Public Health England
Luciana Berger: To ask the Secretary of State for Health what the (a) purpose and (b) cost of international travel undertaken for official purposes by (i) directors of Public Health England and (ii) members of its advisory board has been since 1 April 2012. [197368]
Jane Ellison: The purposes of Public Health England’s (PHE) international travel include:
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to provide expert advice to international agencies such as the World Health Organisation and to the overseas territories of the United Kingdom (UK);
to co-ordinate the global preparedness for serious health threats that might affect the UK;
to provide advice and support to other national public health agencies on public health incidents and initiatives to improve health;
to contribute to humanitarian responses; and
to present PHE contributions at international scientific conferences.
The cost of international travel undertaken for official purposes is as follows:
(i) Directors of PHE: £12,458.57
(ii) Members of PHE’s advisory board since April 2013: £817.74.
International travel has been defined as the cost of transportation wholly outside the UK or tickets to/from a destination outside the UK.
Luciana Berger: To ask the Secretary of State for Health how much Public Health England has spent on the development and implementation of its Global Health Strategy since its inception. [197369]
Jane Ellison: Public Health England’s (PHE) Global Health Strategy is currently in development.
Development of the strategy has been undertaken by PHE’s in-house global health and international teams. The following table shows PHE’s spend on the development of its Global Health Strategy:
| Expense | Cost (£) |
| 1 Staff time includes the contribution from a consultant in public health plus employer related costs. This excludes other staff contributions for which time allocation is not captured. 2 Excludes telephony costs and minor refreshments costs. | |
Luciana Berger: To ask the Secretary of State for Health how much Public Health England has spent on consultancy workers in 2013-14. [197371]
Jane Ellison: Public Health England (PHE) has incurred no expenditure with professional consultancy firms of the nature described in the Cabinet Office definition of consultancy.
However, PHE sought approval under the Department’s Professional Services approvals route for £8.1 million of contingent labour where the daily rate of the individuals concerned was more than £220 per day. This involves approval by the Chief Executive of PHE, by the Department’s Procurement and by the Department’s Financial Approvals Panel.
Royal College of Obstetricians and Gynaecologists
Robert Flello:
To ask the Secretary of State for Health what assessment he has made of the recent decision by the Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists (RCOG) to refuse to allow doctors who have a conscientious objection to supplying certain abortive-type contraceptive drugs or devices to undertake and complete specialist training with the aim
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of gaining Membership of the Faculty of Sexual and Reproductive Healthcare of the RCOG. [197137]
Jane Ellison: The Faculty of Sexual and Reproductive Healthcare is responsible for decisions on the syllabus of its diploma, the requirements for entry to the diploma course, and the award of a diploma qualification.
The Department understands that the guidelines on the syllabus on possible conscientious objection have not changed.
Sickle Cell Diseases
Kate Green: To ask the Secretary of State for Health what steps he is taking to raise awareness among clinicians of sickle cell disease and its incidence among those of non-African-Caribbean extraction. [196521]
Jane Ellison: While the highest incidence of sickle cell disease occurs in people of African or African Caribbean origin, it is known that there are other ethnic groups in which the disease is also more common.
To support clinicians in the diagnosis treatment and care of patients with a range of diseases and conditions, the National Institute for Health and Care Excellence has developed the Clinical Knowledge Summaries (CKS) website. The CKS for sickle cell disease sets out that the condition disease affects one in every 2,400 live births in England and is now the most common genetic condition at birth. It lists nine other ethnic groupings, in addition to African or African Caribbean, with a clinically significant prevalence of the sickle cell gene which clinicians should consider when assessing a patient. The CKS for sickle cell disease can be found at the following link:
http://cks.nice.org.uk/sickle-cell-disease
Smoking: Motor Vehicles
Alex Cunningham: To ask the Secretary of State for Health when he plans to bring forward regulations for the introduction of the ban on smoking in cars with children present. [197384]
Jane Ellison: The Children and Families Act 2014 contains regulation-making powers to prohibit smoking in private vehicles carrying children. The Department is currently drawing up proposals for how this could be achieved, which we will consult on. We plan to introduce these regulations during the lifetime of this Parliament.
Social Work
Luciana Berger: To ask the Secretary of State for Health which Minister in his Department is responsible for social work work force planning. [196483]
Norman Lamb: I am the Minister for Care and Support at the Department of Health responsible for adult social care work force issues, which includes social work. The Department for Education is responsible for children and families social work.
However, it is the responsibility of the individual employers of social workers to plan the work force, ensuring they have the right number of trained social work staff in place to deliver the required service.
