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1136415

registered interest
date	02/07/2019
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	Vitamins
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what assessment they have made of (1) the safety, and (2) the effectiveness, of using IV vitamin drips and other related therapies offered by retail clinics.
tabling member printed	Lord Birt
uin	HL16865
answer	answer is ministerial correction date of answer 10/07/2019 answer text <p>If retail clinics are intending to administer vitamin drips and other related therapies intravenously for a medicinal purpose then the products and associated advertising must be in compliance with all relevant aspects of medicines legislation which includes an assessment of the safety quality and efficacy for licensed medicines.</p><p>The Medicines and Healthcare products Regulatory Agency (MHRA) is the United Kingdom body responsible for ensuring that medicines work and are acceptably safe.</p><p>Intravenous drips which are not intended for a medical purpose are not medicines and these products fall outside the MHRA’s jurisdiction.</p> answering member printed Baroness Blackwood of North Oxford question first answered 10/07/2019 15:27:10 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	2533 label Biography information for Lord Birt

1135741

registered interest
date	01/07/2019
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	Mefloquine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what assessment they have made of the European Medicines Agency Pharmacovigilance Risk Assessment Committee’s 2014 report on the toxicity of mefloquine (Larium).
tabling member printed	The Countess of Mar
uin	HL16834
answer	answer is ministerial correction date of answer 10/07/2019 answer text <p>At its meeting in February 2014, the Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency recommended that the product information for mefloquine (Lariam) be amended to state that neuropsychiatric adverse reactions may persist for months, or longer, even after discontinuation of the drug. The Medicines and Healthcare products Regulatory Agency (MHRA) accepted the recommendations and implemented the advice of the PRAC, which is reflected in the United Kingdom product information for mefloquine. In addition, the MHRA has since taken further action to ensure that these risks are adequately conveyed to UK prescribers and patients in the form of improved checklists for healthcare professionals and a patient alert card.</p> answering member printed Baroness Blackwood of North Oxford question first answered 10/07/2019 15:26:45 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	1861 label Biography information for The Countess of Mar

1135745

registered interest
date	01/07/2019
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	Sexually Transmitted Infections
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what steps they are taking to tackle the increasing number of cases of sexually transmitted infections in England.
tabling member printed	Baroness Masham of Ilton
uin	HL16838
answer	answer is ministerial correction date of answer 10/07/2019 answer text <p>The total number of those attending sexual health services, including consultations via e-Sexual Health Services in England increased by 7% between 2017 and 2018 (from 3,337,677 to 3,561,548), continuing the increasing trend over the past five years. Early detection and prompt treatment is vital to control transmission of sexually transmitted infections (STIs).</p><p>We are concerned to see the increase in STIs which highlights the importance of people practicing safe sex by using condoms. Local councils are increasingly offering a range of options including online testing to improve choice and convenience, with almost a fifth of chlamydia tests now accessed online and there are many schemes that offer free condoms to young people, gay men and other higher risk groups.</p> answering member printed Baroness Blackwood of North Oxford question first answered 10/07/2019 15:10:32 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	1850 label Biography information for Baroness Masham of Ilton

1135746

registered interest
date	01/07/2019
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	Genito-urinary Medicine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what plans they have to develop a national sexual health strategy.
tabling member printed	Baroness Masham of Ilton
uin	HL16839
answer	answer is ministerial correction date of answer 10/07/2019 answer text <p>The development of a national sexual health strategy is a key recommendation in the Health and Social Care Committee’s report on sexual health, which was published on 2 June 2019. The Government is currently considering the report’s recommendations and will publish a formal response shortly.</p> answering member printed Baroness Blackwood of North Oxford question first answered 10/07/2019 15:09:54 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	1850 label Biography information for Baroness Masham of Ilton

1135747

registered interest
date	01/07/2019
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	Genito-urinary Medicine: Finance
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what plans they have to increase funding for sexual health services in England.
tabling member printed	Baroness Masham of Ilton
uin	HL16840
answer	answer is ministerial correction date of answer 10/07/2019 answer text <p>The Government provides funding to local authorities for their public health responsibilities, including sexual health services, through a public health grant. It is for individual local authorities to decide their spending priorities based on an assessment of local need, including the need for sexual health services taking account of their statutory duties. They are required by regulations to provide services for sexually transmitted infection testing and treatment and contraception.</p><p>Future funding for local authorities’ public health responsibilities will be considered carefully in the next spending review, taking full account of the available evidence.</p> answering member printed Baroness Blackwood of North Oxford question first answered 10/07/2019 15:10:11 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	1850 label Biography information for Baroness Masham of Ilton

