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750552

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	General Practitioners
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government what assessment they have made of the chronic fatigue syndrome myalgic encephalomyelitis (ME/CFS) clinical services which were set up between 2004 and 2006; what proportion of patients accessing services recover from ME/CFS or show signs of improvement; and what assessment they have made of the value for money of these services.
tabling member printed	The Countess of Mar
uin	HL684
answer	answer is ministerial correction date of answer 19/07/2017 answer text <p>No central assessment has been made of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) clinical services established between 2004 and 2006. The commissioning of services for people with CFS/ME is a local matter, and the management of patients within such services is the responsibility of the commissioners, providers and clinicians responsible for their care. Clinical commissioning groups have a duty to exercise their functions effectively, efficiently and economically</p><p> </p><p>Since its publication in 2007, the National Institute for Health and Care Excellence (NICE) clinical guideline on the management of CFS/ME in adults and children, which set outs best practice on the care, treatment and support of people with the condition, has supported the local National Health Service in delivering services for people with the condition. The guidance recognises the challenges in managing a condition for which there is no definitive diagnostic test, no clear understanding of the causes and process of disease and no cure. The guidance is also clear that there is no one form of treatment to suit every patient and that treatment and care should take into account the personal needs and preferences of the patient. NICE is currently reviewing the guidance to ensure it reflects the latest available evidence and a decision regarding this matter is expected shortly.</p><p><br></p> answering member printed Lord O'Shaughnessy question first answered 19/07/2017 11:03:01 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1861 label Biography information for The Countess of Mar

750553

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	General Practitioners
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government whether they have any plans to set up an independent review of ME/CFS services which includes an epidemiological study to establish the true incidence of ME/CFS in the population and the impact of the shortage of doctors trained in this specialism; and, if not, why not.
tabling member printed	The Countess of Mar
uin	HL685
answer	answer is ministerial correction date of answer 19/07/2017 answer text <p>There are no plans to set up an independent review of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) services. Services for patients with CFS/ME are supported by independent, evidence-based guidance produced by the National Institute for Health and Care Excellence on the diagnosis, treatment and support of patients with the condition. Commissioners should deliver services that meet the needs of local popuations. Assessments of service need for CFS/ME may be supported by the available population prevalence estimates as required.</p> answering member printed Lord O'Shaughnessy question first answered 19/07/2017 15:08:32 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1861 label Biography information for The Countess of Mar

746633

registered interest
date	29/06/2017
answering body	Home Office
answering dept id	1
answering dept short name	Home Office
answering dept sort name	Home Office
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government what measures they are taking to ensure that flame retardant materials used in homes, offices and public spaces both (1) prevent fires, and (2) are non-toxic, (a) in normal use, (b) during fires, and (c) for disposal or recycling at the end of life of items, such as furniture, foam mattresses, electronic goods and building insulation which contain such materials.
tabling member printed	The Countess of Mar
uin	HL264
answer	answer is ministerial correction date of answer 13/07/2017 answer text <p>Public safety is a priority for Government. There are a range of measures in place across a number of Government departments to ensure the effectiveness and safety of flame retardant materials.</p><p> </p><p>The Department for Business, Energy and Industrial Strategy is responsible for product safety legislation, which requires products to be safe when they are placed on the market.</p><p> </p><p>The Department for the Environment, Food and Rural Affairs has responsibility for ensuring the safety of chemicals, including those used as flame retardants.</p><p> </p><p>The Health and Safety Executive oversees the EU regulations concerning the Registration, Evaluation, Authorisation and restriction of Chemicals (known as REACH). This has several aims, including providing a high level of protection of human health and the environment from the use of chemicals.</p><p> </p><p>Lead responsibility for the safety and effectiveness of flame retardant chemicals will rest with the Department responsible for any legislation specifying their usage.</p> answering member printed Baroness Williams of Trafford grouped question UIN HL265 question first answered 13/07/2017 14:40:39 answering member 4311 label Biography information for Baroness Williams of Trafford
tabling member	1861 label Biography information for The Countess of Mar

