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Written Answers

Thursday 5 December 2013

Banks: Royal Bank of Scotland

Question

Asked by Lord Myners

To ask Her Majesty’s Government what action they plan to take in response to the report from Lawrence Tomlinson on the actions of the Royal Bank of Scotland Global Restructuring Group; and whether there will be an investigation of fraudulent preference in the matter of the bank’s subsidiary, West Register.[HL3630]

The Commercial Secretary to the Treasury (Lord Deighton) (Con): Dr Tomlinson published his report in a private capacity—it is not a Government report. The Government is unable to comment on the veracity of the allegations. Nevertheless these are serious allegations. We understand RBS are investigating them; it is important that their investigation is concluded thoroughly and promptly.

Companies: Beneficial Ownership

Question

Asked by Lord Chidgey

To ask Her Majesty’s Government, with regard to their intention to establish public registries of the beneficial ownership of companies, what steps they are taking at a European level to ensure that public registries of beneficial ownership become the legal standard in the European Union.[HL3646]

The Commercial Secretary to the Treasury (Lord Deighton) (Con): The UK continues to encourage all its international partners to join the UK in leading from the front on implementation of the international standards on anti-money laundering and combating the financing of terrorism, including through publicly accessible registries of company beneficial ownership.

The Prime Minister has written to the Presidency of the European Council and Heads of European Governments, calling on the EU to require publicly accessible central registries of company beneficial ownership. The Treasury, through the negotiation of current proposals for a Fourth Money Laundering Directive, is working with the Council to encourage the inclusion of public registries; this has the support of 11 MEPs. We will continue to encourage European partners to do so.

Data Protection

Question

Asked by Lord Laird

To ask Her Majesty’s Government what steps they have taken to ensure that confidential data held by the Metropolitan Police have not been transferred abroad without authorisation.[HL3716]

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The Parliamentary Under-Secretary of State, Home Office (Lord Taylor of Holbeach) (Con): That is a matter for the Metropolitan Police, and inquiries should be directed to the Commissioner’s office. This Government has been clear that no confidential material should be transferred abroad without appropriate authorisation.

Fluoridation

Questions

Asked by Earl Baldwin of Bewdley

To ask Her Majesty’s Government, further to the Written Answer by Earl Howe on 28 October (WA 212–3), whether in the matter of potential harm from water fluoridation Public Health England distinguish between absence of evidence and evidence of absence.[HL3615]

To ask Her Majesty’s Government, further to the Written Answer by Earl Howe on 28 October (WA 212–3), why Public Health England, in comparing findings by McGrady et al in their BMC Public Health 2012 paper and by the NHS Centre for Reviews and Dissemination at the University of York in their 2000 report on water fluoridation, did not cite the respective figures in fluoridated populations of 55% and 48% for all dental fluorosis in place of figures for the categories of “severe” and “moderate” fluorosis which the York report did not address. [HL3616]

To ask Her Majesty’s Government, further to the Written Answer by Earl Howe on 28 October (WA 212–3), whether they regard the quality of evidence obtained by adding the cross-sectional study by McGrady et al to the five earlier studies cited in the discussion section of his paper and graded by the York report at level C or lower as adequate to show that water fluoridation reduces the social gradient in dental caries.[HL3617]

To ask Her Majesty’s Government, further to the Written Answer by Earl Howe on 28 October (WA 212–3), how accurate they consider the examination of the maxillary central incisors of 11 to 13 year-olds, as conducted by McGrady et al, to be as an indicator of the extent of dental fluorosis in a fluoridated population.[HL3618]

The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con): Water fluoridation schemes have operated for nearly 50 years in England and over 50 years internationally. In that time no evidence has arisen demonstrating that there is harm to general health from these schemes. Furthermore there are communities in England who have consumed fluoride in their water supply for generations at levels close those achieved by water fluoridation schemes. It is reasonable to judge that, after the passage of so many years of public health surveillance, if there was any harm to general health from water fluoridation then this would be apparent.

The authors of the York review of water fluoridation have stated that they found a benefit in the form of reduction in caries, balanced against an increase in

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fluorosis and that no clear evidence of other potential negative effects was found. In 2002, the Medical Research Council made recommendations regarding surveillance and research priorities. The National Institute for Health Research welcomes funding applications for research into any aspect of human health, including water fluoridation. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the scientific quality of the proposals made. Any new evidence emerging regarding water fluoridation will be assessed by Public Health England (PHE). PHE is currently working towards publishing a first report on the health effects of fluoridation by the end of March 2014, as required by legislation. This will be a publicly available document. Further reports will follow within four-yearly time periods in accordance with the timetable prescribed in legislation.

