Asked by: Lord Rooker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what is the prevalence of births affected by neural tube defects in the UK; and what assessment they have made, if any, of how this figure compares with equivalent figures in other OECD member states.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Two neural tube defects, anencephaly and spina bifida, are screened for by the NHS Fetal Anomaly Screening Programme at the 20 week scan. In England and the crown dependencies, there were 752 births with neural tube defects in 2019 and a prevalence of 12.2 births per 10,000 total births.
The National Congenital Anomaly and Rare Disease Registration Service submits data to EUROCAT, the European network of population-based registries for the epidemiological surveillance of congenital anomalies. In 2019, the overall prevalence of neural tube defects for participating full registries across Europe, including full participating regions of England, was 11.36 per 10,000 births.
Asked by: Lord Rooker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what Government-sponsored research is currently underway regarding neural tube defect births.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Through the National Institute for Health Research (NIHR), the Department funds research into the safety of maternity and neonatal services and the national maternity ambition to halve maternal deaths, stillbirths and neonatal deaths and brain injury by 2025. The NIHR’s Oxford Biomedical Research Centre has supported 19 studies on neural tube defects. The NIHR has also funded a £2.2 million multicentre randomised controlled trial, which included children with neural tube defects, to determine the optimal type of shunt to treat hydrocephalus and reduce infection rates. The NIHR welcomes funding applications for research into any aspect of human health, including research on neural tube birth defects.
Asked by: Lord Rooker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the answer by Lord Kamall on 6 July (HL Deb cols 1001–2) regarding the scientific evidence available regarding folic fortification, whether they will publish the science brief referred to by Lord Kamall referencing heliocentrism versus geocentrism.
Answered by Lord Kamall
The scientific contestation referred to is summarised in the paper Folic acid and neural tube defects: Discovery, debate and the need for policy change by Professor Nicholas Wald. Professor Wald asserts that the United Kingdom should pursue a higher level of fortification than would be permitted by the UK’s Tolerable Upper Level (TUL). A copy of the paper is attached.
The Government and its independent scientific advisory bodies have agreed that fortification of non-wholemeal wheat flour with folic acid, at a level informed by the guidance for supplemental intake of folic acid intake advised by the UK Expert Group on Vitamins and Minerals, is a safe and effective measure to reduce the number of neural tube defects (NTDs).
This view is supported by the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) and by the Scientific Advisory Committee on Nutrition (SACN). In 2018 COT published Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment: COT position paper on the current upper level for folic acid intake in response to a previous paper by Professor Wald, addressing the technical points raised in objection to the TUL and continuing to recommend its use. A copy of this paper is attached.
Deaths associated with high levels of folic acid refers to potential unintended harms which may arise following the fortification of flour with folic acid, such as an increase in the potential masking of vitamin B12 deficiency or pernicious anaemia where the deficiency can cause permanent neurological damage which can lead to death if untreated.
No recent discussions have taken place with countries which have implemented folic acid fortification on unintended consequences of the policy. However, evidence from a number of countries, including those which have implemented folic acid fortification policies, was considered by the SACN and COT to establish the safety and efficacy of fortifying food with folic acid. Analysis by COT and the SACN found that there was insufficient evidence to discount a number of potential risks at very levels of fortification.
While there is no specific scientific briefing relating to the debate between heliocentrism versus geocentrism, as I stated in the debate, we will routinely review the policy post-implementation to ensure it meets the objective of reducing NTDs while avoiding any unintended consequences. The forthcoming consultation will outline the proposed fortification levels with the supporting scientific rationale.
Asked by: Lord Rooker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what discussions they have held with governments of other nations which operate a policy of mandatory fortification with folic acid regarding any unintended consequences which have arisen.
Answered by Lord Kamall
The scientific contestation referred to is summarised in the paper Folic acid and neural tube defects: Discovery, debate and the need for policy change by Professor Nicholas Wald. Professor Wald asserts that the United Kingdom should pursue a higher level of fortification than would be permitted by the UK’s Tolerable Upper Level (TUL). A copy of the paper is attached.
