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1082134

registered interest
date	05/03/2019
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	Antimicrobials: Prices
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 his Department has made of the potential merits of using models that de-link the cost of research and development from the price of the final product and the volume of sales, as set out in the 2016 UN Political Declaration of the High-Level Meeting of the General Assembly on antimicrobial resistance, to ensure that new diagnostics, medicines and tools created are accessible and affordable.
tabling member constituency	Central Ayrshire
tabling member printed	Dr Philippa Whitford
uin	228683
answer	answer is ministerial correction date of answer 11/03/2019 answer text <p>The 2016 United Nations political declaration on antimicrobial resistance (AMR) acknowledged the importance of delinking the cost of investment in research and development on AMR from the price and volume of sales to facilitate equitable and affordable access to new products and encouraged governments to explore innovative approaches.</p><p> </p><p>It is critical that the National Health Service makes the best use of its resources. Any payment model must therefore be based on a robust evaluation of the value that a new antimicrobial product brings to patients and the public as a whole. The assessment of how much value a new antibiotic brings is highly complex and will vary considerably from one product to another.</p><p> </p><p>In the United Kingdom, NHS England and the National Institute for Health and Care Excellence (NICE) are leading work to test innovative models that pay companies based primarily on a NICE led health technology assessment of their value to the NHS as opposed to the volumes used. This has the potential to both promote good antimicrobial stewardship and provide a much-needed incentive for the development of new antimicrobial agents that will, over time, provide value for the NHS.</p><p> </p><p>The test will be subject to robust evaluation before considering any wider change to purchasing policy. The UK represents only a small part of the global market for these drugs and we want to send a signal to the rest of the world that there are workable models to achieve the right sort of incentives for these vital medicines.</p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 228682 question first answered 11/03/2019 18:32:38 answering member 4067 label Biography information for Steve Brine previous answer version 106925 answering member constituency Winchester answering member printed Steve Brine answering member 4067 label Biography information for Steve Brine
tabling member	4385 label Biography information for Dr Philippa Whitford

1082185

registered interest
date	05/03/2019
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	Lyme Disease
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 advances in the abilities of medical practitioners to diagnose Lyme Disease; and if he will make a statement.
tabling member constituency	Tewkesbury
tabling member printed	Mr Laurence Robertson
uin	228550
answer	answer is ministerial correction date of answer 11/03/2019 answer text <p>Individual medical schools set undergraduate medical training curricula and the relevant Royal Colleges set postgraduate medical training curricula which have to meet the standards set by the General Medical Council. Curricula should emphasise the skills and approaches that a doctor must develop in order to ensure accurate and timely diagnoses and treatment plans for their patients.</p><p><strong> </strong></p><p>The National Institute for Health and Care Excellence (NICE) published updated guidance in 2018 on the diagnoses and management of Lyme disease, which can be found at the following link:</p><p> </p><p><a href="https://www.nice.org.uk/guidance/ng95" target="_blank">https://www.nice.org.uk/guidance/ng95</a></p><p> </p><p>The guidance aims to raise awareness of when Lyme disease should be suspected and ensure that people have prompt and consistent diagnosis and treatment. NICE’s guidelines help health and care professionals deliver the best possible care based on the best available evidence. The guidelines are not mandatory, although health and care commissioners are expected to take them fully into account. In addition, in February 2019, NICE published the following article at the following link:</p><p> </p><p><a href="https://www.nice.org.uk/news/article/diagnose-lyme-disease-if-bull-s-eye-rash-is-present-says-nice" target="_blank">https://www.nice.org.uk/news/article/diagnose-lyme-disease-if-bull-s-eye-rash-is-present-says-nice</a></p><p> </p><p>Public Health England published guidance on Lyme disease in July 2018, which describes the clinical signs and symptoms of Lyme disease and is consistent with the NICE guidance. The guidance can be found at the folloiwng link:</p><p> </p><p><a href="https://www.gov.uk/government/collections/lyme-disease-guidance-data-and-analysis" target="_blank">https://www.gov.uk/government/collections/lyme-disease-guidance-data-and-analysis</a></p><p> </p><p> </p><p> </p><p><strong> </strong></p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 228551 question first answered 11/03/2019 18:29:30 answering member 4067 label Biography information for Steve Brine previous answer version 106916 answering member constituency Winchester answering member printed Steve Brine answering member 4067 label Biography information for Steve Brine
tabling member	253 label Biography information for Mr Laurence Robertson

