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100036

	registered interest
	date	21/10/2014
	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 what has been the impact since 2009 of the closure of accident and emergency departments on neighbouring hospitals.
	tabling member printed	Baroness McDonagh
	uin	HL2242
	answer	answer is ministerial correction date of answer 27/10/2014 answer text <p>The reconfiguration of local health services is a matter for the local National Health Service. All service changes should be led by clinicians and be in the best interests of patients, not driven from the top down.</p><p> </p><p> </p><p> </p><p>It is for NHS commissioners and providers to work together, with local authorities, patients and the public, in bringing forward proposals that will improve the quality, safety and sustainability of healthcare services.</p><p> </p><p> </p><p> </p><p>Any changes must be supported by the Government’s four tests for service change, namely:</p><p> </p><p> </p><p> </p><p>- support from general practitioner commissioners;</p><p> </p><p>- clarity on the clinical evidence base;</p><p> </p><p>- robust patient and public engagement; and</p><p> </p><p>- support for patient choice.</p><p> </p><p> </p><p> </p><p>Once a decision on a local case for change has been made, it is up to the NHS to ensure its local services meet the needs of its population.</p><p> </p><p> </p><p> </p><p>More generally, we would expect any local plans for changes to acute services to take full account of the impact on neighbouring hospitals.</p><p> </p> answering member printed Earl Howe question first answered 27/10/2014 12:41:26 answering member 2000 label Biography information for Earl Howe
	tabling member	3701 label Biography information for Baroness McDonagh

100550

	registered interest
	date	22/10/2014
	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 Answers by Lord Darzi of Denham on 22 July 2008 (HL4926 and HL4927) and by Earl Howe on 9 July 2012 (HL1211), of how many cycles the Human Fertilisation and Embryology Authority are aware in which fresh embryo transfers took place after 15 or more eggs were collected over each of the past ten years.
	tabling member printed	Lord Alton of Liverpool
	uin	HL2287
	answer	answer is ministerial correction date of answer 29/10/2014 answer text <p>The number of treatment cycles in which fresh embryo transfers took place after 15 or more eggs were collected, in each of the last 10 years, is shown in the following table:</p><p> </p><p> </p><p> </p><table><tbody><tr><td><p>Years</p></td><td><p>Cycles in which fresh embryo transfers took place after 15 or more eggs were collected</p></td></tr><tr><td><p>2004</p></td><td><p>5602</p></td></tr><tr><td><p>2005</p></td><td><p>5737</p></td></tr><tr><td><p>2006</p></td><td><p>5843</p></td></tr><tr><td><p>2007</p></td><td><p>6345</p></td></tr><tr><td><p>2008</p></td><td><p>6589</p></td></tr><tr><td><p>2009</p></td><td><p>7344</p></td></tr><tr><td><p>2010</p></td><td><p>7801</p></td></tr><tr><td><p>2011</p></td><td><p>8195</p></td></tr><tr><td><p>2012</p></td><td><p>8200</p></td></tr><tr><td><p>2013(1)</p></td><td><p>8128</p></td></tr></tbody></table><p> </p><p>Source: The Human Fertilisation and Embryology Authority</p><p> </p><p> </p><p> </p><p>(1) 2013 is the most recent year for which information is available.</p><p> </p> answering member printed Earl Howe question first answered 29/10/2014 12:25:39 answering member 2000 label Biography information for Earl Howe
	tabling member	738 label Biography information for Lord Alton of Liverpool

