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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

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

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

751361

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 he has made of the effect on Bristol hospitals of the decision to close the accident and emergency department at Weston General Hospital overnight.
tabling member constituency	Bristol West
tabling member printed	Thangam Debbonaire
uin	4653
answer	answer is ministerial correction date of answer 17/07/2017 answer text <p>NHS Improvement and NHS England are working closely with the local health community to monitor and manage the impact on neighbouring trusts of the temporary overnight closure of the Weston Area Health NHS Trust’s emergency department.</p><p>Detailed modelling to evaluate the potential movement of patients to other acute providers overnight both in terms of attendances and admissions was undertaken prior to the decision being taken temporarily to close Weston’s emergency department at night. The situation is being monitored on a daily basis to understand actual patient movement overnight as well as the bed occupancy of each hospital.</p> answering member constituency Ludlow answering member printed Mr Philip Dunne question first answered 17/07/2017 14:49:40 answering member 1542 label Biography information for Philip Dunne
tabling member	4433 label Biography information for Thangam Debbonaire

751362

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	Fibroids: Medical Treatments
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what estimate he has made of the average time taken from the presentation of symptoms to a GP to the start of treatment for fibroids.
tabling member constituency	Bristol West
tabling member printed	Thangam Debbonaire
uin	4654
answer	answer is ministerial correction date of answer 17/07/2017 answer text <p>NHS England publishes monthly data on referral to treatment waiting times to monitor performance against the legal right that patients have to start consultant-led treatment within a maximum of 18 weeks from referral for non-urgent conditions. The data that are published include the proportion of patients who waited within 18 high volume specialties but not individual procedures such as fibroids or benign testicular tumours. The information requested is therefore not available.</p> answering member constituency Ludlow answering member printed Mr Philip Dunne grouped question UIN 4655 question first answered 17/07/2017 14:43:10 answering member 1542 label Biography information for Philip Dunne
tabling member	4433 label Biography information for Thangam Debbonaire

751363

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	Tumours: Medical Treatments
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what estimate he has made of the average time taken from the presentation of symptoms to a GP to the start of treatment for benign testicular tumours.
tabling member constituency	Bristol West
tabling member printed	Thangam Debbonaire
uin	4655
answer	answer is ministerial correction date of answer 17/07/2017 answer text <p>NHS England publishes monthly data on referral to treatment waiting times to monitor performance against the legal right that patients have to start consultant-led treatment within a maximum of 18 weeks from referral for non-urgent conditions. The data that are published include the proportion of patients who waited within 18 high volume specialties but not individual procedures such as fibroids or benign testicular tumours. The information requested is therefore not available.</p> answering member constituency Ludlow answering member printed Mr Philip Dunne grouped question UIN 4654 question first answered 17/07/2017 14:43:10 answering member 1542 label Biography information for Philip Dunne
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

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