The Government and its independent scientific advisory bodies have agreed that fortification of non-wholemeal wheat flour with folic acid, at a level informed by the guidance for supplemental intake of folic acid intake advised by the UK Expert Group on Vitamins and Minerals, is a safe and effective measure to reduce the number of neural tube defects (NTDs).
This view is supported by the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) and by the Scientific Advisory Committee on Nutrition (SACN). In 2018 COT published Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment: COT position paper on the current upper level for folic acid intake in response to a previous paper by Professor Wald, addressing the technical points raised in objection to the TUL and continuing to recommend its use. A copy of this paper is attached.
Deaths associated with high levels of folic acid refers to potential unintended harms which may arise following the fortification of flour with folic acid, such as an increase in the potential masking of vitamin B12 deficiency or pernicious anaemia where the deficiency can cause permanent neurological damage which can lead to death if untreated.
No recent discussions have taken place with countries which have implemented folic acid fortification on unintended consequences of the policy. However, evidence from a number of countries, including those which have implemented folic acid fortification policies, was considered by the SACN and COT to establish the safety and efficacy of fortifying food with folic acid. Analysis by COT and the SACN found that there was insufficient evidence to discount a number of potential risks at very levels of fortification.
While there is no specific scientific briefing relating to the debate between heliocentrism versus geocentrism, as I stated in the debate, we will routinely review the policy post-implementation to ensure it meets the objective of reducing NTDs while avoiding any unintended consequences. The forthcoming consultation will outline the proposed fortification levels with the supporting scientific rationale.
Asked by: Lord Rooker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the answer by Lord Kamall on 6 July (HL Deb col 1000), whether they will give details of the cases where people “have died because of high levels of folic acid”.
Answered by Lord Kamall
The scientific contestation referred to is summarised in the paper Folic acid and neural tube defects: Discovery, debate and the need for policy change by Professor Nicholas Wald. Professor Wald asserts that the United Kingdom should pursue a higher level of fortification than would be permitted by the UK’s Tolerable Upper Level (TUL). A copy of the paper is attached.
The Government and its independent scientific advisory bodies have agreed that fortification of non-wholemeal wheat flour with folic acid, at a level informed by the guidance for supplemental intake of folic acid intake advised by the UK Expert Group on Vitamins and Minerals, is a safe and effective measure to reduce the number of neural tube defects (NTDs).
This view is supported by the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) and by the Scientific Advisory Committee on Nutrition (SACN). In 2018 COT published Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment: COT position paper on the current upper level for folic acid intake in response to a previous paper by Professor Wald, addressing the technical points raised in objection to the TUL and continuing to recommend its use. A copy of this paper is attached.
Deaths associated with high levels of folic acid refers to potential unintended harms which may arise following the fortification of flour with folic acid, such as an increase in the potential masking of vitamin B12 deficiency or pernicious anaemia where the deficiency can cause permanent neurological damage which can lead to death if untreated.
No recent discussions have taken place with countries which have implemented folic acid fortification on unintended consequences of the policy. However, evidence from a number of countries, including those which have implemented folic acid fortification policies, was considered by the SACN and COT to establish the safety and efficacy of fortifying food with folic acid. Analysis by COT and the SACN found that there was insufficient evidence to discount a number of potential risks at very levels of fortification.
While there is no specific scientific briefing relating to the debate between heliocentrism versus geocentrism, as I stated in the debate, we will routinely review the policy post-implementation to ensure it meets the objective of reducing NTDs while avoiding any unintended consequences. The forthcoming consultation will outline the proposed fortification levels with the supporting scientific rationale.
Asked by: Lord Rooker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the answer by Lord Kamall on 6 July (HL Deb col 999), whether they will cite the “scientific contestation” referred to concerning folic acid fortification as part of the Bread and Flour Regulations review.
Answered by Lord Kamall
The scientific contestation referred to is summarised in the paper Folic acid and neural tube defects: Discovery, debate and the need for policy change by Professor Nicholas Wald. Professor Wald asserts that the United Kingdom should pursue a higher level of fortification than would be permitted by the UK’s Tolerable Upper Level (TUL). A copy of the paper is attached.