100591

	registered interest
	date	22/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Orthopaedics
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government in how many Clinical Commissioning Groups rates of (1) major, and (2) minor, amputations are more than 33 per cent above the national average; and how the national average compares with other European Union member states.
	tabling member printed	Lord Harrison
	uin	HL2328
	answer	answer is ministerial correction date of answer 29/10/2014 answer text <p>It is not possible to distinguish in Hospital Episode Statistics between 'major' and 'minor' amputations.</p><p> </p><p>The Health and Social Care Information Centre (HSCIC) has calculated the England average rate of amputation per 100,000 population and highlighted the clinical commissioning groups (CCGs) of residence having rates more than 33% higher than the national average. There are 25 such CCGs.</p><p> </p><p>This is not a count of people as the same person may have had more than one episode of care within the same time period.</p><p> </p><p>We do not have information on a comparison of rates of amputation with other European Union member states.</p><p> </p><table><tbody><tr><td><p>Clinical Commissioning Group of residence</p></td><td><p>Count of finished consultant episodes</p></td><td><p>Population</p></td><td><p>Rate per 100,000 population</p></td></tr><tr><td><p>NHS SCARBOROUGH AND RYEDALE CCG</p></td><td><p>68</p></td><td><p>110,488</p></td><td><p>61.5</p></td></tr><tr><td><p>NHS EAST RIDING OF YORKSHIRE CCG</p></td><td><p>169</p></td><td><p>314,504</p></td><td><p>53.7</p></td></tr><tr><td><p>NHS DONCASTER CCG</p></td><td><p>159</p></td><td><p>302,739</p></td><td><p>52.5</p></td></tr><tr><td><p>NHS MANSFIELD AND ASHFIELD CCG</p></td><td><p>101</p></td><td><p>192,539</p></td><td><p>52.5</p></td></tr><tr><td><p>NHS BLACKPOOL CCG</p></td><td><p>72</p></td><td><p>141,976</p></td><td><p>50.7</p></td></tr><tr><td><p>NHS KNOWSLEY CCG</p></td><td><p>74</p></td><td><p>145,936</p></td><td><p>50.7</p></td></tr><tr><td><p>NHS DURHAM DALES, EASINGTON AND SEDGEFIELD CCG</p></td><td><p>138</p></td><td><p>273,043</p></td><td><p>50.5</p></td></tr><tr><td><p>NHS KERNOW CCG</p></td><td><p>272</p></td><td><p>540,178</p></td><td><p>50.4</p></td></tr><tr><td><p>NHS FAREHAM AND GOSPORT CCG</p></td><td><p>98</p></td><td><p>196,078</p></td><td><p>50.0</p></td></tr><tr><td><p>NHS LANCASHIRE NORTH CCG</p></td><td><p>78</p></td><td><p>158,528</p></td><td><p>49.2</p></td></tr><tr><td><p>NHS NORTHERN, EASTERN AND WESTERN DEVON CCG</p></td><td><p>421</p></td><td><p>869,408</p></td><td><p>48.4</p></td></tr><tr><td><p>NHS STOKE ON TRENT CCG</p></td><td><p>124</p></td><td><p>258,114</p></td><td><p>48.0</p></td></tr><tr><td><p>NHS TELFORD AND WREKIN CCG</p></td><td><p>80</p></td><td><p>167,682</p></td><td><p>47.7</p></td></tr><tr><td><p>NHS HEREFORDSHIRE CCG</p></td><td><p>88</p></td><td><p>184,932</p></td><td><p>47.6</p></td></tr><tr><td><p>NHS HULL CCG</p></td><td><p>122</p></td><td><p>257,204</p></td><td><p>47.4</p></td></tr><tr><td><p>NHS NORTH KIRKLEES CCG</p></td><td><p>88</p></td><td><p>186,706</p></td><td><p>47.1</p></td></tr><tr><td><p>NHS BOLTON CCG</p></td><td><p>131</p></td><td><p>278,984</p></td><td><p>47.0</p></td></tr><tr><td><p>NHS EAST STAFFORDSHIRE CCG</p></td><td><p>58</p></td><td><p>123,945</p></td><td><p>46.8</p></td></tr><tr><td><p>NHS COASTAL WEST SUSSEX CCG</p></td><td><p>222</p></td><td><p>476,677</p></td><td><p>46.6</p></td></tr><tr><td><p>NHS LINCOLNSHIRE EAST CCG</p></td><td><p>106</p></td><td><p>228,111</p></td><td><p>46.5</p></td></tr><tr><td><p>NHS HALTON CCG</p></td><td><p>58</p></td><td><p>125,692</p></td><td><p>46.1</p></td></tr><tr><td><p>NHS NEWARK &amp; SHERWOOD CCG</p></td><td><p>53</p></td><td><p>115,897</p></td><td><p>45.7</p></td></tr><tr><td><p>NHS THANET CCG</p></td><td><p>62</p></td><td><p>135,661</p></td><td><p>45.7</p></td></tr><tr><td><p>NHS SOMERSET CCG</p></td><td><p>243</p></td><td><p>534,950</p></td><td><p>45.4</p></td></tr><tr><td><p>NHS BRADFORD CITY CCG</p></td><td><p>37</p></td><td><p>82,319</p></td><td><p>44.9</p></td></tr></tbody></table><p> </p> answering member printed Earl Howe question first answered 29/10/2014 12:26:37 answering member 2000 label Biography information for Earl Howe
	tabling member	2488 label Biography information for Lord Harrison

