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755154

	registered interest
	date	20/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Microplastics: Food
	house id	2
	legislature	25277 pref label House of Lords
	question text	Her Majesty's Government what assessment they have made of the risk to humans of microbeads and other plastics entering the human food chain.
	tabling member printed	Lord Kennedy of Southwark
	uin	HL1162
	answer	answer is ministerial correction date of answer 31/07/2017 answer text <p>On the basis of current information, the Food Standards Agency (FSA) considers it is unlikely that the presence of the low levels of microplastic particles that have been reported to occur in certain types of seafood would cause harm to consumers. The FSA will continue to monitor and assess emerging information concerning microplastics in seafood.</p> answering member printed Lord O'Shaughnessy question first answered 31/07/2017 14:27:14 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4153 label Biography information for Lord Kennedy of Southwark

753942

	registered interest
	date	19/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Nurses: Training
	house id	2
	legislature	25277 pref label House of Lords
	question text	Her Majesty's Government what discussions they have had with (1) the Royal College of Nursing, (2) the Royal College of Midwives, and (3) UNISON, as a consequence of the fall since 2016 reported by UCAS in the number of applications to universities to study for nursing degrees.
	tabling member printed	Lord MacKenzie of Culkein
	uin	HL1089
	answer	answer is ministerial correction date of answer 31/07/2017 answer text <p>Ministers routinely meet nursing leaders and discuss a range of issues, including recruitment and retention of nurses and midwives.</p><p> </p><p>The Government remains committed to reforming nursing, midwifery and allied health pre-registration education and increasing the number of places available for students so that two in three nursing applicants are no longer turned down for a place; at the same time ensuring these students have more money available to them while they study.</p><p> </p><p>Health Education England is confident that the National Health Service will have the required number of students it needs starting courses this year and will continue to work with the education sector to deliver these reforms successfully for the longer term.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL1090 question first answered 31/07/2017 14:34:31 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2507 label Biography information for Lord MacKenzie of Culkein

753944

	registered interest
	date	19/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Nurses: Training
	house id	2
	legislature	25277 pref label House of Lords
	question text	Her Majesty's Government what progress has been made to date in implementing their plan to provide 10,000 additional nursing student places by 2020; and how much additional funding has been provided to universities as part of this plan.
	tabling member printed	Lord MacKenzie of Culkein
	uin	HL1090
	answer	answer is ministerial correction date of answer 31/07/2017 answer text <p>Ministers routinely meet nursing leaders and discuss a range of issues, including recruitment and retention of nurses and midwives.</p><p> </p><p>The Government remains committed to reforming nursing, midwifery and allied health pre-registration education and increasing the number of places available for students so that two in three nursing applicants are no longer turned down for a place; at the same time ensuring these students have more money available to them while they study.</p><p> </p><p>Health Education England is confident that the National Health Service will have the required number of students it needs starting courses this year and will continue to work with the education sector to deliver these reforms successfully for the longer term.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL1089 question first answered 31/07/2017 14:34:31 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2507 label Biography information for Lord MacKenzie of Culkein

755128

	registered interest
	date	20/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Parkinson's Disease
	house id	2
	legislature	25277 pref label House of Lords
	question text	Her Majesty's Government what steps they are taking to improve access to timely and appropriate support for people with Parkinson's disease who are experiencing anxiety or depression.
	tabling member printed	Baroness Gale
	uin	HL1136
	answer	answer is ministerial correction date of answer 02/08/2017 answer text <p>As set out in <em>Implementing the Five Year Forward View for Mental Health</em> the expansion of Improving Access to Psychological Therapies services will focus on people with long term conditions, including neurological conditions such as Parkinson’s, and/or medically unexplained symptoms. New psychological therapy provision will see physical and mental health care provision co-located. Therapy will be integrated into existing medical pathways and services – either primary care, or secondary care services including neurology.</p><p>Although the majority of people with Parkinson’s can be cared for through routine access to primary and secondary care, NHS England commissions the specialised elements of Parkinson’s care that patients may receive from 24 specialised neurological treatment centres across England. Within these centres neurological multidisciplinary teams ensure patients can access a range of health professionals, including neurologists, neurosurgeons, clinical nurse specialists, psychologists, and that they can receive specialised treatment and support, according to their needs.</p><p>The Neurology Advisory Group will ensure that there is system alignment and a national approach when considering the recommendations, which will be of benefit to patients.</p><p>NHS England is also working with the Neurological Alliance, following the publication on 5 July 2017 of their report on mental health and neurological conditions, <em>Parity of esteem for people affected by neurological conditions: meeting the emotional, cognitive &amp; mental health needs of neurology patients</em>.</p><p>A copy of the report is attached.</p> answering member printed Lord O'Shaughnessy question first answered 02/08/2017 15:07:06 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name HL1136 Parity-of-esteem-for-people-affected-by-neuro-conditions-2017.pdf title Mental health and neurological conditions
	tabling member	2503 label Biography information for Baroness Gale

