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Written Question
Electronic Cigarettes: Children
Monday 22nd January 2024

Asked by: Marquess of Lothian (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many children under the age of 18 were treated by NHS England for vaping-related disorders in (1) 2021, (2) 2022, and (3) 2023; and what assessment they have made of the need to reduce vaping by the under-18s, including measures to make vapes available only on prescription.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England recently published data on vaping related disorders as either the primary or secondary diagnosis. Data shows 46 people 19 years old and under were admitted for a vaping related disorder in 2022/23, down from 54 in 2021/22. Due to the size of the data, a copy of the full data set is attached.

On 12 October 2023, we launched a public consultation, seeking views on creating the first smokefree generation, our plans to crack down on youth vaping by reducing the appeal, availability and affordability of vapes to our children, and options to ensure the law is enforced. The consultation closed on 6 December 2023, and we will respond in the coming weeks ahead of the introduction of the Tobacco and Vapes Bill.

There are no medicinally licensed vaping products approved by the Medicines and Healthcare products Regulatory Agency. As such, the Government is not currently considering making vaping products prescription-only.


Written Question
Care Workers: Migrant Workers
Tuesday 19th December 2023

Asked by: Marquess of Lothian (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government what detailed assessment they have undertaken of the potential impact on recruitment into the social care system of requiring that UK citizens must be earning at least £38,700 to sponsor foreign family members to get a family visa; how many social care positions are currently vacant in the UK; and what impact an under-staffed social care system with too few care beds will have on the ability of NHS hospitals to discharge patients in need of social care, and the consequent effect on (1) hospital waiting lists, and (2) A&E waiting times.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The Secretary of State for the Home Department has committed to put estimates of the impact of these announcements in the House of Commons Library. This will be done in due course.

According to Skills for Care, the total number of vacancies in 2022/23 was 152,000, a decrease of 11,000 or 7% of vacant posts from 2021/22. It is important to note vacancies are not necessarily a good measure of workforce capacity or of levels of need in social care. Vacancies include posts that are vacant in the short term due to recent or anticipated staff turnover and posts created by employers who want to expand and grow their businesses rather than only roles needed to meet statutory entitlements.

This Government is investing an additional £600 million this year, and £1 billion next year through the Discharge Fund. This funding will enable the National Health Service and local authorities in England to reduce discharge delays, including by commissioning additional packages of care and support for rehabilitation and reablement.

In September, alongside £200 million to boost resilience in the NHS, we announced a £40 million fund, targeted at local authorities in the most challenged NHS systems in England. This fund will strengthen urgent and emergency care resilience and performance this winter by preventing avoidable admissions or by reducing discharge delays.


Written Question
Accident and Emergency Departments: Standards
Tuesday 28th November 2023

Asked by: Marquess of Lothian (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government what action is being taken to reduce waiting times in A&E departments in NHS England, following the publication of A&E Attendances and Emergency Admissions figures for October which found that nearly 30 per cent of patients waited four hours or more to be assessed and nearly 45,000 patients waited for more than 12 hours for a bed following admission.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Under our Delivery plan for recovering urgent and emergency care services, we are taking a range of measures to improve patient flow through hospital and reduce waiting times in accident and emergency departments. These include the delivery of 5,000 more staffed, permanent beds this year compared to 2022/23 plans, supported by £1 billion of dedicated funding. This is alongside a further £1.6 billion of funding over two years to support the National Health Service and local authorities to ensure timely and effective discharge from hospital. We are also improving hospital discharge processes by establishing ‘Care transfer hubs’ in every hospital ahead of winter, alongside scaling up the use of virtual wards by an additional 3,000 beds, with over 10,000 beds now available nationally.

A copy of the plan is attached.


Written Question
Doctors: Career Development
Wednesday 22nd November 2023

Asked by: Marquess of Lothian (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the General Medical Council report The state of medical education and practice in the UK: Workforce report 2023, published on 13 November, in particular of the findings relating to traditional or non-traditional career pathways; and what steps they are taking to support greater flexibility in career and training for NHS doctors.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

No assessment has been made. NHS England is continuing the Enhancing Junior Doctors Working Lives programme to implement a number of measures aimed at supporting junior doctors, encouraging them to stay in training and the National Health Service, reducing overall attrition. Examples of these measures include less than full time training options, to allow trainees to continue to work in the NHS and progress with their training on a reduced working pattern, where this is beneficial for their personal circumstances.

NHS England is also working with partners to develop a broader range of career pathways and opportunities available to the medical workforce. This includes a commitment to increase career flexibility and training opportunities for doctors in training, locally employed doctors, and specialty and specialist doctors.


Written Question
NHS: Drugs
Monday 13th November 2023

Asked by: Marquess of Lothian (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many Serious Shortage Protocols (SSPs) for medication or medical appliances are currently in place owing to a national or worldwide supply shortage; for which medications treating which conditions are these SSPs in place; and what steps they are taking to support affected patients, in particular, those patients facing a shortage of prescribed medication to help manage their ADHD symptoms.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

There are currently three Serious Shortage Protocols (SSPs) in place. These are for Estradot 100microgram hormone replacement therapy patches for treatment of the menopause, clarithromycin antibiotic 125mg/5ml oral suspension and clarithromycin antibiotic 250mg/5ml oral suspension for the treatment of a variety of infections including chest infections and other respiratory infections.

