Asked by: Lord Wigley (Plaid Cymru - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the Draft Agreement on the withdrawal of the United Kingdom of Great Britain and Northern Ireland from the European Union and the European Atomic Energy Community, published on 14 November, whether, under the provision of Article 18(k)(ii), it is their policy to refuse economically inactive persons who become residents of the UK access to the NHS.
Answered by Lord O'Shaughnessy
All people in the United Kingdom are able to access the National Health Service. However, since the UK has a residency based healthcare system, charges for most non-primary care services will apply to those people that are neither ordinarily resident in the UK, nor exempt from charge under the NHS (Charges to Overseas Visitors) Regulations 2015, as amended.
European Union citizens who are currently ordinarily resident in the UK are treated in the same way as ordinarily resident UK nationals for the purpose of receiving NHS-funded healthcare. There is no requirement for European Economic Area nationals to have a ‘right to reside’ in the UK under the Free Movement Directive, nor to exercise treaty rights or hold Comprehensive Sickness Insurance, in order to meet the ordinary residence definition.
For EU citizens resident in the UK by the end of the implementation period and in scope of the Withdrawal Agreement, their entitlement to free NHS services will not change, as long as they continue to be ordinarily resident in the UK.
When EU citizens living in the UK apply to the EU settlement scheme for UK immigration status, they will not be required to demonstrate they have held comprehensive sickness insurance as a qualifying criteria. The settlement scheme will be open to all EU citizens resident in the UK by 31 December 2020, including EU citizens studying in the UK. Those granted pre- or settled status under the settlement scheme will continue to have access to the NHS as long as they are ordinarily resident in the UK and therefore be able to access care as a UK national would.
EU students in the UK at the end of the implementation period will also have a European Health Insurance Card. Under the Withdrawal Agreement they can continue to use this during their stay to access needs arising healthcare.
Asked by: Lord Wigley (Plaid Cymru - Life peer)
Question to the Department of Health and Social Care:
Her Majesty's Government what plans they have to introduce in England legislation analogous to the Nurse Staffing Levels (Wales) Act 2016 to make provision for safe nurse staffing levels in hospitals in England.
Answered by Lord O'Shaughnessy
Appropriate staffing levels are already a core element of the Care Quality Commission’s (CQC’s) registration regime underpinned by legislation. All providers of regulated activities must be registered with the CQC and meet the registration requirements. The 16 safety and quality requirements set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 include a requirement for the deployment of sufficient numbers of suitably qualified, competent, skilled and experienced persons.
In July 2016, the National Quality Board published Supporting NHS providers to deliver the right staff, with the right skills, in the right place at the right time: Safe, sustainable and productive staffing. This safe staffing improvement resource provides an updated set of expectations for nursing and midwifery care staffing, to help National Health Service provider boards make local decisions that will support the delivery of high quality care for patients within the available staffing resource.
A copy of Supporting NHS providers to deliver the right staff, with the right skills, in the right place at the right time: Safe, sustainable and productive staffing is attached.
We now have 13,100 more nurses on our wards than in 2010.
Asked by: Lord Wigley (Plaid Cymru - Life peer)
Question to the Department of Health and Social Care:
Her Majesty's Government what is their assessment of the current provision of wheelchairs for disabled people; the adequacy of funding for such provision; and whether they will investigate reports at the recent British Medical Association Annual Conference that disabled people are resorting to crowd-funding to pay for wheelchairs.
Answered by Lord O'Shaughnessy
In England, local clinical commissioning groups (CCGs) are responsible for commissioning wheelchair services for their local populations and funding for these services is determined locally.
NHS England’s wheelchair operational data collection is designed to enable the gathering and dissemination of data that can be used for benchmarking and improving the commissioning of wheelchair services and outcomes for wheelchair users. The data collection, which has been undertaken since July 2015, is available as an online only resource.
NHS England is setting targets for CCGs for improvements in wheelchair provision. In the planning guidance issued to the National Health Service in September 2016, CCGs have been asked to describe how they will halve the number of children waiting 18 weeks or more by Q4 2017/18 and eliminate 18 week waits for wheelchairs by the end of 2018/19.
As part of comprehensive plans for the expansion of personal budgets, a specific personal health budget for wheelchair users has been developed. The personal wheelchair budget model introduces potential for using wider-system resources to support individuals’ whole needs. For example, individuals can use a personal wheelchair budget to provide for a higher specification wheelchair to maximise their independence.
Asked by: Lord Wigley (Plaid Cymru - Life peer)
Question to the Department of Health and Social Care:
Her Majesty's Government what is their latest estimate of the number of nursing posts vacant within the NHS in England.
Answered by Lord O'Shaughnessy
The information is not available in the format requested.
