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48233

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what estimate has he made of the cost to the economy of untreated mental illness.
	tabling member constituency	High Peak
	tabling member printed	Andrew Bingham
	uin	196255
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The International Classification of Diseases is the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems.</p><p>The Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems includes in Chapter V a detailed classification of more than 300 mental and behavioural disorders. Its publication follows extensive field-testing by more than 100 clinical and research centres in 40 countries.</p><p>Aggregate primary care trust (PCT) expenditure on mental health was £11.28 billion in 2012-13, which is 11.9% of the £94.78 billion total spend by PCTs. The estimate of expenditure on mental health does not include the majority of expenditure on primary care appointments which is recorded as a separate programme category.</p><p> </p><p>It is not possible to provide an estimate of expenditure on physical health. A number of programme categories will have elements of expenditure which could be classified as non-physical, for example, learning disabilities, neurological and social care.</p><p> </p><p>The Department has made no estimate of the cost to the economy of untreated mental illness.</p><p> </p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196245 196254 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	3994 label Biography information for Andrew Bingham

48237

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what proportion of NHS funding is allocated to (a) mental and (b) physical health care.
	tabling member constituency	High Peak
	tabling member printed	Andrew Bingham
	uin	196254
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The International Classification of Diseases is the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems.</p><p>The Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems includes in Chapter V a detailed classification of more than 300 mental and behavioural disorders. Its publication follows extensive field-testing by more than 100 clinical and research centres in 40 countries.</p><p>Aggregate primary care trust (PCT) expenditure on mental health was £11.28 billion in 2012-13, which is 11.9% of the £94.78 billion total spend by PCTs. The estimate of expenditure on mental health does not include the majority of expenditure on primary care appointments which is recorded as a separate programme category.</p><p> </p><p>It is not possible to provide an estimate of expenditure on physical health. A number of programme categories will have elements of expenditure which could be classified as non-physical, for example, learning disabilities, neurological and social care.</p><p> </p><p>The Department has made no estimate of the cost to the economy of untreated mental illness.</p><p> </p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196245 196255 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	3994 label Biography information for Andrew Bingham

48242

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what criteria his Department use to define illness as mental as opposed to physical.
	tabling member constituency	High Peak
	tabling member printed	Andrew Bingham
	uin	196245
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The International Classification of Diseases is the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems.</p><p>The Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems includes in Chapter V a detailed classification of more than 300 mental and behavioural disorders. Its publication follows extensive field-testing by more than 100 clinical and research centres in 40 countries.</p><p>Aggregate primary care trust (PCT) expenditure on mental health was £11.28 billion in 2012-13, which is 11.9% of the £94.78 billion total spend by PCTs. The estimate of expenditure on mental health does not include the majority of expenditure on primary care appointments which is recorded as a separate programme category.</p><p> </p><p>It is not possible to provide an estimate of expenditure on physical health. A number of programme categories will have elements of expenditure which could be classified as non-physical, for example, learning disabilities, neurological and social care.</p><p> </p><p>The Department has made no estimate of the cost to the economy of untreated mental illness.</p><p> </p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196254 196255 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	3994 label Biography information for Andrew Bingham

