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156457

registered interest
date	18/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Mefloquine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what assessment the Medicines and Healthcare Products Regulatory Agency and the Advisory Committee for Malaria Prevention have made of the United States Food and Drug Administration's Safety Communication of 29 July 2013 warning of the risk of psychiatric and nerve side effects from taking Lariam (mefloquine) as a malaria prophylactic.
tabling member printed	Baroness Corston
uin	HL2899
answer	answer is ministerial correction date of answer 02/12/2014 answer text <p>Mefloquine (brand name Lariam) is one of several drugs licensed for the prevention (<strong>c</strong>hemoprophylaxis) or treatment of malaria. As with any medicine, mefloquine may cause side effects in some people and the potential risks should be balanced against the expected benefits of therapy. Information on possible side effects is available to the medical profession via the Summary of Product Characteristics (SmPC), and to patients via the Patient Information Leaflet.</p><p> </p><p> </p><p> </p><p>In 2013, the Medicines and Healthcare products Regulatory Agency (MHRA) strengthened the warnings in the mefloquine SmPC, particularly regarding the well-established risk of neuropsychiatric side effects. The licence holder (Roche) also issued a letter to healthcare professionals at the end of October 2013 to increase awareness of these possible risks, alongside a prescriber checklist and patient alert card to aid compliance with the warnings. In November 2013, the MHRA issued a further communication to healthcare professionals on the risks of mefloquine via its Drug Safety Update bulletin:</p><p> </p><p> </p><p> </p><p>www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON336723</p><p> </p><p> </p><p> </p><p>As with all medicines, the MHRA will keep the safety of mefloquine under continual review.</p><p> </p><p> </p><p> </p><p>The Advisory Committee for Malaria Prevention (ACMP) carefully considered all available data following the Food and Drug Administration’s safety communication and subsequent modification of the SmPC by Roche in September 2013. SmPC recommendations for monitoring of liver function and eye assessment in long term use have also been added to the guidelines. The ACMP continues to believe that mefloquine is a valuable option for prophylaxis against malaria when appropriate risk assessments are undertaken.</p><p> </p> answering member printed Earl Howe question first answered 02/12/2014 12:38:24 answering member 2000 label Biography information for Earl Howe
tabling member	215 label Biography information for Baroness Corston

156460

registered interest
date	18/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Malaria
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what the unit cost is of (1) Lariam (mefloquine), and (2) malarone.
tabling member printed	Baroness Corston
uin	HL2902
answer	answer is ministerial correction date of answer 02/12/2014 answer text <p>The current edition of the British National Formulary lists the price of Lariam (mefloquine) as £14.53 for a pack of 8 tablets and the price of Malarone (proguanil hydrochloride with atovaquone) as £25.21 for a pack of 12 tablets.</p><p> </p> answering member printed Earl Howe question first answered 02/12/2014 12:37:24 answering member 2000 label Biography information for Earl Howe
tabling member	215 label Biography information for Baroness Corston

156461

registered interest
date	18/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Malaria
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government on how many occasions the Advisory Committee for Malaria Prevention has met in the last two years.
tabling member printed	Baroness Corston
uin	HL2903
answer	answer is ministerial correction date of answer 02/12/2014 answer text <p>Full meetings of the Advisory Committee for Malaria Prevention occurred in March and August of 2012 and January and December of 2013. The next full meeting is planned for January 2015. There was a sub-group meeting in 2014 to approve the 2014 version of the <em>Guidelines for malaria prevention in travellers from the UK</em>.</p><p> </p> answering member printed Earl Howe question first answered 02/12/2014 12:41:24 answering member 2000 label Biography information for Earl Howe
tabling member	215 label Biography information for Baroness Corston

156463

registered interest
date	18/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	IVF
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, further to the Written Answer by Earl Howe on 17 November (HL2643), whether the records held by the Human Fertilisation and Embryology Authority on foetal reductions carried out in the first trimester and early in the second trimester following in vitro fertilisation or donor insemination indicate that it has any significant impact on "the single biggest risk to the health and welfare of children born following fertility treatment"; if so, what is the effect and how it is represented numerically; and to what extent the recommendation that prevention of multiple pregnancies through single embryo transfer should be preferred to multi-foetal pregnancy reduction reflects a lack of efficacy of foetal reductions in reducing risks or emotional trauma associated with such a procedure.
tabling member printed	Lord Alton of Liverpool
uin	HL2905
answer	answer is ministerial correction date of answer 02/12/2014 answer text <p>The Human Fertilisation and Embryology Authority has advised that it has not undertaken such an analysis but that it plans to do so.</p><p> </p> answering member printed Earl Howe question first answered 02/12/2014 12:41:51 answering member 2000 label Biography information for Earl Howe
tabling member	738 label Biography information for Lord Alton of Liverpool

