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Written Question
Babies
Wednesday 27th March 2024

Asked by: Lord Alton of Liverpool (Crossbench - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the five recommendations made in the report by the First 1001 Days Movement, A Manifesto for Babies, published on 19 March; and whether they intend to respond to each recommendation.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

There is strong evidence that the 1,001 days from pregnancy to the age of two years old set the foundations for our cognitive, emotional, and physical development. Investing in this critical period presents a real opportunity to improve outcomes and tackle health disparities by ensuring that thousands of babies and families have improved access to quality support and services. The Government is therefore already taking forward a range of actions in line with recommendations in the report by the First 1001 Days Movement to ensure that every baby gets the best start in life.

For example, in March 2021, the Government published The best start for life: a vision for the 1,001 critical days, a copy of which is attached. This vision sets out six action areas for improving support for families during the 1,001 critical days to ensure every baby in England is given the best possible start in life, regardless of background.

The Government is also investing approximately £300 million to improve support for families though the Family Hubs and Start for Life programme. The programme is implementing many elements of the Best Start for Life Vision and is delivering a step change in outcomes for babies, children and their parents and carers in 75 local authorities in England, including those with high levels of deprivation. Many local authorities without funding have also chosen to implement elements of the vision.

The programme funding package includes £10 million to enable five local authorities and their partners to pilot innovative early years workforce models, with the aim of improving the access, experience and outcomes of babies, children, and families, and supporting the capacity and job satisfaction of the workforces involved.

To support new parents, Statutory Maternity Pay is paid by employers to qualifying employed women for a maximum of 39 weeks, the first six weeks of which are paid at 90% of the women’s salary followed by 33 weeks at the lower of either the standard rate or 90% of the woman’s average weekly earnings. For those who cannot get Statutory Maternity Pay, Maternity Allowance may be available. This is a benefit paid by the Department for Work and Pensions to eligible women and is intended for those who cannot get Statutory Maternity Pay. The standard rate of maternity pay is reviewed annually.

Paternity Leave arrangements enable employed fathers and partners, including same sex partners, who meet the qualifying conditions to take up to two weeks of paid leave within the first eight weeks following the birth of their child or placement for adoption. The Government has recently announced changes to make Paternity Leave and Pay more flexible for working families from April 2024. This includes allowing fathers and partners to take their leave and pay at any point in the first year after the birth or adoption of their child.

A Shared Parental Leave and Pay scheme is also available, giving working families much more choice and flexibility about who cares for their child in the first year, and when.


Written Question
Mirtazapine
Tuesday 26th March 2024

Asked by: Lord Alton of Liverpool (Crossbench - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many prescriptions for mirtazapine were issued in each year since 2014; how many Yellow Card reports of sexual dysfunction and persistent sexual dysfunction the MHRA received for mirtazapine in each year since 2014; and what consideration NHS England has given to adding sexual dysfunction as a side effect on the patient information leaflets for mirtazapine.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The following table shows the total number of items issued for mirtazapine, each year since 2014 to 2023:

Time Period

Total items issued

2014

6,056,918

2015

6,783,906

2016

7,526,200

2017

8,198,345

2018

8,938,362

2019

9,702,599

2020

10,532,577

2021

11,249,963

2022

11,776,025

2023

12,401,593

Source: Data was provided by the NHS Business Services Authority, using the British National Formulary chemical substance mirtazapine

Note: Items have been dispensed, but not necessarily prescribed, in England.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring medicines, medical devices, and blood components for transfusion meet applicable standards of safety, quality, and efficacy. The MHRA rigorously assesses available data, including from the Yellow Card scheme, and seeks advice from their independent advisory committee, the Commission on Human Medicines, where appropriate to inform regulatory decisions.

The MHRA has received a total of 46 Yellow Card reports of sexual dysfunction related reactions suspected to be associated with mirtazapine, four of which include information that suggest the suspected adverse reactions persisted after mirtazapine was withdrawn. The following table shows the number of Yellow Card reports of suspected mirtazapine related sexual dysfunction, and reports of sexual dysfunction that persisted after the drug was withdrawn, each year from 2014 to 2024:

Year

Reports of sexual dysfunction

Reports of sexual dysfunction that continued after mirtazapine was withdrawn

2014

3

0

2015

1

0

2016

2

0

2017

3

0

2018

1

0

2019

5

1

2020

3

0

2021

5

1

2022

10

1

2023

9

0

2024

4

1

Source: data provided by the MHRA.

It is important to note that the inclusion of a particular report on the MHRA’s system does not necessarily mean that the adverse reactions reported have been caused by the suspect drug. Additionally, the number of reports received should not be used as a basis for determining the incidence of a reaction, as neither the total number of reactions occurring, nor the number of patients using the drug, is known.

The MHRA continuously monitors the safety of medicines on the United Kingdom’s market, including mirtazapine. Reports of suspected adverse reactions are reviewed weekly by a multidisciplinary team as part of the MHRA’s signal detection process. The term signal is used to define any suspected adverse reaction or potential safety concern that requires further evaluation.

