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418933

registered interest
date	15/09/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Prescription Drugs: Internet
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps he is taking to (a) reduce and (b) monitor the sale of prescription drugs on the internet.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	10263
answer	answer is ministerial correction date of answer 21/09/2015 answer text <p>In the United Kingdom, all categories of medicines may be traded online legally but in the case of prescription only medicines (POM) and pharmacy (P) medicines, these may only be sold or supplied to the public through registered pharmacy premises (by or under the supervision of a pharmacist). Additionally, POMs may only be supplied in response to a prescription from an authorised healthcare professional.</p><p> </p><p> </p><p> </p><p>A UK registered pharmacy may have a presence on the internet; however the requirements of legislation apply equally to both UK internet pharmacies and bricks-and-mortar premises.</p><p> </p><p> </p><p> </p><p>The Medicines and Healthcare products Regulatory Agency (MHRA) monitors the internet for websites operating outside legal requirements and, in collaboration with Internet Service Providers, takes steps to close down sites both in the UK and abroad. The MHRA has closed down 1,973 websites (including those based overseas) during 2015 alone and brought into compliance many others.</p><p> </p><p> </p><p> </p><p>The illegal sale and supply of medicines via Internet poses considerable risks to UK patients but this is in essence a global problem and the MHRA is working with other regulators, law enforcement authorities and Government Departments within the UK, European Union and elsewhere to address the complex issues involved.</p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 21/09/2015 14:47:22 answering member 4020 label Biography information for George Freeman
tabling member	4131 label Biography information for Jim Shannon

418934

registered interest
date	15/09/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Pregnancy: Paroxetine
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what recent discussions he has had with the Royal Colleges on the effect of the consumption of the paxil and seroxat forms of the drug paroxetine on the incidence of depression among pregnant women.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	10265
answer	answer is ministerial correction date of answer 21/09/2015 answer text <p>There have been no recent discussions with the Royal Colleges on the effects of taking the paxil and seroxat forms of paroxetine on the incidence of depression among pregnant women.</p><p> </p><p> </p><p> </p><p>The Mandate from the Government to NHS England includes an objective for NHS England to work with partner organisations to reduce the incidence and impact of postnatal depression through earlier diagnosis, and better intervention and support.</p><p> </p><p>The Government will provide an additional £75 million over the next five years for services to support women with mental ill health in the perinatal period.</p><p> </p><p> </p><p> </p><p>The British National Formulary advises that medication should be prescribed only when it is necessary, and in all cases the benefit of administering the medicine should be considered in relation to the risk involved. This is particularly important during pregnancy, when the risk to both mother and fetus must be considered.</p><p> </p><p> </p><p> </p> answering member constituency North East Bedfordshire answering member printed Alistair Burt question first answered 21/09/2015 16:03:29 answering member 1201 label Biography information for Alistair Burt
tabling member	4131 label Biography information for Jim Shannon

418935

registered interest
date	15/09/2015
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 recent discussions he has had with the Royal Colleges on the development and use of progesterone and tamoxifen to treat breast cancer.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	10266
answer	answer is ministerial correction date of answer 21/09/2015 answer text <p>There have been no such discussions.</p><p> </p><p> </p><p> </p><p>Research into the use of progesterone in combination with tamoxifen for the treatment of breast cancer is still at an early stage and has not yet been trialled in humans.</p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 21/09/2015 14:41:04 answering member 4020 label Biography information for George Freeman
tabling member	4131 label Biography information for Jim Shannon

418936

registered interest
date	15/09/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Dementia: Diabetes
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what discussions he has had with the Royal College of Physicians on a link between type 2 diabetes and dementia; and what steps he is taking to treat dementia caused in that way.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	10243
answer	answer is ministerial correction date of answer 21/09/2015 answer text <p>NHS England is implementing the NHS Diabetes Prevention Programme, and it is possible that prevention of Type 2 diabetes may in the longer term reduce dementia risk, although at this point this is speculative rather than being based on evidence.</p><p> </p><p> </p><p> </p><p>The treatment of dementia associated with Type 2 diabetes is as for any dementia, although it is important to also address the Type 2 diabetes and vascular risk. People with dementia who also have diabetes need support to manage their condition.</p><p> </p><p> </p><p> </p><p>Improving the treatment and care of people with dementia, reducing the incidence of dementia and improving dementia research, is a key priority for the Government. That is why in February 2015, the Prime Minister launched his Challenge on Dementia 2020 as a successor to the Prime Minister’s Challenge on Dementia 2012-2015.</p><p> </p><p><strong> </strong></p><p> </p><p>My Rt. hon. Friend the Secretary of State has had and continues to have discussions on these matters with a range of organisations including the Royal College of Physicians.</p><p> </p> answering member constituency Battersea answering member printed Jane Ellison question first answered 21/09/2015 15:01:16 answering member 3918 label Biography information for Jane Ellison
tabling member	4131 label Biography information for Jim Shannon