48229

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	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 role independent pharmacies play in relieving pressures on other health and welfare services; and what steps he has taken to disseminate best practice.
	tabling member constituency	Hendon
	tabling member printed	Dr Matthew Offord
	uin	196239
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>Pharmacy already plays a vital role in supporting the health of people in their local communities, providing high quality care and support, improving people's health and reducing health inequalities. However, as we move to more integrated care, there is real potential for pharmacists and their teams to play an even greater role in the future, particularly in keeping people healthy, supporting those with long term conditions and helping make sure patients and the National Health Service get the best use from medicines.</p><p> </p><p>NHS England's public consultation, <em>Improving care through community pharmacy –</em> <em>a call to action</em>, which closed on 18 March, has provided an important opportunity to explore the contribution community pharmacists and their teams can make. This will inform a strategic framework for commissioning wider primary care services in the autumn. A copy of the consultation document is at:</p><p> </p><p>www.england.nhs.uk/ourwork/qual-clin-lead/calltoaction/pharm-cta/</p><p> </p><p>In the meantime, NHS England's <em>The earlier, the better</em> campaign, launched in January 2014, specifically sought to raise the profile of community pharmacy with the public, to increase the number of people accessing community pharmacy services when they have a minor ailment and reduce pressures on other parts of the NHS.</p><p> </p><p>On 14 April, the Department and NHS England published <em>Transforming Primary Care - Safe, proactive, personalised care for those who need it most</em>. This sets out plans for more proactive, personalised and joined up care, part of which is harnessing the potential of pharmacists. This recognises the vital role that pharmacists have in optimising medicines use, helping to prevent avoidable hospital admissions and supporting people to manage their own care. A copy has been placed in the Library.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196241 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb attachment 1 file name 196239_and_196241_-_Library_document[1].pdf title Transforming Primary Care document
	tabling member	4006 label Biography information for Dr Matthew Offord

48241

	registered interest
	date	10/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what steps he has taken to increase public understanding of the services offered by independent pharmacies.
	tabling member constituency	Hendon
	tabling member printed	Dr Matthew Offord
	uin	196241
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>Pharmacy already plays a vital role in supporting the health of people in their local communities, providing high quality care and support, improving people's health and reducing health inequalities. However, as we move to more integrated care, there is real potential for pharmacists and their teams to play an even greater role in the future, particularly in keeping people healthy, supporting those with long term conditions and helping make sure patients and the National Health Service get the best use from medicines.</p><p> </p><p>NHS England's public consultation, <em>Improving care through community pharmacy –</em> <em>a call to action</em>, which closed on 18 March, has provided an important opportunity to explore the contribution community pharmacists and their teams can make. This will inform a strategic framework for commissioning wider primary care services in the autumn. A copy of the consultation document is at:</p><p> </p><p>www.england.nhs.uk/ourwork/qual-clin-lead/calltoaction/pharm-cta/</p><p> </p><p>In the meantime, NHS England's <em>The earlier, the better</em> campaign, launched in January 2014, specifically sought to raise the profile of community pharmacy with the public, to increase the number of people accessing community pharmacy services when they have a minor ailment and reduce pressures on other parts of the NHS.</p><p> </p><p>On 14 April, the Department and NHS England published <em>Transforming Primary Care - Safe, proactive, personalised care for those who need it most</em>. This sets out plans for more proactive, personalised and joined up care, part of which is harnessing the potential of pharmacists. This recognises the vital role that pharmacists have in optimising medicines use, helping to prevent avoidable hospital admissions and supporting people to manage their own care. A copy has been placed in the Library.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196239 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb attachment 1 file name 196239_and_196241_-_Library_document[1].pdf title Transforming Primary Care document
	tabling member	4006 label Biography information for Dr Matthew Offord

48563

	registered interest
	date	25/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what recent assessment he has made of the data collected by the Palliative Care Funding Review Pilot sites; and whether enough data has been collected to allow a decision to be made before the end of this Parliament on implementing free social care at the end of life.
	tabling member constituency	Totnes
	tabling member printed	Dr Sarah Wollaston
	uin	196585
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>NHS England is due to receive the health and social care data from the Palliative Care Funding Review Pilots by the end of May. Once these data have been analysed, this will form the evidence base for a decision on free social care at the end of life, along with wider policy and financial considerations.</p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	4073 label Biography information for Dr Sarah Wollaston

