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750163

	registered interest
	date	10/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	GP Surgeries: Repairs and Maintenance
	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 carried out to ensure that the proposed £1,000 financial assistance offered to GP practices which accept the full repairing lease contract will be sufficient to cover the legal and survey work associated with those leases.
	tabling member constituency	Bristol West
	tabling member printed	Thangam Debbonaire
	uin	4033
	answer	answer is ministerial correction date of answer 13/07/2017 answer text <p>The £1,000 + VAT offered to general practitioner practices is intended to assist with the legal fees associated with documenting a lease. The calculation is based on the fact that the ‘template’ lease has already been negotiated and agreed with NHS Property Services and the British Medical Association, which minimises negotiations with practices.</p><p> </p><p>The nature of lease – either Full Repairing and Insuring or Internal Repairs – determines the level of reimbursement for the current market rent. This includes both the lease rent and an element for upkeep of the tenanted areas. This is set out in the Premises Costs Directions 2013.</p><p> </p><p>Ultimately, it is for the landlord and tenant to agree the terms of any lease to suit their specific circumstances.</p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 4036 question first answered 13/07/2017 13:05:44 answering member 4067 label Biography information for Steve Brine
	tabling member	4433 label Biography information for Thangam Debbonaire

750164

	registered interest
	date	10/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	General Practitioners: Finance
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what plans he has to review the Carr-Hill funding formula for GP practices with atypical populations.
	tabling member constituency	Bristol West
	tabling member printed	Thangam Debbonaire
	uin	4034
	answer	answer is ministerial correction date of answer 13/07/2017 answer text <p>NHS England recognises that atypical practices with a significantly skewed patient population will not necessarily have their workload reflected through the Carr-Hill Formula. It is for this reason that NHS England is exploring the additional demands on atypical practices, testing out in the first instance, the experiences of practices that serve university populations, practices with significant number of non-English speaking patients, and practices operating within remote or isolated areas.</p><p> </p><p>Commissioner guidance was published in December 2016 and further analysis of the workload implications is being undertaken.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 13/07/2017 11:47:14 answering member 4067 label Biography information for Steve Brine
	tabling member	4433 label Biography information for Thangam Debbonaire

750166

	registered interest
	date	10/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	GP Surgeries: Repairs and Maintenance
	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 on GP funding of the proposed full repairing leases offered to GP surgeries.
	tabling member constituency	Bristol West
	tabling member printed	Thangam Debbonaire
	uin	4036
	answer	answer is ministerial correction date of answer 13/07/2017 answer text <p>The £1,000 + VAT offered to general practitioner practices is intended to assist with the legal fees associated with documenting a lease. The calculation is based on the fact that the ‘template’ lease has already been negotiated and agreed with NHS Property Services and the British Medical Association, which minimises negotiations with practices.</p><p> </p><p>The nature of lease – either Full Repairing and Insuring or Internal Repairs – determines the level of reimbursement for the current market rent. This includes both the lease rent and an element for upkeep of the tenanted areas. This is set out in the Premises Costs Directions 2013.</p><p> </p><p>Ultimately, it is for the landlord and tenant to agree the terms of any lease to suit their specific circumstances.</p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 4033 question first answered 13/07/2017 13:05:44 answering member 4067 label Biography information for Steve Brine
	tabling member	4433 label Biography information for Thangam Debbonaire

750926

	registered interest
	date	11/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Breast Cancer: Drugs
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what proportion of drugs for the treatment and post-treatment needs of breast cancer patients contain lactose; and what provision is made for breast cancer patients who are intolerant or allergic to lactose.
	tabling member constituency	Bristol West
	tabling member printed	Thangam Debbonaire
	uin	4161
	answer	answer is ministerial correction date of answer 17/07/2017 answer text <p>Lactose (milk sugar) is commonly used as a diluent in solid oral dosage forms such as tablets and capsules; however is rarely present in oral liquid presentations or parenteral dosage forms, such as injections. While no list of “lactose-free” medicines is maintained, the presence or absence of lactose in any licensed medicine, including those for breast cancer, can be readily identified.</p><p> </p><p>Where a medicine contains lactose, this is highlighted, together with the quantity of lactose, within the Summary of Product Characteristics. The package leaflet for that medicine will also highlight in qualitative terms whether the medicine contains lactose. The package leaflet is provided with each pack of medicine sold or dispensed in the United Kingdom.</p><p> </p><p>The British National Formulary, a standard medical text in the UK, advises that the lactose content in most medicines is too small to cause problems in most lactose-intolerant patients. However, in patients with severe lactose intolerance, lactose content should be determined before prescribing especially if they are taking several products containing lactose.</p><p> </p><p>Clinicians prescribe the medicines and drugs that are most appropriate for their patient, taking into account all relevant factors and guidance. The Medicines and Healthcare products Regulatory Agency, which is responsible for the regulation of medicines in the UK, will help prescribers to establish the availability of a lactose free version of any particular medicine.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 17/07/2017 15:49:05 answering member 4067 label Biography information for Steve Brine
	tabling member	4433 label Biography information for Thangam Debbonaire

