Asked by: Baroness Gardner of Parkes (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether the recommendations of the Dilnot Commission will be implemented by the end of this Parliament.
Answered by Lord Prior of Brampton
The Government remains committed to introducing a cap on care costs and extension of means tested support, which will be implemented from April 2020.
The Spending Review 2015 set budgets for the next four years to 2019-20. The final year includes funding to cover the costs of local authorities preparing to implement the changes the following year. Decisions about the allocation of funding for these reforms will be confirmed nearer the time.
The Department will continue to develop the policy underpinning the cap on care costs in the run-up to a consultation on draft regulations and guidance in the summer of 2018. The Department will work closely with the sector to ensure that their views are taken into account as we plan for implementation.
In addition to the cap on care costs, the Dilnot commission recommended the introduction of national eligibility criteria and universal Deferred Payment Agreements, both of which have been implemented from April 2015.
Asked by: Baroness Gardner of Parkes (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Earl Howe on 22 April 2013 (HL372), and in the light of the water supply being fluoridated in Birmingham but not Manchester, on what evidential basis their assessment was made that there are no significant differences in the general health of the populations of Manchester and Birmingham, other than differences in average decayed, missing and filled teeth.
Answered by Lord Prior of Brampton
Health profiles maintained by Public Health England (PHE) show that there are no significant differences in the general health of the populations of Manchester and Birmingham that might be attributable to water fluoridation. PHE’s Water fluoridation: Health monitoring report for England 2014 compared a range of dental and non-dental health indicators in fluoridated and non-fluoridated areas in England. The report concluded that water fluoridation is a safe and effective public health measure as there were reduced levels of tooth decay in fluoridated areas and no evidence of potential harm for the health indicators measured. A copy of this report is attached.
Asked by: Baroness Gardner of Parkes (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Earl Howe on 22 April 2013 (WA 372), and in the light of proposals to introduce fluoride to tap water in Hull, what are the most recent figures for the average number of decayed, missing or filled teeth amongst (1) five year old children and (2) 12 year old children, in (a) Birmingham, and (b) Manchester.
Answered by Lord Prior of Brampton
The most recent comparable statistics are from the Public Health England Dental Public Health Intelligence Programme. The 2015 survey of five-year-old children showed an average of 0.8 decayed, missing or filled teeth among children in Birmingham and 1.3 teeth among those in Manchester. A copy of the National Dental Epidemiology Programme for England: oral health survey of five-year-old children 2015 A report on the prevalence and severity of dental decay is attached. There are no more recent figures for twelve-year-old children than those given by Earl Howe in his response of 22 April 2013 (WA 372), the 2009 survey showing an average of 0.65 decayed missing or filled teeth in Birmingham and 1.12 in Manchester.
Asked by: Baroness Gardner of Parkes (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many patients on long-term Warfarin prescriptions now have access to self-monitoring technology; and whether Clinical Commissioning Groups support moves towards further patient self-management.
Answered by Lord Prior of Brampton
Information on the number of patients on long-term Warfarin prescriptions who have access to self-monitoring technology is not collected centrally.
NHS England and clinical commissioning groups (CCGs) have responsibility for commissioned services for patients who receive anticoagulation treatments. It is for individual CCGs to commission treatment and services for patients on anticoagulation treatment or other medications which require monitoring, as they are best placed to identify what is needed in their local areas.
There is guidance in place to support CCGs in planning services for patients who receive anticoagulation treatments. Under its Diagnostics Assessment Programme, the National Institute for Health and Care Excellence (NICE) has published guidance on self-monitoring of anticoagulation treatments which is attached and also available at:
http://www.nice.org.uk/guidance/dg14
NICE has also published quality standards on the management and treatment of atrial fibrillation which set out that self-monitoring should be offered as an option to appropriate patients. The guidance is also attached and available at:
Asked by: Baroness Gardner of Parkes (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether they have plans to make representations to Manchester City Council to give further consideration to fluoridation of the water supply in Greater Manchester; and whether any such representations will take account of the lower level of tooth decay amongst children in Birmingham, where the water supply has been fluoridated since 1964.
Answered by Lord Prior of Brampton
It has been the policy of successive governments that decisions on water fluoridation are best taken locally. The Health and Social Care Act 2012 gave powers to upper tier and unitary local authorities to make proposals in relation to fluoridation.