48539

	registered interest
	date	25/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how many patients have required further operations due to complications with transvaginal mesh implants in each of the last three years; and what the cost of such procedures was.
	tabling member constituency	Livingston
	tabling member printed	Graeme Morrice
	uin	196743
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The Department of Health does not hold information on the number of patients who have required further operations due to complications with transvaginal mesh implants in each of the last three years or the costs of these operations.</p><p> </p><p>The Department has had two meetings in which polypropylene transvaginal mesh implants were either discussed or on the agenda.</p><p> </p><p>NHS England manages the National Reporting and Learning System (NRLS) for patient safety incident reports from the NHS. NHS England shares incident reports concerning harms arising from medical devices with the Medicines and Healthcare products Regulatory Agency (MHRA).</p><p> </p><p>Manufacturers of medical devices such as transvaginal mesh implants are legally required to report adverse incidents (ie death, serious injury or potential serious injury) involving their devices to the MHRA. General Medical Guidance published in February 2013 makes it clear that clinicians should report medical device incidents to the MHRA, and make information available to patients about how they can report side effects to the MHRA. The MHRA also encourages voluntary reporting of adverse incidents by healthcare workers, carers, patients and members of the public and participates in monthly telephone meetings with regulators in other European Union member states to share information about medical device safety.</p><p> </p><p>The Department is currently engaged in work to assess the effectiveness of existing arrangements for reporting complications relating to transvaginal mesh implants. NHS England is leading this work, which also involves the MHRA, the Royal College of Obstetricians and Gynaecologists, and the relevant professional societies (the British Society of Urogynaecology and the British Association of Urological Surgeons).</p><p> </p><p>Finished Consultant Episodes for women who have received a primary or secondary operative procedure for the insertion of Transvaginal Mesh, Transobturator Tape, Transvaginal Slings and Transvaginal Tape.</p><p> </p><table><tbody><tr><td><p>Procedure</p></td><td><p>2010-11</p></td><td><p>2011-12</p></td><td><p>2012-13</p></td></tr><tr><td><p>Insertion of Transvaginal Mesh</p></td><td><p>1,636</p></td><td><p>1,524</p></td><td><p>1,310</p></td></tr><tr><td><p>Insertion of Transobturator Tape</p></td><td><p>5,426</p></td><td><p>4,885</p></td><td><p>4,476</p></td></tr><tr><td><p>Insertion of Transvaginal Sling</p></td><td><p>130</p></td><td><p>134</p></td><td><p>135</p></td></tr><tr><td><p>Insertion of Transvaginal Tape</p></td><td><p>8,087</p></td><td><p>8,172</p></td><td><p>7,627</p></td></tr></tbody></table><p> </p><p><em>Source</em>: Hospital Episode Statistics (HES), Health and Social Care Information Centre.</p><p><em>Note</em>: Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector.</p><p> </p><p> </p><p>Adverse events reported to MHRA by Health Professionals concerning Vaginal tape and mesh implants are as follows</p><p> </p><table><tbody><tr><td> </td><td><p>Vaginal Tapes for Stress Urinary Incontinence</p></td><td><p>Vaginal Mesh for Pelvic Organ Prolapse</p></td><td><p>Vaginal Mesh for unknown* indication</p></td></tr><tr><td><p>2011</p></td><td><p>3</p></td><td><p>1</p></td><td><p>0</p></td></tr><tr><td><p>2012</p></td><td><p>23</p></td><td><p>31</p></td><td><p>2</p></td></tr><tr><td><p>2013</p></td><td><p>27</p></td><td><p>20</p></td><td><p>0</p></td></tr><tr><td><p>Up to March 2014</p></td><td><p>16</p></td><td><p>7</p></td><td><p>0</p></td></tr></tbody></table><p>*The reporter did not provide enough information on what type of mesh it was</p><p> </p><p> </p><p>Number of patient safety incidents relating to mesh used in gynaecological procedures reported to the NRLS (Year of occurrence by reported degree of harm)</p><p> </p><table><tbody><tr><td><p> </p></td><td><p>No Harm</p></td><td><p>Low</p></td><td><p>Moderate</p></td><td><p>TOTAL</p></td></tr><tr><td><p>2011</p></td><td><p>0</p></td><td><p>2</p></td><td><p>4</p></td><td><p>6</p></td></tr><tr><td><p>2012</p></td><td><p>7</p></td><td><p>4</p></td><td><p>3</p></td><td><p>14</p></td></tr><tr><td><p>2013</p></td><td><p>4</p></td><td><p>1</p></td><td><p>1</p></td><td><p>6</p></td></tr><tr><td><p>TOTAL</p></td><td><p>11</p></td><td><p>7</p></td><td><p>8</p></td><td><p>26</p></td></tr></tbody></table><p>Search strategy: All incidents from gynaecological specialties in the NRLS were searched on 2 December 2013 for the keyword ‘mesh'</p><p> </p><p> </p><p> </p><p>Adverse events reported to MHRA by patients/members of the public concerning Vaginal tape and mesh implants are as follows</p><p> </p><table><tbody><tr><td> </td><td><p>Vaginal Tapes for Stress Urinary Incontinence</p></td><td><p>Vaginal Mesh for Pelvic Organ Prolapse</p></td><td><p>Vaginal Mesh for unknown* indication</p></td></tr><tr><td><p>2011</p></td><td><p>33</p></td><td><p>7</p></td><td><p>3</p></td></tr><tr><td><p>2012</p></td><td><p>26</p></td><td><p>2</p></td><td><p>0</p></td></tr><tr><td><p>2013</p></td><td><p>30</p></td><td><p>10</p></td><td><p>3</p></td></tr><tr><td><p>Up to March 2014</p></td><td><p>7</p></td><td><p>0</p></td><td><p>0</p></td></tr></tbody></table><p>*The reporter did not provide enough information on what type of mesh it was</p><p> </p><p>No incidents relating to transvaginal mesh have been reported to the NRLS by patients.</p><p> </p><p>The Department has answered 11 previous Parliamentary Questions, 27 letters from hon. Members and Peers and 17 letters from members of the public since 1 September 2011. The Chief Executive of the MHRA has replied to six letters from hon. Members since 1 September 2011.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196738 196739 196740 196741 196742 196744 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	4012 label Biography information for Graeme Morrice