Given the degree of scrutiny that has been applied to the links between water fluoridation and general health, the government is satisfied that water fluoridation is a safe and effective public health measure. What is very apparent is the harm caused by dental caries which is still a common cause of children to be admitted to hospital and affects those children from deprived communities the most.

The study by McGrady et al used novel technologies and photographing teeth in order to facilitate a highly standardised and reliable assessment of mottling (fluorosis), reducing potential examiner bias—a key recommendation of the York Review. Fluorosis is primarily a cosmetic issue affecting the appearance of the teeth and therefore, when attempting to assess whether there is a greater level of mottling in populations which may be caused by fluorosis, it is useful to distinguish mottling which is likely to be of aesthetic concern.

Whilst this study by McGrady et al is a cross-sectional study, it is the largest and most recent study to be undertaken on a domestic population since the York Review and addresses methodological concerns raised by that review. The study supports previous work and adds to the evidence base, providing further assurance that water fluoridation reduces oral health inequalities. The aforementioned report by PHE will also review the available information on tooth decay levels in fluoridated communities.

The maxillary central incisors are usually the most visible teeth in the mouth when smiling and speaking and will therefore contribute the most to the aesthetic appearance of the dentition. The use of maxillary central incisors in this study was partly to facilitate the use of a standardised photographic methodology and partly to reflect that the appearance of the two largest upper front teeth will be a key part of an individual’s perception of the appearance of their dentition as a whole. Fluoride absorption during tooth development will potentially affect all developing teeth so examination of the maxillary central incisors should provide a good representation of the teeth as a whole. Furthermore, the enamel of these teeth will be fully visible at the age of 11. Therefore this research methodology appears appropriate for the purpose of providing an accurate estimate of clinical fluorosis levels in a population and

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has advantages over visual examination and scoring as factors such as differences in incident light can affect the appearance of teeth quite markedly.

Health: Birth Defects

Questions

Asked by Lord Rooker

To ask Her Majesty’s Government by what date they plan to have all health regions in England covered by a congenital anomaly register.[HL3604]

To ask Her Majesty’s Government how the United Kingdom compares with other European Union member states in respect of pregnancies affected by neural tube defects.[HL3605]

To ask Her Majesty’s Government whether they will instruct the Chief Medical Officer for England to place on the agenda of her meetings with the chief medical officers from the devolved administrations the issue of fortification of flour with folic acid as a means of reducing pregnancies affected by neural tube defects.[HL3606]

To ask Her Majesty’s Government what methods they use to measure the financial costs to the economy of pregnancies affected by neural tube defects, including the costs resulting from terminations.[HL3607]

To ask Her Majesty’s Government what assessment they have made of the implications for health equality of their current policy regarding prevention of neural tube defect-affected pregnancies.[HL3608]

To ask Her Majesty’s Government what is their policy regarding women not currently planning a pregnancy with respect to avoiding pregnancies affected by neural tube defects.[HL3609]

The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con): Public Health England intends, subject to funding, to have a National Congenital Anomaly and Rare Disease Registration Service covering the entire population of England in place by end of 2015.

The prevalence of neural tube defects in live births, fetal deaths (over 20 weeks’ gestation) and terminations of pregnancy for fetal anomaly between 2007 and 2011 in the British Isles Network of Congenital Anomaly Registers (BINOCAR) registers (covering 36% of the births in England and Wales) was 11.9 per 10,000 births and in European Surveillance of Congenital Anomalies (EUROCAT) registries was 8.7 per 10,000 births. EUROCAT covers proportions of the following countries: Austria, Belgium, Bulgaria, Croatia, Denmark, France, Germany, Hungary, Ireland, Italy, Malta, Netherlands, Norway, Poland, Portugal, Spain, Switzerland and Ukraine. The prevalence rates across these countries range from 4.4 per 10,000 births in Poland to 21.6 per 10,000 in one region in France (Isle de la Reunion). Differences in total prevalence rates over time or between regions may reflect one or more of the following factors: genetic differences, environmental

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differences, differences in diagnostic services, differences in the methods of collecting epidemiological data, and even chance differences.

The Chief Medical Officer (CMO) is an independent adviser to the Secretary of State and the United Kingdom Government on all medical matters and liaises with the CMOs in the devolved administrations on issues of mutual interest. The Government does not set the agendas for these discussions.

The Government uses a standard methodology recommended in the Treasury’s Green Book to measure the financial costs to the economy of health related issues.

We are considering the Scientific Advisory Committee on Nutrition’s (SACN’s) recommendations on mandatory fortification of flour with folic acid including considering current policy on supplementation advice and wider implications.

It is important that women are able to access the full range of contraception from a choice of providers in order to avoid unwanted pregnancy and to plan when to start a family. We are considering the issue of neural tube defects arising from unplanned pregnancies as part of our response to SACN’s recommendations.