759725

	registered interest
	date	12/09/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Benzodiazepines
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what data his Department collected on benzodiazepine dependence relating to 2016.
	tabling member constituency	Bristol West
	tabling member printed	Thangam Debbonaire
	uin	10122
	answer	answer is ministerial correction date of answer 09/10/2017 answer text <p>Data specific to this question is not held centrally.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 09/10/2017 11:28:10 answering member 4067 label Biography information for Steve Brine
	tabling member	4433 label Biography information for Thangam Debbonaire

772219

	registered interest
	date	17/10/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Motor Neurone Disease: Drugs
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what plans his Department has to assess the (a) clinical benefit and (b) value for money of Endaravone in extending the lifespan of people with motor neurone disease.
	tabling member constituency	Bristol West
	tabling member printed	Thangam Debbonaire
	uin	108151
	answer	answer is ministerial correction date of answer 25/10/2017 answer text <p>We have assumed the Hon. Member is referring to edaravone (Radicava). Edaravone is not currently licensed or under assessment within the European Union for any indication and the Department therefore has no such plans. If the manufacturer seeks a marketing authorisation for edaravone in the United Kingdom or EU, it will be assessed for safety, efficacy and quality through the established licensing process and then considered through the topic selection process for possible assessment of clinical and cost effectiveness by the National Institute for Health and Care Excellence (NICE).</p><p> </p><p>Where a drug or treatment has not been appraised by NICE, funding decisions should be made by the relevant National Health Service commissioner, based on an assessment of the available evidence and on the basis of an individual patient’s clinical circumstances.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 25/10/2017 15:57:33 answering member 4067 label Biography information for Steve Brine
	tabling member	4433 label Biography information for Thangam Debbonaire

750165

	registered interest
	date	10/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	GP Surgeries: Service Charges
	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 increased service charges on GP surgeries which lease their buildings from NHS Property Services.
	tabling member constituency	Bristol West
	tabling member printed	Thangam Debbonaire
	uin	4035
	answer	answer is ministerial correction date of answer 13/07/2017 answer text <p>NHS England confirmed the introduction of the market rent model, applying the property sector’s standard method of charging, to the National Health Service in January 2016. It was part of a long-planned move across the public sector to improve utilisation and value for money in property occupancy by putting publicly-owned property on a level with privately-owned alternatives.</p><p> </p><p>The Department agrees that understanding the real cost of running public service buildings has benefits for tenants and the wider NHS:</p><p> </p><p>- It helps the NHS understand the true cost of occupation and reflect these transparently;</p><p>- It informs decisions about the best location for services and investment; and</p><p>- It drives better and more efficient use of space.</p><p>Customer invoices should be based on accurate property information. This includes the precise amount of space used, as well as reflecting an assessment of the facilities provided for that space, e.g. cleaning, reception services and maintenance. This data was not always available in predecessor Primary Care Trust or Strategic Health Authority records.</p><p>NHS Property Services owns only a small proportion of general practitioner (GP) surgeries in England and its approach is consistent with the way those with private sector landlords are treated. The company has endeavoured to improve the quality of its property data and to negotiate and agree lease terms with customers, providing them with the assurance they require. Transparently agreeing precise occupancy details is one reason why some GPs, are</p><p>seeing their costs increase, while others have seen a reduction. NHS Property Services recognises a requirement from its customers to explain any billing changes fully and accurately. It shares their wish to make invoicing totally transparent and is focussed on this quality improvement work.</p><p> </p><p>Within the Premises Cost Direction 2013 under sections 46 and 47 there is the facility for the GP to apply to NHS England for transitional funding related to large increases to service charges.</p><p> </p><p>It is only by improved understanding of the true costs that better informed decisions about the best location for NHS services can be made, as well as also encouraging the most efficient use of NHS space – both of which are important elements of securing best value for taxpayers from the health service estate.</p> answering member constituency Ludlow answering member printed Mr Philip Dunne question first answered 13/07/2017 12:44:17 answering member 1542 label Biography information for Philip Dunne
	tabling member	4433 label Biography information for Thangam Debbonaire

