Asked by: Dominic Raab (Conservative - Esher and Walton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the Answer of 4 September 2023 to Question 195426 on Brain: Tumours, how much and what proportion of the National Institute for Health and Care Research's allocated spend was spent on research infrastructure in each year since 2018.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Research (NIHR)’s infrastructure investment funds the world-class facilities, expertise, and skilled delivery workforce for research across the National Health Service and wider health and care system in England from early translational clinical research through to applied health and care research.
It is difficult to attribute this funding to specific disease and therapy areas as the staff and facilities funded through the NIHR infrastructure support research across disciplines. For example, the NIHR Clinical Research Network supported almost one million participants to take part in health and care research in England in 2022/23 across 5,000 studies and 30 specialties, and the 20 NIHR Biomedical Research Centres supported 8,700 experimental medicine studies in 2021/22.
Whilst audited data for NIHR expenditure for 2022/23 is not yet available, the following table shows the NIHR spend on research infrastructure each financial year between 2018/19 and 2021/22 as well the proportion of spend on research infrastructure compared to overall NIHR spend:
| 2017/18 | 2018/19 | 2019/20 | 2020/21 | 2021/22 | |
| Infrastructure spend | £521,892 | £545,974 | £548,613 | £541,361 | £615,077 |
| Total allocated spend | £1,012,711 | £1,012,920 | £1,036,723 | £1,116,137 | £1,259,436 |
| Infrastructure spend as proportion of total allocated spend | 52% | 54% | 53% | 49% | 49% |
Asked by: Dominic Raab (Conservative - Esher and Walton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how much funding his Department (a) allocated to and (b) spent on research on brain tumours in each year since 2018.
Answered by Will Quince
In May 2018 the Government announced £40 million for brain tumour research as part of the Tessa Jowell Brain Cancer Mission through the National Institute for Health and Care Research (NIHR).
The £40m funding will remain available; if we can spend more on the best quality science, we will do. The level of funding for brain tumour research depends on funding applications received. It is worth noting that all applications to NIHR that have been assessed as “fundable” in open competition have been funded and this will continue.
The following table shows NIHR’s committed spend on research into brain tumours in each year since 2018:
2018/19 | 2019/20 | 2020/21 | 2021/22 | 2022/23 |
£2.9 million | £432,000 | £2.1 million | £5.3 million | £746,873 |
Additionally, NIHR research infrastructure supports brain tumour research studies, mainly in the National Health Service. This infrastructure – people and facilities - is instrumental to the delivery of research funded by the NIHR, charities and others. Resources are significant, though it is difficult to disaggregate purely brain tumour spend to add to the figures above.
Asked by: Dominic Raab (Conservative - Esher and Walton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how many people were living with a brain tumour, including all intercranial tumours, on the last date for which figures are available.
Answered by Jane Ellison
The UK Cancer Prevalence Project from the National Cancer Intelligence Network and Macmillan Cancer Support will publish 20-year cancer prevalence data in summer 2015, including new statistics on brain tumour survivors. Previous data can be found at:
http://www.ncin.org.uk/view.aspx?rid=76
Note: The brain tumour statistic relates to International Classification of Diseases’ version 10 codes C70-C72.
Asked by: Dominic Raab (Conservative - Esher and Walton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what estimate he has made of the money that will be raised as a result of the steps his Department is taking to ensure greater recovery of the costs of NHS care provided to visitors and migrants from (a) EEA countries and (b) non-EEA countries in (i) 2014-15 and (ii) each of the next three financial years.
Answered by Jane Ellison
Following the public consultation undertaken in August 2014[1] and the Government’s response of December 2014[2], the Department of Health has been working to design and implement key improvements through the Visitor and Migrant NHS Cost Recovery Programme. The programme has the stated aim to recover up to £500 million per year from chargeable overseas visitors and migrants (or their home countries) by the middle of the next Parliament (2017/18). This will be reinvested into the National Health Service to support the sustainability of NHS frontline services.
The £500 million will be made up of £200 million a year from health surcharge income, £200 million a year from better identification of patients from the European Economic Area[3] (EEA) and recharging to their home countries, and £100 million a year from better identification and recovery directly from patients outside of the EEA. These figures represent a significant improvement on the baseline of £73 million recovered in 2012/13.
