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387709

registered interest
date	06/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Mesothelioma: Chemotherapy
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether, following the decision by the panel of the Cancer Drugs Fund (CDF) that the clinical benefits of pemetrexed as a maintenance treatment in patients with locally advanced or metastatic non-squamous non-small cell lung cancer, and who had previously not progressed on chemotherapy with the combination of cisplatin and pemetrexed, were insufficient to justify retaining pemetrexed within the CDF, pemetrexed will be withdrawn as a treatment option for patients with mesothelioma.
tabling member printed	Lord Alton of Liverpool
uin	HL1086
answer	answer is ministerial correction date of answer 20/07/2015 answer text <p>NHS England has advised that pemetrexed (Alimta) for maintenance treatment of stage IIIB/IV non-squamous non-small cell lung cancer after response to pemetrexed-containing first line therapy will be reviewed by the national Cancer Drug Fund (CDF) panel at its next meeting at the end of July 2015. It will remain on the national CDF list for that indication pending the outcome of that further review.</p><p> </p><p> </p><p> </p><p>Pemetrexed remains available for those patients who meet the criteria set out in the National Institute for Health and Care Excellence’s technology appraisal guidance on pemetrexed for the treatment of malignant pleural mesothelioma (TA135).</p><p> </p> answering member printed Lord Prior of Brampton question first answered 20/07/2015 10:39:14 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	738 label Biography information for Lord Alton of Liverpool

387712

registered interest
date	06/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Medical Records: Transgender People
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what steps are being taken to ensure that the Health and Social Care Information Centre informs transsexual patients whose health data has been wrongly disclosed to third parties.
tabling member printed	Baroness Barker
uin	HL1089
answer	answer is ministerial correction date of answer 20/07/2015 answer text <p>The Health and Social Care Information Centre (HSCIC) takes every precaution to ensure compliance with legislation and that identifiable data is not disclosed without a legal basis to do so. There are strict controls set out within the Data Protection Act that govern the disclosure of sensitive data.</p><p> </p><p><strong> </strong></p><p> </p><p>In all scenarios involving patient’s health data being wrongly disclosed, irrespective of the personal circumstances of a patient, HSCIC would seek to ensure appropriate reporting, investigations and corrective actions took place.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL1090 question first answered 20/07/2015 10:38:41 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	2501 label Biography information for Baroness Barker

387713

registered interest
date	06/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Health and Social Care Information Centre: Gender Recognition
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what steps they are taking to ensure that the Health and Social Care Information Centre does not contravene section 22 of the Gender Recognition Act 2004.
tabling member printed	Baroness Barker
uin	HL1090
answer	answer is ministerial correction date of answer 20/07/2015 answer text <p>The Health and Social Care Information Centre (HSCIC) takes every precaution to ensure compliance with legislation and that identifiable data is not disclosed without a legal basis to do so. There are strict controls set out within the Data Protection Act that govern the disclosure of sensitive data.</p><p> </p><p><strong> </strong></p><p> </p><p>In all scenarios involving patient’s health data being wrongly disclosed, irrespective of the personal circumstances of a patient, HSCIC would seek to ensure appropriate reporting, investigations and corrective actions took place.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL1089 question first answered 20/07/2015 10:38:42 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	2501 label Biography information for Baroness Barker

387717

registered interest
date	06/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Monitor: Employment Agencies
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how many agency staff Monitor has used since 2010; and at what cost.
tabling member printed	Lord Hunt of Kings Heath
uin	HL1094
answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>Monitor use agency staff to temporarily fill administrative and clerical roles according to the business needs of the organisation, providing cover for vacancy, holiday and sickness.</p><p> </p><p> </p><p> </p><p>The table below shows Monitor’s approximate average headcount for agency staff between 2010-11 and 2014-15. The total cost over this period was £1.564 million including VAT.</p><p> </p><p> </p><p> </p><p>To note, there is some discrepancy in the data as collection methodology changed in 2011, when it started to be collected monthly.</p><p> </p><p> </p><p> </p><p>Figures for headcount and spend on agency staff:</p><p> </p><p> </p><p> </p><table><tbody><tr><td> </td><td><p>Average Headcount</p></td><td><p>Cost, £000 incl VAT</p></td></tr><tr><td><p>2010-11</p></td><td><p>5.5</p></td><td><p>160**</p></td></tr><tr><td><p>2011-12</p></td><td><p>8</p></td><td><p>235**</p></td></tr><tr><td><p>2012-13</p></td><td><p>13</p></td><td><p>385*</p></td></tr><tr><td><p>2013-14</p></td><td><p>12.5</p></td><td><p>418</p></td></tr><tr><td><p>2014-15</p></td><td><p>10.5</p></td><td><p>366</p></td></tr><tr><td> </td><td> </td><td> </td></tr><tr><td><p>Sum</p></td><td><p>50</p></td><td><p>1,564</p></td></tr><tr><td><p>Average</p></td><td><p>10</p></td><td><p>313</p></td></tr></tbody></table><p> </p><p>* Extrapolation of full year position from incomplete data</p><p> </p><p>** Extrapolation based on trends</p><p> </p> answering member printed Lord Prior of Brampton question first answered 14/07/2015 15:28:39 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