48547

	registered interest
	date	25/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how many (a) meetings, (b) items of written correspondence, (c) phone calls, (d) consultation responses, (e) tenders and (f) other individual communications and contacts his Department has had with (i) Johnson & Johnson, (ii) Ethicon and (iii) BARD.
	tabling member constituency	Livingston
	tabling member printed	Graeme Morrice
	uin	196778
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>Within the last 12 months, the Department has had regular communication with a number of pharmaceutical, device and diagnostic manufacturers, on a wide range of topics. However, the information requested could only be provided at disproportionate cost.</p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	4012 label Biography information for Graeme Morrice

48571

	registered interest
	date	25/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how many cases of complications with transvaginal mesh implants have been reported by health professionals in each of the last three years.
	tabling member constituency	Livingston
	tabling member printed	Graeme Morrice
	uin	196741
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The Department of Health does not hold information on the number of patients who have required further operations due to complications with transvaginal mesh implants in each of the last three years or the costs of these operations.</p><p> </p><p>The Department has had two meetings in which polypropylene transvaginal mesh implants were either discussed or on the agenda.</p><p> </p><p>NHS England manages the National Reporting and Learning System (NRLS) for patient safety incident reports from the NHS. NHS England shares incident reports concerning harms arising from medical devices with the Medicines and Healthcare products Regulatory Agency (MHRA).</p><p> </p><p>Manufacturers of medical devices such as transvaginal mesh implants are legally required to report adverse incidents (ie death, serious injury or potential serious injury) involving their devices to the MHRA. General Medical Guidance published in February 2013 makes it clear that clinicians should report medical device incidents to the MHRA, and make information available to patients about how they can report side effects to the MHRA. The MHRA also encourages voluntary reporting of adverse incidents by healthcare workers, carers, patients and members of the public and participates in monthly telephone meetings with regulators in other European Union member states to share information about medical device safety.</p><p> </p><p>The Department is currently engaged in work to assess the effectiveness of existing arrangements for reporting complications relating to transvaginal mesh implants. NHS England is leading this work, which also involves the MHRA, the Royal College of Obstetricians and Gynaecologists, and the relevant professional societies (the British Society of Urogynaecology and the British Association of Urological Surgeons).</p><p> </p><p>Finished Consultant Episodes for women who have received a primary or secondary operative procedure for the insertion of Transvaginal Mesh, Transobturator Tape, Transvaginal Slings and Transvaginal Tape.