156464

registered interest
date	18/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	IVF
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, further to the Written Answer by Earl Howe on 17 November (HL2642), whether they consider that any of the mitochondrial diseases listed in Annex D of the "Mitochondrial Donation" consultation document could ever arise from a nuclear gene defect; and if so, what is their assessment of the frequency with which it occurs and how that has been reflected when discussing mitochondrial diseases that may be candidates for pronuclear transfer or spindle-chromosomal complex transfer.
tabling member printed	Lord Alton of Liverpool
uin	HL2906
answer	answer is ministerial correction date of answer 02/12/2014 answer text <p>As stated in my Written Answer of 17 November 2014 (<em>Official Report</em>, col. WA59) the mitochondrial diseases listed in Annex D of the mitochondrial donation consultation document are diseases caused by an inherited mutation in mitochondrial DNA. As such, none of these diseases are caused by a nuclear gene defect. Mitochondrial disorders caused by a nuclear gene defect are distinct from those listed in Annex D.</p><p> </p> answering member printed Earl Howe question first answered 02/12/2014 12:42:21 answering member 2000 label Biography information for Earl Howe
tabling member	738 label Biography information for Lord Alton of Liverpool

156465

registered interest
date	18/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Ovarian Hyperstimulation Syndrome
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, further to the Written Answers by Earl Howe on 3 December 2010 (WA 492–3) and 17 November (HL2641), to what extent the collection of eggs only at licensed fertility clinics in line with the guidance outlined in the Human Fertilisation and Embryology Authority (HFEA) Code of Practice is already proven to eliminate the incidence of ovarian hyperstimulation syndrome (OHSS); how many clinics they are aware of that had not been licensed by the HFEA, whether in the United Kingdom or anywhere else worldwide, at which the incidence of OHSS was as a direct consequence significantly higher than that previously reported in the journal <i>Human Fertility</i> (volume 10, issue 3, pages 183–7); and how they have assessed the impact of HFEA regulation on OHSS incidence in the absence of an evidence base to predict the cohort of patients that may develop OHSS.
tabling member printed	Lord Alton of Liverpool
uin	HL2907
answer	answer is ministerial correction date of answer 02/12/2014 answer text <p>The Human Fertilisation and Embryology Authority (HFEA) has advised that it has not carried out an analysis of the extent to which the collection of eggs at licensed fertility clinics in line with the guidance outlined in the Authority’s Code of Practice is proven to eliminate the incidence of Ovarian Hyperstimulation Syndrome (OHSS).</p><p> </p><p> </p><p> </p><p>The HFEA is not aware of any unlicensed clinics in the United Kingdom which carry out egg collection, intrauterine insemination or in vitro fertilisation. Clinics which administer fertility drugs but do not carry out egg collection, intrauterine insemination or in vitro fertilisation in the United Kingdom are not under the HFEA’s regulatory remit and therefore are not licensed by the HFEA.</p><p> </p><p> </p><p> </p><p>The HFEA has also advised that it has not assessed the impact of its policies on the incidence of OHSS.</p><p> </p> answering member printed Earl Howe question first answered 02/12/2014 12:40:56 answering member 2000 label Biography information for Earl Howe
tabling member	738 label Biography information for Lord Alton of Liverpool

156468

registered interest
date	18/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Genomics
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether, in view of developments in genomic medicine and the case for communicating accurately and sensitively the significance of genomic data to patients, they will reconsider the possibility of mandatory registration of genomic counsellors.
tabling member printed	Lord Walton of Detchant
uin	HL2910
answer	answer is ministerial correction date of answer 02/12/2014 answer text <p>The Government has emphasised the importance of developing a well-trained National Health Service work force to benefit from the advances in genomic medicine. The education and training requirements of genetic counsellors and their regulatory arrangements are currently being considered as part of the Health Education England’s Genomics Programme. NHS England is focused on ensuring it fulfils its contribution to meeting the objectives of the 100,000 Genomes Project and the elements for which it is accountable. This includes establishing NHS Genomic Medicine Centres through a robust procurement process, as part of which all potential NHS Genomic Medicine Centres will be required to demonstrate what arrangements they will put in place to ensure validated findings are fed back to patients in an appropriate and timely manner.</p><p> </p> answering member printed Earl Howe question first answered 02/12/2014 12:39:09 answering member 2000 label Biography information for Earl Howe
tabling member	1716 label Biography information for Lord Walton of Detchant

