Asked by: Lord Balfe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they have any plans to seek a closer relationship with the European Medicines Agency.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
This Government will seek to reset the relationship with European partners and work to improve the United Kingdom’s relationship with the European Union.
The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for regulating all medicines and medical devices in the UK and works closely with a range of international regulators, including the European Medicines Agency (EMA), through both international regulatory groups and bilateral collaborations.
We recognise the importance of a closer relationship with the EMA and that cooperation between the MHRA and EMA is of mutual benefit.
Asked by: Lord Balfe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, with reference to the report Disagreements in the care of critically ill children published by the Department of Health and Social Care on 18 September, what changes they intend to make to the care of critically ill children and when they anticipate these will come into effect.
Answered by Lord Markham
The Department is considering the recommendations made in the report and what actions can be taken to help avoid disagreements arising between the parents of critically ill children and clinicians treating them and, where this is not possible, resolve disagreements more quickly and compassionately.
Asked by: Lord Balfe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 7 February (HL5154), what is the upper age limit for screening for bowel cancer; and whether those who have been screened in the past but have now passed the previous upper age limit for screening will be invited to re-apply under the new rules.
Answered by Lord Markham
The NHS Bowel Cancer Screening programme is currently offered to people between the ages of 60 years old and 74 years old. The programme is expanding to make it available to everyone aged 50 years old to 59 years old, this is happening gradually over four years and started in April 2021.
If people over the age of 74 years old have concerns about bowel cancer, they should speak to their general practitioner who will determine the best course of actions to take.
Asked by: Lord Balfe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Lord Markham on 22 November (HL3405), what plans they have, if any, to give an indication of (1) a timetable for the commencement of the independent review into the causes of disputes between those with parental responsibility and those responsible for the care or medical treatment of critically ill children, (2) details of the membership of the review, and (3) terms of reference for the review, which is due to report by 1 October 2023.
Answered by Lord Markham
We expect the commissioning process to be completed in the coming weeks. While the review will not have a fixed membership, it will engage with a range of interested or affected people and organisations. This will include health professionals and the families of critically ill children, to ensure it develops a balanced evidence base for identifying solutions. The organisation undertaking the review will be asked to publish its terms of reference shortly after it has been commissioned.
Asked by: Lord Balfe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the answer by Lord Kamall on 8 September (HL Deb, col 272), whether they will provide an update on the progress of commissioning an independent review into the causes of disputes between those with parental responsibility and those responsible for the care or medical treatment of critically ill children.
Answered by Lord Markham
The Department is currently examining the commissioning process for the review and further information will be available in due course.
Asked by: Lord Balfe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government when section 177 of the Health and Care Act 2022 came, or will come, into force.
Answered by Lord Kamall
Section 117 of the Health and Care Act 2022 will come into force on 1 October 2022.
Asked by: Lord Balfe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government when they expect to reply to the letter from Lord Balfe to the Department for Health and Social Care of 14 December 2021, regarding their reply of 13 December 2021 on do not attempt cardiopulmonary resuscitation (DNACPR) notices.
Answered by Lord Kamall
We replied to the noble Lord on 9 February 2022.
Asked by: Lord Balfe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the Written Answers by Lord Kamall (HL5606 and HL5607), whether, in the case of a do not attempt cardiopulmonary resuscitation (DNACPR) notice being issued against the expressed wish of a patient or their family, (1) the patient, (2) their family, or (3) both, will be notified of the decision in good time for a second opinion and review to be sought and undertaken.
Answered by Lord Kamall
When a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision is being made, the clinician should consider the patient’s wishes and every effort should be taken to reach an agreement with the patient or, if they lack capacity, their family or representative. If the patient or their family or representative do not agree with the decision, they should be given time to ask for a second opinion or review. This is in line with the National Health Service guidance for DNACPR decisions.
When a DNACPR decision is made the patient should also be told when it will be reviewed, and this is usually recorded on the DNACPR form. It is recommended that a DNACPR decision is reviewed each time a patient’s situation changes, for example when they leave hospital. If a patient is concerned about a DNACPR decision, they can contact their local Healthwatch to find out about how to get help making a complaint.
Asked by: Lord Balfe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they have given advice and direction to GPs on their mandatory working hours; and what assessment they have made of whether GPs working their mandatory hours would lead to a reduction in the number of patients referred to Accident and Emergency departments without first being seen by their GP.
Answered by Lord Kamall
We have provided no such advice or direction as general practitioners are independent contractors with no mandatory working hours Therefore, no specific assessment has been made.
Asked by: Lord Balfe (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the reported increase in the use of Do Not Attempt Cardiopulmonary Resuscitation orders during the COVID-19 pandemic, what additional guidance they have provided to hospitals regarding consulting patients and their families prior to such orders being issued; and when this guidance was distributed.
Answered by Lord Bethell
Failure to consult people and their families on decisions around CPR causes significant distress and we have taken decisive action to prevent this from happening. NHS England and NHS Improvement clinical leaders issued a number of letters to the health and social care system throughout April and May 2020, and in March 2021, to clarify best practice around do not attempt cardiopulmonary resuscitation (DNACPR) decisions.
Joint guidance for clinicians from the British Medical Association, the Resuscitation Council UK and Royal College of Nursing reflects that agreement to a DNACPR is an individual decision and should involve the person concerned or, where the person lacks capacity, their families, carers, guardians or other legally recognised advocates. The Department reiterated this message in the Adult Social Care Winter Plan in 2020.
The DNACPR Ministerial Oversight Group continues to review the resources available to ensure adherence to DNACPR guidance across the system. Sensitive and well communicated DNACPRs can and should be an important part of patient care and end of life experience. We are committed to taking continued action to ensure those decisions are managed and communicated well in all settings.