1135751

registered interest
date	01/07/2019
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	100,000 Genomes Project
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether those who have taken part in the NHS 100,000 Genome Project are being denied access to their own genome data; and if so, why.
tabling member printed	Lord Scriven
uin	HL16844
answer	answer is ministerial correction date of answer 10/07/2019 answer text <p>Genomics England is committed to returning results to every patient in the 100,000 Genomes Project via their National Health Service clinical team. All of the patient results will have been returned to the NHS by the end of the year.</p><p>Under the Data Protection Legislation, participants in the 100,000 Genomes Project can request their genomic and clinical data. However, a whole genome sequence is around 3 billion letters long and written in code so it is very difficult to interpret. Genomics England can provide access to a visual representation on request or provide access to the raw data. A NHS clinical team is the best route to providing a clinical interpretation of the genome results.</p> answering member printed Baroness Blackwood of North Oxford question first answered 10/07/2019 15:26:14 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	4333 label Biography information for Lord Scriven

1135412

registered interest
date	27/06/2019
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	IVF: Breast Cancer
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the Written Answers by the Parliamentary Under-Secretary of State for Health on 14 July 2014 (HC Deb, col 448W), Earl Howe on 3 December 2014 (HL273), Lord O'Shaughnessy on 3 December 2018 (HL11600), and comments by the Parliamentary Under-Secretary of State for Health on 20 January 2016 (HC Deb, col 623WH), to what extent the Human Fertilisation and Embryology Authority (HFEA) database is linked to (1) NHS databases, and (2) cancer registries; whether data from the register of patients and treatments that is maintained by the HFEA is sufficient to assess the contention that IVF in older women linked to an increased risk of breast cancer; and how the HFEA will ensure that information provided to patients regarding any potential long-term safety implications associated with treatment will include appropriate reference to such risks.
tabling member printed	Lord Alton of Liverpool
uin	HL16733
answer	answer is ministerial correction date of answer 10/07/2019 answer text <p>The Human Fertilisation and Embryology Authority (HFEA) Register is not linked to any National Health Service databases or cancer registries; and data from the Register alone would not allow an assessment of the risk to be identified. However, under the Human Fertilisation and Embryology Act (Disclosure of Information for Research Purposes) Regulations 2010, the HFEA may authorise the processing of disclosable protected information contained in the Register for research, in the public interest or in the interests of improving patient care. A recent study by University College London investigated risks of ovarian, breast, and corpus uteri cancer in women treated with Assisted Reproductive Technologies and found no link between the use of ovarian stimulatory drugs and an increased risk of cancer.</p><p>The HFEA continually updates patient information whenever new clinical information is available. The HFEA is advised by the Scientific and Clinical Advances Advisory Committee on scientific and clinical developments (including research) in assisted conception, embryo research and related areas.</p> answering member printed Baroness Blackwood of North Oxford question first answered 10/07/2019 15:08:03 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	738 label Biography information for Lord Alton of Liverpool

1135413

registered interest
date	27/06/2019
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	IVF: Drugs
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the Written Answers by the Parliamentary Under-Secretary of State for Health on 14 July 2014 (HC Deb, col 448W), Earl Howe on 3 December 2014 (HL273), and comments by the Parliamentary Under-Secretary of State for Health on 20 January 2016 (HC Deb, col 623WH), how the Human Fertilisation and Embryology Authority (HFEA) ensures that clinics follow National Institute for Health and Care Excellence guidelines on limiting the use of ovulation induction or ovarian stimulation agents to the lowest effective dose and duration of use without collecting information on the identity of drugs used in treatment, the dosage used and the associated regimen for ovarian stimulation at each licensed centre; and what would be needed for the HFEA to regulate the administration of drugs during in vitro fertilisation treatment.
tabling member printed	Lord Alton of Liverpool
uin	HL16734
answer	answer is ministerial correction date of answer 10/07/2019 answer text <p>The Human Fertilisation and Embryology Acts 1990 and 2008 do not provide for the regulation of the use or monitoring of medicines used in fertility treatment.</p><p>Medicines used in fertility treatment are licensed by the Medicines and Healthcare products Regulatory Agency. These medicines may be used in Human Fertilisation and Embryology Authority-licensed clinics or in other settings, for example by general practitioners.</p><p>Medicine prescribing is a matter of clinical judgement, taking account of the individual patient’s circumstances and professional guidance. It is the duty of every clinician to take into account the welfare and best interest of their patient when deciding on the appropriate treatment for them for any medical condition, in line with General Medical Council’s good medical practice guidance.</p> answering member printed Baroness Blackwood of North Oxford question first answered 10/07/2019 15:09:39 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	738 label Biography information for Lord Alton of Liverpool