755177

	registered interest
	date	20/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	HIV Infection: Foreign Nationals
	house id	2
	legislature	25277 pref label House of Lords
	question text	Her Majesty's Government whether the Department of Health has monitored risks associated with overseas visitors seeking or receiving HIV treatment, as set out in that Department's guidance on HIV treatment for overseas visitors in England from 1 October 2012; if so, how many such visitors have been identified; and whether any of those visitors were refused treatment.
	tabling member printed	Lord Ryder of Wensum
	uin	HL1185
	answer	answer is ministerial correction date of answer 31/07/2017 answer text <p>From 1 October 2012, an amendment to the NHS (Charges to Overseas Visitors) Regulations meant that HIV treatment was no longer chargeable to any overseas visitors. This means that no-one should be charged for or refused HIV treatment based on residency.</p><p> </p><p>Public Health England monitors the country of birth of persons reported in England who are living with HIV infection and whether or not they are receiving HIV treatment according to their level of HIV-related immunosuppression. Information on their residency or visitor status is not recorded routinely by treating clinicians and therefore is not available.</p> answering member printed Lord O'Shaughnessy question first answered 31/07/2017 14:27:56 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	1250 label Biography information for Lord Ryder of Wensum

755184

	registered interest
	date	20/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Human Papillomavirus: Vaccination
	house id	2
	legislature	25277 pref label House of Lords
	question text	Her Majesty's Government whether they plan to extend the HPV vaccination programme to boys in the UK; and if so, when.
	tabling member printed	Baroness Tonge
	uin	HL1192
	answer	answer is ministerial correction date of answer 02/08/2017 answer text <p>The Joint Committee on Vaccination and Immunisation (JCVI) has recently reviewed whether or not the HPV vaccination programme for girls should be extended to adolescent boys.</p><p>In an interim statement on the 19 July, the JCVI stated that:</p><p>“Taking the evidence as a whole the Committee therefore is unable to recommend extension of the national HPV programme to adolescent boys according to the most robust cost-effectiveness analyses undertaken.”</p><p>It also recognised arguments made by stakeholders on the issue of equality of access and noted that these require consideration.</p><p>A copy of the statement from 19 July is attached.</p><p>The JCVI is consulting on these interim findings. Subject to the results of the consultation, the JCVI’s final advice is expected in November. The Department will consider and respond to this final advice in due course.</p> answering member printed Lord O'Shaughnessy question first answered 02/08/2017 14:59:10 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name Extending_HPV_Vaccination.pdf title JCVI statement on HPV vaccination
	tabling member	200 label Biography information for Baroness Tonge

755158

	registered interest
	date	20/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Drugs: Prices
	house id	2
	legislature	25277 pref label House of Lords
	question text	Her Majesty's Government which public body is responsible for enforcing regulations concerning the retail prices of medicines; and what enforcement mechanisms are in place to sanction non-compliant retailers.
	tabling member printed	Baroness Mobarik
	uin	HL1167
	answer	answer is ministerial correction date of answer 31/07/2017 answer text <p>The price of over-the-counter medicines charged by retailers is not subject to regulatory control. Competition between retailers acts to prevent excessive prices.</p> answering member printed Lord O'Shaughnessy question first answered 31/07/2017 14:29:38 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4335 label Biography information for Baroness Mobarik

755157

	registered interest
	date	20/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	NHS: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	Her Majesty's Government, further to the Written Answer by Lord O'Shaughnessy on 19 July (HL914), what plans they have to reduce the costs to the NHS of the supply of drugs such as Apomorphine that are long out of patent and simple and cheap to manufacture; and what consideration they have given to increasing supplies of such drugs by seeking suppliers who will invest in regulatory approvals in exchange for a fixed-price, fixed-term contract.
	tabling member printed	Lord Lucas
	uin	HL1165
	answer	answer is ministerial correction date of answer 31/07/2017 answer text <p>The cost of branded medicines to the National Health Service is controlled by the voluntary pharmaceutical price regulation scheme or the statutory medicines price regulation scheme. Often when patents expire, generic versions enter the market and, as a result of competition, prices often go down.</p><p> </p><p>In primary care, the community pharmacy contractual framework provides an incentive for pharmacies to get the best medicines prices; in secondary care, a system of central tenders delivers similar levels of savings. In general, the system works well – the United Kingdom has the lowest generic prices across the Organisation for Economic Co-operation and Development.</p> answering member printed Lord O'Shaughnessy question first answered 31/07/2017 14:28:31 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	1879 label Biography information for Lord Lucas