1082191

registered interest
date	05/03/2019
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	Lyme Disease
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what training is given to medical practitioners to enable them to (a) recognise the symptoms of and (b) treat Lyme Disease; and if he will make a statement.
tabling member constituency	Tewkesbury
tabling member printed	Mr Laurence Robertson
uin	228551
answer	answer is ministerial correction date of answer 11/03/2019 answer text <p>Individual medical schools set undergraduate medical training curricula and the relevant Royal Colleges set postgraduate medical training curricula which have to meet the standards set by the General Medical Council. Curricula should emphasise the skills and approaches that a doctor must develop in order to ensure accurate and timely diagnoses and treatment plans for their patients.</p><p><strong> </strong></p><p>The National Institute for Health and Care Excellence (NICE) published updated guidance in 2018 on the diagnoses and management of Lyme disease, which can be found at the following link:</p><p> </p><p><a href="https://www.nice.org.uk/guidance/ng95" target="_blank">https://www.nice.org.uk/guidance/ng95</a></p><p> </p><p>The guidance aims to raise awareness of when Lyme disease should be suspected and ensure that people have prompt and consistent diagnosis and treatment. NICE’s guidelines help health and care professionals deliver the best possible care based on the best available evidence. The guidelines are not mandatory, although health and care commissioners are expected to take them fully into account. In addition, in February 2019, NICE published the following article at the following link:</p><p> </p><p><a href="https://www.nice.org.uk/news/article/diagnose-lyme-disease-if-bull-s-eye-rash-is-present-says-nice" target="_blank">https://www.nice.org.uk/news/article/diagnose-lyme-disease-if-bull-s-eye-rash-is-present-says-nice</a></p><p> </p><p>Public Health England published guidance on Lyme disease in July 2018, which describes the clinical signs and symptoms of Lyme disease and is consistent with the NICE guidance. The guidance can be found at the folloiwng link:</p><p> </p><p><a href="https://www.gov.uk/government/collections/lyme-disease-guidance-data-and-analysis" target="_blank">https://www.gov.uk/government/collections/lyme-disease-guidance-data-and-analysis</a></p><p> </p><p> </p><p> </p><p><strong> </strong></p> answering member constituency Winchester answering member printed Steve Brine grouped question UIN 228550 question first answered 11/03/2019 18:29:30 answering member 4067 label Biography information for Steve Brine previous answer version 106918 answering member constituency Winchester answering member printed Steve Brine answering member 4067 label Biography information for Steve Brine
tabling member	253 label Biography information for Mr Laurence Robertson