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Stationery
Mr Redwood: To ask the Secretary of State for Health what levels of stock his Department holds of (a) stationery, (b) printer cartridges, (c) treasury tags and other fasteners and (d) other office consumables. [196208]
Dr Poulter: The Department makes use of the Government Office Supplies contract to obtain supplies of stationery and associated items. In March 2014, the Department ordered 1,957 units of stationery, which included 54 boxes of foldback clips, 41 boxes of bar tags and 15 boxes of paperclips. These items are ordered directly from Banner on an “as required” basis by individual directorates and no records of any small local stocks are maintained.
The Department does not hold central stocks of the consumables associated with the provision of multi- functional device services such as printers. These items are replenished automatically by the supplier when required.
In a small number of cases, standalone printer cartridges are sourced through XMA Ltd under the Government Office Supplies contract. In March 2014, the Department sourced 13 units through this contract. A small number of these items may be held locally but these are not recorded.
Surgery
Charlotte Leslie: To ask the Secretary of State for Health what information patients are entitled to as to whether a medical operation will be undertaken by a fully surgically qualified member of staff. [196993]
Dr Poulter: It is the responsibility of the individual national health service trust or NHS foundation trusts to ensure that patients are treated by suitably qualified staff.
The Department encourages patients to make an informed decision before having medical operations. As part of this, patients can ask to have information on the clinical staff that will be conducting any medical operation and the Department would expect that the trust should provide this information to them.
The NHS Constitution sets out patients’ rights when using NHS services, and these include:
The right to be treated with a professional standard of care, by appropriately qualified and experienced staff, in a properly approved or registered organisation that meets required levels of safety and quality; and
The right to be involved in discussions and decisions about your health and care, including your end of life care, and to be given information to enable you to do this. Where appropriate this right includes your family and carers.
One of the Care Quality Commission’s (CQC) core 16 quality and safety standards is that providers must ensure that those carrying on a regulated activity, such as medical operations, must have the qualifications, skills and experience necessary for the work to be performed. The CQC can take action against health care providers if they are concerned about them employing inappropriately qualified staff.
In addition, the General Medical Council (GMC) holds the central registers of doctors’ qualifications. The medical register shows who is properly qualified to practise medicine, while the specialist register shows
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doctors who have completed specialist training, including surgical training. Patients may visit the GMC website to search the medical register online.
On patient consent, the GMC’s guidance, ‘Consent: patients and doctors making decisions together’, states patients must be provided with the information they have requested on:
“the people who will be mainly responsible for and involved in their care, what their roles are, and to what extent students may be involved.”
This means that, as part of the consent process, doctors are expected to give honest answers to any questions from patients, including questions about their qualifications to carry out the particular procedure in question. This is specifically expressed in the GMC’s document, ‘Good Medical Practice’,paragraph 66, where it says:
“You must always be honest about your experience, qualifications and current role.”
Charlotte Leslie: To ask the Secretary of State for Health how many surgical care practitioners have practised in the NHS in each year since 2005. [196994]
Dr Poulter: The information is not held centrally. The number of surgical care practitioners who have practised in the national health service in each year since 2005 is not identified separately in the annual NHS workforce census.
Charlotte Leslie: To ask the Secretary of State for Health what assessment he has made of the effect of the number of surgical care practitioners on the training of junior doctors in surgery. [197050]
Dr Poulter: The Government have mandated Health Education England (HEE) to provide national leadership on education, training and workforce development in the national health service.
HEE supports the delivery of excellent health care and health improvement to the patients and public of England, by ensuring that our workforce has the right numbers, skills, values and behaviours, at the right time and in the right place. A key part of that role is a continuing responsibility for ensuring the provision of an appropriate number of surgical trainees. Assurance of the quality of surgical training is the responsibility of the General Medical Council.
Tamiflu
Jonathan Edwards: To ask the Secretary of State for Health what pharmaceutical companies supplied the Government's stockpile of Tamiflu. [196368]
Jane Ellison: Roche is the only supplier of the Government’s stockpile of Tamiflu. There are currently no other suppliers of Tamiflu.
Teenage Pregnancy
Luciana Berger: To ask the Secretary of State for Health what estimate his Department has made of the number of teenage pregnancy co-ordinators in (a) 2010-11, (b) 2011-12, (c) 2012-13 and (d) 2013-14. [196447]
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Jane Ellison: The Department does not collect this information centrally. Efforts to tackle teenage pregnancy are led by local authorities, who will make local decisions on whether a teenage pregnancy co-ordinator is needed in their local area. There is no requirement for them to report centrally on whether they have a co-ordinator.