418937

registered interest
date	15/09/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Dementia: Vitamin D
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what discussions he has had with the Royal College of Physicians on using vitamin D as a treatment for delaying or preventing dementia.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	10244
answer	answer is ministerial correction date of answer 21/09/2015 answer text <p>Current evidence is not supportive of using vitamin D as a treatment for delaying or preventing dementia.</p><p> </p> answering member constituency Battersea answering member printed Jane Ellison question first answered 21/09/2015 15:04:47 answering member 3918 label Biography information for Jane Ellison
tabling member	4131 label Biography information for Jim Shannon

418938

registered interest
date	15/09/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Prescriptions
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps his Department takes to monitor the level of prescriptions issued by GPs; and if he will make a statement.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	10256
answer	answer is ministerial correction date of answer 21/09/2015 answer text <p>Clinicians are responsible for their own treatment decisions taking any relevant guidance into account. They should always satisfy themselves that the drugs or other substances they consider appropriate for their patients can be safely prescribed, that patients are adequately monitored and that, where necessary, additional support or supervision is available.</p><p> </p><p><strong> </strong></p><p> </p><p>Within the General Medical Services (GMS) and Personal Medical Services Regulations and Alternative Provider Medical Services Directions there are clauses in relation to prescribing and dispensing. The GMS Contracts Regulations Schedule 6 Part 3 paragraph 46 says:</p><p> </p><p> </p><p> </p><p>“Excessive prescribing</p><p> </p><p>46 - (1) The contractor shall not prescribe drugs, medicines or appliances whose cost or quantity, in relation to any patient is, by reason of the character of the drug, medicine or appliance in question in excess of that</p><p> </p><p>which was reasonably necessary for the proper treatment of that patient.</p><p> </p><p> </p><p> </p><p>(2) In considering whether a contractor has breached its obligations under sub-paragraph (1) NHS England must seek the views of the Local Medical Committee (if any) for the area in which the contractor provides services under the contract.”</p><p> </p><p> </p><p> </p><p>Practitioners are encouraged to prescribe rationally and to make the best possible use of National Health Service resources.</p><p> </p><p> </p><p> </p><p>Professional bodies issue standards and/or guidance for their members on prescribing. An example of this is the General Medical <em>Council’s “Good practice in prescribing and managing medicines and devices”</em>. It provides more detailed advice on how to comply with these principles when prescribing and managing medicines and medical devices, including appliances. If clinicians act outside of this guidance they can be held to account and potentially lose their professional registration, meaning they are unable to practice.</p><p> </p><p><strong> </strong></p><p> </p><p><strong> </strong></p><p> </p><p><strong> </strong></p><p> </p> answering member constituency North East Bedfordshire answering member printed Alistair Burt question first answered 21/09/2015 15:37:56 answering member 1201 label Biography information for Alistair Burt
tabling member	4131 label Biography information for Jim Shannon

418939

registered interest
date	15/09/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Prescription Drugs
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, if he will hold discussions with representatives of the pharmaceuticals industry on the potential merits of the use of identity cards for the use of prescription drugs to minimise misuse of such drugs.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	10257
answer	answer is ministerial correction date of answer 21/09/2015 answer text <p>We have no plans to do so.</p><p> </p><p> </p><p> </p><p>My Rt. hon. Friend the Home Secretary commissioned the Advisory Council on the Misuse of Drugs to explore the potential for medical and social harms arising from the diversion and illicit supply of prescription drugs.</p><p> </p><p> </p><p> </p><p>The Committee’s report is expected later this year and we will consider its conclusions carefully.</p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 21/09/2015 15:37:09 answering member 4020 label Biography information for George Freeman
tabling member	4131 label Biography information for Jim Shannon

418940

registered interest
date	15/09/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Drugs: Misuse
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what assistance his Department provides to people addicted to legal highs.
tabling member constituency	Strangford
tabling member printed	Jim Shannon
uin	10258
answer	answer is ministerial correction date of answer 21/09/2015 answer text <p>The dependence-forming potential of many new psychoactive substances (NPS) is still largely unknown, and the number of people attending specialist drug treatment services is relatively small. If users need help, it will more likely be because they have acute NPS-related problems (eg, agitation, palpitations, seizures) and they will probably first present at accident and emergency (A&amp;E) departments.</p><p> </p><p> </p><p> </p><p>Local authorities are responsible for assessing drug treatment needs in their local areas and providing services to meet that need. This includes determining the scale of NPS use and harm in their areas and ensuring there are services to tackle that harm.</p><p> </p><p> </p><p> </p><p>Public Health England (PHE) supports local authorities in their work of assessing need and planning services, by improving data, intelligence and information sharing systems, to ensure prevention and treatment are as effective as they can be in the changing NPS market.</p><p> </p><p> </p><p> </p><p>PHE has produced an NPS toolkit for substance misuse commissioners which gives a broad overview of the challenges from NPS and provides commissioners with resources and advice to inform their work.</p><p> </p><p> </p><p> </p><p>PHE has also supported Project NEPTUNE, which is producing detailed and practical clinical guidance and tools for A&amp;E, drug treatment and other services that deal with people who have NPS problems.</p><p> </p><p><strong> </strong></p><p> </p> answering member constituency Battersea answering member printed Jane Ellison question first answered 21/09/2015 14:54:24 answering member 3918 label Biography information for Jane Ellison
tabling member	4131 label Biography information for Jim Shannon