746634

registered interest
date	29/06/2017
answering body	Home Office
answering dept id	1
answering dept short name	Home Office
answering dept sort name	Home Office
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government whether there is any one Government department charged with ensuring that all fire retardant materials are safe and effective at all times.
tabling member printed	The Countess of Mar
uin	HL265
answer	answer is ministerial correction date of answer 13/07/2017 answer text <p>Public safety is a priority for Government. There are a range of measures in place across a number of Government departments to ensure the effectiveness and safety of flame retardant materials.</p><p> </p><p>The Department for Business, Energy and Industrial Strategy is responsible for product safety legislation, which requires products to be safe when they are placed on the market.</p><p> </p><p>The Department for the Environment, Food and Rural Affairs has responsibility for ensuring the safety of chemicals, including those used as flame retardants.</p><p> </p><p>The Health and Safety Executive oversees the EU regulations concerning the Registration, Evaluation, Authorisation and restriction of Chemicals (known as REACH). This has several aims, including providing a high level of protection of human health and the environment from the use of chemicals.</p><p> </p><p>Lead responsibility for the safety and effectiveness of flame retardant chemicals will rest with the Department responsible for any legislation specifying their usage.</p> answering member printed Baroness Williams of Trafford grouped question UIN HL264 question first answered 13/07/2017 14:40:39 answering member 4311 label Biography information for Baroness Williams of Trafford
tabling member	1861 label Biography information for The Countess of Mar

746644

registered interest
date	29/06/2017
answering body	Ministry of Justice
answering dept id	54
answering dept short name	Justice
answering dept sort name	Justice
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government what is the average total cost to (1) local authorities, (2) health authorities, (3) local education authorities, and (4) the courts, of prosecuting an unfounded case of Munchausen's syndrome by proxy.
tabling member printed	The Countess of Mar
uin	HL275
answer	answer is ministerial correction date of answer 13/07/2017 answer text <p>The information requested is not held.</p> answering member printed Lord Keen of Elie question first answered 13/07/2017 15:40:06 answering member 4538 label Biography information for Lord Keen of Elie
tabling member	1861 label Biography information for The Countess of Mar

732744

registered interest
date	26/06/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government, further to the Written Answer by the Parliamentary Under-Secretary of State, Department of Health, on 24 April (HC70973), when and how the Commission on Human Medicines "thoroughly review the data" on human papilloma virus (HPV) vaccine adverse reactions.
tabling member printed	The Countess of Mar
uin	HL182
answer	answer is ministerial correction date of answer 04/07/2017 answer text <p>The Commission on Human Medicines (CHM) is the Government’s scientific advisory committee, from which the Medicines and Healthcare products Regulatory Agency (MHRA) seeks independent scientific advice.</p><p> </p><p>The CHM considered a thorough review of the safety of human papillomavirus (HPV) vaccine at its meeting on 16 July 2015. Prior to 2015, the CHM considered reviews of HPV vaccine at meetings in September 2012, September 2010, September 2009, June 2009 and February 2009. These reviews included evaluation of United Kingdom Yellow Card reports, analysis of data from the Clinical Practice Research Datalink (CPRD), published safety studies and safety data from other countries.</p><p>Most recently, the CHM considered the safety of HPV vaccine at its meeting on 15 October 2015. At this meeting, the MHRA sought advice from the CHM on the (Co)-Rapporteurs’ assessment reports prepared for the European Medicines Agency (EMA) review into reports of postural orthostatic tachycardia syndrome and complex regional pain syndrome following HPV vaccine, in order to inform the UK position in the review.</p><p><strong> </strong>As with all vaccines and medicines, the safety of HPV vaccine remains under continual review by the MHRA.</p> answering member printed Lord O'Shaughnessy question first answered 04/07/2017 16:04:46 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1861 label Biography information for The Countess of Mar

732745

registered interest
date	26/06/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government whether, in the light of the significant increase in the number of cases of postural orthostatic tachycardia syndrome (POTS) reported as an adverse reaction to HPV vaccination since July 2015, they will ask the European Medicines Agency to review the safety signal.
tabling member printed	The Countess of Mar
uin	HL183
answer	answer is ministerial correction date of answer 03/07/2017 answer text <p>The European Medicines Agency (EMA) concluded a thorough review of reports of postural orthostatic tachycardia syndrome (POTS) following human papillomavirus (HPV) vaccine in November 2015, which found that the evidence did not support a causal association between HPV vaccination and POTS.</p><p> </p><p>As of 26 June 2017, the Medicines and Healthcare products Regulatory Agency (MHRA) has received 60 reports of POTS following HPV vaccine via the Yellow Card Scheme. More than three million girls have been vaccinated against HPV since 2008 across the United Kingdom, and the MHRA’s evaluation remains that the number of reports does not exceed what would be expected to occur in the absence of HPV vaccine and that the evidence does not suggest a causal association with the vaccine.</p><p> </p><p>The MHRA does not currently propose to ask the EMA to conduct a further review. As with the safety of all vaccines and medicines, this issue will remain under review.</p> answering member printed Lord O'Shaughnessy question first answered 03/07/2017 16:44:42 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1861 label Biography information for The Countess of Mar