The Government and its independent scientific advisory bodies have agreed that fortification of non-wholemeal wheat flour with folic acid, at a level informed by the guidance for supplemental intake of folic acid intake advised by the UK Expert Group on Vitamins and Minerals, is a safe and effective measure to reduce the number of neural tube defects (NTDs).
This view is supported by the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) and by the Scientific Advisory Committee on Nutrition (SACN). In 2018 COT published Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment: COT position paper on the current upper level for folic acid intake in response to a previous paper by Professor Wald, addressing the technical points raised in objection to the TUL and continuing to recommend its use. A copy of this paper is attached.
Deaths associated with high levels of folic acid refers to potential unintended harms which may arise following the fortification of flour with folic acid, such as an increase in the potential masking of vitamin B12 deficiency or pernicious anaemia where the deficiency can cause permanent neurological damage which can lead to death if untreated.
No recent discussions have taken place with countries which have implemented folic acid fortification on unintended consequences of the policy. However, evidence from a number of countries, including those which have implemented folic acid fortification policies, was considered by the SACN and COT to establish the safety and efficacy of fortifying food with folic acid. Analysis by COT and the SACN found that there was insufficient evidence to discount a number of potential risks at very levels of fortification.
While there is no specific scientific briefing relating to the debate between heliocentrism versus geocentrism, as I stated in the debate, we will routinely review the policy post-implementation to ensure it meets the objective of reducing NTDs while avoiding any unintended consequences. The forthcoming consultation will outline the proposed fortification levels with the supporting scientific rationale.
Asked by: Lord Rooker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, following the Written Statement by Lord Kamall on 11 October (HLWS298), what progress is being made in introducing mandatory fortification of flour with folic acid.
Answered by Lord Kamall
Officials from the Department of Health and Social Care, the Department for the Environment, Food and Rural Affairs, the Food Standards Agency and Food Standards Scotland are working to implement folic acid fortification, as part of the review on the Bread and Flour Regulations 1998 and the Bread and Flour (Northern Ireland) Regulations 1998.
The UK Government and the devolved administrations have engaged industry on the decision to fortify non-wholemeal wheat flour with folic acid and are now developing draft legislation and an impact assessment for future consultation.
Asked by: Lord Rooker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps they have taken to purchase UK-made biodegradable PPE products as opposed to single use plastic products.
Answered by Lord Kamall
The Department has investigated biodegradable personal protective equipment (PPE) from United Kingdom and overseas suppliers. However, waste stream channels from health and social care settings do not facilitate the separation of these products, unless they have been used for non-healthcare functions, such as catering. Most biodegradable products are single use and contribute to the environmental impacts from excessive manufacture, transportation and storage. Therefore, biodegradable products are not the most effective solution for single use health care infected PPE. The Department is exploring reusable products for Type IIR masks, eye protection and transparent masks.
Asked by: Lord Rooker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to their response to the Forty-Second report of the Public Accounts Committee 2019–21 on 28 April, what steps they will take to incentivise the NHS Supply Chain to buy PPE which is made in the UK.
Answered by Lord Kamall
NHS Supply Chain is working with 30 United Kingdom manufacturers to build resilience within the manufacture of personal protective equipment. This also includes addressing innovation, sustainability and fit testing of masks for the National Health Service and social care.
Asked by: Lord Rooker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what plans they have to update Table A in their COVID-19 guidance 'Personal protective equipment (PPE) made in the UK as at 1 December 2020', published on 9 March, to set out the UK-made items of PPE compared to expected demand.
Answered by Lord Kamall
Personal protective equipment (PPE) made in the UK as at 1 December 2020 reported on the delivery of a specific commitment to ensure that UK Make supply would be sufficient to meet 70% of demand for the coming winter, for all items except gloves, by 1 December 2020. The table referred to reports on that commitment and confirms that it was met therefore there are no plans to update or modify it. In practice, we found that UK Make supply met 82% of the demand for that period.