1082223

registered interest
date	05/03/2019
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	Hormone Replacement Therapy
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, what estimate he has made of the amount of HRT that was (a) prescribed and (b) dispensed in England and Wales in 2017-18.
tabling member constituency	Redditch
tabling member printed	Rachel Maclean
uin	228786
answer	answer is ministerial correction date of answer 12/03/2019 answer text <p>NHS Digital does not hold the data in the format requested. Data is not collected centrally on prescriptions written but not dispensed. Therefore no such estimate has been made. NHS Digital holds data on prescription items of female sex hormones and their modulators written in the United Kingdom and dispensed in the community in England for the period requested, via an FP10 prescription form, which is available in the following table.</p><p> </p><table><tbody><tr><td><p>Financial Year</p></td><td><p>British National Formulary (BNF) Code</p></td><td><p>BNF sub-paragraph name</p></td><td><p>Number of Items</p></td></tr><tr><td><p>2017/18</p></td><td><p>BNF 6.4.1.1</p></td><td><p>Oestrogens and Hormone Replacement Therapy (HRT)</p></td><td><p>2,591,408</p></td></tr><tr><td><p>2017/18</p></td><td><p>BNF 6.4.1.2</p></td><td><p>Progestogens and Progesterone Receptor Modulators</p></td><td><p>683,594</p></td></tr></tbody></table><p>Source: Prescription Cost Analysis, NHS Digital</p><p> </p><p>Notes:</p><ol><li>Data is provided for female sex hormones and their modulators, listed in the BNF paragraph 6.4.1, split by BNF subparagraphs 6.4.1.1 Oestrogens and Hormone Replacement Therapy and 6.4.1.2 Progestogens and Progesterone Receptor Modulators.</li><li>NHS Digital only has information about NHS prescription items dispensed to patients in the community in England using a FP10 prescription form. Accordingly, NHS Digital does not hold data: on drugs dispensed in hospitals, on private prescriptions, on prescriptions written but not dispensed and about other supply routes.</li><li>NHS Digital has no access to data for medicines dispensed in Wales.</li></ol> answering member constituency Winchester answering member printed Steve Brine question first answered 12/03/2019 12:32:31 answering member 4067 label Biography information for Steve Brine
tabling member	4668 label Biography information for Rachel Maclean

1082279

registered interest
date	05/03/2019
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	Surgery: Alexandra Hospital Redditch
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, when he expects a decision will be made on the commissioning of a prostate surgery robotic unit at the Alexandra Hospital in Redditch.
tabling member constituency	Redditch
tabling member printed	Rachel Maclean
uin	228787
answer	answer is ministerial correction date of answer 12/03/2019 answer text <p>There are some significant changes in the new service specification for Specialised Kidney, Bladder and Prostate cancer services for adults which was published on 25 February 2019. The publication can be found at the following link:</p><p> </p><p><a href="https://www.england.nhs.uk/wp-content/uploads/2019/02/Specialised-kidney-bladder-and-prostate-cancer-services-adults.pdf" target="_blank">https://www.england.nhs.uk/wp-content/uploads/2019/02/Specialised-kidney-bladder-and-prostate-cancer-services-adults.pdf</a></p><p> </p><p>These changes are based on the latest clinical evidence to ensure NHS England deliver the best outcomes to our patients. NHS England is required to review the provision of specialised kidney, bladder and prostate cancer services for adults across the West Midlands to ensure compliance. This review will include the provision of robotic prostatectomy as it is part of the kidney, bladder and prostate cancer service.</p><p> </p><p>This will mean that, in conjunction with the West Midland Cancer Alliance, specialised commissioners will undertake a programme of work to develop a new commissioning framework for these services over the next 12 months that ensures compliance with the new service specification. Following this, NHS England will be able to work with trusts and local populations to implement the new model across the West Midlands.</p><p> </p><p>No decision about robotic services in Worcester will be made until this review is complete to ensure that robotic surgery is commissioned appropriately.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 12/03/2019 12:28:02 answering member 4067 label Biography information for Steve Brine
tabling member	4668 label Biography information for Rachel Maclean

1082309

registered interest
date	05/03/2019
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	Obesity: Children
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, how many children aged (a) four to five and (b) 10 to 11 years were recorded as obese in (i) England, (ii) each English region and (iii) each London borough in each year since 2010-11.
tabling member constituency	Leicester South
tabling member printed	Jonathan Ashworth
uin	228739
answer	answer is ministerial correction date of answer 13/03/2019 answer text <p><strong></strong>Data on the number of children recorded as obese in England, each region and each London Borough aged four to five years and aged 10 to 11 years, are attached.</p> answering member constituency Winchester answering member printed Steve Brine attachment 1 file name Table 1_Number of children aged 4-5 years measured in the National Child Measurement Programme (NCMP) in the obese category.docx title PQ228739 attached table 2 file name Table 2_Number of children aged 10-11 years measured in the National Child Measurement Programme (NCMP) in the obese category.docx title PQ228739 attached table question first answered 13/03/2019 12:32:22 answering member 4067 label Biography information for Steve Brine
tabling member	4244 label Biography information for Jonathan Ashworth

