Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Lord Markham on 26 March (HL3163), in each year since 2014, how many prescriptions for vortioxetine were issued; what was the annual cost to the National Health Service of those prescriptions; how many Yellow Card reports of sexual dysfunction and persistent sexual dysfunction the MHRA received for vortioxetine; and what consideration has NHS England given to adding sexual dysfunction as a side effect on the patient information leaflets for vortioxetine.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The following table shows the number of items issued for vortioxetine and the net ingredient cost (NIC) from 2014 to 2023, and from January to May of 2024:

Source: data provided by the NHS Business Services Authority, based on information within the Prescription Cost Analysis published statistics, using British National Formulary chemical substance vortioxetine.

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

"Persistent sexual dysfunction" does not represent a specific medical condition, so this term is not a category available for a structured search of the Medicines and Healthcare products Regulatory Agency’s (MHRA) Adverse Drug Reaction database. The structured data field search terms are drawn from the regulatory drugs dictionary, the medical dictionary (MedDRA), or from terms adopted in clinical coding guidance such as The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, or the International Classification of Diseases 11th Revision. A search of the database would therefore rely on manual assessment of individual cases.

The MHRA has received a total of 29 Yellow Card reports of sexual dysfunction related reactions, suspected to be associated with vortioxetine, between 1 January 2014 and 21 July 2024. This includes reactions grouped under MedDRA Higher Level Terms, which are more specific than sexual dysfunction and persistent sexual dysfunction. The following table shows the number of spontaneous suspected Yellow Card reports of sexual dysfunction related reactions suspected to be associated with vortioxetine in the United Kingdom, received by the MHRA each year from 2014 to 2024:

Source: data provided by the MHRA.

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.

Sexual dysfunction was assessed as part of the clinical studies to support the authorisation of vortioxetine. The clinical studies indicated that doses between 5 milligrams and 15 milligrams did not show a difference from placebo in relation to the risk of sexual dysfunction. However, the 20 milligram dose was associated with an increase in sexual dysfunction. This information was included in the Summary of Product Characteristics (SmPC) for healthcare professionals for all strengths of vortioxetine since authorisation in 2021. The SmPC and patient information leaflet were subsequently updated in April 2024 to list sexual dysfunction as a possible side effect for all strengths, following reports of sexual dysfunction associated with doses below 20 milligrams.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government what assessment they have made of Ethiopia’s adequacy of draft transitional justice policy in safeguarding human rights; and how they are supporting their counterparts in Ethiopia to ensure that justice and accountability for the Tigray War are prioritised as a pathway to the peaceful co-existence of communities.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

We welcome the approval of the national transitional justice policy by the Ethiopian Government's Council of Ministers. The nationally owned policy and recently published roadmap are encouraging steps towards accountability and justice. The test of the policy will be will in the implementation. The UK has continually called for a credible, inclusive, and survivor-centred approach to transitional justice and for all human rights violations and atrocities in Ethiopia to be investigated and perpetrators to be held to account. Through our Human Rights and Peacebuilding Programme, we support survivors of sexual and gender-based violence in northern Ethiopia to lead the recovery from conflict and advance women's leadership and inclusion in regional and national dialogue, accountability and peacebuilding processes.

Question to the Home Office:

To ask His Majesty's Government whether they will ensure that intergovernmental agreements on safe and ethical work migration are in place before operators are allowed to recruit from new territories under the Seasonal Worker visa (Temporary Work) scheme.

Answered by Lord Hanson of Flint - Minister of State (Home Office)

A key objective of the route is to ensure that overseas workers are protected against modern slavery and other labour abuses. The sponsor licence regime places a broad range of responsibilities on Scheme Operators to ensure that the rights of migrant workers are protected.

The Government is carefully considering the Migration Advisory Committee’s review of the Seasonal Worker route and will announce a detailed response in due course. We will consider all these points in the round. Any question regarding tax and pension contributions will, however, need to be directed to the relevant Government departments.

Should the Seasonal Worker Interest Group wish to request a meeting with the Home Office Ministers, I would ask that they write to the department and any such request will be given appropriate consideration.

Question to the Home Office:

To ask His Majesty's Government whether they plan to reform visa fees, and tax and pension contributions for those on Seasonal Worker visas (Temporary Work) to reduce the financial burden on such workers.

Answered by Lord Hanson of Flint - Minister of State (Home Office)

A key objective of the route is to ensure that overseas workers are protected against modern slavery and other labour abuses. The sponsor licence regime places a broad range of responsibilities on Scheme Operators to ensure that the rights of migrant workers are protected.

