Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what consideration they have given to ensuring all children under the age of 18 who have been referred to the Tavistock and Portman NHS Foundation Trust’s Gender Identity Development Service in respect of possible gender dysphoria or reassignment participate in an independent long-term study to improve the understanding of such conditions, possible courses of treatment and support for such children.
Answered by Baroness Blackwood of North Oxford
The Tavistock and Portman NHS Foundation Trust has been awarded a research grant by the National Institute for Health Research to fund a LOGIC study (Longitudinal Outcomes of Gender Identity in Children) that will follow up children and young people aged 13 years and under referred to the Gender Identity Development Service (GIDS). This will look at outcomes with regard to young people’s physical health, quality of life and psychological wellbeing. The United Kingdom GIDS is the largest such service in the world and this combined with the increase in referrals in recent years means that it is uniquely positioned to undertake research of this kind.
The research will importantly investigate outcomes over time, whether children and young people and their families remain in contact with NHS services or not. This thereby investigates outcomes for the entire cohort, encompassing those in receipt of physical (hormone/endocrine) treatments and those not receiving such interventions. The findings generated from this research will help address important gaps in the evidence, enabling services to provide better and more individualized care, benefiting patients and their families.
Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of whether the NHS document A guide for young trans people in the UK stereotypes gender characteristics and advises young people to go abroad for puberty blocking treatment which is not permitted in the UK.
Answered by Lord O'Shaughnessy
No assessment has been made of the content of the document A guide for young trans people in the UK as it is no longer current.
This document was published in 2007, before NHS England’s inception in 2013, when it became the direct commissioner of specialised gender dysphoria services for the population of England.
In 2016, NHS England published a clinical commissioning policy that sets out strict guidelines regarding the prescription of puberty-blocking and cross-sex hormones in youngsters. These drugs may only be prescribed with the agreement of a specialist multidisciplinary team and after a diagnosis of gender dysphoria has been made following a careful assessment of the individual, and generally once the patient is around 15 years old for hormone blockers and 16 years old for cross sex hormones.
A copy of NHS England’s commissioning policy NHS Standard Contract for Gender Identity Development Service For Children And Adolescents is attached.
Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
Her Majesty's Government, further to the Written Answer by Lord O'Shaughnessy on 19 July (HL914), what plans they have to reduce the costs to the NHS of the supply of drugs such as Apomorphine that are long out of patent and simple and cheap to manufacture; and what consideration they have given to increasing supplies of such drugs by seeking suppliers who will invest in regulatory approvals in exchange for a fixed-price, fixed-term contract.
Answered by Lord O'Shaughnessy
The cost of branded medicines to the National Health Service is controlled by the voluntary pharmaceutical price regulation scheme or the statutory medicines price regulation scheme. Often when patents expire, generic versions enter the market and, as a result of competition, prices often go down.
In primary care, the community pharmacy contractual framework provides an incentive for pharmacies to get the best medicines prices; in secondary care, a system of central tenders delivers similar levels of savings. In general, the system works well – the United Kingdom has the lowest generic prices across the Organisation for Economic Co-operation and Development.
Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
Her Majesty's Government how much the NHS pays for a one year supply of Apomorphine for a patient with Parkinson's Disease; how much they estimate it costs to manufacture a year's supply of that drug; what assessment they have made of the difficulties of manufacturing Apomorphine to clinical standards; and whether they intend to take any steps to reduce the cost of that drug to the NHS.
Answered by Lord O'Shaughnessy
The drug cost to the National Health Service for a one year supply of Apomorphine for a patient with Parkinson's Disease is estimated to be in the region of £5,300 and £9,000, based on the usual daily dose of 3 – 30mg. However, the maximum daily is 100mg, so the annual cost for some patient’s treatment may be higher.
We have no estimate of the cost of manufacture. We are not aware of any particular issues relating to the manufacture of this drug. Pharmaceutical companies participate in either the voluntary pharmaceutical price regulation scheme (PPRS) or the statutory medicines price regulation scheme, both of which regulate the cost of medicines to the NHS. Products covered by the statutory scheme are subject to a 15% cut to their list price. Companies in the PPRS pay a percentage of sales to the Government when growth in NHS spending on medicines exceeds an agreed level. NHS purchasers may also negotiate discounts with pharmaceutical companies in addition to national price regulation.
Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government whether they will ask general practitioners who prescribe antifungals to patients with Alzheimer's disease to notify the National Health Service of the results of that treatment, in the light of the article published online by <i>Nature </i>on 15 October regarding the infection of different brain regions with fungi in Alzheimer's.
Answered by Lord Prior of Brampton
The use of antifungal medication is not licensed for the treatment of patients with Alzheimer's disease. Consequently there would be no requirement for systematic monitoring of the use of these drugs.