept sort name	Defence
	hansard heading	Armed Forces: Mefloquine
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what assessment they have made of neurotoxicity resulting from the administration of mefloquine to military personnel; and what steps they have taken to ensure that veterans suffering from mental health problems are not given drugs that may exacerbate their illness due to a reaction with mefloquine.
	tabling member printed	The Countess of Mar
	uin	HL3229
	answer	answer is ministerial correction date of answer 22/11/2017 answer text <p>There is no established evidence of prophylactic drugs having long-term side effects causing mental health issues.</p><p>The Royal College of Psychiatrists' 'Good Psychiatric Practice' report states clinicians must &quot;be competent in obtaining a full and relevant history that incorporates developmental, psychological, social, cultural and physical factors&quot;. This includes the consideration and assessment of the effect of medication and the circumstances in which it is being prescribed.</p> answering member printed Earl Howe question first answered 22/11/2017 16:15:55 answering member 2000 label Biography information for Earl Howe
	tabling member	1861 label Biography information for The Countess of Mar

788919

	registered interest
	date	14/11/2017
	answering body	Ministry of Defence
	answering dept id	11
	answering dept short name	Defence
	answering dept sort name	Defence
	hansard heading	Armed Forces: Medical Records
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what steps they have taken to ensure that the medical histories of all military personnel are accurate and complete and that Post Traumatic Stress Disorder is accurately diagnosed.
	tabling member printed	The Countess of Mar
	uin	HL3228
	answer	answer is ministerial correction date of answer 22/11/2017 answer text <p>Under national medical and professional body regulations and guidelines, there is a duty on health professionals to maintain accurate and comprehensive records. The Ministry of Defence (MOD) has a number of governance and other processes to ensure the accuracy and quality of the medical records of serving Armed Forces personnel. On discharge from Service, an individual's medical record is routinely checked before their care is passed to the NHS or equivalent primary healthcare services.</p><p>Every effort is made to correctly identify Armed Forces personnel with Post-Traumatic Stress Disorder (PTSD). When PTSD symptoms are recognised by a Defence Primary Care clinician it triggers a referral to an MOD Department of Community Mental Health. An assessment is then conducted by a nurse, psychiatrist or psychologist. The diagnosis of PTSD can only be confirmed by a consultant psychiatrist or psychologist and a nurse will request their review of the case to confirm the diagnosis.</p> answering member printed Earl Howe question first answered 22/11/2017 16:15:01 answering member 2000 label Biography information for Earl Howe
	tabling member	1861 label Biography information for The Countess of Mar

476484

	registered interest
	date	15/03/2016
	answering body	Ministry of Defence
	answering dept id	11
	answering dept short name	Defence
	answering dept sort name	Defence
	hansard heading	Gulf War Syndrome
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government, further to the Written Answer by Earl Howe on 15 March (HL6835), whether they accept the findings of the Boston University School of Public Health that research "clearly and consistently" shows that exposure to pesticides and other toxins caused Gulf War Illness, and whether they are aware of any criticisms of this study that have been published following scientific peer review.
	tabling member printed	The Countess of Mar
	uin	HL7060
	answer	answer is ministerial correction date of answer 22/03/2016 answer text <p>The paper published by the Boston University School of Public Health is not new research but a review of the published peer-reviewed literature on the health of 1990-91 Gulf War veterans, notably that which has been published since 2008. We have carefully considered the paper, its findings and conclusions, and cannot agree that the review and studies cited demonstrate a causal association between pesticides and other exposures and Gulf War illness or specific diagnoses. We are not aware of any comments on the Boston University paper, either critical or in support.</p> answering member printed Earl Howe question first answered 22/03/2016 17:01:10 answering member 2000 label Biography information for Earl Howe
	tabling member	1861 label Biography information for The Countess of Mar

458683

	registered interest
	date	08/03/2016
	answering body	Ministry of Defence
	answering dept id	11
	answering dept short name	Defence
	answering dept sort name	Defence
	hansard heading	Gulf War Syndrome
	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 finding in the report from the Boston University School of Public Health in <i>Cortex</i> that research "clearly and consistently" shows that exposure to pesticides and other toxins caused Gulf War Illness; and what bearing that report will have on the treatment of sick Gulf War veterans.
	tabling member printed	The Countess of Mar
	uin	HL6835
	answer	answer is ministerial correction date of answer 15/03/2016 answer text <p>The Government greatly values the service of all 1990-91 Gulf War veterans. We have long accepted that the ill-health of some veterans of the 1990-91 Gulf War may be associated with their service in the Gulf. In such cases, and where a link is proven, compensation may be claimed under the War Pensions Scheme, with appropriate medical care provided by the National Health Service across the UK.</p><p>The Department has funded extensive research into Gulf War illness including some research into rehabilitative therapies for those veterans with persistent symptoms. Our strategy on research topics and studies has been informed and overseen by independent scientific experts nominated by the Medical Research Council, taking account of published peer-reviewed international literature and international studies. We have no plans to undertake further research on Gulf War issues. We continue to monitor any Gulf War research that is published around the world, including in the United States.</p> answering member printed Earl Howe question first answered 15/03/2016 17:07:04 answering member 2000 label Biography information for Earl Howe
	tabling member	1861 label Biography information for The Countess of Mar

228976

	registered interest
	date	23/03/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Pharmacy
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what will be the position of patients, previously served by a dispensing doctor practice, who live within 1.6 km of a pharmacy that closes, but still retains its licence, as a result of the closure of the Essential Small Pharmacies Scheme on 1 April 2015.
	tabling member printed	The Countess of Mar
	uin	HL5941
	answer	answer is ministerial correction date of answer 25/03/2015 answer text <p>The ending of the essential small pharmacy local pharmaceutical services scheme on 31 March 2015 does not require such pharmacies to close. That is a decision for the individual contractor concerned. They may decide to return to the main National Health Service pharmaceutical list and come under the terms of the national community pharmacy contractual framework. Alternatively, they can decide to submit a proposal to NHS England to provide local pharmaceutical services. NHS England is working with individual providers of essential small pharmacies to ensure people in affected communities can continue to access appropriate NHS pharmaceutical services. However, if an essential small pharmacy – or any other type of pharmacy - did decide to close, it would no longer be able to provide NHS pharmaceutical services.</p><p> </p><p> </p><p> </p><p>Patients can at any time request in writing that a doctor provides them with NHS pharmaceutical services. Applications should be made via the doctor to the appropriate NHS England office. To be eligible to receive dispensing services from a doctor, a patient must meet certain criteria, such as having serious difficulty obtaining services from a pharmacy or the patient lives in a designated rural area, more than 1.6 kilometres from the nearest pharmacy. These criteria are set out in Regulation 48 of the National Health Services (Pharmaceutical Services and Local Pharmaceutical Services) Regulations 2013 – SI 2013/349. A patient must also be on the doctor’s patient list, or the patient list of the practice at which the doctor provides or performs primary medical services, and the practice must be authorised by NHS England to provide NHS dispensing services.</p><p> </p> answering member printed Earl Howe question first answered 25/03/2015 16:21:09 answering member 2000 label Biography information for Earl Howe
	tabling member	1861 label Biography information for The Countess of Mar