In 2014 Public Health England published a water fluoridation health monitoring report which showed lower levels of tooth decay in areas with water fluoridation.
Public Health England has also, in 2014, published an evidence informed toolkit for local authorities to support them in planning, reviewing and commissioning oral health improvement interventions for children and young people, including the potential role of water fluoridation.
Asked by: Baroness Gardner of Parkes (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 27 July (HL1635), whether they have plans to introduce day surgery appointments for the clearance or extraction of deciduous teeth under general anaesthetic.
Answered by Lord Prior of Brampton
Many extractions are already carried out on a day case basis; whether the extraction is carried out as a day case or requires an overnight admission is a matter for the clinicians involved.
NHS England has advised that NHS Lancashire and Greater Manchester have for a number of years commissioned day case surgery as well as overnight admission for children who require a full clearance of deciduous teeth under general anaesthetic.
Asked by: Baroness Gardner of Parkes (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what immediate action is planned to address waiting times, in particular in Manchester, for children whose dental condition requires hospital admission and clearance of their deciduous teeth under general anaesthetic.
Answered by Lord Prior of Brampton
The Government is seeking to address waiting times by reducing the number of children requiring admissions for clearance of their deciduous teeth and action is being taken by local commissioners and public health departments.
For instance, Greater Manchester advises that it is working with consultants in dental public health, public health commissioning, and oral health improvement teams in local authorities to develop oral health strategies. They intend to target delivery of care to areas of identified need according to the “National Dental Epidemiology Programme for England, oral health survey of five-year-old children 2012.” A copy of the survey is attached.
Asked by: Baroness Gardner of Parkes (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, in the light of the proposed relocation of the Eastman Dental Hospital, what steps are being taken to ensure the continuation of the specialised dental postgraduate training and research facilities currently offered.
Answered by Lord Prior of Brampton
We understand there are no plans to reduce the specialised dental postgraduate training and research currently offered as a consequence of the proposed move from the current site.
Asked by: Baroness Gardner of Parkes (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what opportunities will be available to participate in the Accelerated Access Review announced in November 2014 as "The Innovative Medicines and Medical Technology Review" for (1) the public and patient groups, (2) medical charities, (3) academics, (4) researchers, and (5) other interested parties; and when they expect it to report.
Answered by Lord Prior of Brampton
In order to inform his recommendations, the independent chair of the Accelerated Access Review, Sir Hugh Taylor, will be seeking views from a variety of stakeholder groups, including patients and their carers, medical charities, academics and researchers, as well as industry, the National Health Service and key arm’s length bodies such as the National Institute for Health and Care Excellence and NHS England. We have agreed a systematic engagement approach for these groups to ensure they all have the opportunity to input. A workshop involving representation from all these stakeholder groups was held on 2 July, and the review team is asking umbrella organisations and trade bodies to support it in continuing to reach a wide audience by holding a series of engagement events throughout the summer; these events are currently being planned. The review’s website is also being developed to include a crowdsourcing platform to allow these groups, and the wider public, to participate.
We expect the report of the Accelerated Access review to be submitted by the end of the year.
Asked by: Baroness Gardner of Parkes (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what has been the cost to the National Health Service in the last year of the number of children being hospitalised for the extensive extraction of deciduous teeth; and whether they will consider setting up day-care clinics that could carry out such work.
Answered by Earl Howe - Deputy Leader of the House of Lords
The following table shows the estimated cost of tooth extractions for children aged 18 years and under for 2012-13. The data covers all tooth extractions, and does not distinguish between deciduous or adult teeth.
Healthcare Resource Group description | Estimated total cost £million |
Minor Extraction of Tooth, 18 years and under | 3.1 |
Extraction of Multiple Teeth, 18 years and under | 27.4 |
Source: Reference costs, Department of Health1
Tooth extractions in children often involve general anaesthesia. Extractions involving general anaesthesia were restricted to the hospital setting following the recommendations of the 2000 report ‘A conscious decision’ that patients should have access to high quality critical care facilities when general anaesthesia is given. There are currently no plans to change this. Many extractions are carried out on a day case basis; whether the extraction is carried out as a day case or requires an overnight admission is a matter for the clinicians involved.
70% of five year olds now have no dental decay but we recognise that significant inequalities remain. Wider work is under way through dental contract reform and other prevention focussed initiatives to improve oral health.
Note:
1www.gov.uk/government/publications/nhs-reference-costs-2012-to-2013