100642

	registered interest
	date	23/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Transatlantic Trade and Investment Partnership
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government whether they have undertaken an impact assessment of the potential impacts on the National Health Service of the Transatlantic Trade and Investment Partnership which is being negotiated between the European Union and the United States.
	tabling member printed	Baroness Manzoor
	uin	HL2373
	answer	answer is ministerial correction date of answer 29/10/2014 answer text <p>The Transatlantic Trade and Investment Partnership (TTIP) will not affect the way the United Kingdom Government runs the National Health Service. It has been made clear by negotiators from both the United States and the European Union that it is up to the UK alone to decide how the NHS is run and any assertion that TTIP will undermine the Government’s control of the NHS is a red herring.</p><p> </p><p> </p><p> </p><p>The TTIP could offer great benefits to British business and for British jobs. Greater consistency in existing and new regulatory requirements would make it easier for companies - especially small and medium enterprises - to access markets and, for patients, potentially help to increase access to new medicines and medical devices.</p><p> </p> answering member printed Earl Howe grouped question UIN HL2374 HL2375 question first answered 29/10/2014 12:27:46 answering member 2000 label Biography information for Earl Howe
	tabling member	4289 label Biography information for Baroness Manzoor

100643

	registered interest
	date	23/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Transatlantic Trade and Investment Partnership
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what are the implications for the National Health Service and the staff who work in the National Health Service if the Transatlantic Trade and Investment Partnership is agreed.
	tabling member printed	Baroness Manzoor
	uin	HL2374
	answer	answer is ministerial correction date of answer 29/10/2014 answer text <p>The Transatlantic Trade and Investment Partnership (TTIP) will not affect the way the United Kingdom Government runs the National Health Service. It has been made clear by negotiators from both the United States and the European Union that it is up to the UK alone to decide how the NHS is run and any assertion that TTIP will undermine the Government’s control of the NHS is a red herring.</p><p> </p><p> </p><p> </p><p>The TTIP could offer great benefits to British business and for British jobs. Greater consistency in existing and new regulatory requirements would make it easier for companies - especially small and medium enterprises - to access markets and, for patients, potentially help to increase access to new medicines and medical devices.</p><p> </p> answering member printed Earl Howe grouped question UIN HL2373 HL2375 question first answered 29/10/2014 12:27:47 answering member 2000 label Biography information for Earl Howe
	tabling member	4289 label Biography information for Baroness Manzoor