A team within the Department deals specifically with medicine supply problems arising both in the community and in hospitals. It has well-established procedures to deal with medicine shortages and works closely with the Medicines and Healthcare products Regulatory Agency, the pharmaceutical industry, NHS England and others operating in the supply chain to help prevent shortages and to ensure that the risks to patients are minimised when shortages do arise.

We are aware of supply issues affecting medicines used in the management of attention deficit hyperactivity disorder (ADHD). We have issued communications, in the form of a National Patient Safety Alert to the National Health Service, to advise healthcare professionals on the management of patients during this time. We continue to work closely with the manufacturers to resolve the issues as soon as possible and to ensure patients have continuous access to ADHD medicines in the United Kingdom. Supply disruptions affecting various ADHD products are resolving and we anticipate the supply of the remaining medications to resolve between now and December 2023.

Patients are advised to speak to their clinician regarding any concerns they have and to discuss the suitability of treatment with alternative medicines.


Written Question
Maternity Services: Finance
Thursday 28th September 2023

Asked by: Marquess of Lothian (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government what is the current annual (1) maternity, and (2) neonatal, budget for NHS England; and how much NHS England has expended annually in clinical negligence compensation for maternity care in each of the past five years.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The annual budget for the NHS England Maternity Programme is £122 million. NHS England does not commission or budget for Maternity Services which is the responsibility of integrated care boards (ICBs). NHS Providers, based on the latest available data which is 2021/22 Reference Costs, spent approximately £4 billion annually on Maternity Services. Neonatal services are commissioned and budgeted for through Specialised Commissioning. The latest available data shows an annual spend for 2023/24 of approximately £1 billion.

NHS Resolution manages clinical negligence and other claims against the National Health Service in England. The following table shows the cost of Clinical Negligence Claims Closed or otherwise Settled as a Periodical Payment Order (PPO) between 2018/19 and 2022/23 with damages paid (including PPOs paid to date), where the Specialty is 'Obstetrics', as advised by NHS Resolution:

Year of Closure of case (Settlement Year for PPOs)

Damages Paid (£)

NHS Legal Costs Paid (£)

Claimant Legal Costs Paid (£)

Total Paid (£)

2018/19

605,688,009

25,560,735

78,394,471

709,643,216

2019/20

495,458,879

22,536,708

72,295,468

590,291,055

2020/21

501,965,729

22,080,962

68,796,850

592,843,541

2021/22

503,741,949

21,897,291

78,114,994

603,754,235

2022/23

596,598,917

25,039,074

84,939,593

706,577,584

Total

2,703,453,483

117,114,772

382,541,376

3,203,109,631


Written Question
Disability: Mental Illness
Wednesday 13th September 2023

Asked by: Marquess of Lothian (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government, following the publication of the Inequalities in disability report by the Institute of Fiscal Studies on 23 August, what steps they are taking to address the rise in mental health issues and disability benefit claims among children, and in particular the doubling of the rate of girls aged 16 who are in contact with mental health services since 2017–18.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

We are progressing work with NHS England to increase access to children and young people’s mental health services as outlined in the NHS Long Term Plan. The NHS Long Term Plan commits to increasing investment in mental health services by at least £2.3 billion a year by March 2024 so that an additional 345,000 children and young people are able to get the National Health Service-funded mental health support they need.


Written Question
Physician Associates: Employment
Wednesday 19th July 2023

Asked by: Marquess of Lothian (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government what safeguards are in place to ensure that the increased employment of physician associates (PAs) as part of the NHS Long Term Workforce Plan to tackle staff shortages in the NHS do not compromise patient safety; and what measures are in place to ensure that patients understand when they are being treated by a PA and not by a fully qualified GP.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

Physician associates (PAs) are medically trained generalist healthcare professionals who work alongside doctors and provide medical care as an integral part of the multidisciplinary team. They should always work with a registered medical supervisor, whether in primary care or a hospital setting, so that they have immediate access to appropriate support and guidance.

The Government is progressing the required legislation which will the enable the General Medical Council (GMC) to regulate the PA role. We plan to lay legislation before the House at the end of 2023, which will allow the GMC to commence regulation by the end of 2024. Regulation by the GMC will provide a standardised framework of governance and assurance for the clinical practice and professional conduct of PAs.

PAs, like all other members of the primary care team, are expected to introduce themselves to each patient that they see, and this introduction should include explaining their role in the multi-professional team.


Written Question
Radiology: Vacancies
Friday 16th June 2023

Asked by: Marquess of Lothian (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government, in the light of the finding by the Royal College of Radiologists on 8 June that there are "chronic staff shortages" in the NHS, when they will publish the NHS workforce strategy.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government has committed to publishing the long term workforce plan shortly.


Written Question
Doctors: Resignations
Friday 26th May 2023

Asked by: Marquess of Lothian (Conservative - Life peer)

Question to the Department of Health and Social Care:

To ask His Majesty's Government how many UK-trained doctors are currently practising in the UK; how many UK-trained doctors are currently practising overseas; and how many UK-trained doctors left the NHS in each of the past 10 years before pension age.

Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)

In 2021 the General Medical Council reported that there were 178,173 doctors registered with them who are licenced to practice in the United Kingdom and whose primary medical qualification was from the UK. This data though does not identify if those doctors are practicing at a given point in time. However, the data will include doctors working in the National Health Service as well as those working for private providers across the UK.

Organisation for Economic Co-operation and Development data reported that in 2020, around 13,400 UK trained doctors were reported as practicing in foreign countries. There are likely more than this because it excludes countries such as the United States of America who have not returned data in recent years.

The Department does not hold data on UK trained doctors who are leaving the NHS before pension age.