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1141957

	registered interest
	date	24/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Breast Cancer: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what are the drugs approved by NICE to treat HER2+ breast cancer; and what assessment they have made of the efficacy of such drugs.
	tabling member printed	Lord Willis of Knaresborough
	uin	HL17501
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>The National Institute for Health and Care Excellence (NICE) is the independent body responsible for making recommendations for the National Health Service on whether drugs and other treatments represent a clinically and cost effective use of NHS resources.</p><p>NICE has recommended the following drugs for the treatment of HER2-positive breast cancer: trastuzumab emtansine (Kadcyla) for treating HER2-positive advanced breast cancer after trastuzumab (Herceptin) and a taxane; pertuzumab (Perjeta) with trastuzumab (Herceptin) and docetaxel for treating HER2-positive breast cancer; pertuzumab (Perjeta) for the neoadjuvant treatment of HER2-positive breast cancer; and pertuzumab (Perjeta) for adjuvant treatment of HER2-positive early stage breast cancer.</p><p>NHS commissioners are legally required to fund drugs recommended in NICE technology appraisal guidance. It is for clinicians to decide on the most appropriate treatment for an individual patient based on their clinical judgement and in discussion with the patient.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL17502 question first answered 25/07/2019 16:45:03 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4151 label Biography information for Lord Willis of Knaresborough

1141958

	registered interest
	date	24/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Pertuzumab
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what advice they provide to clinicians for the use of Pertuzumab rather than Herceptin for the treatment of HER2+ breast cancer.
	tabling member printed	Lord Willis of Knaresborough
	uin	HL17502
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>The National Institute for Health and Care Excellence (NICE) is the independent body responsible for making recommendations for the National Health Service on whether drugs and other treatments represent a clinically and cost effective use of NHS resources.</p><p>NICE has recommended the following drugs for the treatment of HER2-positive breast cancer: trastuzumab emtansine (Kadcyla) for treating HER2-positive advanced breast cancer after trastuzumab (Herceptin) and a taxane; pertuzumab (Perjeta) with trastuzumab (Herceptin) and docetaxel for treating HER2-positive breast cancer; pertuzumab (Perjeta) for the neoadjuvant treatment of HER2-positive breast cancer; and pertuzumab (Perjeta) for adjuvant treatment of HER2-positive early stage breast cancer.</p><p>NHS commissioners are legally required to fund drugs recommended in NICE technology appraisal guidance. It is for clinicians to decide on the most appropriate treatment for an individual patient based on their clinical judgement and in discussion with the patient.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL17501 question first answered 25/07/2019 16:45:03 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	4151 label Biography information for Lord Willis of Knaresborough

1141255

	registered interest
	date	23/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Non-surgical Cosmetic Procedures: Children
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what legal duties govern the administering of dermal fillers to people under the age of 18 by non-regulated practitioners.
	tabling member constituency	North Durham
	tabling member printed	Mr Kevan Jones
	uin	280927
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>Currently there are no restrictions that limit the administration of dermal fillers on young people under the age of 18 years old.</p><p>The Department is exploring options to introduce age restrictions on access to cosmetic procedures, bringing them in line with legislation on tattoos, teeth whitening and the use of sunbeds. From May 2020 all dermal fillers, irrespective of their composition and intended use, will be regulated as medical devices under Annex XVI of the Medical Device Regulations (EU 2017/745). The new Regulations will significantly improve the quality and safety of dermal fillers.</p><p>The Government is committed to improving the safety of cosmetic procedures through better training for practitioners, and clear information so that people can make informed decisions about their care. The growth in non-surgical treatments increases the need for consumer protection and we are currently working with stakeholders to strengthen the regulation of cosmetic procedures.</p><p>We urge anyone seeking a cosmetic procedure to take the time to find a reputable, insured and appropriately qualified practitioner who is either subject to statutory regulation or on a voluntary register accredited by the Professional Standards Authority.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price question first answered 25/07/2019 16:32:36 answering member 4065 label Biography information for Dame Jackie Doyle-Price
	tabling member	1438 label Biography information for Mr Kevan Jones

1141380

	registered interest
	date	23/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	MMR Vaccine: Safety
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what steps he is taking to maintain and improve pharmacovigilance in relation to the MMR vaccine.
	tabling member constituency	Gravesham
	tabling member printed	Adam Holloway
	uin	280998
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>As with all vaccines and medicines, the safety of the Measles, Mumps and Rubella (MMR) vaccine remains under continual review by the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA uses all available sources of evidence in pharmacovigilance, including regular review of suspected adverse reactions submitted through the Yellow Card Scheme, data from clinical and epidemiological studies, the medical literature and information from pharmaceutical companies and other worldwide regulatory authorities. The MHRA’s processes and data analysis systems are regularly evaluated to ensure optimal performance in monitoring the safety of vaccines and medicines.</p><p>The balance of benefits and risks of MMR vaccine remains overwhelmingly favourable.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price question first answered 25/07/2019 16:35:38 answering member 4065 label Biography information for Dame Jackie Doyle-Price
	tabling member	1522 label Biography information for Adam Holloway

