Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the possible increases in travel insurance for UK citizens if the UK were no longer to be part of the European Health Insurance Card scheme after Brexit.
Answered by Lord O'Shaughnessy
The Department has not made a formal assessment of the possible increases in travel insurance for United Kingdom citizens if the UK were no longer to be part of the European Health Insurance Card scheme after Brexit.
However, the Department engages regularly with the Association of British Insurers and industry to discuss matters relating to reciprocal healthcare and this will continue.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, in the light of proposals to restrict access to prescription-based vitamin D maintenance, whether they will undertake a study into how such proposals might affect at-risk groups, as set out in NICE Guidelines 56-2, and in particular those in the at-risk groups on low or fixed incomes.
Answered by Lord O'Shaughnessy
NHS England undertook a study into how the proposals in the consultation Conditions for which over the counter items should not routinely be prescribed in primary care: A Consultation on guidance for CCGs might affect at-risk groups by accompanying the consultation with a full Equality and Health Inequalities Impact Assessment. The Impact Assessment, Equality and Health Inequalities – Full Analysis Form – Conditions for which over the counter items should not routinely be prescribed in primary care sets out how the proposals may affect groups protected by the Equality Act 2010 and those people on low income and ethnic minorities, including those at-risk groups, as set out in National Institute for Health and Care Excellence guidelines. Copies of the consultation and Impact Assessment are attached.
In the summer months most people should be able to get all the vitamin D they need from sunlight on the skin. It is also found in some foods – oily fish, red meat, liver, egg yolks and fortified foods – such as most fat spreads and some breakfast cereals.
The Advisory Committee on Borderline Substances states that vitamins and minerals should be prescribed only in the management of actual or potential vitamin or mineral deficiency, and are not to be prescribed as dietary supplements. We understand that NHS England’s current consultation is in line with this. Prescribing vitamin D for maintenance would be classed as a treatment for prevention or as a dietary supplement.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they intend to ensure that women over 60 years old are routinely offered bone density scans to ascertain bone health.
Answered by Lord O'Shaughnessy
Fracture liaison services (FLS) provide secondary prevention for fragility fractures. These services identify patients in secondary and/or primary care who have suffered a fragility fracture and assess the patient’s risk of future fragility fracture in a timely fashion. A FLS then provides advice and/or therapy to reduce that risk.
The National Institute for Health and Care Excellence (NICE) evidence based guideline Osteoporosis: assessing the risk of fragility fracture, updated in February 2017, sets out best practice on management of fracture risk in patients with osteoporosis. A copy of the guideline is attached. The guidance recommends that clinicians consider assessment of fracture risk in all women aged 65 years and over and all men aged 75 years and over. Women aged less than 65 years and men aged less than 75 years should be considered for assessment in the presence of certain risk factors, such as a family history of hip fracture or low body mass index.
Regarding bone density scanning, NICE recommends it be considered after patients have first been assessed using a validated risk assessment tool, such as FRAX, which clinicians can use to evaluate the 10-year probability of bone fracture risk in patient. The guidance also recommends other circumstances where bone density scanning should be considered, including for patients who are to undergo treatment which may affect bone density, such as certain treatments for breast or prostate cancer.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they intend to ensure that all NHS users over 50 years old have access to Fracture Liaison Services to identify the link between any fracture and the bone health of the patient.
Answered by Lord O'Shaughnessy
Fracture liaison services (FLS) provide secondary prevention for fragility fractures. These services identify patients in secondary and/or primary care who have suffered a fragility fracture and assess the patient’s risk of future fragility fracture in a timely fashion. A FLS then provides advice and/or therapy to reduce that risk.
The National Institute for Health and Care Excellence (NICE) evidence based guideline Osteoporosis: assessing the risk of fragility fracture, updated in February 2017, sets out best practice on management of fracture risk in patients with osteoporosis. A copy of the guideline is attached. The guidance recommends that clinicians consider assessment of fracture risk in all women aged 65 years and over and all men aged 75 years and over. Women aged less than 65 years and men aged less than 75 years should be considered for assessment in the presence of certain risk factors, such as a family history of hip fracture or low body mass index.
