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Embryology

Lord Alton of Liverpool asked Her Majesty's Government:

The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): As part of its consultation on hybrid embryos, the Human Fertilisation and Embryology Authority (HFEA) carried out an extensive literature review and consulted several leading scientific institutions. The aim was to gather information on which research groups had already created human-animal cytoplasmic hybrid embryos abroad, and to explore the pre-implantation development of human-animal cytoplasmic hybrid embryos. The HFEA did try to correspond with the authors of the paper quoted but they refused to give any additional information. The HFEA did not review the study in order to assess the potential of human cells for reproductive cloning as reproductive cloning is illegal in the United Kingdom. Also, as it is illegal for a cytoplasmic hybrid to be transferred into the womb of a woman, it was not relevant for the authority to look at published work that may have done this in animals.

Lord Alton of Liverpool asked Her Majesty’s Government:

Lord Darzi of Denham: It is for the Human Fertilisation and Embryology Authority (HFEA) to decide upon criteria for the assessment of the predominance of animal DNA in an admixed embryo. All applications to create and use human admixed embryos would be considered on their merits and the HFEA would have to be satisfied that none of the activities was prohibited, that the activities proposed were necessary or desirable for one of the purposes defined in the Act and that the use of human admixed embryos was necessary for that purpose.



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If the proposed research was to create and use admixed embryos under the provision in Section 4A(6)(e) then the application would have to include the methodology that would be used to create the embryos and an explanation of what proportion of animal DNA would be present, as well as the reasons why creating and using these embryos was necessary. All applications are sent for peer review and the reviewers are asked to give an opinion as to whether the activities proposed were necessary or desirable for one of the purposes defined in the Act and that the use of human embryos was necessary for that purpose.

Lord Alton of Liverpool asked Her Majesty’s Government:

Lord Darzi of Denham: The “hamster test” was not viewed as providing a precedent when the Human Fertilisation and Embryology Authority (HFEA) considered whether admixed embryos fell under the remit of the Human Fertilisation and Embryology Act 1990. The HFEA considered evidence on whether “cytoplasmic hybrid” human admixed embryos would be human and decided that they would be; therefore, any person creating and using such embryos would require a licence from the HFEA.

Lord Alton of Liverpool asked Her Majesty’s Government:

Lord Darzi of Denham: The Human Fertilisation and Embryology Authority’s scientific and clinical advisory group was asked to consider the various methods of deriving embryonic stem cells from human embryos and whether any of the methods would, potentially, be prohibited under the Human Fertilisation and Embryology Act 1990. This discussion involved the views of and information provided by Dr Daniel Brison and Professor Alan Trounson, leading experts in the field of embryonic stem cells. The view of the group was that none of the methods currently used would be prohibited because entities which form when

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human embryos are allowed to outgrow their structure are not classed as live human embryos and do not breach Sections 3(3)(a) and 3(4) of the 1990 Act. This is because the entities do not have the organisation structure of a viable embryo and are not representative of a 3D suspended embryo undergoing gastrulation—the stage of development during which the primitive streak emerges.

Lord Alton of Liverpool asked Her Majesty's Government:

Lord Darzi of Denham: The Medical Research Council provided briefing containing the view that combining gametes or nuclei from animal and human cells could be useful in exploring the mechanisms by which mitochondrial DNA is activated, including when and how much it replicates and how the genes carried by mitochondrial DNA are regulated, and how nuclear proteins influence this.

In considering the new provisions in the Human Fertilisation and Embryology Bill relating to the creation of admixed embryos, including the creation of true hybrids, the Human Fertilisation and Embryology Authority's (HFEA) scientific and clinical advisory group was asked for views as to what, if any, reasons would scientists wish to create and use these types of embryos. It was suggested to the group that these embryos could, potentially, be used to study mitochondrial disease.

To date the HFEA has had no queries from scientists about the future creation of true hybrids for this purpose. If the HFEA were to receive an application for the use of gametes from different species, this would have to be considered on its own merits and would be subjected to the usual mandatory scrutiny.

If a proposed gamete recovery programme involves pain, suffering, distress, or lasting harm to an animal, a licence under the Animals (Scientific Procedures) Act 1986 (ASPA) is required. It is government policy not to allow the use of great apes—gorillas, chimpanzees, orangutans—in procedures under ASPA.