</p><p> </p><table><tbody><tr><td><p>Procedure</p></td><td><p>2010-11</p></td><td><p>2011-12</p></td><td><p>2012-13</p></td></tr><tr><td><p>Insertion of Transvaginal Mesh</p></td><td><p>1,636</p></td><td><p>1,524</p></td><td><p>1,310</p></td></tr><tr><td><p>Insertion of Transobturator Tape</p></td><td><p>5,426</p></td><td><p>4,885</p></td><td><p>4,476</p></td></tr><tr><td><p>Insertion of Transvaginal Sling</p></td><td><p>130</p></td><td><p>134</p></td><td><p>135</p></td></tr><tr><td><p>Insertion of Transvaginal Tape</p></td><td><p>8,087</p></td><td><p>8,172</p></td><td><p>7,627</p></td></tr></tbody></table><p> </p><p><em>Source</em>: Hospital Episode Statistics (HES), Health and Social Care Information Centre.</p><p><em>Note</em>: Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector.</p><p> </p><p> </p><p>Adverse events reported to MHRA by Health Professionals concerning Vaginal tape and mesh implants are as follows</p><p> </p><table><tbody><tr><td> </td><td><p>Vaginal Tapes for Stress Urinary Incontinence</p></td><td><p>Vaginal Mesh for Pelvic Organ Prolapse</p></td><td><p>Vaginal Mesh for unknown* indication</p></td></tr><tr><td><p>2011</p></td><td><p>3</p></td><td><p>1</p></td><td><p>0</p></td></tr><tr><td><p>2012</p></td><td><p>23</p></td><td><p>31</p></td><td><p>2</p></td></tr><tr><td><p>2013</p></td><td><p>27</p></td><td><p>20</p></td><td><p>0</p></td></tr><tr><td><p>Up to March 2014</p></td><td><p>16</p></td><td><p>7</p></td><td><p>0</p></td></tr></tbody></table><p>*The reporter did not provide enough information on what type of mesh it was</p><p> </p><p> </p><p>Number of patient safety incidents relating to mesh used in gynaecological procedures reported to the NRLS (Year of occurrence by reported degree of harm)</p><p> </p><table><tbody><tr><td><p> </p></td><td><p>No Harm</p></td><td><p>Low</p></td><td><p>Moderate</p></td><td><p>TOTAL</p></td></tr><tr><td><p>2011</p></td><td><p>0</p></td><td><p>2</p></td><td><p>4</p></td><td><p>6</p></td></tr><tr><td><p>2012</p></td><td><p>7</p></td><td><p>4</p></td><td><p>3</p></td><td><p>14</p></td></tr><tr><td><p>2013</p></td><td><p>4</p></td><td><p>1</p></td><td><p>1</p></td><td><p>6</p></td></tr><tr><td><p>TOTAL</p></td><td><p>11</p></td><td><p>7</p></td><td><p>8</p></td><td><p>26</p></td></tr></tbody></table><p>Search strategy: All incidents from gynaecological specialties in the NRLS were searched on 2 December 2013 for the keyword ‘mesh'</p><p> </p><p> </p><p> </p><p>Adverse events reported to MHRA by patients/members of the public concerning Vaginal tape and mesh implants are as follows</p><p> </p><table><tbody><tr><td> </td><td><p>Vaginal Tapes for Stress Urinary Incontinence</p></td><td><p>Vaginal Mesh for Pelvic Organ Prolapse</p></td><td><p>Vaginal Mesh for unknown* indication</p></td></tr><tr><td><p>2011</p></td><td><p>33</p></td><td><p>7</p></td><td><p>3</p></td></tr><tr><td><p>2012</p></td><td><p>26</p></td><td><p>2</p></td><td><p>0</p></td></tr><tr><td><p>2013</p></td><td><p>30</p></td><td><p>10</p></td><td><p>3</p></td></tr><tr><td><p>Up to March 2014</p></td><td><p>7</p></td><td><p>0</p></td><td><p>0</p></td></tr></tbody></table><p>*The reporter did not provide enough information on what type of mesh it was</p><p> </p><p>No incidents relating to transvaginal mesh have been reported to the NRLS by patients.</p><p> </p><p>The Department has answered 11 previous Parliamentary Questions, 27 letters from hon. Members and Peers and 17 letters from members of the public since 1 September 2011. The Chief Executive of the MHRA has replied to six letters from hon. Members since 1 September 2011.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196738 196739 196740 196742 196743 196744 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	4012 label Biography information for Graeme Morrice