387718

registered interest
date	06/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Monitor: Temporary Employment
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what assessment they have made of Monitor’s use of temporary staff to work with NHS Foundation Trusts on reducing agency staff costs as a model for the National Health Service.
tabling member printed	Lord Hunt of Kings Heath
uin	HL1095
answer	answer is ministerial correction date of answer 20/07/2015 answer text <p>This Government is determined to reduce expensive staffing agency costs in the National Health Service.</p><p> </p><p> </p><p> </p><p>Monitor’s project will look at how best to reduce this spend and enable the NHS to set up systems to deliver savings.</p><p> </p><p><strong> </strong></p><p> </p><p>Spending on temporary staff in the NHS was £2.4 billion in 2013-14. In contrast, this initial work, led by Monitor, will cost £175,000 (excluding VAT) and could lead to substantive appointments being made to take the work forwards if required.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 20/07/2015 10:39:45 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

387719

registered interest
date	06/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Health Professions: Training
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what representations they have received from Monitor regarding the case for increasing training places for doctors and nurses since 2010.
tabling member printed	Lord Hunt of Kings Heath
uin	HL1096
answer	answer is ministerial correction date of answer 20/07/2015 answer text <p>The Department has not received any specific representations from Monitor regarding increasing the number of training places for doctors and nurses.</p><p> </p><p><strong> </strong></p><p> </p><p>Health Education England (HEE) is responsible for workforce planning for the National Health Service and as part of that process liaise with all arms length bodies, including Monitor, individual healthcare providers and key stakeholders regards medical and non medical staffing requirements going forward.</p><p> </p><p> </p><p> </p><p>The Department set up HEE to deliver a better health and healthcare workforce for England. HEE is responsible for ensuring a secure workforce supply for the future balancing need against demand, taking into account factors such as the age profile of the existing workforce, the impact of technology, and new drugs.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 20/07/2015 10:41:02 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

387737

registered interest
date	06/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Folic Acid
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what consideration they have given to reducing the use of folic supplementation by women of child-bearing age.
tabling member printed	Lord Rooker
uin	HL1114
answer	answer is ministerial correction date of answer 20/07/2015 answer text <p>The Government has not given consideration to reducing the use of folic acid supplementation by women of child-bearing age.</p><p> </p><p> </p><p> </p><p>To reduce the risk of neural tube defect affected pregnancies, all women who could become pregnant are advised to take an additional 400μg/day folic acid as a medicinal or food supplement prior to conception and until the twelfth week of pregnancy.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 20/07/2015 10:41:30 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	302 label Biography information for Lord Rooker

387738

registered interest
date	06/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Folic Acid
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether they have any recent evidence that a folic acid deficiency in men may lead to birth defects in their offspring.
tabling member printed	Lord Rooker
uin	HL1115
answer	answer is ministerial correction date of answer 20/07/2015 answer text <p>Public Health England is not aware of any evidence to suggest that a folic acid deficiency in men may lead to birth defects in their offspring.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 20/07/2015 10:41:44 answering member 127 label Biography information for Lord Prior of Brampton
tabling member	302 label Biography information for Lord Rooker

387739

registered interest
date	06/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Folic Acid
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what were the serum folate levels in women of child-bearing age in the latest results of the National Diet and Nutrition Survey; and how these compare to the World Health Organisation thresholds.
tabling member printed	Lord Rooker
uin	HL1116
answer	answer is ministerial correction date of answer 20/07/2015 answer text <p>Serum total folate concentrations were published in a National Diet and Nutrition Survey Supplementary Report on 20 March 2015, available at the following link and has also been attached.</p><p> </p><p> </p><p> </p><p><a href="https://www.gov.uk/government/statistics/national-diet-and-nutrition-survey-supplementary-report-blood-folate" target="_blank">https://www.gov.uk/government/statistics/national-diet-and-nutrition-survey-supplementary-report-blood-folate</a></p><p> </p><p> </p><p> </p><p>For women of child bearing age (16 to 49 years) in the United Kingdom, mean serum total folate concentration was 20.0 nmol/L, 16.5% had concentrations below 10 nmol/L, the World Health Organization (WHO) threshold indicating biochemical folate deficiency.</p><p> </p> answering member printed Lord Prior of Brampton question first answered 20/07/2015 10:42:49 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name NDNS_Y1_4_Folate_report.pdf title Folate Report
tabling member	302 label Biography information for Lord Rooker

387206

registered interest
date	02/07/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Vitamin B12
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether they plan to replace the current test for human vitamin B12 status with the Active B12 (holotranscobalamin) test; and if not, why not.
tabling member printed	The Countess of Mar
uin	HL1042
answer	answer is ministerial correction date of answer 14/07/2015 answer text <p>The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, <em>Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders</em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.</p><p> </p><p>The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.</p><p> </p><p> </p><p> </p><p>The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.</p><p> </p><p> </p><p> </p><p>When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.</p><p> </p><p> </p><p> </p><p>Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.</p><p> </p><p> </p><p> </p><p>Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.</p><p> </p><p> </p><p> </p><p>The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.</p><p> </p> answering member printed Lord Prior of Brampton grouped question UIN HL1032 HL1033 HL1034 HL1035 HL1036 question first answered 14/07/2015 15:00:42 answering member 127 label Biography information for Lord Prior of Brampton attachment 1 file name colbalamin and folate disorders.pdf title BSCH Guidance
tabling member	1861 label Biography information for The Countess of Mar