Health: Alzheimer's

Lord Morris of Manchester asked Her Majesty’s Government:



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The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): The department welcomes the Alzheimer’s Society’s report and its focus on improvements in access and quality of care for people with dementia in care homes and their families. In June 2008, we launched a national debate on the future of care and support. Establishing a system of funding for care that is sustainable and fair to service users, their families and those who care for them, as well as the taxpayer, will be an important part of this debate.

The department is presently consulting on the first ever draft national dementia strategy and implementation plan.

Health: Assessment and Remuneration

Lord Maginnis of Drumglass asked Her Majesty’s Government:

The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): NHS foundation trusts have the freedom to innovate and to invest in improved care for patients. The report High Quality Care for All welcomed recent initiatives that have seen some NHS foundation trusts share the proceeds of their success with all their staff, from the porter to the senior clinician, and encouraged more to do likewise.

The report also referred to the clinical excellence awards (CEA) scheme which was agreed and introduced at the same time as the new consultant contract in 2003. It rewards those consultants who contribute most towards the delivery of safe and high-quality care to patients and to the continuous improvement of NHS services, including those who do so through their contribution to academic medicine. The report announced our intention to strengthen this scheme and to make new awards, and the renewal of existing awards, more conditional on clinical activity and quality indicators. The scheme will continue to operate as at present, but the existing criteria used by local and national awarding committees will be refined to include relevant quality indicators. We have committed to involving the profession in developing and introducing this.

Lord Maginnis of Drumglass asked Her Majesty's Government:

Lord Darzi of Denham: The Government do not intend to publish an effectiveness scale against which surgeons will be assessed for each type of operation.



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The Government announced in High Quality Care for All: NHS Next Stage Review Final Report in June 2008 that:

An initial set of clinical quality and outcome metrics will be developed for use by NHS acute services in the financial year 2009-10. Some mental health metrics are also being considered for this round. Further indicators will be developed over subsequent years. The indicators’ primary use will be to guide quality improvement through comparison and benchmarking by clinical teams to facilitate local improvement efforts. The indicators will not be available at the level of individual consultants. Although we will begin with acute services, from next year we will also develop and pilot a quality framework for community services.

Lord Maginnis of Drumglass asked Her Majesty’s Government:

Lord Darzi of Denham: Nothing in Agenda for Change would prevent specific bonuses being given to staff if they meet measurable targets and provide fair and equal opportunities for all staff within the organisation to participate. These bonuses are not part of regular pay. It is for the organisations themselves to decide whether bonuses were merited in any particular case.

Lord Maginnis of Drumglass asked Her Majesty’s Government:

Lord Darzi of Denham: Nothing in Agenda for Change, the pay system that covers non-medical NHS employed staff in hospital cleaning teams, would prevent specific bonuses being given to staff, if they meet measurable targets and provide fair and equal opportunities for all staff within the organisation to participate. It is for the organisations themselves to decide if this were merited in any particular case.

Health: Bone Marrow

Lord Harrison asked Her Majesty's Government:

The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): The National Blood Service (NBS) asks new blood donors

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about joining the British Bone Marrow Registry (BBMR) when they first become a blood donor. In order to increase the number of matches available for patients from black and minority ethnic (BME) groups, the NBS has launched the “One-Blood” campaign, to attract more people from these groups to become blood donors and join the BBMR.

To ensure young people understand the importance of donation of blood, organs, tissue and bone marrow, and to encourage them to become donors in the future, NHS Blood and Transplant (NHSBT) has developed the Give and Let Live educational pack and website for schools. A revised version of the pack will be sent out in this year’s autumn term.

The Department of Health, the Department for Children, Schools and Families and NHSBT are working together to ensure that young people are made aware of the importance of donation. A joint ministerial letter will be sent to all secondary schools, highlighting how donation can be taught within the curriculum and encouraging schools to use the new pack.

Health: Cardiac Problems

Lord Colwyn asked Her Majesty’s Government:

The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): The information requested on the number of people diagnosed with cardiac arrhythmia is not available centrally.


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