The 2014/15 financial year-end data will not be available until summer 2015.
Early indications from one initiative – the European Health Insurance Card[4] (EHIC) financial incentive introduced on 1 October 2014 – already show an increase in both the value of EHIC patient activity being recorded and the number of NHS trusts who are collecting EHIC details from patients.
[1] www.gov.uk/government/consultations/migrants-and-overseas-visitors-use-of-the-nhs
[2] www.gov.uk/government/consultations/migrants-and-overseas-visitors-use-of-the-nhs
[3] The EEA provides for the free movement of persons. The EEA includes EU countries and also Iceland, Liechtenstein and Norway. Switzerland is also included as it is part of the single market: this means Swiss nationals have the same rights to live and work in the UK as other EEA nationals.
[4] If visitors from the EEA are insured under their respective state’s healthcare system, they are eligible for a EHIC. This gives access to medically necessary state provided healthcare during a temporary stay under the same conditions as people insured in that country. This card allows us to recover costs from respective states. If a visitor does not have an EHIC, we can charge directly at 100% of tariff, providing they are not exempt under the regulations.
Asked by: Dominic Raab (Conservative - Esher and Walton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what his assessment is of the contribution made by (a) the Care Quality Commission and (b) Monitor to (i) safeguarding and (ii) raising standards in healthcare.
Answered by Norman Lamb
The Care Quality Commission (CQC) is the independent regulator of health and adult social care providers in England and has a key responsibility in the overall assurance of safety and quality of health and adult social care services.
The CQC has provided the following information about its contribution to safeguarding:
The CQC receives information that may relate to safeguarding from various sources, both professional and public. All concerns are relayed through the CQC’s National Customer Service Centre. The specialist team triage the information to identify whether this is information already known to a local authority or not, and if not CQC ensure an alert is made. All information relating to safeguarding concerns or alerts involving regulated services are sent directly to the appropriate inspection teams. Where the information indicates a serious concern, an unannounced inspection would be triggered. Depending on the outcome of that inspection, enforcement action could be taken against the provider.
The CQC also use safeguarding information it collects to inform key publications. In the State of Care 2013-14 Report, the CQC used the information it holds on safety and safeguarding to highlight poor practice and signal where improvement is required from each of the sectors the CQC regulates.
Monitor is the sector regulator for health services in England and its main duty is to protect and promote the interests of patients. Monitor is responsible for promoting the provision of health care services which is effective, efficient and which maintains or improves the quality of services.
Monitor is also responsible for ensuring that foundation trusts (FTs) are run well so they can continue delivering good quality services for patients. To do this they work closely with the CQC, the quality and safety regulator. When the CQC establishes that an FT is failing to provide good quality care, Monitor can take action to address the problem.
The licencing regime, introduced in the Health and Social Care Act is Monitor’s main tool for regulating providers of NHS services (unless exempt under section 83 of the Health and Social Care Act 2012) and gives it a means to carry out its responsibilities as sector regulator.
FTs are expected to carry out external reviews of their governance every three years. Monitor provides guidance on this and sets out that the provision of safe, high quality, compassionate care should be a top priority for all FTs.
FTs must also have regard to the NHS Constitution and, as autonomous organisations, are expected to adhere to regulations required of them by government.
Monitor also meet with Ministers at the Department of Health on a quarterly basis to assess all aspects of their performance.
Asked by: Dominic Raab (Conservative - Esher and Walton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will make it his policy to ensure that all GP surgeries are open for at least one evening each week.
Answered by Dan Poulter
All practices are currently offered the opportunity to provide extended hours access, i.e. appointments outside of 8am-6.30pm weekdays, under a Directed Enhanced Service.
The Prime Minister’s £50 million Challenge Fund is currently improving general practitioner access for over four million patients across England. This includes offering evening and weekend appointments, as well as better use of technology.
The Prime Minister recently announced another £100 million of funding for next year to improve access for even more patients.
Asked by: Dominic Raab (Conservative - Esher and Walton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, if he will make it his policy to amend working time rules to give trainee doctors, surgeons and medics additional time to train and practice.
Answered by Dan Poulter
Health Education England is working with the Department to explore the recommendations resulting from the Royal College of Surgeons of England led review of the impact of the Working Time Directive.