750176

	registered interest
	date	10/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	GP Surgeries: Repairs and Maintenance
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, on what basis the deadline of October 2017 has been set for GP surgeries to agree full repairing leases with NHS Property Services.
	tabling member constituency	Bristol West
	tabling member printed	Thangam Debbonaire
	uin	4037
	answer	answer is ministerial correction date of answer 13/07/2017 answer text <p>The Full Repairing and Insuring Lease is a standard, recognised property industry lease and as such is put forward as a starting point in the Standard Lease Agreement agreed between NHS Property Services (NHS PS) and the British Medical Association in 2016.</p><p> </p><p>NHS England has committed to a date of 30 November 2017 by which it will offer certain additional benefits to general practitioner practices which enter into a Lease. These are as follows:</p><p> </p><p>- NHS England will reimburse Stamp Duty Land Tax for an initial term of up to 15 years;</p><p>- NHS England will reimburse legal fees for conveyancing up to a maximum of £1,000, plus VAT; and</p><p>- NHS England will reimburse the Management Fee for Service Charges for both 2016/17 and 2017/18.</p><p> </p><p>NHS PS is working with all GP practices to facilitate outcomes which work for both parties in all cases, using the framework as outlined by NHS England.</p> answering member constituency Ludlow answering member printed Mr Philip Dunne question first answered 13/07/2017 12:51:36 answering member 1542 label Biography information for Philip Dunne
	tabling member	4433 label Biography information for Thangam Debbonaire

751339

	registered interest
	date	12/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Weston Hospital: Accident and Emergency Departments
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what assessment has been made of the potential effect of the decision to close Weston General Hospital's accident and emergency department at night on the long-term staffing of that department.
	tabling member constituency	Bristol West
	tabling member printed	Thangam Debbonaire
	uin	4695
	answer	answer is ministerial correction date of answer 21/07/2017 answer text <p>Since the Trust Board’s decision temporarily to close Weston General Hospital’s accident and emergency department at night, North Bristol NHS Trust and University Hospitals Bristol NHS Foundation Trust (UHB) have invested in additional staff shifts in their emergency departments and medical assessment units, and UHB has increased bed numbers. Additional community resources have also been made available in north Somerset to support people in their own homes.</p><p> </p><p>Before the temporary closure, the Bristol, North Somerset and South Gloucestershire Sustainability and Transformation Plan put in place a comprehensive set of actions to mitigate the impact. These included agreeing a bespoke policy whereby patients who are expected to stay in hospital for more than 48 hours are transported back to Weston General Hospital as soon as they are deemed clinically fit enough to travel, in order to reduce the burden on neighbouring hospitals.</p><p> </p><p>Weston General Hospital is working with local general practitioners, community services, social care colleagues and neighbouring hospitals to strengthen, redesign and rebuild urgent and emergency care services in north Somerset. This includes exploring alternative staffing models for its emergency department.</p><p>By consolidating the small number of senior medical staff into daytime hours, the Trust is now able to deliver improved staff training and team building. The aim is that leadership will improve, making its emergency department a more attractive place to work. The Trust has already recruited two new consultants to work in its emergency department since the closure was announced.</p> answering member constituency Ludlow answering member printed Mr Philip Dunne grouped question UIN 4696 question first answered 21/07/2017 09:03:45 answering member 1542 label Biography information for Philip Dunne
	tabling member	4433 label Biography information for Thangam Debbonaire

751340

	registered interest
	date	12/07/2017
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Weston Hospital: Accident and Emergency Departments
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what additional resources have been allocated to accident and emergency departments in neighbouring hospitals after the decision to close Weston General Hospital's accident and emergency department at night.
	tabling member constituency	Bristol West
	tabling member printed	Thangam Debbonaire
	uin	4696
	answer	answer is ministerial correction date of answer 21/07/2017 answer text <p>Since the Trust Board’s decision temporarily to close Weston General Hospital’s accident and emergency department at night, North Bristol NHS Trust and University Hospitals Bristol NHS Foundation Trust (UHB) have invested in additional staff shifts in their emergency departments and medical assessment units, and UHB has increased bed numbers. Additional community resources have also been made available in north Somerset to support people in their own homes.</p><p> </p><p>Before the temporary closure, the Bristol, North Somerset and South Gloucestershire Sustainability and Transformation Plan put in place a comprehensive set of actions to mitigate the impact. These included agreeing a bespoke policy whereby patients who are expected to stay in hospital for more than 48 hours are transported back to Weston General Hospital as soon as they are deemed clinically fit enough to travel, in order to reduce the burden on neighbouring hospitals.</p><p> </p><p>Weston General Hospital is working with local general practitioners, community services, social care colleagues and neighbouring hospitals to strengthen, redesign and rebuild urgent and emergency care services in north Somerset. This includes exploring alternative staffing models for its emergency department.</p><p>By consolidating the small number of senior medical staff into daytime hours, the Trust is now able to deliver improved staff training and team building. The aim is that leadership will improve, making its emergency department a more attractive place to work. The Trust has already recruited two new consultants to work in its emergency department since the closure was announced.</p> answering member constituency Ludlow answering member printed Mr Philip Dunne grouped question UIN 4695 question first answered 21/07/2017 09:03:45 answering member 1542 label Biography information for Philip Dunne
	tabling member	4433 label Biography information for Thangam Debbonaire