Health: Cardiology

Questions

Asked by Lord Hunt of Kings Heath

To ask Her Majesty’s Government what action they are taking to ensure an improvement in heart failure services above the standard reported in National Heart Failure Audit 2012–13.[HL3683]

To ask Her Majesty’s Government what action they are taking to ensure that patients with Left Ventricular Systolic Dysfunction are treated in line with National Institute for Health and Care Excellence clinical guidelines.[HL3684]

To ask Her Majesty’s Government what assessment they have made of the adoption by the National Health Service of the Cardiovascular Disease Outcomes Strategy.[HL3685]

The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con): Responsibility for determining the overall national approach to improving clinical outcomes from healthcare services lies with NHS England. NHS England hosts a number of strategic clinical networks which cover cardiovascular disease and which are intended to support the development and dissemination of good clinical practice.

It is for individual clinical commissioning groups to commission treatment and services for patients with heart failure, as they are best placed to identify what is needed in their local areas, taking into account relevant guidance from National Institute for Health and Care Excellence.

NHS England advises that it has established a Cardiovascular Disease Outcomes Strategy implementation group and that it is working with a variety of partners and stakeholders to deliver the strategy.

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Housing

Question

Asked by Lord Taylor of Warwick

To ask Her Majesty’s Government what assessment they have made of the availability of housing in London; and what steps they are taking to ensure that affordable homes are available.[HL3425]

The Parliamentary Under-Secretary of State, Department for Communities and Local Government (Baroness Stowell of Beeston) (Con): The Mayor of London has oversight of strategic housing, regeneration and economic development in London. Government has provided £1.1 billion to the Greater London Authority across 2012-13 to 2014-15 to deliver affordable housing in London. The Mayor published his Draft London Housing Strategy on 25 November 2013, which sets out an ambitious plan to increase the supply of housing across all tenures in London. I know that the Mayor and his team are working hard with providers to deliver London's share of the 170,000 new affordable homes being built in England between 2011 and 2015; and my hon Friend, the Parliamentary Under-Secretary of State for the Department for Communities and Local Government (Kris Hopkins), is working closely with him to agree an allocation for London from the £3.3 billion of Government funding which we will be providing, to build 165,000 additional affordable homes between 2015 and 2018.

NHS: Hospital Admissions

Question

Asked by Baroness Browning

To ask Her Majesty’s Government what percentage of patients admitted to hospital wards in England have (1) a hospital passport on admission, and (2) a hospital passport prepared for them during their stay in hospital.[HL3743]

The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con): This information is not centrally collected.

NHS: Salaries

Question

Asked by Lord Hunt of Kings Heath

To ask Her Majesty’s Government what is the salary structure for senior officials of Clinical Commissioning Units.[HL3769]

The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con): Clinical commissioning groups (CCGs) have been established under the NHS Act 2006 as amended by the Health and Social Care Act 2012. They are statutory bodies which have the function of commissioning services for the purposes

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of the health services in England and are treated as NHS bodies for the purposes of the National Health Service Act 2006.

It is for CCGs to determine their own remuneration and reimbursement policies for staff working for the CCG. Each CCG should set out how it will discharge its responsibilities in its constitution and Standing Financial Instructions.

NHS England published guidance in 2012 entitled CCG Governing Board Members: Role outlines, attributes and skills which had an annexe setting out the principles relating to reimbursement and remuneration. A copy of the guidance has been placed in the Library.

The NHS England guidance does not apply to chief officer roles where being a clinician has been deemed an essential requirement. NHS England has proposed 3 pay ranges for chief officers and chief finance officers, based on the population sizes of CCGs, set out in the following table.

CCG levelPopulation sizePay range for chief officerPay range for chief finance officer

Level 3

At or over 500,000

£120,000 - £130,000

£95,000 - £110,000

Level 2

150,000 to 499,000

£105,000 - £120,000

£85,000 - £95,000

Level 1

149,000 or below

£90,000 - £105,000

£75,000 - £85,000

Railways: Bank Holidays

Question

Asked by Lord Bassam of Brighton

To ask Her Majesty’s Government what plans they have under the terms of the Southern Rail franchise operable from September 2014 to include additional east and west coast services and in particular to include an obligation to run services on Boxing Day from Seaford to Brighton to enable sustainable travel to Boxing Day football fixtures.[HL3773]

The Minister of State, Department for Transport (Baroness Kramer) (LD): The minimum service specification for the Thameslink, Southern and Great Northern (TSGN) franchise, into which existing Southern services will be incorporated from July 2015, is intended to be consistent with today’s service levels on the East and West Coastways. As such, no specific requirements are included for Boxing Day services between Seaford and Brighton.