732746

registered interest
date	26/06/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government who advised the Commission on Human Medicines that the available evidence does not support a causal association between HPV vaccination and development of postural orthostatic tachycardia syndrome (POTS) or complex regional pain syndrome (CRPS) according to the Commission's minutes of 15–16 October 2015; and why this statement was made before the European Medicines Agency Scientific Advisory Group (SAG) reported on 21 October 2015.
tabling member printed	The Countess of Mar
uin	HL184
answer	answer is ministerial correction date of answer 04/07/2017 answer text <p>The Commission on Human Medicines (CHM) is the Government’s scientific advisory committee, from which the Medicines and Healthcare products Regulatory Agency (MHRA) seeks independent scientific advice.</p><p> </p><p>Following a review of human papillomavirus (HPV) vaccine safety on 16 July 2015, the CHM advised the MHRA that the available evidence does not support a causal association between HPV vaccination and development of postural orthostatic tachycardia syndrome (POTS) or complex regional pain syndrome (CRPS), as well as other chronic illnesses. The public minutes of this meeting were made available online on 18 November 2015.</p><p> </p><p>At its meeting on 15 October 2015, the MHRA sought advice from the CHM on the (Co)-Rapporteurs’ assessment reports prepared for the European Medicines Agency (EMA) review into reports of POTS and CRPS following HPV vaccine, in order to inform the United Kingdom position in the review. The public minutes of this meeting were made available online on 21 December 2015.</p><p> </p><p>The CHM did not make a statement in October in advance of the EMA’s Scientific Advisory Group meeting. The CHM’s minutes were published on the above dates in line with usual practice and have informed the MHRA’s responses to enquiries about the safety of HPV vaccine.</p> answering member printed Lord O'Shaughnessy question first answered 04/07/2017 16:05:33 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1861 label Biography information for The Countess of Mar

732747

registered interest
date	26/06/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
house id	2
legislature	25277 pref label House of Lords
question text	Her Majesty's Government what assessment they have made of the implications that the European Court of Justice's decision in Case C–621/15 will have for UK claims for vaccine damage.
tabling member printed	The Countess of Mar
uin	HL185
answer	answer is ministerial correction date of answer 06/07/2017 answer text <p>The European Court of Justice’s decision on this case does not impact on the United Kingdom. This case relates to specific circumstances and law in France.</p> answering member printed Lord O'Shaughnessy question first answered 06/07/2017 15:54:04 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1861 label Biography information for The Countess of Mar

712609

registered interest
date	20/03/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Chronic Fatigue Syndrome
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government upon what scientific basis the Expert Reference Group for the Joint Commissioning Panel for Mental Health (JCPMH), in publishing their guide on Commissioning for Medically Unexplained Symptoms (MUS), based their decision that myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) should be categorised as a functional somatic disorder, given that the World Health Organisation’s mandatory International Classification of Diseases categorises the illness as neurological under ICD 10-G93.3, and that the National Institute for Health and Care Excellence (NICE) has not listed ME/CFS as a functional somatic disorder; and whether they will withdraw the recommendation for cognitive behaviour therapy and graded exercise to be commissioned for patients with ME/CFS until NICE Guideline CG53 is reviewed.
tabling member printed	The Countess of Mar
uin	HL6204
answer	answer is ministerial correction date of answer 28/03/2017 answer text <p>The Joint Commissioning Panel for Mental Health is not a Government body, it is a collaboration between 17 leading organisations including the Department of Health, and is co-chaired by the Royal College of Psychiatrists and the Royal College of General Practitioners. The Department was not closely involved in the writing or production of this document.</p><p> </p><p>The National Institute for Health and Care Excellence (NICE) is currently reviewing the guidance GC53 to consider whether it should be updated to take account of new evidence. NICE are expected to reach a decision on whether the guidance should be updated in summer 2017.</p><p><strong> </strong></p> answering member printed Lord O'Shaughnessy question first answered 28/03/2017 13:23:12 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	1861 label Biography information for The Countess of Mar