Tobacco: Packaging
Alex Cunningham: To ask the Secretary of State for Health when he plans to bring forward draft regulations for the introduction of standard packaging for tobacco products. [197385]
Jane Ellison: Before reaching a final decision on standardised packaging of tobacco products, and in order to ensure that the decision is properly and fully informed, we intend to publish the draft regulations to make sure that intentions are clear, alongside a final short consultation.
This consultation will ask, in particular, for views on anything new since the last full public consultation that is relevant to a final decision. The content and timing of the consultation will be announced shortly.
Trade Unions
Graeme Morrice: To ask the Secretary of State for Health whether his Department has any plans to end the employee trade union membership dues check-off system. [196767]
Dr Poulter: In accordance with a request from the Minister for the Cabinet Office and Paymaster General, my right hon. Friend the Member for Horsham (Mr Maude), the Department and its Executive agencies (Medicines and Healthcare products Regulatory Agency and Public Health England) have undertaken a review of the provision of the check-off facility. Upon completion, this review will be submitted to the Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Mr Hunt), for consideration.
Transvaginal Mesh Implants
Graeme Morrice: To ask the Secretary of State for Health (1) what meetings his Department has had in which polypropylene transvaginal mesh implants were (a) discussed or (b) on the agenda; [196744]
(2) what representations his Department has received communicating concerns with polypropylene transvaginal mesh implants; [196738]
(3) how many patients have reported complications with polypropylene transvaginal mesh implants in each of the last three years; [196739]
(4) how many patients have received polypropylene transvaginal mesh implants through the NHS in each of the last three years; [196740]
(5) how many cases of complications with transvaginal mesh implants have been reported by health professionals in each of the last three years; [196741]
(6) what processes his Department and the NHS have in place to monitor the safety of transvaginal mesh implants; [196742]
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(7) how many patients have required further operations due to complications with transvaginal mesh implants in each of the last three years; and what the cost of such procedures was. [196743]
Norman Lamb: The Department of Health does not hold information on the number of patients who have required further operations due to complications with transvaginal mesh implants in each of the last three years or the costs of these operations.
The Department has had two meetings in which polypropylene transvaginal mesh implants were either discussed or on the agenda.
NHS England manages the National Reporting and Learning System (NRLS) for patient safety incident reports from the NHS. NHS England shares incident reports concerning harms arising from medical devices with the Medicines and Healthcare products Regulatory Agency (MHRA).
Manufacturers of medical devices such as transvaginal mesh implants are legally required to report adverse incidents (ie death, serious injury or potential serious injury) involving their devices to the MHRA. General Medical Guidance published in February 2013 makes it clear that clinicians should report medical device incidents to the MHRA, and make information available to patients about how they can report side effects to the MHRA. The MHRA also encourages voluntary reporting of adverse incidents by healthcare workers, carers, patients and members of the public and participates in monthly telephone meetings with regulators in other European Union member states to share information about medical device safety.
The Department is currently engaged in work to assess the effectiveness of existing arrangements for reporting complications relating to transvaginal mesh implants. NHS England is leading this work, which also involves the MHRA, the Royal College of Obstetricians and Gynaecologists, and the relevant professional societies (the British Society of Urogynaecology and the British Association of Urological Surgeons).
| Finished consultant episodes for women who have received a primary or secondary operative procedure for the insertion of transvaginal mesh, transobturator tape, transvaginal slings and transvaginal tape | |||
| Procedure | 2010-11 | 2011-12 | 2012-13 |
| Note: Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector. Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre. | |||
Adverse events reported to MHRA by health professionals concerning vaginal tape and mesh implants are as follows:
| Vaginal tapes for stress urinary incontinence | Vaginal mesh for pelvic organ prolapse | Vaginal mesh for unknown1 indication | |
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| 1 The reporter did not provide enough information on what type of mesh it was | |||
| Number of patient safety incidents relating to mesh used in gynaecological procedures reported to the NRLS (Year of occurrence by reported degree of harm) | ||||
| No harm | Low | Moderate | Total | |
| Search strategy: All incidents from gynaecological specialties in the NRLS were searched on 2 December 2013 for the keyword ‘mesh’ | ||||
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Adverse events reported to MHRA by patients/members of the public concerning vaginal tape and mesh implants are as follows:
| Vaginal tapes for stress urinary incontinence | Vaginal mesh for pelvic organ prolapse | Vaginal mesh for unknown1 indication | |
| 1 The reporter did not provide enough information on what type of mesh it was. | |||
No incidents relating to transvaginal mesh have been reported to the NRLS by patients.
The Department has answered 11 previous parliamentary questions, 27 letters from hon. Members and Peers and 17 letters from members of the public since 1 September 2011. The chief executive of the MHRA has replied to six letters from hon. Members since 1 September 2011.