1141381

	registered interest
	date	23/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	MMR Vaccine
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what steps he is taking to help ensure (a) transparency and (b) accountability in the process of manufacturing the MMR vaccine.
	tabling member constituency	Gravesham
	tabling member printed	Adam Holloway
	uin	280999
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>Two Measles, Mumps and Rubella (MMR) vaccines are licensed for use in the United Kingdom: M-M-RVaxPro and Priorix. Both vaccines are on the National Health Service’s routine immunisation schedule. The quality, safety and efficacy of both M-M-RVaxPro and Priorix have been evaluated before they were given a Marketing Authorisation in Europe, and the Marketing Authorisation Holder for each vaccines is legally required to submit periodic safety update reports to the regulator, which are documents intended to provide an evaluation of the risk-benefit balance of a medicinal product at defined time points after its authorisation. The sites at which the products are manufactured are also required to undergo periodic inspections to ensure that they comply with Good Manufacturing Practices. Each batch of vaccines is tested by an official medicines control laboratory (OMCL). OMCL testing is independent of and in addition to the manufacturer’s testing. These procedures ensure that the MMR vaccines available in the UK are safe and efficacious and that the manufacturers/Marketing Authorisation holders are held accountable for their products.</p><p>A European Public Assessment Report (EPAR) for M-M-RVaxPro is available at the following link:</p><p><a href="https://www.ema.europa.eu/en/documents/scientific-discussion/m-m-rvaxpro-epar-scientific-discussion_en.pdf" target="_blank">https://www.ema.europa.eu/en/documents/scientific-discussion/m-m-rvaxpro-epar-scientific-discussion_en.pdf</a></p><p>Priorix was approved before public assessment reports were a requirement. The EPAR for M-M-RVaxPro contains a general summary of the manufacturing information that was provided during the assessment process; however, the specific details of the manufacturing process are confidential.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price question first answered 25/07/2019 16:38:57 answering member 4065 label Biography information for Dame Jackie Doyle-Price
	tabling member	1522 label Biography information for Adam Holloway

1140806

	registered interest
	date	22/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Public Health: Disadvantaged
	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 of reductions in public health funding on health inequalities.
	tabling member constituency	Strangford
	tabling member printed	Jim Shannon
	uin	280246
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>Public health services can have a significant impact in improving the health of the population and reducing unfair differences between marginalised groups of people or communities.</p><p>The Government has made difficult choices to protect public services in the long term. We remain committed to securing five extra years of healthy, independent life by 2035 and reducing the gap between rich and poor with proposals set out in the Prevention Green Paper and a Long Term Plan for the National Health Service with a greater focus on prevention. We want everyone to have the same opportunity to have a long healthy life, whoever they are and whatever their social circumstances.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price grouped question UIN 280247 question first answered 25/07/2019 16:09:54 answering member 4065 label Biography information for Dame Jackie Doyle-Price
	tabling member	4131 label Biography information for Jim Shannon

1140807

	registered interest
	date	22/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Public Health: Disadvantaged
	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 of reductions in public health funding on the health and wellbeing of the most marginalised people in the UK.
	tabling member constituency	Strangford
	tabling member printed	Jim Shannon
	uin	280247
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>Public health services can have a significant impact in improving the health of the population and reducing unfair differences between marginalised groups of people or communities.</p><p>The Government has made difficult choices to protect public services in the long term. We remain committed to securing five extra years of healthy, independent life by 2035 and reducing the gap between rich and poor with proposals set out in the Prevention Green Paper and a Long Term Plan for the National Health Service with a greater focus on prevention. We want everyone to have the same opportunity to have a long healthy life, whoever they are and whatever their social circumstances.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price grouped question UIN 280246 question first answered 25/07/2019 16:09:54 answering member 4065 label Biography information for Dame Jackie Doyle-Price
	tabling member	4131 label Biography information for Jim Shannon