100644

	registered interest
	date	23/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	NHS: Transatlantic Trade and Investment Partnership
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what are the implications for hospitals and foundation trusts if the Transatlantic Trade and Investment Partnership is agreed.
	tabling member printed	Baroness Manzoor
	uin	HL2375
	answer	answer is ministerial correction date of answer 29/10/2014 answer text <p>The Transatlantic Trade and Investment Partnership (TTIP) will not affect the way the United Kingdom Government runs the National Health Service. It has been made clear by negotiators from both the United States and the European Union that it is up to the UK alone to decide how the NHS is run and any assertion that TTIP will undermine the Government’s control of the NHS is a red herring.</p><p> </p><p> </p><p> </p><p>The TTIP could offer great benefits to British business and for British jobs. Greater consistency in existing and new regulatory requirements would make it easier for companies - especially small and medium enterprises - to access markets and, for patients, potentially help to increase access to new medicines and medical devices.</p><p> </p> answering member printed Earl Howe grouped question UIN HL2373 HL2374 question first answered 29/10/2014 12:27:46 answering member 2000 label Biography information for Earl Howe
	tabling member	4289 label Biography information for Baroness Manzoor

92769

	registered interest
	date	13/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Mental Capacity
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government what steps they are taking to assist local authorities to address the consequences of the Supreme Court’s judgments in <i>P v Cheshire West and Chester Council</i> and <i>P and Q v Surrey County Council</i> on deprivation of liberty of mentally incapacitated persons, in the light of the likely costs of compliance with those judgments.
	tabling member printed	Lord Beecham
	uin	HL2005
	answer	answer is ministerial correction date of answer 21/10/2014 answer text <p>So that we might better understand the consequences of the 19 March 2014 Supreme Court judgment in the case of Cheshire West, we have asked the Health and Social Care Information Centre to perform additional data collections as to the number of Deprivation of Liberty Safeguard (DoLS) applications made and the number authorised. The first data set was published in early October 2014. The next will be published in early November 2014.</p><p> </p><p> </p><p> </p><p> </p><p> </p><p>In the meantime, to assist local authorities, the Government has commissioned the Association of Directors of Adult Social Services to review and redesign the standard forms that support the DoLS process. This will reduce bureaucracy on local authorities whilst maintaining robust safeguards for the service user.</p><p> </p><p> </p><p> </p><p> </p><p> </p><p>In addition, the Government has commissioned the Law Society to produce guidance to assist local authority DoLS practitioners (including social workers) to understand what constitutes a deprivation of liberty following the Supreme Court judgment.</p><p> </p> answering member printed Earl Howe question first answered 21/10/2014 11:08:49 answering member 2000 label Biography information for Earl Howe
	tabling member	4181 label Biography information for Lord Beecham

