Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, following research from Cancer Research UK which found that brain, other central nervous system and intracranial tumours incidence rates have increased by almost two-fifths in the UK since the early 1990s, what steps they are taking to ensure that the funding spent on brain tumour research keeps pace with the increased incidence.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Research is crucial in tackling cancer, which is why the Department invests over £1 billion per year in health research, through the National Institute for Health Research (NIHR). NIHR research expenditure for all cancers was £121.8 million in 2022/23, and the NIHR spends more on cancer than any other disease group.
The NIHR funds research in response to proposals received from scientists rather than allocating funding to specific disease areas. It is not usual practice to ring-fence funds for particular topics or conditions. Applications are subject to peer review and judged in open competition, with awards made on the basis of the importance of the topic to patients and health and care services, value for money, and scientific quality.
In May 2018 the Government announced £40 million for brain tumour research as part of the Tessa Jowell Brain Cancer Mission (TJBCM) through the NIHR. Since the 2018 announcement, the NIHR has committed £11.3 million across 17 projects. It is worth noting that all applications that were fundable in open competition, have been funded.
There is still funding available from the original £40 million announced in 2018. We are committed to funding high-quality brain cancer research, and we expect to spend more as new research progresses.
Brain tumours are a difficult research area with a relatively small research community. To increase the quality, diversity, and number of brain cancer research proposals, the NIHR is working with the TJBCM and the research community to develop research capacity in the brain cancer community. The NIHR continues to encourage and welcome more funding applications for research into brain tumours.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the increase in incidents of (1) gonorrhoea, from 58 diagnoses per 100,000 people in 2013 to 146 diagnoses in 2023, and (2) syphilis, from 6.4 diagnoses per 100,000 people in 2013 to 15.4 diagnoses in 2023; and what assessment they have made of the impact of the resulting loss of working days.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Sexually transmitted infection diagnosis data is published annually, as official statistics by the UK Health Security Agency (UKHSA), and is available at the GOV.UK website, in an online only format. There were 82,592 gonorrhoea diagnoses and 8,692 infectious syphilis diagnoses, including primary, secondary, and early latent, reported in sexual health services in England, in 2022. This is compared to 31,177 gonorrhoea diagnoses and 3,345 infectious syphilis diagnoses, primary, secondary, and early latent, in 2013.
Gonorrhoea is increasing in people of all ages, but the rise is highest among young people aged 15 to 24 years old. Infectious syphilis, including primary, secondary, and early latent, is increasing among gay, bisexual, or other men, who have sex with men and heterosexual people.
Dedicated sexual health services play a key public health role in diagnosis, early treatment and management of STIs and we are providing local authorities with more than £3.5 billion in 2023/24 (increasing to £3.6 billion in 2024/25) through our public health grant to support this activity.
We continue to support the delivery of local services, providing guidance and data through UKHSA and my department. In March 2023 the Department of Health and Social Care in collaboration with UKHSA, published the Integrated Sexual Health Service Specification to support local authorities in comprehensive commissioning of services and provide advice and guidance on managing STIs outbreaks.
UKHSA has also published a Syphilis Action Plan to address the increase in syphilis diagnosis in England, focusing on key interventions such as targeted testing, partner notification and awareness raising.
No assessment has been made of any resulting loss of working days, due to gonorrhoea and syphilis diagnoses.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they are satisfied that the Medicines and Healthcare products Regulatory Agency undertook a sufficiently rigorous approach to the licensing of montelukast, in view of the US Food and Drug Administration’s black box warning about its use.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Medicines and Healthcare products Regulatory Agency (MHRA) actively reviews the safety and efficacy of medicines throughout their life cycle. As well as through the licensing process itself, this is done via the Yellow Card safety reporting system, the actions of other international regulators, and patient feedback.
