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800571

	registered interest
	date	04/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Neuromuscular Disorders
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what assessment he has made of the (a) extent and (b) effect on patient care of variation in specialist services for multiple sclerosis and Parkinson's among clinical commissioning groups in England.
	tabling member constituency	York Outer
	tabling member printed	Julian Sturdy
	uin	117192
	answer	answer is ministerial correction date of answer 12/12/2017 answer text <p>We know that variation exists between clinical commissioning groups (CCGs) in the provision of care for neurological conditions, such as Parkinson’s disease and multiple sclerosis. Whilst it is right that CCGs have autonomy to shape services for local populations, there is a range of work ongoing at a national level to identify unwarranted variation in order to drive improvement, including:</p><p> </p><p>- Through the RightCare programme, which was rolled out to every CCG in 2016/17, NHS England provides practical support to commissioners to tackle unwarranted variation and identify improvements and savings, including for neurological services;</p><p>- Public Health England’s Neurology intelligence network collates and interprets data on adult neurological conditions to provide intelligence for the National Health Service, policy makers, and clinicians; and</p><p>- The Getting it Right First Time programme, supported by NHS Improvement, expanded earlier in 2017 to include neurology and will soon provide insight to demonstrate the value of better neurological services both in hospitals and in the community.</p><p> </p><p>NHS England will continue to work with the Neurological Alliance (an umbrella organisation for neurological condition charities) to support the new national Neurology Advisory Group (NAG), led by consultant neurologist Professor Adrian Williams. The NAG brings together system partners, professional bodies stakeholders to align work to improve neurological care, and has working to understand how best to utilise new and emerging data in services and outcomes. More information on national initiatives to reduce unwarranted variation and drive improvement can be found at the following links:</p><p> </p><p><a href="http://www.england.nhs.uk/rightcare/" target="_blank">www.england.nhs.uk/rightcare/</a></p><p> </p><p><a href="http://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals" target="_blank">www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals</a></p><p> </p><p><a href="http://gettingitrightfirsttime.co.uk/" target="_blank">gettingitrightfirsttime.co.uk/</a></p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 117193 question first answered 12/12/2017 17:07:27 answering member 4067 label Biography information for Steve Brine
	tabling member	4079 label Biography information for Julian Sturdy

800572

	registered interest
	date	04/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Neuromuscular Disorders
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what assessment his Department has made of the potential for improved specialist services for multiple sclerosis and Parkinson's delivering significant savings for the NHS; and if he will make a statement.
	tabling member constituency	York Outer
	tabling member printed	Julian Sturdy
	uin	117193
	answer	answer is ministerial correction date of answer 12/12/2017 answer text <p>We know that variation exists between clinical commissioning groups (CCGs) in the provision of care for neurological conditions, such as Parkinson’s disease and multiple sclerosis. Whilst it is right that CCGs have autonomy to shape services for local populations, there is a range of work ongoing at a national level to identify unwarranted variation in order to drive improvement, including:</p><p> </p><p>- Through the RightCare programme, which was rolled out to every CCG in 2016/17, NHS England provides practical support to commissioners to tackle unwarranted variation and identify improvements and savings, including for neurological services;</p><p>- Public Health England’s Neurology intelligence network collates and interprets data on adult neurological conditions to provide intelligence for the National Health Service, policy makers, and clinicians; and</p><p>- The Getting it Right First Time programme, supported by NHS Improvement, expanded earlier in 2017 to include neurology and will soon provide insight to demonstrate the value of better neurological services both in hospitals and in the community.</p><p> </p><p>NHS England will continue to work with the Neurological Alliance (an umbrella organisation for neurological condition charities) to support the new national Neurology Advisory Group (NAG), led by consultant neurologist Professor Adrian Williams. The NAG brings together system partners, professional bodies stakeholders to align work to improve neurological care, and has working to understand how best to utilise new and emerging data in services and outcomes. More information on national initiatives to reduce unwarranted variation and drive improvement can be found at the following links:</p><p> </p><p><a href="http://www.england.nhs.uk/rightcare/" target="_blank">www.england.nhs.uk/rightcare/</a></p><p> </p><p><a href="http://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals" target="_blank">www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals</a></p><p> </p><p><a href="http://gettingitrightfirsttime.co.uk/" target="_blank">gettingitrightfirsttime.co.uk/</a></p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 117192 question first answered 12/12/2017 17:07:27 answering member 4067 label Biography information for Steve Brine
	tabling member	4079 label Biography information for Julian Sturdy

