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228378

registered interest
date	18/03/2015
answering body	Foreign and Commonwealth Office
answering dept id	16
answering dept short name	Foreign and Commonwealth Office
answering dept sort name	Foreign and Commonwealth Office
hansard heading	Middle East
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, further to the Written Answer by Baroness Anelay of St Johns on 13 March (HL5374), what steps they are taking to alert Gazan citizens of the need to vacate the area where Hamas are rebuilding tunnels close to the border with Israel.
tabling member printed	Lord Turnberg
uin	HL5848
answer	answer is ministerial correction date of answer 24/03/2015 answer text <p>We have no plans to alert Gazan citizens of the need to vacate areas where Hamas are rebuilding tunnels. It would be the role of the de facto government in Gaza or the Government of Israel to give a warning if the civilian population were under threat from any military action. International Humanitarian Law requires warring parties to give ‘effective advance warning’ of attacks that may affect civilian populations.</p><p>We stress the importance of protecting the civilian population in accordance with international law with the Government of Israel and we have asked all those with influence to stress the same point to Hamas.</p> answering member printed Baroness Anelay of St Johns question first answered 24/03/2015 13:52:52 answering member 3474 label Biography information for Baroness Anelay of St Johns
tabling member	2537 label Biography information for Lord Turnberg

228379

registered interest
date	18/03/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Tuberous Sclerosis: Everolimus
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what policies NHS England has adopted for the funding of everolimus for patients with tuberous sclerosis.
tabling member printed	Lord Turnberg
uin	HL5849
answer	answer is ministerial correction date of answer 25/03/2015 answer text <p>NHS England has advised that decisions on which specialised services and treatments to invest in are based on an assessment of their effectiveness following clinical trials or other evidence of effectiveness, taking into account the views of expert clinicians and other stakeholders.</p><p> </p><p> </p><p> </p><p>Over the coming weeks, the six Programmes of Care that are responsible for advising NHS England on specialised services will be drawing up the work programme for 2015-16, which will include developing a number of policies, including ones for the provision of everolimus for tuberous sclerosis for complex related renal angiomyolipoma and everolimus for Subependymal Giant Cell Astrocytoma.</p><p> </p><p> </p><p> </p><p>In the meantime, NHS England does not routinely commission everolimus for the treatment of tuberous sclerosis, although it will consider funding it in exceptional clinical circumstances. Clinicians can submit individual funding requests for this treatment to us on behalf of their patients.</p><p> </p> answering member printed Earl Howe question first answered 25/03/2015 13:56:36 answering member 2000 label Biography information for Earl Howe
tabling member	2537 label Biography information for Lord Turnberg

228380

registered interest
date	18/03/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Rare Diseases
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether they have asked NHS England whether it will rationalise the number of committees concerned with assessing the funding of treatments for patients with rare diseases.
tabling member printed	Lord Turnberg
uin	HL5850
answer	answer is ministerial correction date of answer 25/03/2015 answer text <p>NHS England substantially revised their decision making process regarding specialised services at the end of 2014 in preparation for work planning in 2015.</p><p> </p><p> </p><p> </p><p>NHS England has responsibility for the commissioning of specialised services and is currently consulting on changes to the principles and processes by which it makes decisions on prioritising investment in specialised services.</p><p> </p><p> </p><p> </p><p>NHS England has provided assurance that any prioritisation which is urgent on clinical grounds will continue to be dealt with quickly through their existing procedures. The route for individual funding requests remains in place.</p><p> </p><p><strong> </strong></p><p> </p><p>The consultation can be found at:</p><p> </p><p> </p><p> </p><p><a href="http://www.engage.england.nhs.uk/consultation/investing-in-specialised-commissioning" target="_blank">www.engage.england.nhs.uk/consultation/investing-in-specialised-commissioning</a></p><p> </p> answering member printed Earl Howe question first answered 25/03/2015 14:01:21 answering member 2000 label Biography information for Earl Howe
tabling member	2537 label Biography information for Lord Turnberg