418941

registered interest
date	15/09/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Psychiatry: Children and Young People
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 effectiveness of the contribution made by Child and Adolescent Psychotherapists to the NHS.
tabling member constituency	Sittingbourne and Sheppey
tabling member printed	Gordon Henderson
uin	10240
answer	answer is ministerial correction date of answer 21/09/2015 answer text <p>The Department has not made a specific assessment of the effectiveness of the contribution made by Child and Adolescent Psychotherapists to the National Health Service.</p><p> </p><p> </p><p> </p><p>Child and Adolescent Psychotherapists form part of the wider workforce on children and young people’s mental health and wellbeing and can provide support in a range of settings. Health Education England commissions training for Child and Adolescent Psychotherapy as part of a four year doctorate. The training and practice is accredited by the Association of Child Psychotherapists.</p><p> </p><p> </p><p> </p><p>Building the capacity, capability and confidence of both the specialist and wider workforce is a key part of the Government’s approach to improving children and young people’s mental health and wellbeing, sustained through a culture of continuous evidence-based service improvement, delivered by a workforce with the right mix of skills, competencies and experience.</p><p> </p><p> </p><p> </p><p>In addition, the Children and Young People's Improving Access to Psychological Therapies programme is transforming existing Child and Adolescent Mental Health Services to ensure they are providing evidence based therapies coupled with session by session outcome monitoring. The programme is being expanded to cover additional areas of clinical practice, so that all children and young people’s mental health services are able to deliver high quality evidence-based care by 2018.</p><p> </p><p><strong> </strong></p><p> </p><p><strong> </strong></p><p> </p> answering member constituency North East Bedfordshire answering member printed Alistair Burt question first answered 21/09/2015 16:02:16 answering member 1201 label Biography information for Alistair Burt
tabling member	4050 label Biography information for Gordon Henderson

418942

registered interest
date	15/09/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Primary Health Care
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what steps he is taking to increase capacity in (a) general practice and (b) primary care.
tabling member constituency	South Derbyshire
tabling member printed	Heather Wheeler
uin	10324
answer	answer is ministerial correction date of answer 21/09/2015 answer text <p>The Government is committed to increasing the primary and community care workforce by at least 10,000 by 2020, including an estimated 5,000 extra doctors working in general practice and a further 5,000 other primary care. To release capacity in general practice we are also are working with NHS England to consider ways that we can reduce bureaucracy and re-shape patient demand.</p><p> </p><p> </p><p> </p><p>In order to improve general practitioner (GP) access, £175 million (including £25 million from the Infrastructure Fund) has been invested in the Prime Minister’s GP Access Fund to test improved access to GP services. We have also committed £1 billion to a four year Primary Care Infrastructure Fund, to accelerate improvements in GP premises and infrastructure. Southern Derbyshire Clinical Commissioning Group (CCG) has benefitted from both of these initiatives, having piloted new models of access (e.g. video consultations) through the Access Fund, and also three local GP premises have had their developments approved as part of the 2015/16 Infrastructure Fund.</p><p> </p><p> </p><p> </p><p>We are also committed to promoting innovative models of primary care and wider out-of-hospital services, as well as making better use of pharmacists, which will improve capacity by breaking down barriers between care providers. For example community pharmacists can provide support to GPs is by providing seasonal flu vaccinations – a new advanced service under the community pharmacy contractual framework has recently been introduced. Southern Derbyshire CCG is also exploring the potential to pilot clinical pharmacists in general practice to reduce workload pressures on GPs. Furthermore, Dental practices in Derby City have been allocated £600,000 by NHS England to provide access for over 8,000 additional patients per annum.</p><p> </p><p><strong> </strong></p><p> </p> answering member constituency North East Bedfordshire answering member printed Alistair Burt question first answered 21/09/2015 16:04:40 answering member 1201 label Biography information for Alistair Burt
tabling member	4053 label Biography information for Mrs Heather Wheeler