156479

registered interest
date	18/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Health: Weather
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what discussions have taken place internally within the Department of Health regarding the impact of cold homes on the health of older people.
tabling member printed	Baroness Greengross
uin	HL2921
answer	answer is ministerial correction date of answer 02/12/2014 answer text <p> </p><p /> <p>The impact of cold homes on the health of older people has been discussed internally within the Department (DH) during the development of policy initiatives to prevent major avoidable effects on health during periods of cold weather. These initiatives include the <em><a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/365756/CWP_2014.pdf" target="_blank">The Cold Weather Plan for England</a></em>, <em><a href="https://www.gov.uk/government/publications/keep-warm-keep-well-leaflet-gives-advice-on-staying-healthy-in-cold-weather" target="_blank">Keep Warm Keep Well</a> </em>leaflet and the <em><a href="http://www.metoffice.gov.uk/learning/get-ready-for-winter" target="_blank">Get Ready For Winter</a></em> campaign hosted by the Met Office.</p><p /> <p> </p><p /> <p>Further discussions were held at the Annual Cold Weather Plan seminar<strong> – </strong>this stakeholder event brings together colleagues from the DH, Local Government Association, NHS England, Public Health England, academia and the voluntary and community sector to discuss issues around the cold weather plan and how to best support local action. In addition, discussions were held at the Health officials working group – this is a regular meeting attended by the Department of Energy and Climate Change, DH and Public Health England. The aim of this group is to share information on cold weather, fuel poverty and health impacts with a view to ensure the fuel poverty strategy is aligned with health policy.</p><p> </p> answering member printed Earl Howe question first answered 02/12/2014 14:11:48 answering member 2000 label Biography information for Earl Howe
tabling member	2518 label Biography information for Baroness Greengross

156480

registered interest
date	18/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Health: Weather
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 financial impact on the National Health Service of poor health caused by cold homes.
tabling member printed	Baroness Greengross
uin	HL2922
answer	answer is ministerial correction date of answer 02/12/2014 answer text <p>The annual cost to the National Health Service in England of cold housing is reported to be between £850 million<sup>1</sup> and £1.36 billion<sup>2</sup>.This does not include additional spending by social services, or economic losses through absences from work. Total costs to the NHS and the country are unknown<sup>3</sup>.</p><p> </p><p><em><a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/365756/CWP_2014.pdf" target="_blank">The Cold Weather Plan for England</a> </em><sup>3 </sup>is a framework intended to protect the population from harm to health from cold weather, including vulnerable older people. It aims to prevent the major avoidable effects on health during periods of cold weather in England by alerting people to the negative health effects of cold weather, and enabling them to prepare and respond appropriately.</p><p> </p><p>Help is available through Cold Weather Payments which provide more targeted support for vulnerable low-income groups. The Government has permanently increased Cold Weather Payments from £8.50 to £25 for the duration of this Parliament for each qualifying period of cold weather.</p><p> </p><p>This winter over 2 million low income households, including over 1.4 million poorer pensioners, will receive a discount of £140 off their electricity bill through the Warm Home Discount scheme.</p><p> </p><p>Winter Fuel Payments also provide assurance to older people, who may suffer the worst impacts of a progressive condition, so that they can keep warm during the winter months. In addition, around 482,000 low income and vulnerable homes have received energy efficiency measures under Energy Companies Obligation.</p><p> </p><p> </p><p> </p><p>The Department of Energy and Climate Change have commissioned work that will allow them to model the potential cost-savings to health and social care services from energy efficiency measures and other interventions.</p><p> </p><p> </p><p> </p><p><em>Notes: </em></p><p> </p><p>1. Department of Health (2010) ‘Winter kills’, in 2009 <a href="http://tinyurl.com/2009CMOReport" target="_blank">Annual Report of the Chief Medical Officer</a></p><p> </p><p> </p><p> </p><p>2. <a href="http://www.ageuk.org.uk/Documents/EN-GB/Campaigns/The_cost_of_cold_2012.pdf?dtrk=true" target="_blank">The Cost of Cold: Why we need to protect the health of older people in winter</a></p><p> </p><p> </p><p> </p><p>3. Public Health England (2014) <a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/365269/CWP_Making_the_Case_2014_FINAL.pdf" target="_blank">The Cold Weather Plan for England. Making the case: why long-term strategic planning for cold weather is essential to health and wellbeing</a></p><p> </p> answering member printed Earl Howe question first answered 02/12/2014 14:14:59 answering member 2000 label Biography information for Earl Howe
tabling member	2518 label Biography information for Baroness Greengross

156494

registered interest
date	18/11/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Staffordshire and Stoke on Trent Partnership NHS Trust
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 role of the Ambassador for Cultural Change at the Staffordshire and Stoke-on-Trent Partnership NHS Trust.
tabling member printed	Lord MacKenzie of Culkein
uin	HL2936
answer	answer is ministerial correction date of answer 26/11/2014 answer text <p>We welcome local innovations such as the role of the Ambassador for Cultural Change at the Staffordshire and Stoke-on-Trent Partnership NHS Trust, but we have not made a formal assessment.</p><p> </p><p> </p><p> </p><p>We do not have plans to roll out this position nationally. Local National Health Service organisations are responding to the challenges of the Francis Inquiry in a number of different ways, and we will continue to support them through mechanisms such as the patient safety collaboratives, and the work of organisations such as Health Education England and NHS England.</p><p> </p> answering member printed Earl Howe grouped question UIN HL2937 question first answered 26/11/2014 12:53:38 answering member 2000 label Biography information for Earl Howe
tabling member	2507 label Biography information for Lord MacKenzie of Culkein