Responsibility for adding a side effect to the product information leaflet sits with the MHRA. The product information for mirtazapine reflects the data currently available, and does not include sexual dysfunction as a possible side effect. However, data from Yellow Card reports and other sources such as published studies and periodic safety assessments are kept under continuous review by the MHRA. The marketing authorisation holder has recently submitted the latest periodic safety update report to the MHRA, and this will be carefully assessed. If there is sufficient evidence and associated data about the potential to experience sexual dysfunction as a side effect, the patient information for mirtazapine can be updated.


Written Question
Antidepressants: Young People
Monday 25th March 2024

Asked by: Lord Alton of Liverpool (Crossbench - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many antidepressant prescriptions were issued to patients under the age of 25 in each year since 2014.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Many medicines, including medicines used to treat depression, are licensed and prescribed for other conditions. The Department expects prescribers to always satisfy themselves that the medicines they consider appropriate for their patients can be safely prescribed.

The following table shows the number of patients aged under 18 and 25 years old, who were prescribed antidepressants, each year from 2015 to 2023:

Year

Antidepressants prescribed to people under 18 years old

Antidepressants prescribed to people under 25 years old

2015/16

312,113

2,477,798

2016/17

332,706

2,759,953

2017/18

346,126

2,910,607

2018/19

367,850

3,202,784

2019/20

393,762

3,525,602

2020/21

406,391

3,890,347

2021/22

437,365

4,170,154

2022/23

448,515

4,119,463

Source: NHS Business Services Authority

Notes:

  1. This is based on the information within the published statistics for medicines used in mental health, that uses British National Formulary section 0403 for antidepressant drugs, prescribed in England and dispensed in the community in England, Scotland, Wales, the Isle of Man, or the Channel Islands.
  2. Prescriptions do not state the purpose for which they are written, so there may be instances where medicines are used for other conditions.

Written Question
Antidepressants: Children
Monday 25th March 2024

Asked by: Lord Alton of Liverpool (Crossbench - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many antidepressant prescriptions were issued to patients under the age of 18 in each year since 2014.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Many medicines, including medicines used to treat depression, are licensed and prescribed for other conditions. The Department expects prescribers to always satisfy themselves that the medicines they consider appropriate for their patients can be safely prescribed.

The following table shows the number of patients aged under 18 and 25 years old, who were prescribed antidepressants, each year from 2015 to 2023:

Year

Antidepressants prescribed to people under 18 years old

Antidepressants prescribed to people under 25 years old

2015/16

312,113

2,477,798

2016/17

332,706

2,759,953

2017/18

346,126

2,910,607

2018/19

367,850

3,202,784

2019/20

393,762

3,525,602

2020/21

406,391

3,890,347

2021/22

437,365

4,170,154

2022/23

448,515

4,119,463

Source: NHS Business Services Authority

Notes:

  1. This is based on the information within the published statistics for medicines used in mental health, that uses British National Formulary section 0403 for antidepressant drugs, prescribed in England and dispensed in the community in England, Scotland, Wales, the Isle of Man, or the Channel Islands.
  2. Prescriptions do not state the purpose for which they are written, so there may be instances where medicines are used for other conditions.

Written Question
Nortriptyline and Prozac: Children
Friday 22nd March 2024

Asked by: Lord Alton of Liverpool (Crossbench - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government what estimate they have made of the number prescriptions for fluoxetine and nortriptyline issued in England each year since 2014 to patients under the age of 18.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The tables below show the total of prescription items for patients aged under 18 who were prescribed fluoxetine or nortriptyline for the partial year of April–Dec 2015, and then full calendar years 2016–23.

The NHS Business Services Authority does not hold patient level data prior to April 2015.

This information is extracted from ePACT2, using British National Formulary chemical substance, prescribed in England that are then dispensed in the community in England, Scotland, Wales, Isle of Man or the Channel Islands.

Total number of items issued for Fluoxetine Hydrochloride

Time Period

Total items issued to age range (Under 18)

Part year 2015 (Apr – Dec)

91,685

2016

126,193

2017

129,205

2018

136,275

2019

143,271

2020

147,555

2021

155,398

2022

156,324

2023

149,839

Total number of items issued for Nortriptyline

Time Period

Total items issued to age range (Under 18)

Part year 2015 (Apr – Dec)

1,481

2016

1,931

2017

1,673

2018

1,514

2019

1,616

2020

1,599

2021

1,777

2022

1,758

2023

1,915

Prescriptions do not state the purpose for which they are written, so there may be instances where medicines are used for other conditions.

Many medicines, including medicines used to treat depression, are licensed and prescribed for other conditions. The Department expects prescribers to always satisfy themselves that the medicines they consider appropriate for their patients can be safely prescribed.