800513

	registered interest
	date	04/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Breast Cancer: Biosimilar Medicines
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, whether NHS England has provided any guidance to hospital trusts and clinicians on the introduction of a biosimilar of Herceptin (trastuzumab) for breast cancer.
	tabling member constituency	West Ham
	tabling member printed	Lyn Brown
	uin	117134
	answer	answer is ministerial correction date of answer 12/12/2017 answer text <p>A final date for the availability of a biosimilar of Herceptin (trastuzumab) has yet to be agreed. Therefore NHS England has not yet issued any guidance on the introduction of a biosimilar of Herceptin (trastuzumab) for breast cancer. However, NHS England has discussed the introduction and uptake of biosimilar trastuzumab with the Cancer Vanguard. The Vanguard is a group of National Health Service trusts looking at developing new models of care and providing replicable models for cancer care nationally that will act as blueprints for the NHS.</p><p> </p><p>The Cancer Vanguard will provide guidance and supporting documentation to hospital trusts and clinicians in the same way that documents were provided to support the introduction of biosimilar rituximab. Once a firm date is known, NHS trusts will be contacted regarding the availability of biosimilar trastuzumab and what they must do to ensure uptake. This will include linkages to the supporting documents issued by the Vanguard.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 12/12/2017 17:11:26 answering member 4067 label Biography information for Steve Brine
	tabling member	1583 label Biography information for Ms Lyn Brown

800800

	registered interest
	date	04/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Lung Diseases: Drugs
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how many (a) metered-dose and (b) dry powder inhalers were prescribed in England in each of the last five years.
	tabling member constituency	Wakefield
	tabling member printed	Mary Creagh
	uin	117421
	answer	answer is ministerial correction date of answer 07/12/2017 answer text <p>The number of metered dose and dry powder inhalers prescribed in England in each of the last financial years can be found in the table below:</p><p> </p><table><tbody><tr><td><p>Time Period</p></td><td><p>Metered Dose Inhalers Total Number of Items</p></td><td><p>Metered Dose Inhalers Total Number of Inhalers</p></td><td><p>Dry Powder Inhalers Total Number of Items</p></td><td><p>Dry Powder Inhalers Total Number of Inhalers</p></td></tr><tr><td><p><sup>1</sup>Financial 2012/13</p></td><td><p>16,865,011</p></td><td><p>22,200,978</p></td><td><p>6,232,791</p></td><td><p>77,106,658</p></td></tr><tr><td><p>Financial 2013/14</p></td><td><p>33,285,250</p></td><td><p>43,706,232</p></td><td><p>13,050,690</p></td><td><p>163,352,892</p></td></tr><tr><td><p>Financial 2014/15</p></td><td><p>34,896,944</p></td><td><p>45,485,666</p></td><td><p>13,796,383</p></td><td><p>170,303,819</p></td></tr><tr><td><p>Financial 2015/16</p></td><td><p>34,999,252</p></td><td><p>45,253,625</p></td><td><p>14,120,657</p></td><td><p>169,800,742</p></td></tr><tr><td><p>Financial 2016/17</p></td><td><p>35,821,122</p></td><td><p>45,780,844</p></td><td><p>14,456,394</p></td><td><p>168,747,335</p></td></tr><tr><td><p><sup>2</sup>Financial 2017/18</p></td><td><p>17,456,205</p></td><td><p>22,171,264</p></td><td><p>7,181,685</p></td><td><p>83,215,366</p></td></tr><tr><td><p>Total</p></td><td><p>173,323,784</p></td><td><p>224,598,609</p></td><td><p>68,838,600</p></td><td><p>832,526,812</p></td></tr></tbody></table><p> </p><p>Notes:</p><p> </p><p><sup>1</sup>Financial 2012/13 covers time period October 2012 to March 2013</p><p> </p><p><sup>2</sup>Financial 2017/18 covers time period April 2017 to September 2017</p><p> </p><p>This information has been provided by the NHS Business Services Authority.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 07/12/2017 17:50:30 answering member 4067 label Biography information for Steve Brine
	tabling member	1579 label Biography information for Mary Creagh

800801

	registered interest
	date	04/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Lung Diseases: Drugs
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, whether his Department has undertaken a cost-benefit analysis of encouraging the prescription of more dry powder inhalers; and if he will make a statement.
	tabling member constituency	Wakefield
	tabling member printed	Mary Creagh
	uin	117422
	answer	answer is ministerial correction date of answer 07/12/2017 answer text <p>The Department has not undertaken a cost-benefit analysis. The National Institute for Health and Care Excellence has made assessments on the health effectiveness of inhalers, which are used to treat a number of health conditions and have published a number of resources to assist clinicians in treating those conditions. The Department is not leading on policies related to fluorinated greenhouse gases. We, however, will continue to provide advice to Department for Environment Food and Rural Affairs on any potential health impact in relation to their policies.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 07/12/2017 17:46:50 answering member 4067 label Biography information for Steve Brine
	tabling member	1579 label Biography information for Mary Creagh

800658

	registered interest
	date	04/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Obesity: Children
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what the level of childhood obesity was in each region of England in each year for which data is available and what estimate he has made of the levels of childhood obesity in each of the next five years.
	tabling member constituency	Vale of Clwyd
	tabling member printed	Chris Ruane
	uin	117279
	answer	answer is ministerial correction date of answer 12/12/2017 answer text <p>Data on the level of childhood obesity in each region of England can be found in the attached documents ‘Obesity Prevalence in Reception’ and ‘Obesity Prevalence in Year 6’.</p><p> </p><p>No estimate of the levels of childhood obesity in each of the next five years has been made.</p> answering member constituency Winchester answering member printed Steve Brine attachment 1 file name Obesity Prevalence in Year 6.pdf title PQ117279 attached doc. 2 file name Obesity Prevalence in Reception.pdf title PQ117279 attached doc. question first answered 12/12/2017 12:29:13 answering member 4067 label Biography information for Steve Brine
	tabling member	534 label Biography information for Chris Ruane

