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101009

registered interest
date	27/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	General Practitioners: Pay
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, further to the announcement by NHS England that general practitioners are to be paid an additional £55 for diagnosing dementia in patients, what other complaints or illnesses diagnosed by general practitioners are already rewarded by payments additional to their salaries; and whether they will review the system of additional payments of this sort.
tabling member printed	Lord Stoddart of Swindon
uin	HL2465
answer	answer is ministerial correction date of answer 05/11/2014 answer text <p>General Practitioner (GP) income is made up of global sum payments for carrying out essential and additional services under the contract. Practices may also receive further payments for specific services including:</p><p> </p><p> </p><p> </p><p>- enhanced services – those that require an enhanced level of service provision above what is required under the core contract. The additional payment for diagnosing dementia falls within this category; and</p><p> </p><p> </p><p> </p><p>- the quality and outcomes framework (QOF) - a voluntary incentive scheme that provides payment to GP practices for how well they care for patients based on performance against a number of agreed indicators.</p><p> </p><p> </p><p> </p><p>Specifically on diagnosis, a number of QOF indicators are concerned with the establishment of disease registers. In order to receive payment GPs are required to ensure diagnosis levels consistent with those expected for their population for the following conditions:</p><p> </p><p> </p><p> </p><p>- atrial fibrillation;</p><p> </p><p>- coronary heart disease;</p><p> </p><p>- heart failure;</p><p> </p><p>- hypertension;</p><p> </p><p>- peripheral arterial disease;</p><p> </p><p>- stroke and trans-ischaemic attack;</p><p> </p><p>- diabetes mellitus;</p><p> </p><p>- hypothyroidism;</p><p> </p><p>- asthma;</p><p> </p><p>- chronic obstructive pulmonary disease;</p><p> </p><p>- dementia;</p><p> </p><p>- depression;</p><p> </p><p>- schizophrenia, bipolar affective disorder and other psychoses and other patients on lithium therapy;</p><p> </p><p>- cancer;</p><p> </p><p>- chronic kidney disease;</p><p> </p><p>- epilepsy;</p><p> </p><p>- osteoporosis;</p><p> </p><p>- rheumatoid arthritis; and</p><p> </p><p>- obesity.</p><p> </p><p><strong> </strong></p><p> </p><p> </p><p> </p><p>Each year NHS Employers, on behalf of NHS England, negotiates the new GP contract with the General Practitioners Council of the British Medical Association. This includes discussion of changes to the Enhanced Services and QOF.</p><p> </p> answering member printed Earl Howe question first answered 05/11/2014 12:10:48 answering member 2000 label Biography information for Earl Howe
tabling member	950 label Biography information for Lord Stoddart of Swindon

101109

registered interest
date	27/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	School Milk
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what assessment she has made of the effect of recent changes to the nursery milk scheme on the ability of schools to fulfil the requirements of the School Food Standards in relation to milk.
tabling member constituency	Livingston
tabling member printed	Graeme Morrice
uin	212127
answer	answer is ministerial correction date of answer 03/11/2014 answer text <p>A modernised Nursery Milk Scheme is currently under development and expected to be tendered in due course.</p><p> </p><p> </p><p> </p><p>The assessment of any effects of the changes to the Nursery Milk Scheme are part of ongoing discussions between officials via a cross Government Nursery Milk Scheme Task and Finish Group.</p><p> </p><p> </p><p> </p><p>The changes have no impact on either the current School Food Standards Regulations or the new School Food Standards Regulations which come into force on 1 January 2015.</p><p> </p><p> </p><p> </p><p>The Nursery Milk Scheme is available to all children under five who attend an eligible childcare setting for two hours per day or more. Eligible settings include child-minders, day care providers, private and local authority run nurseries. The School Food Standards apply to schools rather than nursery and private childcare and child minder settings.</p><p> </p><p> </p><p> </p><p><strong> </strong></p><p> </p> answering member constituency Central Suffolk and North Ipswich answering member printed Dr Daniel Poulter question first answered 03/11/2014 16:47:01 answering member 3932 label Biography information for Dr Dan Poulter
tabling member	4012 label Biography information for Graeme Morrice

100854

registered interest
date	24/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Care Workers: Minimum Wage
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, whether his Department has made an assessment of or received evidence on the effect on care standards of non-payment of the national minimum wage in the social care sector.
tabling member constituency	Stockton North
tabling member printed	Alex Cunningham
uin	211866
answer	answer is ministerial correction date of answer 03/11/2014 answer text <p>The Department has not conducted any recent research on the effect of treatment of staff on standards of care and on the relationship between levels of pay and quality of social care services.</p><p> </p><p> </p><p> </p><p>As part of the development of Caring for our Future white paper in 2011, the Department undertook extensive engagement with both service users and carers who highlighted a range of issues they felt needed addressing to ensure high quality care and support is available. In addressing this, the Department, working with the Sector Skills Council – Skills for Care – and other partners, has implemented a range of policies that has included setting out clear minimum training standards, recruiting more apprentices and supporting the transformation of the social work profession.</p><p> </p><p> </p><p> </p><p>There are a number of factors that determine the quality of care provided in the social care sector, including the way staff are treated. Pay is not the single most significant factor in delivering high quality services.</p><p> </p><p> </p><p> </p><p>The Department is clear however that care providers must abide by the law with regards to payment of the national minimum wage and is taking steps to ensure this happens. The Department is liaising with the Department for Business, Innovation and Skills to name and shame any social care providers who do not comply with the national minimum wage legislation and Her Majesty’s Revenue and Customs is continuing to carry out enforcement action in the social care sector and will investigate all complaints made by care workers that their employer is not paying them the national minimum wage. In addition, it is looking to ensure that the statutory guidance that will accompany the Care Act on commissioning and market shaping explicitly states local authorities should have evidence that contract terms, conditions and fee levels are appropriate to provide the agreed care packages with agreed quality of care.</p><p> </p><p> </p><p> </p> answering member constituency North Norfolk answering member printed Norman Lamb question first answered 03/11/2014 16:37:18 answering member 1439 label Biography information for Norman Lamb
tabling member	4122 label Biography information for Alex Cunningham