The competition to operate the TSGN franchise from September 2014 is currently under way. It is open to bidders for the franchise to propose additional services over and above the minimum requirements that have been specified, and they can expect to receive credit in the evaluation process for high-quality proposals that meet a demonstrable passenger need. Any such proposals made by the successful bidder would be incorporated into the franchise agreement.

It will also be open to the successful bidder, during the lifetime of the franchise, to propose further service enhancements. To provide an incentive for them to do so, given that the TSGN franchise is being let as a

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“management contract” in which farebox revenues will flow to the Department for Transport, the draft franchise agreement includes provision to allow the franchisee to receive some financial benefit for proposing and implementing such enhancements (where agreed by the Department).

Schools: Religious Tolerance

Question

Asked by Lord Bourne of Aberystwyth

To ask Her Majesty’s Government what steps they are taking to promote religious tolerance in schools.[HL3713]

The Parliamentary Under-Secretary of State for Schools (Lord Nash) (Con): This country has a long and noble tradition of religious tolerance and promotes this important value in schools. Every maintained school and academy must teach Religious Education (RE), which helps to develop young people’s beliefs and values, and promotes respect and empathy. RE fosters civilised debate and reasoned argument, and helps pupils to understand the place of religion and belief in the modern world. All publicly funded schools, including academies and free schools, also have a duty to promote community cohesion.

Academies, free schools and independent schools are all required to meet the Independent School Standard on the spiritual, moral, social and cultural development of pupils. The standard requires schools to promote principles which assist pupils to acquire “appreciation and respect for their own and other cultures in a way that promotes tolerance and harmony between different cultural traditions”. They should also encourage pupils to respect specified British values, which include ‘tolerance of those with different faiths and beliefs’. Ofsted’s inspection frameworks for maintained schools, academies, free schools and independent schools include a focus on pupils’ spiritual, moral, social and cultural development. This enables inspectors to identify any inappropriate practice which might undermine religious tolerance.

Syria

Question

Asked by Baroness Kinnock of Holyhead

To ask Her Majesty’s Government whether discussions are taking place in response to the view expressed by the United Nations High Commissioner for Human Rights, Navi Pillay, that Syria should be referred to the International Criminal Court. [HL3637]

The Senior Minister of State, Department for Communities and Local Government & Foreign and Commonwealth Office (Baroness Warsi) (Con): The UK has consistently called for the situation in Syria to be referred to the International Criminal Court. Though the UN Security Council (UNSC) remains divided on the matter, we succeeded in ensuring that UNSC Resolution 2118

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stressed the importance of a process of accountability for those responsible for the use alchemical weapons. We also ensured that the 2 October UN Security Council Presidential Statement on humanitarian access made clear that those responsible for human rights abuses must be brought to justice. On 31 October, we co-sponsored a UN General Assembly resolution which stressed the role of international courts in the vital task of holding responsible those who violate international humanitarian law, We will continue to argue that those responsible for violations and abuses of international human rights and humanitarian law in Syria should be held accountable, including as part of a future transitional justice effort.

Taxation: Automatic Information Exchange

Question

Asked by Lord Chidgey

To ask Her Majesty’s Government what is their policy on automatic information exchange; whether they discussed this at the sixth Organisation for Economic Co-operation and Development Global Forum on Tax and Transparency; and whether the Global Forum’s proposed new global standard will provide concessions to make it easier for developing countries to participate.[HL3650]

The Commercial Secretary to the Treasury (Lord Deighton) (Con): The Government is working internationally to promote a new single global standard in automatic information exchange in order to tackle tax evasion. This formed a central part of the UK's presidency of the G8, where the creation of a new global standard was strongly endorsed. The G20 has

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since called on the OECD to produce this new standard by February 2014 and the Global Forum recently established a new group focused on automatic exchange.

The UK with France, Germany, Italy and Spain (the G5) has committed to be early adopters of the new global standard of automatic information exchange. This commitment has now been joined by 37 jurisdictions in total.

As emphasised during the UK's presidency of the G8, we want all countries to benefit from the increased levels of tax transparency. To this end, the G20 has asked the Development Working Group to develop a roadmap showing how developing countries can participate in the automatic exchange of information standard.

Taxation: Corporation Tax

Question

Asked by Lord Myners

To ask Her Majesty’s Government whether HM Treasury will be required to amend its proposals for a Patent Box in response to interventions by the European Commission.[HL3631]

The Commercial Secretary to the Treasury (Lord Deighton) (Con): The UK Government is committed to the Patent Box, and remains confident that the Patent Box does not breach the criteria of the EU Code of Conduct on Business Taxation. The UK Patent Box is more tightly defined and imposes tougher eligibility criteria than other measures that have previously been approved or considered by the Code of Conduct Group. It is more focused in scope than other existing royalty boxes, and there are specific rules that require a company to be carrying on economic activity in order for it to benefit.