92779

	registered interest
	date	13/10/2014
	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 what are the (1) average, and (2) median, earnings of a salaried general practitioner in England and Wales.
	tabling member printed	Lord Lipsey
	uin	HL2015
	answer	answer is ministerial correction date of answer 24/10/2014 answer text <p>The information in relation to salaried general practitioners (GP) (HL2015) is recorded in the following table:</p><p> </p><p> </p><p> </p><p><strong> </strong></p><p> </p><table><tbody><tr><td colspan="7"><p>Salaried GPs – Income before tax in Cash terms – England and Wales 2012-13</p></td></tr><tr><td rowspan="2"><p> </p><p> </p></td><td colspan="3"><p>Mean Earnings</p></td><td colspan="3"><p>Median Earnings</p></td></tr><tr><td><p>Gross Income</p></td><td><p>Expenses</p></td><td><p>Income before Tax</p></td><td><p>Gross Income</p></td><td><p>Expense</p></td><td><p>Income before Tax</p></td></tr><tr><td><p>England</p></td><td><p>£64,700</p></td><td><p>£8,100</p></td><td><p>£56,600</p></td><td colspan="2"><p>Data not held</p><p> </p></td><td><p>£53,700</p></td></tr><tr><td><p>Wales</p></td><td><p>£65,200</p></td><td><p>£11,100</p></td><td><p>£54,100</p></td><td colspan="2"><p>Data not held</p><p> </p></td><td><p>£53,300</p></td></tr></tbody></table><p> </p><p><strong> </strong></p><p> </p><p><strong> </strong></p><p> </p><p>The information relating to partner general practitioners (HL2016) is recorded in the following table:</p><p> </p><p> </p><p> </p><table><tbody><tr><td colspan="7"><p>Contractor GPs – Income before tax in Cash terms – England and Wales 2012-13</p></td></tr><tr><td rowspan="2"><p> </p><p> </p></td><td colspan="3"><p>Mean Earnings</p></td><td colspan="3"><p>Median Earnings</p></td></tr><tr><td><p>Gross Income</p></td><td><p>Expenses</p></td><td><p>Income before Tax</p></td><td><p>Gross Income</p></td><td><p>Expense</p></td><td><p>Income before Tax</p></td></tr><tr><td><p>England</p></td><td><p>£289,300</p></td><td><p>£184,200</p></td><td><p>£105,100</p></td><td colspan="2"><p>Data not held</p></td><td><p>£102,100</p></td></tr><tr><td><p>Wales</p></td><td><p>£233,800</p></td><td><p>£142,800</p></td><td><p>£91,000</p></td><td colspan="2"><p>Data not held</p></td><td><p>£90,700</p></td></tr></tbody></table><p> </p><p>Copyright © 2014 Health and Social Care Information Centre</p><p> </p><p>Source: GP Earnings and Expenses Enquiries</p><p> </p><p> </p><p> </p><p><strong> </strong></p><p> </p><p><em>Notes:</em></p><p> </p><table><tbody><tr><td><p>The tables are presented in cash terms of income before tax for contractor GPs (partners) and salaried GPs under a General Medical Services (GMS) or Personal Medical Services (PMS) contract and exclude expenses. This is taxable income before pension contributions are deducted, made up of gross earnings less total expenses, also known as net income.</p></td></tr><tr><td><p>The data covers income from both NHS and private sources where a GP has at least some NHS income. Figures are rounded to the nearest £100.</p><p> </p><p>The median earnings gross income and expenses data is not held, only the income before tax.</p></td></tr></tbody></table><p> </p><p>Data is for GPs under a GMS or PMS contract only</p><p> </p> answering member printed Earl Howe grouped question UIN HL2016 question first answered 24/10/2014 11:34:32 answering member 2000 label Biography information for Earl Howe
	tabling member	2492 label Biography information for Lord Lipsey