Health Education England (HEE) provide estimates of staff shortages in National Health Service trusts as part of their Workforce Plan for England publication. Staff shortages as defined by HEE may be filled by nurses working in agency, bank or overtime, however no estimate of the extent to which this occurs is available.
HEE plan to publish the Workforce Plan for England 2017/18 in due course.
Asked by: Lord Wigley (Plaid Cymru - Life peer)
Question to the Department of Health and Social Care:
Her Majesty's Government what discussions, if any, they have held with representatives of NHS doctors regarding the potential impact of the increasing cost of medical indemnity.
Answered by Lord O'Shaughnessy
The Department is aware of pressures for doctors regarding the potential impact of the increasing cost of medical indemnity.
General practitioners (GPs) are the National Health Service doctors who are most directly affected by the rising cost of medical indemnity. Doctors working in hospitals are not directly exposed to rising costs as their employers purchase indemnity to cover their activities. The Department has been in frequent dialogue with GP representative bodies on the subject of rising cost of indemnity, and this has been a subject of interest for some time. The Department has a series of regular scheduled meetings with GP representatives, and indemnity is frequently discussed at these meetings. In addition, it is not uncommon for discussions to take place outside of these scheduled meetings where either party has a reason to have a more specific conversation about indemnity costs.
Indemnity for clinical negligence claims brought against NHS employed GPs, doctors and all NHS staff in England is provided by the employer organisation. All NHS providers of care are members of NHS Resolution’s Clinical Negligence Scheme for Trusts and claims for compensation will ordinarily be brought against the NHS care provider organisation.
The Government has publically committed to ensuring that NHS Resolution has appropriate funding to cover changes to hospitals’ clinical negligence costs.
Asked by: Lord Wigley (Plaid Cymru - Life peer)
Question to the Department of Health and Social Care:
Her Majesty's Government whether they plan to allow the prescription of the drug Orkambi for cystic fibrosis sufferers under the age of 12; and if not, why not.
Answered by Lord O'Shaughnessy
Orkambi does not have a marketing authorisation in the United Kingdom for use in the treatment of children aged under 12 with cystic fibrosis. Where clinically appropriate and subject to the relevant commissioner making funding available, Orkambi may be prescribed as an off-label drug. Off-label prescribing is supported in guidance given to prescribers by both the General Medical Council and by the Medicines and Healthcare products Regulatory Agency.
Asked by: Lord Wigley (Plaid Cymru - Life peer)
Question to the Department of Health and Social Care:
Her Majesty's Government how many mental health patients in England were sent away from their local area for treatment in each of the past three years for which figures are available.
Answered by Lord O'Shaughnessy
The Out of Area Placement (OAP) definition was agreed in October 2016. The latest data published on OAPs covers the period from 17 October 2016 to 30 April 2017. During that time 4,153 OAPs have been recorded as starting in England.
Asked by: Lord Wigley (Plaid Cymru - Life peer)
Question to the Department of Health and Social Care:
Her Majesty's Government what steps they plan to take to address the shortage of psychiatrists.
Answered by Lord O'Shaughnessy
A five year workforce plan to deliver the Five Year Forward View for Mental Health is currently being finalised by Health Education England (HEE) and will be published in due course. Analysis and development of the workforce strategy have been completed and HEE is now working with arm’s length body partners to agree the associated goals, trajectories, actions, and other deliverables associated with the implementation of the strategy.
Asked by: Lord Wigley (Plaid Cymru - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many general practitioners in England retired during the past 12 months; and, of those, how many were aged under 60 at the time of retirement.
Answered by Lord Prior of Brampton
For the last 12 months for which data is available, (the period 1 April 2015 to 31 March 2016) 992 general practitioners retired and claimed retirement benefits from the NHS Pension Scheme in England and Wales.
Of these, 580 were under 60 years of age.
General practitioners, in common with other staff groups, are able to claim retirement benefits and return to the National Health Service. This may be on a full time or part-time basis. This is common practice but exact numbers are not known.
Asked by: Lord Wigley (Plaid Cymru - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what plans they have to increase the United Kingdom’s capacity to conduct research into mesothelioma and associated diseases.
Answered by Lord Prior of Brampton
The National Institute for Health Research (NIHR) has invited researchers to apply for mesothelioma research funding, in particular to address the research questions identified through the Mesothelioma Priority Setting Partnership and published in December 2014. Eight NIHR programmes are participating in this themed call, including the NIHR fellowships programme which supports outstanding individuals to become the health research leaders of the future.
The NIHR funds infrastructure capacity for experimental medicine to translate scientific developments into benefits for patients. Such infrastructure supporting studies in mesothelioma includes biomedical research centres and units, clinical research facilities, and experimental cancer medicine centres. The NIHR funds infrastructure capacity for later phase trials and studies through the NIHR Clinical Research Network (CRN). The CRN is currently recruiting to seven studies in mesothelioma.