The Department, Health Education England and Royal College of Surgeons have agreed a legal framework to assist the identification of time that can be established as training and not work. A joint group of key stakeholders are considering the recommendations of the review and exploring options for the optimal delivery of training within the existing legal framework and that identified by the legal teams.
Asked by: Dominic Raab (Conservative - Esher and Walton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the effect on front-line NHS services of the ring-fence on NHS spending.
Answered by Dan Poulter
The Government has taken tough decisions in order to protect the National Health Service budget in the face of the ongoing fiscal challenge.
The Autumn Statement announced further funding of £1.98 billion for frontline NHS services in England in 2015-16. Funding will therefore be £16 billion higher in cash terms in 2015-16 than in 2010-11, which equates to an increase of £6.8 billion in real terms.
Coupled with significant efficiency improvements – with savings of £15 billion reported over the last three years – this has enabled the NHS to continue to meet rapidly rising demands whilst improving the quality of care.
Compared to 2009-10, in 2013-14 there were 8,300 more doctors and 1,300 more nurses supporting 6.1 million more outpatient attendances, 3.6 million more diagnostic tests, 1.3 million more accident and emergency attendances and 1.1 million more hospital admissions. The Cancer Drugs Fund has helped over 55,000 patients, healthcare associated infections have halved and mixed sex accommodation breaches have reduced by 98% since 2010.
The additional funding announced in the Autumn Statement underlines the priority the Government places on the NHS. It will enable the NHS to continue to meet rapidly rising demand in the short term while also providing significant investment for new models of care in order to make the vision set out in the NHS Five Year Forward View a reality and to place the NHS on a sustainable footing for the long term.
Asked by: Dominic Raab (Conservative - Esher and Walton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the potential effect of agreement on the Transatlantic Trade and Investment Partnership on (a) service delivery and (b) costs in the NHS.
Answered by George Freeman
The Transatlantic Trade and Investment Partnership (TTIP) will not affect the way the United Kingdom Government runs the National Health Service. It has been made clear by negotiators from both the United States and the European Union that it is up to the UK alone to decide how the NHS is run and any assertion that TTIP will undermine the government’s control of the NHS is a red herring.
The TTIP could offer great benefits to British business and for British jobs. Greater consistency in existing and new regulatory requirements would make it easier for companies - especially Small and Medium Enterprises - to access markets and, for patients, potentially help to increase access to new medicines and medical devices.
Asked by: Dominic Raab (Conservative - Esher and Walton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, with reference to the Answer of 1 April 2014, Official Report, column 711, on brain tumours (children), what proportion of the £450 million which the Government has committed to enable earlier diagnosis of cancer has been allocated to reduce the delay of diagnosis of brain tumours in children.
Answered by Jane Ellison
None of the £450 million has been allocated to a specific cancer. A small part of the additional funding was held centrally for Be Clear on Cancer (BCOC) symptom awareness campaigns and for some work to help support general practitioners (GPs). The rest was allocated to the National Health Service to meet the additional costs associated with tackling late diagnosis of cancer, specifically to enable increased general practitioner (GP) access to four key diagnostic tests, including magnetic resonance imaging scans to support diagnosis of brain tumours and; the increased testing, and treatment costs in secondary care associated with more people being referred and diagnosed.
In 2012, to increase the awareness of cancer among GPs and support GPs to assess patients more effectively, the Department funded the British Medical Journal Learning to provide an e-learning tool for GPs. Four modules were developed including diagnosing osteosarcoma and brain tumours in children and young people.
This module helps GPs to understand the main types of brain tumours in children and young people, and their common presentations, and to recognise when patients need urgent referral.
To date the Department and Public Health England (since April 2013), have run national BCOC campaigns to raise awareness of the following cancers - bowel, lung, bladder and kidney, and breast. Regional campaigns have also been run for ovarian and oesophago-gastric cancers. A campaign was piloted at local level to raise awareness of four key symptoms of cancer and a local skin cancer pilot is running from 16 June to 27 July in Devon, Cornwall and Somerset. Decisions on further BCOC campaign activity in 2014-15 are being made over the summer, based on the evidence and learning from previous campaigns. We will continue to keep these campaigns under review and work with relevant experts to see what might be done to tackle other cancers.