92780

	registered interest
	date	13/10/2014
	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 what are the (1) average and (2) median, earnings of a partner general practitioner in England and Wales.
	tabling member printed	Lord Lipsey
	uin	HL2016
	answer	answer is ministerial correction date of answer 24/10/2014 answer text <p>The information in relation to salaried general practitioners (GP) (HL2015) is recorded in the following table:</p><p> </p><p> </p><p> </p><p><strong> </strong></p><p> </p><table><tbody><tr><td colspan="7"><p>Salaried GPs – Income before tax in Cash terms – England and Wales 2012-13</p></td></tr><tr><td rowspan="2"><p> </p><p> </p></td><td colspan="3"><p>Mean Earnings</p></td><td colspan="3"><p>Median Earnings</p></td></tr><tr><td><p>Gross Income</p></td><td><p>Expenses</p></td><td><p>Income before Tax</p></td><td><p>Gross Income</p></td><td><p>Expense</p></td><td><p>Income before Tax</p></td></tr><tr><td><p>England</p></td><td><p>£64,700</p></td><td><p>£8,100</p></td><td><p>£56,600</p></td><td colspan="2"><p>Data not held</p><p> </p></td><td><p>£53,700</p></td></tr><tr><td><p>Wales</p></td><td><p>£65,200</p></td><td><p>£11,100</p></td><td><p>£54,100</p></td><td colspan="2"><p>Data not held</p><p> </p></td><td><p>£53,300</p></td></tr></tbody></table><p> </p><p><strong> </strong></p><p> </p><p><strong> </strong></p><p> </p><p>The information relating to partner general practitioners (HL2016) is recorded in the following table:</p><p> </p><p> </p><p> </p><table><tbody><tr><td colspan="7"><p>Contractor GPs – Income before tax in Cash terms – England and Wales 2012-13</p></td></tr><tr><td rowspan="2"><p> </p><p> </p></td><td colspan="3"><p>Mean Earnings</p></td><td colspan="3"><p>Median Earnings</p></td></tr><tr><td><p>Gross Income</p></td><td><p>Expenses</p></td><td><p>Income before Tax</p></td><td><p>Gross Income</p></td><td><p>Expense</p></td><td><p>Income before Tax</p></td></tr><tr><td><p>England</p></td><td><p>£289,300</p></td><td><p>£184,200</p></td><td><p>£105,100</p></td><td colspan="2"><p>Data not held</p></td><td><p>£102,100</p></td></tr><tr><td><p>Wales</p></td><td><p>£233,800</p></td><td><p>£142,800</p></td><td><p>£91,000</p></td><td colspan="2"><p>Data not held</p></td><td><p>£90,700</p></td></tr></tbody></table><p> </p><p>Copyright © 2014 Health and Social Care Information Centre</p><p> </p><p>Source: GP Earnings and Expenses Enquiries</p><p> </p><p> </p><p> </p><p><strong> </strong></p><p> </p><p><em>Notes:</em></p><p> </p><table><tbody><tr><td><p>The tables are presented in cash terms of income before tax for contractor GPs (partners) and salaried GPs under a General Medical Services (GMS) or Personal Medical Services (PMS) contract and exclude expenses. This is taxable income before pension contributions are deducted, made up of gross earnings less total expenses, also known as net income.</p></td></tr><tr><td><p>The data covers income from both NHS and private sources where a GP has at least some NHS income. Figures are rounded to the nearest £100.</p><p> </p><p>The median earnings gross income and expenses data is not held, only the income before tax.</p></td></tr></tbody></table><p> </p><p>Data is for GPs under a GMS or PMS contract only</p><p> </p> answering member printed Earl Howe grouped question UIN HL2015 question first answered 24/10/2014 11:34:33 answering member 2000 label Biography information for Earl Howe
	tabling member	2492 label Biography information for Lord Lipsey

92783

	registered interest
	date	13/10/2014
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Mental Health Services: Children
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty’s Government why waiting times for children referred to Child and Adolescent Mental Health Services have increased; and what action they will take to reduce waiting times.
	tabling member printed	Lord Ouseley
	uin	HL2019
	answer	answer is ministerial correction date of answer 24/10/2014 answer text <p>Information on waiting times for Child and Adolescent Mental Health Services is not collected centrally. There is anecdotal evidence of increasing waiting times in some areas. We do not know whether or not this is due to an increase in referrals or the prevalence of mental health conditions but will be seeking further information by commissioning a survey into the prevalence of mental illness in children and young people.</p><p> </p><p> </p><p> </p><p>NHS England and the Department have set up a Taskforce to look into the complex system of provision and commissioning of children and young people’s mental health services. The Taskforce is considering ways to improve access and create services that are more responsive to children’s needs. Additional funding this year is being invested into improving specialised, in-patient mental health services for children and young people. This will help to fund additional bed capacity and case management will also be improved.</p><p> </p><p> </p><p> </p><p><em>Achieving Better Access to Mental Health Services by 2020</em> announced improvements that will be made to services for patients with emerging psychosis, including setting the first ever waiting time standard in mental health from April 2015. It also sets out a longer term ambition to extend waiting time standards across all mental health services by 2020.</p><p> </p> answering member printed Earl Howe question first answered 24/10/2014 11:23:20 answering member 2000 label Biography information for Earl Howe
	tabling member	2170 label Biography information for Lord Ouseley