48572

	registered interest
	date	25/04/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how many patients have received polypropylene transvaginal mesh implants through the NHS in each of the last three years.
	tabling member constituency	Livingston
	tabling member printed	Graeme Morrice
	uin	196740
	answer	answer is ministerial correction date of answer 06/05/2014 answer text <p>The Department of Health does not hold information on the number of patients who have required further operations due to complications with transvaginal mesh implants in each of the last three years or the costs of these operations.</p><p> </p><p>The Department has had two meetings in which polypropylene transvaginal mesh implants were either discussed or on the agenda.</p><p> </p><p>NHS England manages the National Reporting and Learning System (NRLS) for patient safety incident reports from the NHS. NHS England shares incident reports concerning harms arising from medical devices with the Medicines and Healthcare products Regulatory Agency (MHRA).</p><p> </p><p>Manufacturers of medical devices such as transvaginal mesh implants are legally required to report adverse incidents (ie death, serious injury or potential serious injury) involving their devices to the MHRA. General Medical Guidance published in February 2013 makes it clear that clinicians should report medical device incidents to the MHRA, and make information available to patients about how they can report side effects to the MHRA. The MHRA also encourages voluntary reporting of adverse incidents by healthcare workers, carers, patients and members of the public and participates in monthly telephone meetings with regulators in other European Union member states to share information about medical device safety.</p><p> </p><p>The Department is currently engaged in work to assess the effectiveness of existing arrangements for reporting complications relating to transvaginal mesh implants. NHS England is leading this work, which also involves the MHRA, the Royal College of Obstetricians and Gynaecologists, and the relevant professional societies (the British Society of Urogynaecology and the British Association of Urological Surgeons).</p><p> </p><p>Finished Consultant Episodes for women who have received a primary or secondary operative procedure for the insertion of Transvaginal Mesh, Transobturator Tape, Transvaginal Slings and Transvaginal Tape.</p><p> </p><table><tbody><tr><td><p>Procedure</p></td><td><p>2010-11</p></td><td><p>2011-12</p></td><td><p>2012-13</p></td></tr><tr><td><p>Insertion of Transvaginal Mesh</p></td><td><p>1,636</p></td><td><p>1,524</p></td><td><p>1,310</p></td></tr><tr><td><p>Insertion of Transobturator Tape</p></td><td><p>5,426</p></td><td><p>4,885</p></td><td><p>4,476</p></td></tr><tr><td><p>Insertion of Transvaginal Sling</p></td><td><p>130</p></td><td><p>134</p></td><td><p>135</p></td></tr><tr><td><p>Insertion of Transvaginal Tape</p></td><td><p>8,087</p></td><td><p>8,172</p></td><td><p>7,627</p></td></tr></tbody></table><p> </p><p><em>Source</em>: Hospital Episode Statistics (HES), Health and Social Care Information Centre.