226454

registered interest
date	10/03/2015
answering body	Department for International Development
answering dept id	20
answering dept short name	International Development
answering dept sort name	International Development
hansard heading	Palestinians
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, further to the Written Answer by Baroness Northover on 9 March (HL5115), what assessment they have made of reports that Hamas has diverted building materials to reconstruct tunnels adjacent to the border between Gaza and Israel.
tabling member printed	Lord Turnberg
uin	HL5576
answer	answer is ministerial correction date of answer 23/03/2015 answer text <p>DFID is providing £0.5million to the Materials Monitoring Unit (MMU) which oversees and monitors the import, storage, supply and use of construction materials into Gaza under the auspices of the Gaza Reconstruction Mechanism (GRM). This Mechanism is designed to ensure reconstruction material reaches those who need it most.</p><p> </p><p> </p><p> </p><p>We continue to engage with the Palestinian Authority, the UN and the Government of Israel to ensure the mechanism continues to work as intended and that any possible infractions are reported.</p><p> </p> answering member printed Baroness Northover question first answered 23/03/2015 15:18:55 answering member 2539 label Biography information for Baroness Northover
tabling member	2537 label Biography information for Lord Turnberg

222769

registered interest
date	23/02/2015
answering body	Department for International Development
answering dept id	20
answering dept short name	International Development
answering dept sort name	International Development
hansard heading	Sierra Leone
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, further to the Written Answer by Baroness Northover on 11 February (HL4569), about medical relief operations in Sierra Leone, what efforts they are making to co-ordinate their activities with those of the government of Israel which is providing mobile clinics and medical expertise to help combat ebola infections.
tabling member printed	Lord Turnberg
uin	HL5110
answer	answer is ministerial correction date of answer 09/03/2015 answer text <p>The UK is leading the international response to the Ebola crisis in Sierra Leone. We have built 6 Emergency Treatment Centres staffed by British and international healthcare workers, are supporting more than half of all the treatment and isolation beds available for Ebola patients, trained 4000 frontline health care staff, and provided three new laboratories to test one third of all samples collected nationally.</p><p> </p><p> </p><p> </p><p>Israel has donated $8.75 million to the UN’s Ebola Response Multi Partner Trust Fund. The UK is also represented here and coordinates closely with other donors on priorities for the Fund.</p><p> </p> answering member printed Baroness Northover question first answered 09/03/2015 16:42:40 answering member 2539 label Biography information for Baroness Northover
tabling member	2537 label Biography information for Lord Turnberg

179242

registered interest
date	11/02/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS Trusts: Part-time Employment
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 10 February (HL4453), what plans they have to encourage NHS Trusts to employ and re-employ experienced medical staff who wish to practice part-time towards the end of their careers.
tabling member printed	Lord Turnberg
uin	HL4979
answer	answer is ministerial correction date of answer 23/02/2015 answer text <p>It is for local National Health Service organisations to decide how many and what staff they employ, and they are best placed to do this based on the needs of their patients and local communities.</p><p> </p><p><strong> </strong></p><p> </p><p>Health Education England (HEE) is responsible for ensuring the NHS workforce has the right numbers, skills, values and behaviours to meet the needs of patients.</p><p> </p><p> </p><p> </p><p>HEE will work with NHS Employers and other key partners to develop a more strategic and cost-effective approach to staff retention including the encouragement of greater employer focus on retaining and investing in their current staff.</p><p> </p><p> </p><p> </p><p>To support nursing workforce requirements, HEE announced on 29 September 2014 that it is putting £4.7 million into training resources over the next three years as part of a major national campaign that will allow former nurses to return to the workforce.</p><p> </p><p>Over 1,000 have entered Return to Practice programmes this year. These programmes fast track experienced nurses back into the NHS in 3-6 months, compared to 3-4 years training new nurses.</p><p> </p><p>HEE is working with NHS England, the British Medical Association and the Royal College of General Practitioners to standardise a funded scheme which allows general practitioners to return to United Kingdom general practice following a career break. This is anticipated to be launched at the end of March.</p><p> </p> answering member printed Earl Howe question first answered 23/02/2015 12:34:24 answering member 2000 label Biography information for Earl Howe
tabling member	2537 label Biography information for Lord Turnberg