The Government is carefully considering the Migration Advisory Committee’s review of the Seasonal Worker route and will announce a detailed response in due course. We will consider all these points in the round. Any question regarding tax and pension contributions will, however, need to be directed to the relevant Government departments.

Should the Seasonal Worker Interest Group wish to request a meeting with the Home Office Ministers, I would ask that they write to the department and any such request will be given appropriate consideration.

Question to the Home Office:

To ask His Majesty's Government what steps they are taking to protect all workers on the Seasonal Worker visa (Temporary Work) from exploitation.

Answered by Lord Hanson of Flint - Minister of State (Home Office)

A key objective of the route is to ensure that overseas workers are protected against modern slavery and other labour abuses. The sponsor licence regime places a broad range of responsibilities on Scheme Operators to ensure that the rights of migrant workers are protected.

The Government is carefully considering the Migration Advisory Committee’s review of the Seasonal Worker route and will announce a detailed response in due course. We will consider all these points in the round. Any question regarding tax and pension contributions will, however, need to be directed to the relevant Government departments.

Should the Seasonal Worker Interest Group wish to request a meeting with the Home Office Ministers, I would ask that they write to the department and any such request will be given appropriate consideration.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government what is their assessment of the humanitarian situation in Tigray since the end of the mandate of the International Commission of Human Rights Experts on Ethiopia; and how they are monitoring the situation now that no other international or regional mechanisms are reporting on it.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

The humanitarian indicators in Tigray remain worrying, with 3.8 million of the region's estimated population of 6 million needing humanitarian assistance this year. This is why the UK has increased funding for Ethiopia this financial year (2024/25) and adapted our programming to mitigate the most severe humanitarian outcomes, with an increased focus on lifesaving nutrition, health and water and sanitation programming for the most vulnerable populations, including in Tigray. We continue to engage with established systems for monitoring humanitarian need and response plans led by the UN Office for the Coordination of Humanitarian Affairs (OCHA). We are also investing in improving data and evidence to enable the humanitarian community to make informed decisions on the humanitarian response.

Question to the Home Office:

To ask His Majesty's Government whether they will meet with the Seasonal Worker Interest Group to discuss structural reforms to the visa scheme to protect workers from exploitation such as the charging of recruitment fees for those on a Seasonal Worker visa (Temporary Work).

Answered by Lord Hanson of Flint - Minister of State (Home Office)

A key objective of the route is to ensure that overseas workers are protected against modern slavery and other labour abuses. The sponsor licence regime places a broad range of responsibilities on Scheme Operators to ensure that the rights of migrant workers are protected.

The Government is carefully considering the Migration Advisory Committee’s review of the Seasonal Worker route and will announce a detailed response in due course. We will consider all these points in the round. Any question regarding tax and pension contributions will, however, need to be directed to the relevant Government departments.

Should the Seasonal Worker Interest Group wish to request a meeting with the Home Office Ministers, I would ask that they write to the department and any such request will be given appropriate consideration.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government what is their assessment of reports that more than 2 million people are now at risk of starvation in Tigray and what action are they taking to support the affected communities.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

We remain concerned about high levels of humanitarian need across many parts of Ethiopia, including in the north. Climate shocks, conflict, disease outbreaks and high inflation are driving humanitarian need in Ethiopia, including in Tigray. The humanitarian community is targeting 3.8 million people in Tigray with food assistance over the July-September lean season to stave off hunger. A UK co-led pledging conference in April helped increase humanitarian funding by securing $610 million from international development partners. This includes £100 million from the UK, which will provide lifesaving support for hundreds of thousands of Ethiopians, including over 435,000 children and mothers suffering from malnutrition, and more than 230,000 needing access to emergency healthcare. This includes UK support to the government of Ethiopia's Productive Safety Net Programme which is strengthening food security and resilience for 8 million people living in extreme poverty across Ethiopia.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government whether they are planning to review the approaches taken to address the involvement of UK citizens and residents in the Yazidi genocide; and whether they are initiating and pursuing judicial proceedings for genocide, crimes against humanity, or war crimes inflicted on the Yazidi people.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

In August 2023, the UK Government announced that it acknowledges acts of genocide were committed by Daesh against the Yazidis. This sends a strong signal of the UK's commitment of support to Yazidi communities and has been welcomed by Yazidi people, including the Yazidi Prince, Kurdish Regional Government Prime Minister Barzani, and British Parliamentarians. The UK is committed to ensuring that those responsible for the commission of serious international crimes do not go unpunished. Universal jurisdiction has been adopted in the case of certain heinous crimes to accord with customary international law and to comply with the UK's international obligations as set out in various treaties. These include the Geneva Conventions and the Convention Against Torture. The UK is committed to help other countries to prosecute offences that take place on their territory or within their jurisdiction, including the investigation and prosecution of crimes to which universal jurisdiction may apply. Hence, the UK has arrangements to provide mutual legal assistance to other countries and permits the surrender of its own nationals subject to statutory safeguards.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government what assessment they have made of the health of British citizen Jimmy Lai, imprisoned in Hong Kong, and whether they have sought his release on grounds of compassion.