Written Question
Medical Equipment and Protective Clothing: China
Monday 19th February 2024

Asked by: Lord Alton of Liverpool (Crossbench - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government how much personal protective clothing and other medical items stored in China by the NHS remains in storage; what has been the accumulated cost of storage; how much has been destroyed; and what will happen to that which remains.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Since July 2023 all of the Department’s personal protective equipment stock has been stored at sites within the United Kingdom. The total cost of storing items in the freeport in China was £60.6 million for the years 2020 until 2023, when we exited the site.

3,058 million items stored in China, or around 80% of the total volume, were sent to the UK for use in health and social care settings. 57 million items, or around 1.5% of the total volume, have been donated. 699 million items, or around 8% of the total volume, were recycled into energy from waste, which was by far the most cost-effective means of disposal readily available.


Written Question
Antidepressants
Monday 5th February 2024

Asked by: Lord Alton of Liverpool (Crossbench - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Lord Prior of Brampton on 23 July 2015 (HL1632), how many prescriptions for antidepressants have been issued in each year since 2014; what was the annual cost to the National Health Service of those prescriptions; and what guidance is given to doctors and patients about the use of antidepressants, their subsequent withdrawal and potential long-term effects.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The following table shows the latest data available on the number of prescriptions for antidepressants issued between 2014 and 2023, and the associated net ingredient cost:

Time Period

Total Number of Items

Total Net Ingredient Cost (£)

2014

57,149,109

265,008,699

2015

61,021,662

284,746,655

2016

64,703,639

266,562,024

2017

67,530,457

235,076,090

2018

70,873,979

202,526,720

2019

74,814,621

201,729,659

2020

78,866,866

352,682,886

2021

82,620,542

288,099,250

2022

85,404,864

224,648,497

2023 (11 months)

80,970,256

211,852,277

The requirement to provide a patient information leaflet with licensed medicines in the United Kingdom is set out in Regulation 267 of the Human Medicines Regulations 2012. As set out in Schedule 27 of these regulations, the information that must be presented in the leaflet includes special warnings relevant to the safe use of the medicine, and instructions for proper use, including the risk of withdrawal effects and description of all side effects, both long and short term. The leaflet must reflect in lay language, the agreed Summary of Product Characteristics for a medicine, which would include information on risk of addiction, withdrawal and the long-term consequences of taking a medicine. The National Institute for Health and Care Excellence also set outs guidelines for the management and treatment of depression in adults.


Written Question
Abortion
Thursday 3rd August 2023

Asked by: Lord Alton of Liverpool (Crossbench - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many legal abortions have taken place (1) cumulatively, and (2) annually, in Great Britain in each year since 1993.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Information on the number of legal abortions which have taken place cumulatively, and annually, in Great Britain between 1993 and 2021, inclusive, is set out in the following table:

Year

England and Wales

Scotland

Great Britain

Cumulative Great Britain

1993

168,714

11,069

179,783

179,783

1994

166,876

11,389

178,265

358,048

1995

163,638

11,143

174,781

532,829

1996

177,495

11,978

189,473

722,302

1997

179,746

12,109

191,855

914,157

1998

187,402

12,485

199,887

1,114,044

1999

183,250

12,168

195,418

1,309,462

2000

185,375

11,997

197,372

1,506,834

2001

186,274

12,128

198,402

1,705,236

2002

185,385

11,870

197,255

1,902,491

2003

190,660

12,308

202,968

2,105,459

2004

194,498

12,462

206,960

2,312,419

2005

194,353

12,665

207,018

2,519,437

2006

201,173

13,167

214,340

2,733,777

2007

205,598

13,778

219,376

2,953,153

2008

202,158

13,908

216,066

3,169,219

2009

195,743

13,112

208,855

3,378,074

2010

196,109

12,949

209,058

3,587,132

2011

196,082

12,558

208,640

3,795,772

2012

190,972

12,578

203,550

3,999,322

2013

190,800

11,954

202,754

4,202,076

2014

190,092

11,787

201,879

4,403,955

2015

191,014

12,153

203,167

4,607,122

2016

190,406

12,133

202,539

4,809,661

2017

197,533

12,546

210,079

5,019,740

2018

205,295

13,358

218,653

5,238,393

2019

209,519

13,610

223,129

5,461,522

2020

210,860

13,896

224,756

5,686,278

2021

214,869

13,758

228,627

5,914,905

Notes:

  1. Figures for England and Wales are for all legal abortions that occurred in England & Wales.
  2. Figures for Scotland show all legal terminations of pregnancy performed in Scotland.

Written Question
Abortion
Thursday 3rd August 2023

Asked by: Lord Alton of Liverpool (Crossbench - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government what is the current annual cost to the National Health Service of carrying out abortions; and what is its estimate of the total cost to the National Health Service of carrying out abortions in the last 30 years

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

This information is not held centrally.


Written Question
Organs: Human Trafficking
Tuesday 25th July 2023

Asked by: Lord Alton of Liverpool (Crossbench - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the prevalence of attempts to traffic organ donors into the UK; and what estimate they have made of the number of people who have returned to the UK after having illegally paid for organ transplants abroad.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

No assessment has been made.