The MHRA updated the United Kingdom’s product information on using montelukast in 2019, to provide clearer warnings about the risk of neuropsychiatric side effects. The MHRA is currently conducting a further review of the safety data, and will communicate any changes when that review is concluded.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what estimate they have made of the average monthly proportion of lower gastrointestinal cancer patients started treatment within 62 days of referral for each year figures are available.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The following table shows the average monthly proportion of lower gastrointestinal cancer patient starting treatment within 62 days of referral:
Year | Average monthly proportion |
2017/18 | 72.8% |
2018/19 | 70.0% |
2019/20 | 66.7% |
2020/21 | 50.4% |
2021/22 | 48.5% |
2022/23 | 41.7% |
Source: NHS England Cancer Waiting Times data
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the status of the guidance issued by the British Medical Association in its report Safe Scope of Practice for Medical Associate Professionals (MAPs) in relation to Physician and Anaesthesia Associates.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government considers scope of practice guidance for Anaesthesia Associates (AAs) and Physician Associates (PAs) to be a matter for the Royal College of Anaesthetists (RCoA) and the Royal College of Physicians (RCP) respectively, in conjunction with key stakeholders including other medical royal colleges, the Faculty of Physician Associates (FPA), and the Association of Anaesthesia Associates.
The current scope of practice guidance for AAs, which is applicable across the United Kingdom, is published on the RCoA website. The FPA, which is hosted by the RCP, has also published guidance documents relating to the PA curriculum, code of conduct, and supervision. We understand that both the RCoA and the RCP are currently developing further guidance in collaboration with stakeholders, in relation to supervision and scope of practice.
Once regulation begins, the General Medical Council’s published learning outcomes for AAs and PAs will also apply. This sets out a pre-qualification education framework and the outcomes expected of newly qualified AAs and PAs, including professional behaviours and capabilities and minimum expectations for the knowledge and skills required. In addition, employers of AAs and PAs are responsible for ensuring that appropriate governance and supervision are in place, and that individuals within their employment are practicing within their competence.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the dangers to some users of the asthma drug montelukast; and what discussions they have had with the montelukast UK action group, which has highlighted the risks of the drug.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
Montelukast remains a safe and effective medicine in the treatment of asthma. Montelukast is indicated for use in the United Kingdom as an add on treatment for asthma patients who are inadequately controlled on inhaled corticosteroid treatment, and can be prescribed for the symptomatic relief of seasonal allergic rhinitis in patients with asthma.
Neuropsychiatric effects such as depression have been included in the UK product information for montelukast since 2007. This has been subsequently updated with additional terms, based on emerging evidence. This includes the most recent update in 2019, to more fully describe the neuropsychiatric effects. In order to remind prescribers of the risk of the neuropsychiatric effects with montelukast, a Drug Safety Update article was published by the Medicines and Healthcare products Regulatory Agency (MHRA) in 2019 to accompany the updated warnings.
Following a growing number of Yellow Card reports and queries from patients and caregivers raising concerns about a potential ongoing lack of awareness of the risk of the neuropsychiatric effects with montelukast, the MHRA is conducting a further review of the latest data. As part of our review, we are evaluating all available evidence including Yellow Card reports and queries received by the MHRA, literature publications, international regulatory changes, including those made by the United States’ Food and Drug Administration, and listening to and learning from patients’ experiences.
The MHRA has sought advice from our independent expert groups including paediatricians, specialists in mental and respiratory health, as well as experts in medicines safety. Patient representatives from the UK action group, including parents of children and young people who had taken montelukast, were invited to the MHRA’s independent pharmacovigilance expert advisory group (PEAG), to share their lived experiences of dealing with the impact of the neuropsychiatric effects, including the impact of lack of awareness of the side effect. The MHRA is finalising the review process and will communicate on any further measures to minimise the risk, upon completion of our review.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of whether the adoption of the British Medical Association’s report Safe Scope of Practice for Medical Associate Professionals (MAPs) would undermine established governance and frameworks.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government considers scope of practice guidance for Anaesthesia Associates (AAs) and Physician Associates (PAs) to be a matter for the Royal College of Anaesthetists (RCoA) and the Royal College of Physicians (RCP) respectively, in conjunction with key stakeholders including other medical royal colleges, the Faculty of Physician Associates (FPA), and the Association of Anaesthesia Associates.
The current scope of practice guidance for AAs, which is applicable across the United Kingdom, is published on the RCoA website. The FPA, which is hosted by the RCP, has also published guidance documents relating to the PA curriculum, code of conduct, and supervision. We understand that both the RCoA and the RCP are currently developing further guidance in collaboration with stakeholders, in relation to supervision and scope of practice.