178726

registered interest
date	09/02/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Nottingham University Hospitals 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 recent closing of the acute dermatological services at Nottingham University Hospital Trust and the impact it has had on the dermatology services to in-patients with acute medical and surgical conditions and on training capacity in the East Midlands.
tabling member printed	Lord Turnberg
uin	HL4874
answer	answer is ministerial correction date of answer 20/02/2015 answer text <p>The provision of services, including dermatology services, is a matter for the local National Health Service.</p><p> </p><p> </p><p> </p><p>We are advised by the NHS Trust Development Authority that Nottingham University Hospitals NHS Trust has worked with commissioners to ensure a satisfactory service is available to local people from alternative providers and the Trust will continue to provide an out of hours service for its inpatients and those patients requiring emergency treatment.</p><p> </p><p><strong> </strong></p><p> </p><p>Rushcliffe Clinical Commissioning Group has commissioned a review to assess what is needed to meet the needs of the population in the future.</p><p> </p><p><strong> </strong></p><p> </p><p>This Government established Health Education England to co-ordinate education and training activity across the NHS, including the management of training programmes for junior doctors. Health Education England and the Local Education and Training Board in the East Midlands are best placed to work with local employers in Nottingham to understand and manage the impact of changes.</p><p> </p> answering member printed Earl Howe question first answered 20/02/2015 12:41:00 answering member 2000 label Biography information for Earl Howe
tabling member	2537 label Biography information for Lord Turnberg

178727

registered interest
date	09/02/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Pancreatic Cancer
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what measures they are taking to ensure that patients with pancreatic cancer can gain access to the latest and most effective treatments.
tabling member printed	Lord Turnberg
uin	HL4875
answer	answer is ministerial correction date of answer 23/02/2015 answer text <p>NHS England recently committed a further £15 million over three years to evaluate and treat patients with a modern, more precise type of radiotherapy, stereotactic ablative radiotherapy (SABR). This evaluation programme will mean a significant increase in the number of cancer patients eligible to access SABR treatment by around 750 a year. The programme will widen the number of cancers being treated by SABR, including cancer that has spread to another part of the body. This new investment is in addition to NHS England’s pledge to fund up to £6 million over the next five years to cover the National Health Service treatment costs of SABR clinical trials, most of which are being led by Cancer Research UK. One of these trials is for pancreatic cancer.</p><p> </p><p> </p><p> </p><p>Regarding cancer drugs, the National Institute for Health and Care Excellence (NICE) has recommended gemcitabine as a treatment option for pancreatic cancer in technology appraisal guidance published in May 2001, subject to certain clinical criteria, and has been asked to appraise a number of other pancreatic cancer drugs. Where a pancreatic cancer drug is not routinely available on the NHS, patients may be able to access it through the Cancer Drugs Fund (CDF). There is one anti-cancer therapy available through the CDF that is used in pancreatic cancer, Albumin bound Paclitaxel (Abraxane).</p><p> </p><p> </p><p> </p><p>More generally on treatment, NHS England’s pancreatic cancer service specification clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective pancreatic cancer services. This service specification has been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe core and developmental service standards. In addition, a pancreatic cancer clinical guideline and quality standard have been referred to NICE by NHS England.</p><p> </p><p> </p><p> </p><p>Other action is also ongoing to improve cancer survival rates, including for pancreatic cancer, which we know can be particularly difficult to detect and diagnose. In January 2015, NHS England launched a major early diagnosis programme, working jointly with Cancer Research UK and Macmillan Cancer Support to test new approaches to identifying cancer more quickly. These include: offering patients the option to self-refer for diagnostic tests; lowering the threshold for general practitioner (GP) referrals; creating a pathway for vague symptoms like tiredness; and setting up multi-disciplinary diagnostic centres so patients can have several tests done at the same place on the same day. NHS England’s aim is to evaluate these innovative initiatives across more than 60 centres around England to collect evidence on approaches that could be implemented from 2016-17.</p><p> </p><p> </p><p> </p><p>In 2013, Macmillan Cancer Support, partly funded by the Department, piloted an electronic cancer decision support tool, which includes pancreatic cancer, for GPs to use in their routine practice. It is designed to help GPs recognise the symptoms of cancer and identify patients that they might not otherwise refer urgently for suspected cancer. The system is currently installed in over 1,000 GP practices, and Macmillan Cancer Support is working in partnership with companies supplying GP information technology systems to develop versions of this software to make it available to all GPs as part of their standard software offer.</p><p> </p><p> </p><p> </p><p>The Department has regular meetings with NHS England on improving cancer survival rates, including for pancreatic cancer.</p><p> </p> answering member printed Earl Howe grouped question UIN HL4876 question first answered 23/02/2015 14:09:45 answering member 2000 label Biography information for Earl Howe
tabling member	2537 label Biography information for Lord Turnberg