800659

	registered interest
	date	04/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Obesity: Children
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what assessment he has made of the effect of excess sugar consumption on levels of childhood obesity.
	tabling member constituency	Vale of Clwyd
	tabling member printed	Chris Ruane
	uin	117280
	answer	answer is ministerial correction date of answer 11/12/2017 answer text <p>The 2015 Scientific Advisory Committee on Nutrition (SACN) Carbohydrate and Health report provided an assessment of the impact of excess sugar consumption and concluded that a diet high in sugar increases the risk of weight gain. SACN also recommended that intakes of sugar should not exceed five percent of total energy, a halving of the previous recommendation. The report is available at:</p><p><a href="https://www.gov.uk/government/publications/sacn-carbohydrates-and-health-report" target="_blank">https://www.gov.uk/government/publications/sacn-carbohydrates-and-health-report</a></p><p>The 2016 National Diet and Nutrition Survey shows that children’s intakes of sugar are at around three times recommended levels. The survey is available at:</p><p><a href="https://www.gov.uk/government/collections/national-diet-and-nutrition-survey" target="_blank">https://www.gov.uk/government/collections/national-diet-and-nutrition-survey</a></p> answering member constituency Winchester answering member printed Steve Brine question first answered 11/12/2017 17:48:42 answering member 4067 label Biography information for Steve Brine
	tabling member	534 label Biography information for Chris Ruane

800660

	registered interest
	date	04/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Obesity: Children
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what assessment he has made of the effect of targeting food and drink advertising at children and young people on the level of childhood obesity.
	tabling member constituency	Vale of Clwyd
	tabling member printed	Chris Ruane
	uin	117281
	answer	answer is ministerial correction date of answer 12/12/2017 answer text <p>Public Health England’s 2015 report ‘Sugar reduction: The evidence for action’ is available at:</p><p><a href="https://www.gov.uk/government/publications/sugar-reduction-from-evidence-into-action" target="_blank">https://www.gov.uk/government/publications/sugar-reduction-from-evidence-into-action</a></p><p>The report showed that all forms of advertising and marketing, including advertising on television, through social and other online media, increase the preference, choice, purchasing and consumption of high sugar foods and drinks by children. Consuming a diet high in sugar leads to weight gain and therefore contributes to childhood obesity.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 12/12/2017 12:39:56 answering member 4067 label Biography information for Steve Brine
	tabling member	534 label Biography information for Chris Ruane

800718

	registered interest
	date	04/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Drugs: Misuse
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what assessment he has made of the effect of drug use disorders on Disability-Adjusted Life Years lost in each region of England for each year for which data is available.
	tabling member constituency	Vale of Clwyd
	tabling member printed	Chris Ruane
	uin	117339
	answer	answer is ministerial correction date of answer 07/12/2017 answer text <p>There has been no formal assessment of disability adjusted life years lost through drug use disorders broken down by regional level.</p><p> </p><p>An assessment of years of life lost through drug use disorders is available in the publication Changes in health in England, with analysis by English regions and areas of deprivation, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. It assesses the scale of health lost from diseases and injuries in 2013, and estimates the attributable impact of risk factors; data for drug use disorders is included. This report does not include a regional assessment of Disability Adjusted Life Years. It was published on 15 September and is available at:</p><p><a href="https://www.gov.uk/government/publications/burden-of-disease-study-for-england" target="_blank">https://www.gov.uk/government/publications/burden-of-disease-study-for-england</a></p><p>This analysis was conceived and produced jointly by Public Health England and the Institute of Health Metrics and Evaluation, University of Washington.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 07/12/2017 17:00:05 answering member 4067 label Biography information for Steve Brine
	tabling member	534 label Biography information for Chris Ruane

800580

	registered interest
	date	04/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Incinerators: Health Hazards
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what assessment he has made of the effect of the use of waste incinerators on health.
	tabling member constituency	Stroud
	tabling member printed	Dr David Drew
	uin	117201
	answer	answer is ministerial correction date of answer 12/12/2017 answer text <p>The effects of modern municipal waste incinerators on human health were reviewed by the Health Protection Agency, whose functions were transferred to Public Health England (PHE) 1 April 2013. The report, published in September 2009, concluded “Modern, well managed incinerators make only a small contribution to local concentrations of air pollutants. It is possible that such small additions could have an impact on health but such effects, if they exist, are likely to be very small and not detectable.”</p><p> </p><p>PHE will review its advice in light of new substantial research on the health effects of incinerators published in peer reviewed journals. To date, PHE is not aware of any evidence that requires a change in their position statement.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 12/12/2017 13:57:01 answering member 4067 label Biography information for Steve Brine
	tabling member	252 label Biography information for Dr David Drew