Asked by: Stephen O'Brien (Conservative - Eddisbury)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 3 March 2015 to Question 225373, if he will make it his policy that GPs should be able to commission cervical smear tests for diagnostic purposes to investigate presenting symptoms outside the routine screening timeframes; and what additional opportunities there are for patients to be tested for diagnostic purposes outside the screening programme.
Answered by Jane Ellison
A smear test is primarily used for screening purposes, and is unlikely to be appropriate when a woman has gynaecological issues that are symptomatic of cancer.
In such cases the National Institute for Health and Care Excellence Referral Guidelines for Suspected Cancer (2005) are available to help general practitioners (GPs) assess when it is appropriate to refer patients for suspected cancer, including cervical cancer. The Guidelines make clear recommendations in relation to gynaecological cancer, and state that:
“A patient who presents with symptoms suggesting gynaecological cancer should be referred to a team specialising in the management of gynaecological cancer, depending on local arrangements.”
In relation to cervical cancer the guidelines make clear that a smear test is not required before referral:
“In patients found on examination to have clinical features that raise the suspicion of cervical cancer, an urgent referral should be made. A cervical smear test is not required before referral, and a previous negative cancer smear result is not a reason to delay referral.”
Therefore, when a woman is experiencing gynaecological problems which are symptomatic of gynaecological cancer, their GP would be expected to refer them to the appropriate specialist without needing to conduct a smear test.
Asked by: Stephen O'Brien (Conservative - Eddisbury)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will change guidelines on cervical smear tests to permit GPs to conduct such tests on women outside of routine screening time frames, if the GP believes that such tests are necessary to investigate presenting symptoms.
Answered by Jane Ellison
A cervical screening test is a population screening test, not a diagnostic test, and is therefore not appropriate for women with symptoms. Waiting two weeks for a smear test result could delay examination by a gynaecologist. The Department has published guidance for general practitioners (GPs) on managing young women aged 20-24 with abnormal vaginal bleeding. This is available at:
http://www.cancerscreening.nhs.uk/cervical/publications/doh-guidelines-young-women.pdf
Information for women of all ages on the symptoms of cervical cancer is available on the NHS Choices website at:
http://www.nhs.uk/conditions/cancer-of-the-cervix/pages/introduction.aspx
The Department advises women who are concerned about cervical cancer to speak to their GP.
Asked by: Stephen O'Brien (Conservative - Eddisbury)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what support is in place for the provision of public health initiatives in localities considered by Public Health England to have a high prevalence of hepatitis C.
Answered by Jane Ellison
Public Health England supports work on local prioritisation of hepatitis C services by producing factsheets for local government, publishing a template to support commissioning by estimating the number of people infected with hepatitis C locally and the costs of treatment. It has also published local liver profiles at local authority level which includes, key local statistics and prevention guidance on hepatitis C and questions for local authority Health and Wellbeing Boards to consider.
Asked by: Stephen O'Brien (Conservative - Eddisbury)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what recent assessment he has made of the effect of industry rebate payments under the Pharmaceutical Price Regulation Scheme (PPRS) on improving patients' access to innovative medicines; and what estimate he has made of the additional number of innovative medicines prescribed as a result of those payments.
Answered by George Freeman
In England, Pharmaceutical Price Regulation Scheme (PPRS) payments are taken into account in the allocations to NHS England through the Mandate. All the payments will go back into spending on improving patients’ health and care.
The NHS England budget for 2015-16 already takes account for money anticipated from higher than expected PPRS payments. The Mandate for 2015-16 has a set firm NHS England budget for 2015-16, which is £3billion (3%) higher than its budget for 2014-15. This increase takes into account a number of things, including additional funding for the National Health Service announced in the Autumn Statement and the fact that the PPRS payment in 2015-16 is now forecast to be higher than originally expected.
It will be up to NHS England how they split that overall budget between clinical commissioning groups, specialised commissioning etc. Following normal Government accounting rules there is no separately identified ring-fenced funding stream associated with the PPRS payment.
The PPRS helps all member companies to compete globally by providing stability in United Kingdom prices. It includes a number of initiatives to help speed uptake of medicines approved by National Institute for Health and Care Excellence in the NHS. Sales of new active substances launched on or after 1 January 2014 are exempt from payments though still included in the overall limit on growth and the payments made by industry as a whole. This recognises and rewards innovation.
Net sales growth from the first nine months of 2014 compared to 2013 was 5.9 per cent. This was higher than the agreed forecast growth of 3.87 per cent. and shows that patients are benefitting from greater access to branded medicines. Most companies have enjoyed growth in sales in 2014, with over 40 per cent. of companies having double-digit growth rates.
Asked by: Stephen O'Brien (Conservative - Eddisbury)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what financial incentives are available for primary and secondary public health providers for screening programmes to improve diagnosis rates of hepatitis C in (a) localities considered by Public Health England to have a high prevalence of hepatitis C and (b) Cheshire.