Answered by Baroness Chapman of Darlington - Parliamentary Under-Secretary (Foreign, Commonwealth and Development Office)

Diplomats from our Consulate-General in Hong Kong are observing Mr Lai's trial. We are pressing for consular access, which the Hong Kong Prison Authorities have refused on grounds they do not recognise dual nationality.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government what is their policy with regard to British judges serving in Hong Kong courts.

Answered by Baroness Chapman of Darlington - Parliamentary Under-Secretary (Foreign, Commonwealth and Development Office)

Retired UK judges that choose to serve on Hong Kong courts do so in a personal capacity, which is their right as private citizens. The UK judiciary is independent from the UK Government.

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many prescriptions for trazodone have been issued in each year since 2014; how many 'Yellow Card' reports of sexual dysfunction and persistent sexual dysfunction in respect of trazodone the MHRA has received 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 trazodone.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The following table shows the total number of items issued for trazodone from 2014 to 2023, and from January to May 2024:

Source: data was provided by the NHS Business Service Authority, based on information within the Prescription Cost Analysis published statistics, using British National Formulary chemical substance trazodone hydrochloride.
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 the available data, including from the Yellow Card scheme, and where appropriate it seeks advice from its independent advisory committee, the Commission on Human Medicines, to inform on regulatory decisions, including the amending of product information.

The MHRA has received a total of 20 Yellow Card reports of sexual dysfunction related reactions, suspected to be associated with trazodone, between 1 January 2014 and 29 July 2024. This includes reactions grouped under the medical dictionary’s (MedDRA) Higher Level Terms, which are more specific than sexual dysfunction and persistent sexual dysfunction, and include erection and ejaculation conditions and disorders, orgasmic disorders and disturbances, sexual arousal disorders, and others. The following table shows the number of spontaneous suspected Yellow Card reports of sexual dysfunction related reactions suspected to be associated with trazodone in the United Kingdom, received by the MHRA each year from 2014 to 2024:

Source: data provided by the MHRA.

“Persistent sexual dysfunction” does not represent a specific medical condition, so this precise term is not a category available for a structured search of the MHRA’s Adverse Drug Reaction database. The structured data field search terms are drawn from the regulatory drugs dictionary, MedDRA, or from terms adopted in clinical coding guidance such as The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, or the International Classification of Diseases 11th Revision. A search of the database would therefore rely on manual assessment of individual cases.

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 product information for trazodone, which includes the patient information leaflet, reflects the data currently available, and does not include sexual dysfunction as a possible side effect but does include priapism, the prolonged erection of the penis. The Summary of Product Characteristics for healthcare professionals states that there have been reports of priapism which have required surgical intervention, or led to permanent sexual dysfunction. Patients developing priapism should stop using trazodone immediately.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government what is their assessment of the situation in Darfur, particularly with regard to the findings of the Darfur Inquiry published in April 2023 and subsequent concerns raised, including by the UN Special Adviser of the Secretary-General on the Prevention of Genocide, about the serious risk of genocide there.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

The UK condemns in the strongest terms the escalating violence across Sudan, particularly in Darfur. We continue to call for those responsible to be held to account. On 13 June, the UNSC adopted a UK-led resolution demanding a halt to the Rapid Support Forces' siege of El Fasher and calling on the warring parties to immediately end hostilities and to allow safe and unimpeded humanitarian access. The UK continues to support the ICC Prosecutor's continuing investigation into the allegations of atrocity crimes committed in Darfur since 1 July 2002, including consideration of the atrocities committed in the ongoing conflict.

Question to the Cabinet Office:

To ask His Majesty's Government what measures they are taking across all departments to ensure that British supply chains are free of slave labour.

Answered by Baroness Twycross - Baroness in Waiting (HM Household) (Whip)

Public procurement is a key lever for enabling delivery of the Government’s missions, both in terms of sourcing the goods and services required by the public sector but also in using procurement policy to drive up standards.

The government will be ensuring that the powers in the Procurement Act are utilised to support the new government’s priorities. New measures in the Act, which are due to come into force in October 2024, strengthens the rules on disregarding bids and excluding suppliers where there is evidence of modern slavery. This will apply even in circumstances where there has not yet been a conviction or technical breach of an international treaty.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government what security concerns they raised during the meeting between the Foreign Secretary and the Foreign Minister of China at the ASEAN Foreign Ministers meeting held in Vientiane on 26 July, and whether they discussed the use of Chinese surveillance technology in the UK, the presence of Chinese intelligence agents in the Palace of Westminster, the infiltration by China of research programmes in British Universities, and China’s military threats against Taiwan during this meeting.