1082319

registered interest
date	05/03/2019
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	E. coli
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, how many people have been diagnosed with E. coli in each financial year for which data are available since 2010-11.
tabling member constituency	Leicester South
tabling member printed	Jonathan Ashworth
uin	228743
answer	answer is ministerial correction date of answer 12/03/2019 answer text <p>The counts and rates of Escherichia coli (E. coli) bacteraemia (bloodstream infection) cases reported by National Health Service acute trusts in England are given in the following table.</p><p> </p><p>E. coli bacteraemia counts by financial year, England: 2012/13 to 2017/18</p><table><tbody><tr><td><p>Financial Year</p></td><td><p>All reported E. coli bacteraemia cases</p></td></tr><tr><td><p>2012/13</p></td><td><p>32,309</p></td></tr><tr><td><p>2013/14</p></td><td><p>34,286</p></td></tr><tr><td><p>2014/15</p></td><td><p>35,812</p></td></tr><tr><td><p>2015/16</p></td><td><p>38,288</p></td></tr><tr><td><p>2016/17</p></td><td><p>40,630</p></td></tr><tr><td><p>2017/18</p></td><td><p>41,060</p></td></tr></tbody></table><p>Notes:</p><ol><li>Source:</li></ol><p>Annual epidemiological commentary: Gram-negative bacteraemia, Meticillin-Resistant Staphylococcus aureus (MRSA) bacteraemia, Meticillin-Sensitive Staphylococcus aureus (MSSA) bacteraemia and C. difficile infections, up to and including financial year April 2017 to March 2018</p><p> </p><p><a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/724030/Annual_epidemiological_commentary_2018.pdf" target="_blank">https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/724030/Annual_epidemiological_commentary_2018.pdf</a></p><p> </p><ol start="2"><li>Since the mid-2000s onwards, E. coli has been the major cause of bacteraemia. Given the increase in the number of E. coli bacteraemia reports made through the voluntary surveillance programme, the Department made reporting of E. coli bacteraemia by NHS acute trusts mandatory in June 2011.</li></ol><p> </p><p>Data prior to financial year 2012/13 are not available.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 12/03/2019 12:25:22 answering member 4067 label Biography information for Steve Brine
tabling member	4244 label Biography information for Jonathan Ashworth

1082365

registered interest
date	05/03/2019
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	General Practitioners: Easington
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, how many GPs are registered in the Easington constituency.
tabling member constituency	Easington
tabling member printed	Grahame Morris
uin	228654
answer	answer is ministerial correction date of answer 12/03/2019 answer text <p>The data requested is not available in the format requested.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 12/03/2019 12:26:47 answering member 4067 label Biography information for Steve Brine
tabling member	3973 label Biography information for Grahame Morris

1082386

registered interest
date	05/03/2019
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	General Practitioners
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 average annual cost to a GP's surgery is of providing NHS GP funding formula funded primary care to someone between the ages of 20 to 49 years old.
tabling member constituency	Bristol North West
tabling member printed	Darren Jones
uin	228781
answer	answer is ministerial correction date of answer 11/03/2019 answer text <p>We do not collect information for primary medical care practices about the cost of providing care to individual patients or cohorts of patients.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 11/03/2019 18:24:06 answering member 4067 label Biography information for Steve Brine previous answer version 106919 answering member constituency Winchester answering member printed Steve Brine answering member 4067 label Biography information for Steve Brine
tabling member	4621 label Biography information for Darren Jones

1081702

registered interest
date	04/03/2019
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	Diabetes
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 potential merits of NICE guidance on timelines for hyperglycaemia before the provision of additional treatment in order to reduce clinical inertia among type 1 diabetes patients.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	227995
answer	answer is ministerial correction date of answer 12/03/2019 answer text <p>No such assessment has been made.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 12/03/2019 16:26:30 answering member 4067 label Biography information for Steve Brine
tabling member	4131 label Biography information for Jim Shannon