Answered by Jane Ellison
There are currently no national direct financial incentives for screening programmes to improve the diagnostic rates for hepatitis C. However, NHS England sub-regions, working with other commissioners, have the ability to implement local incentives to improve diagnosis. The Department does not hold any information about any such local incentives that might have been put in place, including Cheshire.
Asked by: Stephen O'Brien (Conservative - Eddisbury)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will ensure that all monies received from industry rebate payments under the Pharmaceutical Price Regulation Scheme are utilised for the prescribing of medicines by NHS England.
Answered by George Freeman
In England, Pharmaceutical Price Regulation Scheme (PPRS) payments are taken into account in the allocations to NHS England through the Mandate. All the payments will go back into spending on improving patients’ health and care.
The NHS England budget for 2015-16 already takes account for money anticipated from higher than expected PPRS payments. The Mandate for 2015-16 has a set firm NHS England budget for 2015-16, which is £3billion (3%) higher than its budget for 2014-15. This increase takes into account a number of things, including additional funding for the National Health Service announced in the Autumn Statement and the fact that the PPRS payment in 2015-16 is now forecast to be higher than originally expected.
It will be up to NHS England how they split that overall budget between clinical commissioning groups, specialised commissioning etc. Following normal Government accounting rules there is no separately identified ring-fenced funding stream associated with the PPRS payment.
The PPRS helps all member companies to compete globally by providing stability in United Kingdom prices. It includes a number of initiatives to help speed uptake of medicines approved by National Institute for Health and Care Excellence in the NHS. Sales of new active substances launched on or after 1 January 2014 are exempt from payments though still included in the overall limit on growth and the payments made by industry as a whole. This recognises and rewards innovation.
Net sales growth from the first nine months of 2014 compared to 2013 was 5.9 per cent. This was higher than the agreed forecast growth of 3.87 per cent. and shows that patients are benefitting from greater access to branded medicines. Most companies have enjoyed growth in sales in 2014, with over 40 per cent. of companies having double-digit growth rates.
Asked by: Stephen O'Brien (Conservative - Eddisbury)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 26 June 2014, Official Report, column 281W, on medical treatments, what the most plausible cost per quality adjusted life-year was for each technology appraisal conducted by the National Institute for Care Excellence since June 2010; what the estimated patient population was for each appraised indication; on which appraisals the end-of-life criteria were applied in each final appraisal determination; and on what dates each appraisal was (a) initiated and (b) concluded.
Answered by Norman Lamb
I refer my Rt. hon. Friend to the answer that I gave him on 8 July 2014, Official Report, column 237W.
Asked by: Stephen O'Brien (Conservative - Eddisbury)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, further to his Answer of 19 June 2014, Official Report, column 278W, on haemolytic uraemic syndrome, when the next meeting of the National Institute for Health and Care Excellence's evaluation committee will take place; and how soon after that meeting he expects to place a copy of NHS England's response in the Library.
Answered by Norman Lamb
The National Institute for Health and Care Excellence (NICE) has advised that the next meeting of its highly specialised technology evaluation committee will take place on 24 July 2014. If the committee agrees finaldraft recommendations on eculizumab for the treatment of atypical haemolytic uraemic syndrome, NICE will aim to make them available in September in line with its interim process guide. NHS England's response will form part of the documentation published and a copy will be placed in the Library at this time.
Asked by: Stephen O'Brien (Conservative - Eddisbury)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 26 June 2014, Official Report, column 281W, on Medical Treatments, if he will provide the data requested for the four years from June 2010 on (a) the most plausible cost per quality adjusted life-year for each technology appraisal conducted by the National Institute for Health and Care Excellence, (b) the estimated eligible patient population for each appraisal indication, (c) whether the end-of-life criteria was applied in each final determination and (d) the date on which each such appraisal was (i) initiated and (ii) concluded.
Answered by Norman Lamb
The information requested has been placed in the Library.
Asked by: Stephen O'Brien (Conservative - Eddisbury)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what measures of the value of life and health were included in the evidence submitted as part of the Food Standards Agency's work with the Inter-departmental Group for the Valuation of Life and Health review in 2008.
Answered by Dan Poulter
I refer my Rt. hon. Friend to the answer given on 26 June 2014, Official Report, Column 283W.
The focus of the work of the Inter-departmental Group for the Valuation of Life and Health has been methodological rather than upon specific measures of value. It has focused upon the appropriate units for the measurement of impacts on life and health risks in different circumstances, and the methodology to be applied to valuation of those units in different contexts. Nevertheless, as a spur to the methodological investigation, an initial survey of monetary valuations of various units of impact by different departments and agencies including case studies was undertaken. This was conducted by the Institute of Transport Studies at the University of Leeds and compiled into a “Survey of the Value of Life/ Health used in Government Departments”, which has been placed in the Library. In addition, the Health and Safety Executive and the Department for Transport have already placed in the Library their members' responses to the ITS survey.
Development of monetary thresholds to be applied to the cost-per-quality adjusted life year is not within the remit of the Group.