1140808

	registered interest
	date	22/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Public Health: Expenditure
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what the percentage change has been in the (a) NHS budget and (b) local authority public health grant in each year from 2013-14 to 2019-20.
	tabling member constituency	Strangford
	tabling member printed	Jim Shannon
	uin	280248
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>The following table shows the percentage change in total funding for NHS England and the local authority public health grant in each year since 2013:</p><p> </p><table><tbody><tr><td><p>Year</p></td><td><p>NHS England funding increase %</p></td><td><p>Public Health Grant increase %</p></td></tr><tr><td><p>2013/14</p></td><td><p>First year of NHS England</p></td><td><p>5.5%</p></td></tr><tr><td><p>2014/15</p></td><td><p>3.6%</p></td><td><p>5%</p></td></tr><tr><td><p>2015/16</p></td><td><p>3.3%</p></td><td><p>24%<sup>1,2</sup></p></td></tr><tr><td><p>2016/17</p></td><td><p>5.5%</p></td><td><p>-2.2%</p></td></tr><tr><td><p>2017/18</p></td><td><p>3.6%</p></td><td><p>-2.5%<sup>3</sup></p></td></tr><tr><td><p>2018/19</p></td><td><p>4.6%</p></td><td><p>-2.6%</p></td></tr><tr><td><p>2019/20</p></td><td><p>7.8%</p></td><td><p>-2.6%</p></td></tr></tbody></table><p> </p><p>Notes:</p><p><sup>1 </sup>2015-16 includes a £200 million in-year cut implemented in advance of Spending Review 2015.</p><p><sup>2 </sup>Spending Review 2015 baseline, includes the transfer in October 2015 of funding from NHS England to local authorities for commissioning services for children aged 0 – 5 in October 2015.</p><p><sup>3 </sup>From 2017/18, includes funding retained by 10 Greater Manchester local authorities as part of a business rate pilot, not allocated via a grant.</p> answering member constituency Wimbledon answering member printed Stephen Hammond question first answered 25/07/2019 14:34:35 answering member 1585 label Biography information for Stephen Hammond
	tabling member	4131 label Biography information for Jim Shannon

1140868

	registered interest
	date	22/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Prisoners: Synthetic Cannabinoids
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what programmes there are in prisons to provide support for prisoners with synthetic cannabis drug dependency.
	tabling member constituency	Mansfield
	tabling member printed	Ben Bradley
	uin	280382
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>In prison, patients presenting with problematic psychoactive substance use are assessed in the same way as other drug users and offered an appropriate range of psychosocial interventions.</p><p>In April 2018, NHS England and NHS Improvement published its updated service specification on ‘Integrated Substance Misuse Treatment Service in Prisons in England’. This is fully aligned to ‘Drug Misuse and Dependence: UK Guidelines on Clinical Management’, which sets out how clinicians should treat people with drug misuse and drug dependence problems.</p><p>The service specification describes a fully recovery orientated, integrated prison substance misuse treatment service, which covers traditional drugs of abuse, psychoactive substances (including synthetic cannabis), illicit abuse of prescribed and over the counter drugs and alcohol.</p><p>This improved substance misuse service offer is now being commissioned across all prisons and secures integration with mental health services so that growing numbers of people in prisons can access services to support their recovery and wellbeing.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price question first answered 25/07/2019 16:15:47 answering member 4065 label Biography information for Dame Jackie Doyle-Price
	tabling member	4663 label Biography information for Ben Bradley

1140869

	registered interest
	date	22/07/2019
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Mental Health Services: Nottinghamshire
	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 (a) availability and (b) waiting times for therapeutic services for mental health conditions in Nottinghamshire.
	tabling member constituency	Mansfield
	tabling member printed	Ben Bradley
	uin	280383
	answer	answer is ministerial correction date of answer 25/07/2019 answer text <p>Information on the availability of therapeutic services for mental health conditions delivered through the Improving Access to Psychological Therapies (IAPT) programme in Nottinghamshire clinical commissioning groups (CCGs)<sup>1</sup> is not collected.</p><p>Information on waiting times for such services in the Nottinghamshire CCGs in 2019 is in the following table.</p><table><tbody><tr><td><p>Month</p></td><td><p>Number of referrals finishing a course of treatment</p></td><td><p>Mean wait to enter treatment<sup>2</sup> (days)</p></td><td><p>Percentage of finishing referrals<sup>3</sup> seen within 6 weeks</p></td></tr><tr><td><p>January 2019</p></td><td><p>1,345</p></td><td><p>24.3</p></td><td><p>83</p></td></tr><tr><td><p>February 2019</p></td><td><p>1,290</p></td><td><p>24.8</p></td><td><p>81</p></td></tr><tr><td><p>March 2019</p></td><td><p>1,510</p></td><td><p>25.3</p></td><td><p>79</p></td></tr><tr><td><p>April 2019</p></td><td><p>1,280</p></td><td><p>27.4</p></td><td><p>76</p></td></tr></tbody></table><p>Source: NHS Digital, IAPT dataset</p><p>Notes:</p><p><sup>1</sup> NHS Bassetlaw CCG, NHS Mansfield and Ashfield CCG, NHS Newark and Sherwood CCG, NHS Nottingham City CCG, NHS Nottingham North and East CCG, NHS Nottingham West CCG and NHS Rushcliffe CCG.</p><p><sup>2</sup> Waiting time to enter treatment is calculated as the number of days between the referral received date and the first attended treatment appointment. Referral received date and the first treatment appointment dates do not necessarily occur in the same month.</p><p><sup>3</sup> In order to finish a course of treatment, a referral must have ended in the month with at least two treatment appointments having been attended in the course of the referral.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price question first answered 25/07/2019 16:13:47 answering member 4065 label Biography information for Dame Jackie Doyle-Price
	tabling member	4663 label Biography information for Ben Bradley