Regarding bone density scanning, NICE recommends it be considered after patients have first been assessed using a validated risk assessment tool, such as FRAX, which clinicians can use to evaluate the 10-year probability of bone fracture risk in patient. The guidance also recommends other circumstances where bone density scanning should be considered, including for patients who are to undergo treatment which may affect bone density, such as certain treatments for breast or prostate cancer.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether they will consider the fortification of foods with vitamin D in order to implement the Reference Nutrient Intake for vitamin D recommended by the report of the Scientific Advisory Committee on Nutrition on <i>Vitamin D and health</i>.
Answered by Lord Prior of Brampton
Following the recommendations of the report by the Scientific Advisory Committee on Nutrition on Vitamin D and Health, Public Health England has updated advice on vitamin D on the NHS Choices website. A copy of the NHS Choices advice webpage is attached.
The Government has looked at groups where dietary recommendations are not being reached and has decided that in these cases mandatory fortification is not the right way forward. There is no plan to introduce it for vitamin D in England.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, in the light of the recommendations of the report by the Scientific Advisory Committee on Nutrition on<i> Vitamin D and health</i>, what steps they are taking in conjunction with Public Health England to raise public awareness of the need for greater intake of vitamin D through dietary supplementation and safe sun exposure.
Answered by Lord Prior of Brampton
Following the recommendations of the report by the Scientific Advisory Committee on Nutrition on Vitamin D and Health, Public Health England has updated advice on vitamin D on the NHS Choices website. A copy of the NHS Choices advice webpage is attached.
The Government has looked at groups where dietary recommendations are not being reached and has decided that in these cases mandatory fortification is not the right way forward. There is no plan to introduce it for vitamin D in England.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of the future of the European Health Insurance Card in the light of the EU referendum result.
Answered by Lord Prior of Brampton
As the Prime Minister stated on 20 July 2016, as long as we are a member of the European Union we will respect the rights and obligations of EU membership, therefore the current arrangements for European Health Insurance Cards remain in place. As we move to a new relationship with Europe, our guiding principle will be ensuring the best possible outcome for British people.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what consultations took place with the government of New Zealand prior to their decision to introduce new charges for New Zealand citizens for health and dental treatment in the UK from 6 April.
Answered by Lord Prior of Brampton
On 6 April 2015 the United Kingdom introduced an immigration health surcharge for non-European Economic Area nationals who come to the UK to temporarily reside for a period of over six months. At the time New Zealand nationals were granted a temporary exemption and we entered into a series of discussions with the New Zealand Government on the introduction of the surcharge for its nationals. The Secretary of State for Health wrote to the New Zealand High Commissioner confirming introduction of the surcharge on 17 December 2015. Introduction of the surcharge for New Zealand nationals was publicly announced by the Home Office on 4 February 2016 and subject to Parliamentary approval, it will come into effect from 6 April 2016.
Asked by: Baroness Quin (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what is the average waiting time for a result to be given of a DEXA bone density scan in each NHS region in England; and what assessment they have made of the average waiting time for such results in (1) Scotland, and (2) Wales.
Answered by Lord Prior of Brampton
Data are not collected on the average waiting time for a result to be given for a dual energy X-ray absorptiometry (DEXA) scan. Data are collected on the average waiting time from referral to test, and these are shown in the following table for the four NHS England commissioning regions for most recent period, which is November 2015. Health is a devolved matter in Scotland and Wales.
Table: average median waiting times in weeks for a DEXA scan from referral by NHS England commissioning region, November 2015
Region | Number of weeks |
North of England | 2.1 |
Midlands and East of England | 1.7 |
London | 1.8 |
South of England | 1.8 |
England | 1.9 |