178728

registered interest
date	09/02/2015
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Pancreatic Cancer
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what discussions they have had with NHS England about improving pancreatic survival rates.
tabling member printed	Lord Turnberg
uin	HL4876
answer	answer is ministerial correction date of answer 23/02/2015 answer text <p>NHS England recently committed a further £15 million over three years to evaluate and treat patients with a modern, more precise type of radiotherapy, stereotactic ablative radiotherapy (SABR). This evaluation programme will mean a significant increase in the number of cancer patients eligible to access SABR treatment by around 750 a year. The programme will widen the number of cancers being treated by SABR, including cancer that has spread to another part of the body. This new investment is in addition to NHS England’s pledge to fund up to £6 million over the next five years to cover the National Health Service treatment costs of SABR clinical trials, most of which are being led by Cancer Research UK. One of these trials is for pancreatic cancer.</p><p> </p><p> </p><p> </p><p>Regarding cancer drugs, the National Institute for Health and Care Excellence (NICE) has recommended gemcitabine as a treatment option for pancreatic cancer in technology appraisal guidance published in May 2001, subject to certain clinical criteria, and has been asked to appraise a number of other pancreatic cancer drugs. Where a pancreatic cancer drug is not routinely available on the NHS, patients may be able to access it through the Cancer Drugs Fund (CDF). There is one anti-cancer therapy available through the CDF that is used in pancreatic cancer, Albumin bound Paclitaxel (Abraxane).</p><p> </p><p> </p><p> </p><p>More generally on treatment, NHS England’s pancreatic cancer service specification clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective pancreatic cancer services. This service specification has been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe core and developmental service standards. In addition, a pancreatic cancer clinical guideline and quality standard have been referred to NICE by NHS England.</p><p> </p><p> </p><p> </p><p>Other action is also ongoing to improve cancer survival rates, including for pancreatic cancer, which we know can be particularly difficult to detect and diagnose. In January 2015, NHS England launched a major early diagnosis programme, working jointly with Cancer Research UK and Macmillan Cancer Support to test new approaches to identifying cancer more quickly. These include: offering patients the option to self-refer for diagnostic tests; lowering the threshold for general practitioner (GP) referrals; creating a pathway for vague symptoms like tiredness; and setting up multi-disciplinary diagnostic centres so patients can have several tests done at the same place on the same day. NHS England’s aim is to evaluate these innovative initiatives across more than 60 centres around England to collect evidence on approaches that could be implemented from 2016-17.</p><p> </p><p> </p><p> </p><p>In 2013, Macmillan Cancer Support, partly funded by the Department, piloted an electronic cancer decision support tool, which includes pancreatic cancer, for GPs to use in their routine practice. It is designed to help GPs recognise the symptoms of cancer and identify patients that they might not otherwise refer urgently for suspected cancer. The system is currently installed in over 1,000 GP practices, and Macmillan Cancer Support is working in partnership with companies supplying GP information technology systems to develop versions of this software to make it available to all GPs as part of their standard software offer.</p><p> </p><p> </p><p> </p><p>The Department has regular meetings with NHS England on improving cancer survival rates, including for pancreatic cancer.</p><p> </p> answering member printed Earl Howe grouped question UIN HL4875 question first answered 23/02/2015 14:09:45 answering member 2000 label Biography information for Earl Howe
tabling member	2537 label Biography information for Lord Turnberg

172702

registered interest
date	08/01/2015
answering body	Department for International Development
answering dept id	20
answering dept short name	International Development
answering dept sort name	International Development
hansard heading	Palestinians
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, further to the Written Answer by Baroness Northover on 6 January (HL3815), what co-operation they have had from Hamas in the reconstruction of civilian property in Gaza.
tabling member printed	Lord Turnberg
uin	HL4022
answer	answer is ministerial correction date of answer 22/01/2015 answer text <p>UK policy on Hamas is clear: we do not talk to Hamas and we have no plan to do so at present. At the Gaza Reconstruction Conference, the UK pledged £20 million for early recovery assistance. DFID has already disbursed £5 million and will provide the remainder in 2015/16. The UK was also the first donor to support the temporary tri-partite Gaza Reconstruction Mechanism (GRM) which is facilitating the import of construction materials into Gaza.</p><p> </p> answering member printed Baroness Northover question first answered 22/01/2015 17:09:13 answering member 2539 label Biography information for Baroness Northover
tabling member	2537 label Biography information for Lord Turnberg