1135065

registered interest
date	26/06/2019
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	Bacterial Diseases
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the Written Answer by Baroness Blackwood of North Oxford on 4 June (HL15832), what assessment they have made of (1) the future costs to the NHS as a result of the spread of carbapenem-resistant Enterobacteriaceae, (2) the costs of new measures introduced in 2019 specifically to prevent the transmission of such Enterobacteriaceae, and (3) the views of infection control nurses on investment to prevent the transmission of such Enterobacteriaceae.
tabling member printed	Baroness Gardner of Parkes
uin	HL16692
answer	answer is ministerial correction date of answer 09/07/2019 answer text <p>Public Health England (PHE) has predicted future spread and the health and cost impact to the National Health Service of the Enterobacteriaceae Escherichia coli and a national outbreak of a highly-resistant organism, reflecting carbapenem-resistant Enterobacteriaceae. The models used in this assessment are published in the paper <em>A Risk Assessment of Antibiotic Pan-Drug-Resistance in the UK: Bayesian Analysis of an Expert Elicitation Study</em>. A copy of the paper is attached.</p><p>Such predictions are highly uncertain. There remain unknowns regarding transmission, efficacy of interventions and the additional hospital stay for infected patients (constituting a large part of the cost to the NHS).</p><p>PHE has worked with NHS colleagues, estimating the cost of controlling a carbapenemase-producing Enterobacteriaceae (CPE) outbreak in five London hospitals to be over £1 million. Monitoring costs alongside implementation of PHE’s upcoming update of the CPE toolkit for health and social care is an important component of enabling cost-effectiveness evaluation.</p><p>Staff interviewed about the challenges of implementing the existing CPE toolkit highlighted maintaining awareness and training as key challenges, alongside infection prevention resourcing. An analysis of the responses was published in the paper <em>An evaluation of a toolkit for the early detection, management, and control of carbapenemase-producing Enterobacteriaceae: a survey of acute hospital trusts in England</em>. A copy is attached.</p> answering member printed Baroness Blackwood of North Oxford attachment 1 file name A Risk Assessment of Antibiotic Pan-Drug-Resistance in the UK.pdf title Risk Assessment of Antibiotic Pan Drug Resistance 2 file name An evaluation of a toolkit for the early detection management and control of carbapenemase-producing Enterobacteriaceae. A survey of acute hospital .pdf title An evaluation of a toolkit question first answered 09/07/2019 13:34:21 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	3596 label Biography information for Baroness Gardner of Parkes

1135071

registered interest
date	26/06/2019
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	NHS: Migrant Workers
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what recent assessment they have made of the impact on the ability of the NHS to recruit experienced staff from the EU of the UK leaving the EU without a deal; and what plans they have to make up any shortfall in numbers of staff.
tabling member printed	Lord Jones of Cheltenham
uin	HL16698
answer	answer is ministerial correction date of answer 09/07/2019 answer text <p>The Government recognises the need for the National Health Service to be able to recruit effectively from abroad and the Immigration White Paper, <em>The UK’s future skills-based immigration system</em>, published in December 2018, sets out the foundation for a single immigration system, where it is workers’ skills that matter, not where they come from.</p><p>The Government has taken steps to ensure that European Union citizens can continue to come and work in the NHS once we have left the EU. In March 2019, we put in place legislation that ensures the continued recognition of qualifications from EU countries by all professional regulators covering the health and social care sectors. This means that EU citizens will continue to be able to come and practice in the United Kingdom once we have left the EU, even if we leave without a ‘deal’.</p><p>The NHS Long Term Plan and interim People Plan have both set out a vital strategic framework to ensure that over the next 10 years the NHS will have the staff it needs so that nurses and doctors have the time they need to care, working in a supportive culture that allows them to provide the expert compassionate care they are committed to providing. The interim People Plan sets out how part of this will be made up from an expansion of international recruitment of NHS staff.</p><p> </p> answering member printed Baroness Blackwood of North Oxford question first answered 09/07/2019 12:38:48 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	248 label Biography information for Lord Jones of Cheltenham