Once regulation begins, the General Medical Council’s published learning outcomes for AAs and PAs will also apply. This sets out a pre-qualification education framework and the outcomes expected of newly qualified AAs and PAs, including professional behaviours and capabilities and minimum expectations for the knowledge and skills required. In addition, employers of AAs and PAs are responsible for ensuring that appropriate governance and supervision are in place, and that individuals within their employment are practicing within their competence.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of whether the adoption of the British Medical Association’s report Safe Scope of Practice for Medical Associate Professionals (MAPs) would restrict the role of Physician Associates.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government considers scope of practice guidance for Anaesthesia Associates (AAs) and Physician Associates (PAs) to be a matter for the Royal College of Anaesthetists (RCoA) and the Royal College of Physicians (RCP) respectively, in conjunction with key stakeholders including other medical royal colleges, the Faculty of Physician Associates (FPA), and the Association of Anaesthesia Associates.
The current scope of practice guidance for AAs, which is applicable across the United Kingdom, is published on the RCoA website. The FPA, which is hosted by the RCP, has also published guidance documents relating to the PA curriculum, code of conduct, and supervision. We understand that both the RCoA and the RCP are currently developing further guidance in collaboration with stakeholders, in relation to supervision and scope of practice.
Once regulation begins, the General Medical Council’s published learning outcomes for AAs and PAs will also apply. This sets out a pre-qualification education framework and the outcomes expected of newly qualified AAs and PAs, including professional behaviours and capabilities and minimum expectations for the knowledge and skills required. In addition, employers of AAs and PAs are responsible for ensuring that appropriate governance and supervision are in place, and that individuals within their employment are practicing within their competence.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they will issue guidance to the NHS on whether the Government endorses the British Medical Association’s report Safe Scope of Practice for Medical Associate Professionals (MAPs) in relation to Physician and Anaesthesia Associates.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government considers scope of practice guidance for Anaesthesia Associates (AAs) and Physician Associates (PAs) to be a matter for the Royal College of Anaesthetists (RCoA) and the Royal College of Physicians (RCP) respectively, in conjunction with key stakeholders including other medical royal colleges, the Faculty of Physician Associates (FPA), and the Association of Anaesthesia Associates.
The current scope of practice guidance for AAs, which is applicable across the United Kingdom, is published on the RCoA website. The FPA, which is hosted by the RCP, has also published guidance documents relating to the PA curriculum, code of conduct, and supervision. We understand that both the RCoA and the RCP are currently developing further guidance in collaboration with stakeholders, in relation to supervision and scope of practice.
Once regulation begins, the General Medical Council’s published learning outcomes for AAs and PAs will also apply. This sets out a pre-qualification education framework and the outcomes expected of newly qualified AAs and PAs, including professional behaviours and capabilities and minimum expectations for the knowledge and skills required. In addition, employers of AAs and PAs are responsible for ensuring that appropriate governance and supervision are in place, and that individuals within their employment are practicing within their competence.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they will discuss the implications for Physician and Anaesthesia Associates of the British Medical Association report Safe Scope of Practice for Medical Associate Professionals (MAPs) with the United Medical Associate Professionals.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government considers scope of practice guidance for Anaesthesia Associates (AAs) and Physician Associates (PAs) to be a matter for the Royal College of Anaesthetists (RCoA) and the Royal College of Physicians (RCP) respectively, in conjunction with key stakeholders including other medical royal colleges, the Faculty of Physician Associates (FPA), and the Association of Anaesthesia Associates.
The current scope of practice guidance for AAs, which is applicable across the United Kingdom, is published on the RCoA website. The FPA, which is hosted by the RCP, has also published guidance documents relating to the PA curriculum, code of conduct, and supervision. We understand that both the RCoA and the RCP are currently developing further guidance in collaboration with stakeholders, in relation to supervision and scope of practice.
Once regulation begins, the General Medical Council’s published learning outcomes for AAs and PAs will also apply. This sets out a pre-qualification education framework and the outcomes expected of newly qualified AAs and PAs, including professional behaviours and capabilities and minimum expectations for the knowledge and skills required. In addition, employers of AAs and PAs are responsible for ensuring that appropriate governance and supervision are in place, and that individuals within their employment are practicing within their competence.