100891

registered interest
date	24/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Skin Cancer
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, if he will make it his policy to introduce a screening programme for people who have previously had treatment for skin cancer.
tabling member constituency	Bassetlaw
tabling member printed	John Mann
uin	211914
answer	answer is ministerial correction date of answer 03/11/2014 answer text <p>The National Institute for Health and Care Excellence (NICE) has published cancer service guidance which outlines how healthcare services for people with skin tumours, including melanoma, should be organised. In May 2010 NICE issued a partial update to the guidance, including new recommendations on the management of low-risk basal cell carcinomas in the community.</p><p> </p><p> </p><p> </p><p>NICE is currently developing a clinical guideline on the assessment and management of melanoma, which is currently planned for publication in July 2015.</p><p> </p><p>Further details of NICE’s guidance on skin cancer are available at:</p><p> </p><p> </p><p> </p><p><a href="http://www.nice.org.uk/guidance/conditions-and-diseases/cancer/skin-cancer" target="_blank">http://www.nice.org.uk/guidance/conditions-and-diseases/cancer/skin-cancer</a></p><p> </p><p> </p><p> </p><p>Information for the public on skin cancer is available on the NHS Choices website.</p><p> </p> answering member constituency Battersea answering member printed Jane Ellison question first answered 03/11/2014 17:57:18 answering member 3918 label Biography information for Jane Ellison
tabling member	1387 label Biography information for Lord Mann

100925

registered interest
date	24/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Accident and Emergency Departments
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether they have any plans to locate health visitors in accident and emergency departments.
tabling member printed	Baroness Manzoor
uin	HL2393
answer	answer is ministerial correction date of answer 05/11/2014 answer text <p>The Department knows that some parts of the National Health Service are under pressure at the moment. Health Visitors and other health professionals have the potential to play a strong role in reducing the burden on emergency departments. We welcome proposals on innovative ways to achieve this.</p><p> </p><p> </p><p> </p><p>NHS England has advised that while health visiting services are currently provided in many community locations including children’s centres, community clinics and local general practitioner surgeries, NHS England is carrying out work to look at how health visitors, in response to local need, can support other frontline services and provide more support and advice to parents on caring for their children.</p><p> </p><p> </p><p> </p><p>For example, London and Midland and East Regions are looking at opportunities which will simultaneously enhance the health visiting service provision and support a reduction in accident and emergency attendance and waiting times over the winter period.</p><p> </p><p> </p><p> </p><p>In both regions the services offered will fall within the professional scope of Health Visitors and are designed to support families receive the most appropriate care. In addition, health visitors in accident and emergency departments can support delivery of the high impact areas: particularly managing minor illness, preventing accidents and also support maternal mental health, early attachment, and transition to parenthood and breastfeeding.</p><p> </p><p> </p><p> </p><p>These ideas have been shared with the other regions.</p><p> </p> answering member printed Earl Howe question first answered 05/11/2014 12:09:46 answering member 2000 label Biography information for Earl Howe
tabling member	4289 label Biography information for Baroness Manzoor

100939

registered interest
date	24/10/2014
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 Act 2012
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, further to the answer by Earl Howe on 22 October (HL Deb, col 631), what has been the cost of the reforms introduced under the Health and Social Care Act 2012 in (1) 2012, and (2) 2013; and what are the anticipated costs in (3) 2014, and (4) 2015.
tabling member printed	Lord Brooke of Alverthorpe
uin	HL2407
answer	answer is ministerial correction date of answer 05/11/2014 answer text <p>The cost of the reforms have been recorded by financial year as follows:</p><p> </p><p> </p><p> </p><p>2010-11 £199 million</p><p> </p><p>2011-12 £264 million</p><p> </p><p>2012-13 £633 million</p><p> </p><p>2013-14 £220 million</p><p> </p><p> </p><p> </p><p> </p><p> </p><p>We anticipate the future costs will be below £180 million and within the £1.5 billion as announced in my Written Ministerial Statement of 23 July 2014, columns WS135-136. The majority of the remaining anticipated costs are expected to be incurred in 2014-15.</p><p> </p><p><strong> </strong></p><p> </p><p>These costs have been more than covered by the savings arising from the Health and Social Care Act, which up to 31 March 2014, were approximately £4.9 billion.</p><p> </p> answering member printed Earl Howe question first answered 05/11/2014 12:08:50 answering member 2000 label Biography information for Earl Howe
tabling member	3335 label Biography information for Lord Brooke of Alverthorpe