772990

	registered interest
	date	18/10/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Clinical Audit
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government (1) how many National Clinical Audits and Patient Outcome Audits there are currently in NHS England under the Healthcare Quality Improvement Partnership; (2) what percentage of care costs and English disability adjusted life years these audits cover; and (3) which diseases currently have patient reported outcomes, and which will have by next year.
	tabling member printed	Lord Freyberg
	uin	HL2191
	answer	answer is ministerial correction date of answer 31/10/2017 answer text <p>NHS England has advised that there are 38 projects currently within the National Clinical Audit and Patient Outcomes Programme (NCAPOP) Portfolio, which are at different stages of the commissioning cycle and comprise of 30 National Clinical Audits (NCA) and six Clinical Outcome Review Programmes or Mortality Review Programmes.</p><p> </p><p>The audits’ primary focus is not care costs or disability adjusted life years. The audits are predominately based upon National Institute for Health and Care Excellence (NICE) evidence-based guidelines, technology appraisals and quality standards. NICE takes into account both clinical and cost effectiveness (mainly Quality Adjusted Life Years) where appropriate, and the clinical evidence exists to enable this. The audits commissioned by NCAPOP use the NICE evidence-based outputs as a foundation for the metrics collected so that where possible the audits are based upon a sound pre-existing evidence base. The exception where care costs are investigated is health economic work undertaken by the Sentinel Stroke National Audit Programme.</p><p> </p><p>The following NCAs include patient reported outcomes (PROMS):</p><p> </p><p>- the National Audit of Psychosis, awarded in March 2017, will collect PROMs in year two of its contract (2018-19) and will likely report these at the end of 2019 as part of the annual report;</p><p>- the National Rheumatoid and Early Inflammatory Arthritis Audit, which ran from 2013 to 2016, collected data on PROMS (capturing disease activity and impact of disease). This audit has been recommissioned (contract commenced October 2017) and will once again incorporate PROMs. It is due to report in year two of its contract (2018-19);</p><p>- the National Ophthalmology Audit is undertaking a study to examine the feasibility of collecting cataract PROMs data. This will likely be published in 2018-19;</p><p>- the National Bowel Cancer Audit has undertaken a study to examine the feasibility of reporting PROMs. This is expected to be published later in 2017; and</p><p>- the National Prostate Cancer Audit has collected PROMs data, which is likely to be reported in 2018. The project is being recommissioned and there is currently provision for a national collection of PROMs and patient reported experience measure data within year three of the new contract (2020-21).</p> answering member printed Lord O'Shaughnessy question first answered 31/10/2017 15:04:08 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2593 label Biography information for Lord Freyberg

803021

	registered interest
	date	08/12/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Flour: Folic Acid
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government following the joint letter from the Scottish Government’s Minister for Public Health and Sport and the Welsh Government’s Cabinet Secretary for Health and Social Services to the Secretary of State for Health on 1 December, whether they have any plans to introduce mandatory fortification of flour with folic acid on a UK-wide basis to help reduce neural tube defects in unborn babies.
	tabling member printed	Lord Balfe
	uin	HL3986
	answer	answer is ministerial correction date of answer 20/12/2017 answer text <p>The Scientific Advisory Committee on Nutrition (SACN) recently updated the evidence on folic acid in response to a request from Food Standards Scotland and reiterated its support for mandatory folic acid fortification of United Kingdom flour, provided that this is introduced alongside restrictions on voluntary fortification of foods with folic acid. Ministers are currently considering SACN’s recommendations on mandatory fortification.</p><p> </p><p>Neural tube defects (NTDs) are a serious issue. To help those who may have inadequate folate levels through their diet, the Department provides general advice and health education messages in a range of settings targeted at women of childbearing age to encourage the use of folic acid supplements both pre- and post-conception. Information is also available online via NHS Choices including advice on seeing a healthcare professional as early in pregnancy as possible and that women should take 400 micrograms of folic acid every day prior to conception, and in the first 12 weeks of pregnancy, to help prevent NTDs.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL3984 HL3985 question first answered 20/12/2017 13:50:02 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4302 label Biography information for Lord Balfe