</p><p><em>Note</em>: Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector.</p><p> </p><p> </p><p>Adverse events reported to MHRA by Health Professionals concerning Vaginal tape and mesh implants are as follows</p><p> </p><table><tbody><tr><td> </td><td><p>Vaginal Tapes for Stress Urinary Incontinence</p></td><td><p>Vaginal Mesh for Pelvic Organ Prolapse</p></td><td><p>Vaginal Mesh for unknown* indication</p></td></tr><tr><td><p>2011</p></td><td><p>3</p></td><td><p>1</p></td><td><p>0</p></td></tr><tr><td><p>2012</p></td><td><p>23</p></td><td><p>31</p></td><td><p>2</p></td></tr><tr><td><p>2013</p></td><td><p>27</p></td><td><p>20</p></td><td><p>0</p></td></tr><tr><td><p>Up to March 2014</p></td><td><p>16</p></td><td><p>7</p></td><td><p>0</p></td></tr></tbody></table><p>*The reporter did not provide enough information on what type of mesh it was</p><p> </p><p> </p><p>Number of patient safety incidents relating to mesh used in gynaecological procedures reported to the NRLS (Year of occurrence by reported degree of harm)</p><p> </p><table><tbody><tr><td><p> </p></td><td><p>No Harm</p></td><td><p>Low</p></td><td><p>Moderate</p></td><td><p>TOTAL</p></td></tr><tr><td><p>2011</p></td><td><p>0</p></td><td><p>2</p></td><td><p>4</p></td><td><p>6</p></td></tr><tr><td><p>2012</p></td><td><p>7</p></td><td><p>4</p></td><td><p>3</p></td><td><p>14</p></td></tr><tr><td><p>2013</p></td><td><p>4</p></td><td><p>1</p></td><td><p>1</p></td><td><p>6</p></td></tr><tr><td><p>TOTAL</p></td><td><p>11</p></td><td><p>7</p></td><td><p>8</p></td><td><p>26</p></td></tr></tbody></table><p>Search strategy: All incidents from gynaecological specialties in the NRLS were searched on 2 December 2013 for the keyword ‘mesh'</p><p> </p><p> </p><p> </p><p>Adverse events reported to MHRA by patients/members of the public concerning Vaginal tape and mesh implants are as follows</p><p> </p><table><tbody><tr><td> </td><td><p>Vaginal Tapes for Stress Urinary Incontinence</p></td><td><p>Vaginal Mesh for Pelvic Organ Prolapse</p></td><td><p>Vaginal Mesh for unknown* indication</p></td></tr><tr><td><p>2011</p></td><td><p>33</p></td><td><p>7</p></td><td><p>3</p></td></tr><tr><td><p>2012</p></td><td><p>26</p></td><td><p>2</p></td><td><p>0</p></td></tr><tr><td><p>2013</p></td><td><p>30</p></td><td><p>10</p></td><td><p>3</p></td></tr><tr><td><p>Up to March 2014</p></td><td><p>7</p></td><td><p>0</p></td><td><p>0</p></td></tr></tbody></table><p>*The reporter did not provide enough information on what type of mesh it was</p><p> </p><p>No incidents relating to transvaginal mesh have been reported to the NRLS by patients.</p><p> </p><p>The Department has answered 11 previous Parliamentary Questions, 27 letters from hon. Members and Peers and 17 letters from members of the public since 1 September 2011. The Chief Executive of the MHRA has replied to six letters from hon. Members since 1 September 2011.</p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb grouped question UIN 196738 196739 196741 196742 196743 196744 question first answered 06/05/2014 12:00:00 answering member 1439 label Biography information for Norman Lamb
	tabling member	4012 label Biography information for Graeme Morrice