Answered by Baroness Chapman of Darlington - Parliamentary Under-Secretary (Foreign, Commonwealth and Development Office)

On 26 July, the Foreign Secretary met China's Director of Foreign Affairs Commission Office and Foreign Minister Wang Yi at the ASEAN Foreign Ministers meeting in Vientiane, Laos. The Foreign Secretary outlined this government's vision for a long-term, consistent and strategic approach to UK-China relations. He set out that the government would cooperate where we can, compete where needed and challenge where we must. The Foreign Secretary made clear the UK would always stand firm in prioritising our national security and set out the government's position on Taiwan.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government what human rights concerns they raised during the meeting between the Foreign Secretary and the Foreign Minister of China at the ASEAN Foreign Ministers meeting held in Vientiane on 26 July, and whether they raised the case of Jimmy Lai and the imprisonment of pro-democracy campaigners in Hong Kong, and the reported genocide of Uyghur Muslims in China during this meeting.

Answered by Baroness Chapman of Darlington - Parliamentary Under-Secretary (Foreign, Commonwealth and Development Office)

On 26 July, the Foreign Secretary met China's Director of Foreign Affairs Commission Office and Foreign Minister Wang Yi at the ASEAN Foreign Ministers meeting in Vientiane, Laos. The Foreign Secretary outlined this government's vision for a long-term, consistent and strategic approach to UK-China relations. He set out that the government would cooperate where we can, compete where needed and challenge where we must. The Foreign Secretary made clear this government will stand firm in its support for upholding human rights, underlined the importance of Hong Kong to the UK and raised the case of British national Jimmy Lai.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government what is their response to the House of Commons Resolution passed in April 2021 that Uyghurs and other ethnic and religious minorities in the Xinjiang Uyghur Autonomous Region are suffering Crimes Against Humanity and Genocide.

Answered by Baroness Chapman of Darlington - Parliamentary Under-Secretary (Foreign, Commonwealth and Development Office)

It is the long-standing policy of the British Government that any judgment as to whether crimes against humanity or genocide has occurred is a matter for a competent national or international court, rather than for governments or non-judicial bodies. It should be decided after consideration of all the evidence available in the context of a credible judicial process. Regardless of any court's decision, this Government will stand firm on human rights, including China's repression of Uyghurs and others in Xinjiang.

Question to the Foreign, Commonwealth & Development Office:

To ask His Majesty's Government what is their assessment of the situation facing the Hazara community in Afghanistan, particularly with regard to the findings of the 2022 Hazara Inquiry and the February report of the UN Special Rapporteur on Afghanistan; and what consideration they have given to initiating proceedings before the International Court of Justice against Afghanistan for its failure to prevent and punish the crime of genocide, as per Article 1 of the Genocide Convention.

Answered by Lord Collins of Highbury - Lord in Waiting (HM Household) (Whip)

The Hazara Inquiry report has done much to raise awareness of the situation of Hazaras in Afghanistan. In line with the report's recommendations, we continue to monitor and document discrimination and abuses against Hazaras. The previous Government also welcomed the Special Rapporteur's February report and noted its recommendations. While the Government currently has no plans to initiate a case against Afghanistan at the ICJ, we continue to consider all available accountability measures.

More broadly, officials from the UK Mission to Afghanistan regularly press Taliban acting ministers and Afghan officials on human rights abuses in Afghanistan.

Question to the Home Office:

To ask His Majesty's Government following Canada's decision to proscribe the Iranian Islamic Revolutionary Guards Corps, whether they also plan to proscribe it; and if so, when.

Answered by Lord Hanson of Flint - Minister of State (Home Office)

The Government will keep the list of proscribed organisations under close review, as we seek to protect the UK from the threats that we face. However, we will not routinely comment on whether an organisation is or is not being considered for proscription.

The Government is clear that Iran’s malign activity, including the activities of the Islamic Revolutionary Guard Corps (IRGC), are unacceptable and will not be tolerated in the UK. The UK already maintains sanctions on over 400 Iranian individuals and entities covering human rights abuses and nuclear proliferation, including sanctioning the IRGC in its entirety. The Government will continue to consider what further steps may be taken to deter Iran’s malign activity.

Found: Letter dated 05/08/2024 from Lord Coaker to Lord Alton of Liverpool regarding the removal of Hikvision